Configuration of anchorage holes affects fixation of the acetabular component in cemented total hip replacement - a finite element study

Our survey of current practice among UK orthopaedic surgeons shows wide variations in fixation techniques. The aim of this study is to investigate the effect of drilling different configurations of anchorage holes in the acetabulum on implant stability. To avoid variables that could incur during in-vitro testing, we used commercially-available COSMOS finite element analysis package to investigate the stress distributions, deformations, and strains on the cement mantle when drilling three large anchorage holes and six smaller ones, with straight and rounded cement pegs. The results, which are in line with our in-vitro studies on simulated reconstructed acetabulae, indicate better stability of the acetabular component when three larger holes than six smaller holes are drilled and when the necks of the anchorage holes are rounded. The longevity of total hip replacements could be improved by drilling three large anchorage holes, rather than many smaller ones, as initially proposed by Charnley

Prognosis for long-term survivors of cancer

Background: Many cancer patients who have already survived some time want to know about their prognosis, given the pre-condition that they are still alive. We described and interpreted population-based conditional 5-year relative survival rates. Patients and methods: The long-standing Eindhoven Cancer Registry collects data on all patients diagnosed with cancer in the southern part of the Netherlands. Patients aged 25-74 years, diagnosed between 1960 and 2004, were included. Conditional 5-year relative survival was computed for every additional year survived (follow-up period 1980-2004). Results: For patients with colorectal cancer, cutaneous melanoma or stage I breast cancer, conditional 5-year relative survival was >95% after having survived 3-15 years. However, for stomach, lung, stage II or III breast, prostate cancer or Hodgkin lymphoma, conditional 5-year relative survival did not exceed 75-94%. Initial differences in survival at diagnosis between age, gender and stage groups largely disappeared after having survived for 5-10 years. Conclusion: Prognosis for patients with cancer generally improved with each year survived. Patients with colorectal cancer, cutaneous melanoma or stage I breast cancer hardly exhibit any ex