Improved draught power use for increased food and feed production on Ethiopian highland vertisols

Presents and discusses the effects of animal power use for improved soil surface drainage on food and feed production on the vertisols of the Ethiopian highlands. Examines the on-farm technology validation programme at ILCA; describes crop/livestock interactions in these vertisol areas; highlights the seasonal pattern of draft oxen use; and assesses the economic impact of animal power use for surface drainage

Characteristics and outcome of 27 elbow periprosthetic joint infection: Results from a 14-year cohort study of 358 elbow prostheses

Abstract Background: Elbow arthroplasty is increasingly performed in patients with rheumatic and posttraumatic arthritis. Data on elbow periprosthetic joint infection (PJI) is limited. We investigated characteristics and outcome of elbow PJI in a 14-year cohort of total elbow arthroplasties in a single center. Methods: Elbow prosthesis, which were implanted between 1994 and 2007 at Schulthess Clinic in Zurich, were retrospectively screened for infection. PJI was defined as periprosthetic purulence, presence of sinus tract or microbial growth. A Kaplan-Meier survival method and Cox proportional hazard analysis was performed. Results: Of 358 elbow prostheses, PJI was identified in 27 (7.5%). The median patient age was 61 (39-82) years, 63% were females. 17 patients (63%) had a rheumatic disorder and 10 (37%) osteoarthritis. Debridement and implant retention was performed in 78%, followed by exchange or removal of the prosthesis (15%) or no surgery (7%).The relapse-free survival (95% confidence interval) was 79% (63% - 95%) after 1 year and 65% (45% - 85%) after 2 years. The outcome after 2 years was significantly better when treated according to the algorithm than in patients which were not (100% versus 33%, p <0.05).In 21 patients treated with debridement and retention, the cure rate was also higher when the algorithm was followed (100% versus 11%, p <0.05). Conclusions: This study suggests that the treatment algorithm developed for hip and knee PJI can be applied to elbow PJI. With proper patient selection and antimicrobial therapy, debridement and retention of the elbow prosthesis is associated with good treatment outcome

Long-term survival of GSB III elbow prostheses and risk factors for revisions

INTRODUCTION: Although replacement of the elbow joint is a complex procedure there is not much clinical evidence that contributes to surgical decision-making, mainly due to small clinical samples and short follow-up. Therefore, we performed a long-term analysis up to 30 years after implantation of a GSB III total elbow prosthesis to quantify long-term outcome and to identify possible risk factors for implant revision. MATERIALS AND METHODS: All patients who received a primary GSB III total elbow prosthesis between 1978 and 1998 were included. Information about patient characteristics, the latest known implant status and possible risk factors were collected, Kaplan-Meier survival curves plotted, and 10- and 20-year survival calculated. The cohort was stratified for known risk factors such as diagnosis, age, or gender and included in a Cox regression analysis. RESULTS: A total of 253 patients [mean age at operation 56.9 years (range from 17.5 to 84 years)] with 293 GSB III prostheses were included. The median follow-up was 9.1 years (0 months to 29.3 years). Whereas 81 prostheses did not need revision during the observation period, 76 had been implanted in patients who died before any revision was required, and 75 had not been revised by the last known follow-up. 61 prostheses were revised. This corresponds to a 10-year survival rate of 0.8 (95 % CI 0.74-0.85) and a 20-year rate of 0.67 (95 % CI 0.57-0.76). Prostheses in patients with post-traumatic conditions survived significantly shorter than those in patients with rheumatoid arthritis; previous operations lead to a 2.8 times greater risk of revision (p = 0.004). Neither age at implantation nor gender had a significant influence on prosthesis survival. CONCLUSIONS: The results indicate a good long-term prognosis for this design. The prognosis has to be adjusted for the underlying disease. Previous operations such as joint reconstruction significantly increase the risk of revision