Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Thermal fatigue resistance of plasma sprayed yttria-stabilised zirconia onto borided hot work tool steel, bonded with a NiCrAlY coating: experiments and modelling

Repeated fast surface temperature transients can damage the materials and/or their surface treatments by thermal fatigue. This happens in aluminium diecasting devices. One conducted thermal fatigue tests with samples of hot work tool steel, respectively untreated, simply borided and protected by a multi-layer. In the last case, top coat is yttria stabilised zirconia (YSZ), followed by a nickel superalloy and then a borided layer (undercoat). The zirconia coating was applied with plasma spray. The multi-layer showed poor resistance during the thermal fatigue tests. Better understanding these tests and the resulting thermal fatigue observed on the treated materials was achieved by a lifetime model based on Coffin-Manson equations. © 2010 Elsevier B.V.SCOPUS: ar.jinfo:eu-repo/semantics/publishe