Let us have articles betwixt us: Papers in Historical and Comparative Linguistics in Honour of Johanna L. Wood

Papers in Historical and Comparative Linguistics in Honour of Johanna L. Woo

Effectiveness of accelerated perioperative care and rehabilitation intervention compared to current intervention after hip and knee arthroplasty. A before-after trial of 247 patients with a 3-month follow-up

<p>Abstract</p> <p>Background</p> <p>In Denmark, approximately 12,000 hip and knee arthroplasties were performed in 2006, and the hospital costs were close to US$ 110,000,000. In a randomized clinical trial, we have recently demonstrated the efficacy of accelerated perioperative care and rehabilitation intervention after hip and knee arthroplasty compared to current intervention under ideal circumstances. We do not, however, know whether these results could be reached under usual circumstances of healthcare practice. We therefore investigated whether length of stay after implementation of accelerated perioperative care and rehabilitation after hip and knee arthroplasty could be reduced in a normal healthcare setting, and how the achieved results matched those observed during the randomized clinical trial.</p> <p>Methods</p> <p>An effectiveness study as a before-after trial was undertaken in which all elective primary total hip and total knee arthroplasty patients were divided into a before-implementation group receiving the current perioperative procedure, and an after-implementation group receiving the new accelerated perioperative care and rehabilitation procedures as provided by a new multi-disciplinary organization. We used the Breakthrough Series Collaborative Model for implementation. The primary outcome measure was in hospital length of stay (LOS), and the secondary outcome measure was adverse effects within 3 months postoperatively.</p> <p>Results</p> <p>We included a total of 247 patients. Mean LOS was significantly (<it>P </it>< 0.001) reduced by 4.4 (95% CI 3.8–5.0) days after implementation of the accelerated intervention, from 8.8 (SD 3.0) days before implementation to 4.3 (SD 1.8) days after implementation. No significant differences in adverse effects were observed. LOS in this effectiveness study was significantly lower than LOS reported in the efficacy study.</p> <p>Conclusion</p> <p>Accelerated perioperative care and rehabilitation intervention after hip and knee arthroplasty was successfully and effectively implemented. Results obtained during usual hospital circumstances matched the results achieved under ideal circumstances in this group of patients.</p

Effect of local TGF-β1 and IGF-1 release on implant fixation: comparison with hydroxyapatite coating: A paired study in dogs

Background and purpose Hydroxyapatite (HA) coating stimulates the osseointegration of cementless orthopedic implants. Recently, locally released osteogenic growth factors have also been shown experimentally to stimulate osseointegration so that bone fills gaps around orthopedic implants. Here, we have compared the effect of local release of TGF-β 1 and IGF-1 with that of hydroxyapatite coating on implant fixation

In vivo evaluation of a vibration analysis technique for the per-operative monitoring of the fixation of hip prostheses

<p>Abstract</p> <p>Background</p> <p>The per-operative assessment of primary stem stability may help to improve the performance of total hip replacement. Vibration analysis methods have been successfully used to assess dental implant stability, to monitor fracture healing and to measure bone mechanical properties. The objective of the present study was to evaluate in vivo a vibration analysis-based endpoint criterion for the insertion of the stem by successive surgeon-controlled hammer blows.</p> <p>Methods</p> <p>A protocol using a vibration analysis technique for the characterisation of the primary bone-prosthesis stability was tested in 83 patients receiving a custom-made, intra-operatively manufactured stem prosthesis. Two groups were studied: one (n = 30) with non cemented and one (n = 53) with partially cemented stem fixation. Frequency response functions of the stem-femur system corresponding to successive insertion stages were compared.</p> <p>Results</p> <p>The correlation coefficient between the last two frequency response function curves was above 0.99 in 86.7% of the non cemented cases. Lower values of the final correlation coefficient and deviations in the frequency response pattern were associated with instability or impending bone fracture. In the cases with a partially cemented stem an important difference in frequency response function between the final stage of non cemented trial insertion and the final cemented stage was found in 84.9% of the cases. Furthermore, the frequency response function varied with the degree of cement curing.</p> <p>Conclusion</p> <p>The frequency response function change provides reliable information regarding the stability evolution of the stem-femur system during the insertion. The protocol described in this paper can be used to accurately detect the insertion end point and to reduce the risk for intra-operative fracture.</p

Use of Carboxymethyl Cellulose and Collagen Carrier with Equine Bone Lyophilisate Suggests Late Onset Bone Regenerative Effect in a Humerus Drill Defect – A Pilot Study in Six Sheep

We assessed the use of a filler compound together with the osteoinductive demineralized bone matrix (DBM), Colloss E. The filler was comprised of carboxymethyl-cellulose and collagen type 1. The purpose of the study was to see if the filler compound would enhance the bone formation and distribute the osteoinductive stimulus throughout the bone defect. Six sheep underwent a bilateral humerus drill defect. The drill hole was filled with a compound consisting of 100 mg CMC, 100 mg collagen powder, and 1 ccm autologous full blood in one side, and a combination of this filler compound and 20 mg Colloss E in the other. The animals were divided into three groups of two animals and observed for 8, 12 and 16 weeks. Drill holes was evaluated using quantitative computed tomography (QCT), micro computed tomography (µCT) and histomorphometry. Mean total bone mineral density (BMD) of each implantation site was calculated with both QCT and µCT. Bone volume to total volume (BV/TV) was analyzed using µCT and histomorphometry. Although not statistically significant, results showed increased bone BMD after 16 weeks in µCT data and an increased BV/TV after 16 weeks in both µCT and histology. Correlation between QCT and µCT was R2 = 0.804. Correlation between histomorphometry and µCT BV/TV data was R2 = 0.8935 and with an average overrepresentation of 8.2% in histomorphometry. In conclusion the CMC-Collagen + Colloss E filler seems like a viable osteogenic bone filler mid- to long term. A correlation was found between the analytical methods used in this study

Analysis of polyethylene wear in plain radiographs: The number of radiographs influences the results

Background and purpose Two-dimensional computerized radiographic techniques are frequently used to measure in vivo polyethylene (PE) wear after total hip arthroplasty (THA), and several variables in the clinical set-up may influence the amount of wear that is measured. We compared the repeatability and concurrent validity of linear PE wear on plain radiographs using the same software but a different number of radiographs