Incidence of perioperative complications in total hip and knee arthroplasty in patients with Parkinson disease

INTRODUCTION

The aim of this study is to evaluate the difference in perioperative complication rate in total hip, bipolar hemiarthroplasties and total knee arthroplasty in patients with Parkinson disease in trauma and elective surgery in our Musculoskeletal Center during a period of 10 years.

MATERIAL AND METHOD

Between 2006 and 2016, 45 bipolar hemiarthroplasties in trauma surgery, 15 total knee and 19 total hip arthroplasties in patients with Parkinson's disease were performed. We divided the patients in two groups. Group I included trauma cases (45) and group II elective surgery cases (34). Complications were documented and divided into local minor and major complications and general minor and major complications. Fisher's exact test was used for statistical evaluation.

RESULTS

In both groups, there was one local major complication (p > 0.05): In group I, there was one case of loosening of a K-wire which was removed operatively. In group II, there was one severe intraarticular bleeding requiring puncture of the hematoma. In group I, there were 38 general complications; in group II, there were 17 general complications. There was no statistical difference in complication rate (p > 0.05).

CONCLUSION

Total hip arthroplasty, bipolar hemiarthroplasties and knee arthroplasty in patients with Parkinson disease is possible in elective and trauma surgery. Complication rate is higher in comparison with patients not suffering from Parkinson disease, but there is no difference in complication rate in elective and trauma surgery. Nevertheless, early perioperative neurological consultation in patients with Parkinson disease is recommended to minimize complications and improve early outcomes after arthroplasty.

[Are There any Differences in Quality or Complication Rate in Total Knee Arthroplasty after Establishing a Centre for Endoprosthesis?]

BACKGROUND

The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ).

MATERIAL AND METHODS

We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital. The following parameters were documented which are necessary to establish an EPZ: existence of X-rays before and after operation. Existence of full length weight bearing X-ray before operation or using a navigation device. Existence of preoperative planning, duration of TKA below 100 minutes. The following complications were documented: Periprosthetic infections, occurrence of periprosthetic fissures/fractures, thrombembolism, neurologic complications, patients' satisfaction rate with the hospital stay and mortality rate. Additionally femorotibial angle, femoral angle, tibial angle and tibial slope were measured. Statistical analysis was performed with SPSS 22.0. using the Kolmogorov-Smirnov test, the Qui-Square test and the Mann-Whitney U test.

RESULTS

There were no statistical differences in local or systemic complications. The mean duration of operation was 82.9 min in group I (min.: 55, max.: 141) und 81.5 min in group II (min.: 57, max.: 129; p > 0.05). In group I, there were 20/100 cases (20%) with operation time longer than 100 minutes, in group II 13/100 cases (13%; p < 0.001). Analysis of anatomical femorotibial angle, femur angle, tibial angle and tibial slope showed no significant differences. The rate of documented survey of patients' satisfaction rate improved from 62% in group I to 98% in group II (p < 0.001).

CONCLUSION

By establishing an EPZ, we achieved a significant improvement in the parameters operation time > 100 minutes and documented survey of patients' satisfaction rate, but not in complication rate.

Osteoarthritis in a symptomatic coracoclavicular joint

Coracoclavicular joint (CCJ) is a rare cause of shoulder pain. CCJ is not described in most orthopaedic textbooks, leading to lack of awareness in the general orthopaedic community. In that way the incidence of symptomatic cases is underestimated. We present the case of a symptomatic osteoarthtritic CCJ in a 46-year-old male patient with nearly complete relief of pain after therapeutic injection of the CCJ. The radiological signs of CCJ are briefly discussed to increase awareness of this very rare entity.

Zur Chemie und Strukturchemie von Phosphiden und Polyphosphiden, 49 [1]. Bildung und Struktur des Henicosaphosphids [Li(12-Krone-4)2]3P21(THF)2 / Chemistry and Structural Chemistry of Phosphides and Polyphosphides, 49 [1]. Formation and Structure of the Henicosaphosphide [Li(12-Crown-4)2]3P21(THF)2

The reaction of Li3P7(DME)3 with crown ether 12-crown-4 and (CHT)Cr(CO)3 yields a reddish oil, from which red crystals of [Li(12-crown-4)2]3P21(THF)2 (1), red crystals of Li2P16(12-crown-4)x(THF)2 as well as a not yet identified yellow substance separates. From this mixture crystals of 1 could be isolated. [Li(12-crown-4)2]3P21(THF)2 (1) crystallizes in the space group P21/a with a = 3021.1(6) pm, b = 1901.5(4) pm, c = 1603.0(4) pm, β = 95.98(3)° and Z = 4 formula units in the unit cell. The structure is characterized by isolated 1 ∞[P21 3-] trianions and Li(12-crown-4)2 cations. The trianion has approximately the symmetry mm2. The bond distances d(P-P) range from 213.9 pm to 226.8 pm and are differentiated by their function in the skeleton. The bond angles β(P-P-P) are in the range 86.1° to 107.7° and image clearly the influence of the repulsion of the non-bonded electron pairs of the strained anion. The curvature of the trianion is approx. 0.8 nm-1 and is three times larger than the curvature evaluated from structural models.

Synthesis and Crystal Structure of Ordered, Orthorhombic α-NbBr5

Niobium pentabromide, NbBr5, is prepared in the orthorhombic ordered (α)-form from the elements in sealed quartz ampoules (Nb powder, Br2, l) at 973 K. The structure has been determined from single crystal data (a = 1288.8(2), b = 1869.0(3), c = 614.9(1) pm; Pnma (No. 62); Z = 8; R = 0.055). α-NbBr5_ forms dimeric Nb2Br10 molecules with d̄(Nb–Brb) = 271.5 pm, d̄(Nb–Bre) = 240.8 pm and d̄(Nb– Bra) = 246.1 pm. α-NbBr5 is a diamagnetic semiconductor with cgsχmol dia(300 K) = –72 × 10-6 cm3/mol. The band gaps of NbCl5, α-NbBr5 and NbI5 have been determined by diffuse reflection to be Eg(NbCl5) = 2.74 eV, Eg(α-NbBr5) = 1.99 eV, and Eg(NbI5) = 0.99 eV.

Die Kristallstruktur des Dodekamethyl-hexasila-tetraarsa-adamantans (Sime2)6As4 / Crystal Structure of Dodecamethyl-hexasila-tetraarsa-adamantane (Sime2)6As4

Dodecamethyl-hexasila-tetraarsa-adamantane (Sime2)6As4 crystallizes in the cubic space group I 4̄3m with a = 1098.2 pm and Z = 2 formula units. The bond lengths are As-Si - 235.1 pm and C-Si - 185.9 pm. The bond angles at the As atoms are 103.2° and the Si atoms 121.0°

Reaktionen koordinierter Liganden, III [1]. Stabilisierung von Dimenthyldiphosphen und Menthylphosphiniden als Brückenliganden in Metallcarbonylkomplexen / Reaction of Coordinated Ligands, III [1]. Stabilization of Dim enthyldiphosphene and Menthylphosphinidene as Bridging Ligands in Metal Carbonyl Complexes

Reduction of MentPBr2M(CO)5 1 (M = Cr, W) with magnesium in THF yields the diphos­phene complex (CO)5M(Ment)P=P(Ment)M(CO)5 2 as the main product. In addition, a phosphinidene complex, (CO)5M(Ment)PM(CO)5 (3) is also formed. The latter is obtained in larger amounts, if the reaction is carried out in the presence of M(CO)5THF. The proposed structures are confirmed by NMR and UV data as well as - in the case of the chromium compounds (2a, 3a) - by crystal structure analysis. Compound 2a is obtained only as the frans-isomer. The P-P distance in 2a (204.0 pm) indicates a double bond which does not participate in the complex formation. The P-Cr distance in 3a (average: 230.3 pm) is within the low est range found for this element combination. Reaction of 2a with LiAlH4 yields the diphosphane complex (CO)5CrMent(H)P-P(H)MentCr(CO)5 4 as a mixture of “meso” and “rac” diastereomers.

Darstellung, Kristallstruktur und Eigenschaften von β-Ga2Br4 / Preparation, Crystal Structure and Properties of β-Ga2Br4

The compounds Ga2Br4 (α+β) have been prepared by reacting GaBr3 with Ga metal without a solvent or in a hydrocarbon medium. α-Ga2Br4 is isotypic with Ga2Cl4, and β-Ga2Br4 with Ga2I4. Both forms have to be formulated as Ga+(GaBr4)- according to their crystal structures. The first order phase transition α→β has been investigated by means of DTA and temperature dependent X-ray powder photographs.

The crystal structure of β-Ga2Br4 has been refined with single crystal data (R3c; a = 2163.4(8) pm; c = 869.2(4) pm; Z = 18; R = 0.037). Main building units are GaBr4 - tetrahedra (d̄(Ga -Br) = 232.9 pm), connected in three dimensions by capped trigonal prisms (6+2+1) around Ga+. The crystal chemical relationships between β-Ga2Br4 and Ga2I4 are discussed.

Darstellung und Kristallstrukturen von LiGaBr4 und LiGaBr3/Preparation and Crystal Structure of LiGaBr4 and LiGaBr3

The com pounds LiGaBr4 and LiGaBr3 are prepared by reaction of stoichiometric mixtures of LiBr and GaBr3 or GaBr2, respectively, in glass am poules at 250 °C. Single crystal X-ray studies show LiGaBr4 to be isotypic to LiAlCl4 containing GaBr4 tetrahedra arranged as in the structure of SnBr4 and Li+ ions filling octahedral voids [d̄(GaBr) = 232.5, d̄(Li -Br) = 280.3 pm]. LiGaBr, has to be formulated as Li2[Ga2Br6] and the Ga -Ga-bonded unit Ga2Br6 has an ecliptic confor­mation. The L i+ ions occupy octahedral voids, and the LiBr6 octahedra are linked via apices, [d(Ga -Ga) = 240.4, d̄(Ga -Br) = 238.9, d̄(L i-B r) = 281.1 pm]. The structures is compared with the structures of PuBr3, Re3B, FeB and Ga2I3, and the group-subgroup relationship with GdFeO3 is established.

Bildung und Kristallstruktur von Ethylendiammonium-hydridotrioxophosphat(2–) [H3NCH2CH2NH3][PHO3]a / Formation and Crystal Structure of Ethylenediammonium Hydridotrioxophosphate(2—) [H3NCH2CH2NH3][PHO3]

Ethylenediammonium Hydridotrioxophosphate(2–) [H3NCH2CH2NH3][PHO3] is formed by slow oxidation of white phosphorus by oxygen in ethylendiamine. It crystallizes in the space group Pbca with a = 1570.6(4) pm, b = 676.9(5) pm, c = 1267.8(4) pm and Z = 8 formula units in the unit cell. The structure is built from ethylenediammonium dications and tetrahedral phosphonate dianions, linked by O ··· H–N bonds (d̄(O…N) = 275.8 pm). The bond distances are d̄(P–O) = 151.8 pm, d̄(P–H) = 136.9 pm, d̄(N–C) = 148.3 pm and d̄(C–C) = 151.0 pm.

Die Kristallstruktur von Ga3Cl7/ Crystal Structure of Ga3Cl7

Trigallium heptachloride, G a3Cl7, has been prepared from GaCl3 and Ga in sealed glass ampoules. Ga3Cl7 crystallizes in the space group Pna21 (No. 33) with a = 1181.8(1) pm; b = 889.7(1) pm; c = 1057.5(1) pm; Z = 4. The compound is isotypic with KGa2Cl7 -. The Ga2Cl7 - anion has nearly C2 symmetry (gauche conformation) with d̄ (Ga -Clbridg) = 230.3 pm, d̄ (Ga -Clterm) = 214.3 pm and and ∢ Ga -Cl -Ga = 109.0°. The Ga+ ion is coordinated by ten Cl atoms (4 + 6) with d = 346.2 pm. The coordination of Ga+ and the conformation of Ga2Cl7 - are discussed in detail together with related compounds.

Darstellung, Kristallstruktur und Schwingungsspektren von Cs3As7 und Cs3(NH3)As7/Syntheses, Crystal Structure and Vibrational Spectra of Cs3As7 and Cs3(NH3)As7

Cs3As7, a compound with cage-like As7 3- anions, has been prepared from the elements in sealed quartz ampoules at 820 K. The ruby-red compound undergoes a first order phase transition at 640 K and is obtained as microcrystalline samples. The structure of the low-temperature α-modification is not known, but β-Cs3As7 belongs to the plastically crystalline β-Rb3P7 type of structure (F m 3̄ m , a (673 K) = 1169,2(1) pm). Cs3As7 melts under its own vapour pressure at 1061 K, and is easily soluble in liquid ammonia. From those solutions ruby red crystals of Cs3(NH3)As7 precipitate. In dynamical vacuum NH3 is evaporated in the region of 300 to 520 K, resulting in Cs3As7. Cs3(NH3)As7 crystallizes in the space group P21/a (a = 2759.0(12) pm, b = 744.1(3) pm, c = 751.5(3) pm, β = 90.16(5)°; Z = 4). The structure is closely related to the plastically crystalline β-Rb3P7 type structure (Li3Bi variant). The heptaarsanortricyclene anion is coordinated by cesium atoms, connecting the anions to a three dimensional arrangement. The anion exhibits a differentiation of As - As bond lengths typical for ionic nortricyclenes (d(basis) = 251.2 pm; d(basis-bridge) = 235.5 pm; d(bridge-bridgehead) = 240.1 pm). The distances Cs to As are in the range 372 to 401 pm. The cesium atoms are surrounded by three resp. four As atoms and the NH3 molecules. The FIR and Raman spectra are given for different temperatures as well as of an en-solution of Cs3(NH3)As7. The valence vibrations of NH3 are found at 3175 (A1) and 3320 cm-1 (E ). The fundamental vibrations of the three-membered ring of different heteronortricyclenes with P and As are compared and yield a correlation factor χ = 0.57(1) for the observed frequencies between P3 and As3. The band gaps EG are determined from the diffuse reflexion at 2.14 eV for Cs3(NH3)As7 and 2.00 eV for Cs3As7.

Die Monoantimonide RbSb und CsSb / The Monoantimonides RbSb and CsSb

The alkali metal monoantimonides RbSb and CsSb were synthesized from the elements in sealed quartz ampoules. These compounds crystallize in the NaP-type structure (RbSb: P212121 (No. 19), a = 731.5pm, b = 719.7 pm, c = 1281.5 pm, Z = 8; CsSb: P212121 (No. 19), a = 757.6 pm, b = 734.5 pm, c = 1327.3 pm, Z = 8). The main feature of the structures are 1 ∞[Sb-] chains parallel to the 5-axis with bond distances. d̄(Sb-Sb) = 285.8 pm and 285.3 pm, respectively. These bond lengths are discussed in detail relative to those in elementary antimony and to the tetrahedral or covalent radii. The volume increment of Sb- can be derived to be 29.8 cm3 · mole-1.

Kristall- und Molekülstruktur von As2P2S7/ Crystal and Molecular Structure of As2P2S7

The crystal and molecular structures of As2P2S7 has been determined by single crystal X-ray diffraction (space group V 21/c; Z = 4; a = 1174.6(16) pm; b = 823.9(7) pm; c = 1140.1(10) pm; β - 94.43(9)°; R = 0.073. The molecule is isosteric to P4S7 and possesses C2v symmetry. Mean bond lengths are: d (As-As) = 250.9 pm; d (As-S ) = 225.7 pm; d(P - S) = 208.3 pm and d(P = S) = 193.2 pm. The observed As -As bond length agrees well with spectroscopic results

Notizen: Single-Crystal Structure Refinement of LiZnAs

The crystal structure of LiZnAs has been verified with single crystal X-ray methods. LiZnAs crystallizes in a filled-up zinc blende type of structure (F 43 m, a = 593.9(1) pm, As at site 4a (000); Zn at site 4d (3/4 3/4 3/4); Li at site 4 c (1/4 1/4 1/4); 25 hkl; R = 0.018). As is coordinated by 4 Li and 4 Zn atoms with identical distances of 257.2(1) pm. Li and Zn atoms are tetrahedrally coordinated by As. No indications for a disorder between Li and Zn have been found.

Darstellung und Kristallstrukturen von LiGaCl4 und LiGaI4/ Preparation and Crystal Structure of LiGaCL4 and LiGaI4

The crystal structures of LiGaCl4 and LiGaI4 have been determined by single crystal X-ray methods. Both compounds are isotypic with LiAlCl4 and characterized by LiX6 octahedra and GaX4 tetrahedra. Mean bond lengths are: d̄(Ga-X) = 217.4 pm (Cl) and 255.9 pm (I); d̄(Li-X) = 263.9 pm (Cl) and 305.3 pm (I), respectively. Common features of the isotypic compounds LiGaX4 (X = Cl, Br. I) are discussed.

Calcifying Bursitis ischioglutealis: A Case report

INTRODUCTION

The ischiogluteal bursa is an inconstant anatomical finding located between the ischial tuberosity and the gluteus maximus. Ischiogluteal bursitis is a rare disorder.

CASE REPORT

We report the case of a 43-year-old female patient with bilateral calcifying ischiogluteal bursitis. The patient had no relevant medical history of systemic illness or major trauma to the buttock. After aspiration of both ischiogluteal bursitis which delievered calcareous deposits and instillation of a mixture of 1cc betamethasone (6 mg) and 4 cc of 1% lidocaine the patient was out of any complaints.

CONCLUSION

Calcifying ischiogluteal bursitis is a rare entity but easily diagnosed on radiographs. Aspiration and local steroid instillation give good relief from symptoms.