Initial experience with Vanguard(R) total knee arthroplasty

Introduction Biomet Vanguard(R) Complete Knee System is a total knee replacement system, introduced into the market in 2003: thissystem boasts a designed kneecap track or groove which allows for greater mobility and decreased loss of healthy bone during the replacement process. Clinical and radiographic results in Varese Orthopaedics Unit initial experience are reported. Materials and methods Clinical and radiographic parameters are evaluated in 29 patients who underwent TKA (Vanguard(R) Complete Knee System- Biomet Inc.) for primary gonarthrosis during the last 2 years at Orthopaedics and Traumatology Unit of Ospedale di Circolo\u2014Fondazione Macchi in Varese. ROM, type of anaesthesia, patellar pain, clinical and functional Knee Score (pre-operative), size of implant, ROM, blooding, patellar pain, VAS, clinical and func- tional Knee Score (post-operative) are analyzed. Radiographic follow-up is made at 6 and 12 months. Results Clinical and Functional Knee Score respectively improve from 47 to 88 pts and from 51 to 88 pts in pre- and post-operative period (p\0.001). Post-operatively no patellar pain, 2 pts VAS and 1215 cc blooding are reported. ROM doesn\u2019t significantly improve from pre- to post-operative. No relevant complications are reported. Due to the short follow-up, radiographic evaluation does not allow to demonstrate polyethylene liner wear. Conclusions Vanguard(R) Knee Replacement significantly shows a clinical and functional improvement in patients affected by primary gonarthrosis. Moreover, post-operative pain decrease allows early mobilization and rehabilitation

Subtalar arthroeresis with peek endorthesis in juvanile flexible flafoot: Short-term results

A successful and minimally invasive treatment for adolescent flexible flatfoot is subtalar arthroeresis. This study examines the short-term results of subtalar arthroereisis with a new PEEK device (Pit’Stop®); additional research will be required to determine the device’s true potential, but the preliminary findings are very encour-aging, with a high success rate and a low complication rate (0.08)

Occupational Therapy Intervention with Children Survivors of War

A preventive occupational therapy program with children surviving the Kosovo conflict is examined. The objective of the program was to facilitate the emotional expression of traumatic experiences in order to prevent the development of future psychological problems. The intervention was based on a community-centred approach with spirituality as a central focus of the intervention.The Model of Human Occupation and the Occupational Performance Process Model were utilized to guide the identification and intervention of occupational performance issues.The children’s return from a land of war to a land of children demonstrates the potential of occupational therapy intervention in this field. With increasing awareness of populations facing social and political challenges, there is a growing importance of the concept of occupational justice and the need to work against occupational apartheid.Cet article décrit un programme de prévention en ergothérapie qui était destiné aux enfants ayant survécu au conflit du Kosovo. L’objectif du programme était d’aider les enfants à exprimer les émotions qu’ils avaient ressenties lors d’expériences traumatiques afin de prévenir l’apparition de problèmes psychologiques. L’intervention était basée sur une approche communautaire s’articulant autour de la spiritualité. Le Modèle de l’occupation humaine et le Modèle du processus d’intervention dans le rendement occupationnel ont été utilisés pour cibler les difficultés en matière de rendement occupationnel et pour déterminer les interventions requises. Le retour des enfants d’un monde de guerre vers le monde de l’enfance démontre la possibilité de proposer une intervention ergothérapique dans ce domaine. La conscientisation de plus en plus grand face à la détresse des populations confrontées à des problèmes politiques et sociaux entraîne une augmentation de l’importance du concept de la justice occupationnelle et du besoin de lutter contre l’apartheid occupationnel

Genome-wide scans identify known and novel regions associated with prolificacy and reproduction traits in a sub-Saharan African indigenous sheep (Ovis aries)

Maximizing the number of offspring born per female is a key functionality trait in commercial- and/or subsistence-oriented livestock enterprises. Although the number of offspring born is closely associated with female fertility and reproductive success, the genetic control of these traits remains poorly understood in sub-Saharan Africa livestock. Using selection signature analysis performed on Ovine HD BeadChip data from the prolific Bonga sheep in Ethiopia, 41 candidate regions under selection were identified. The analysis revealed one strong selection signature on a candidate region on chromosome X spanning BMP15, suggesting this to be the primary candidate prolificacy gene in the breed. The analysis also identified several candidate regions spanning genes not reported before in prolific sheep but underlying fertility and reproduction in other species. The genes associated with female reproduction traits included SPOCK1 (age at first oestrus), GPR173 (mediator of ovarian cyclicity), HB-EGF (signalling early pregnancy success) and SMARCAL1 and HMGN3a (regulate gene expression during embryogenesis). The genes involved in male reproduction were FOXJ1 (sperm function and successful fertilization) and NME5 (spermatogenesis). We also observed genes such as PKD2L2, MAGED1 and KDM3B, which have been associated with diverse fertility traits in both sexes of other species. The results confirm the complexity of the genetic mechanisms underlying reproduction while suggesting that prolificacy in the Bonga sheep, and possibly African indigenous sheep is partly under the control of BMP15 while other genes that enhance male and female fertility are essential for reproductive fitness

Imaging of activated complement using ultrasmall superparamagnetic iron oxide particles (USPIO) - conjugated vectors: an in vivo in utero non-invasive method to predict placental insufficiency and abnormal fetal brain development.

In the current study, we have developed a magnetic resonance imaging-based method for non-invasive detection ofcomplement activation in placenta and foetal brain in vivo in utero. Using this method, we found that anti-complementC3-targeted ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles bind within the inflamed placenta and foetal braincortical tissue, causing a shortening of the T2* relaxation time. We used two mouse models of pregnancy complications: a mousemodel of obstetrics antiphospholipid syndrome (APS) and a mouse model of preterm birth (PTB). We found that detection of C3deposition in the placenta in the APS model was associated with placental insufficiency characterised by increased oxidative stress,decreased vascular endothelial growth factor and placental growth factor levels and intrauterine growth restriction. We alsofound that foetal brain C3 deposition was associated with cortical axonal cytoarchitecture disruption and increasedneurodegeneration in the mouse model of APS and in the PTB model. In the APS model, foetuses that showed increased C3in their brains additionally expressed anxiety-related behaviour after birth. Importantly, USPIO did not affect pregnancyoutcomes and liver function in the mother and the offspring, suggesting that this method may be useful for detecting complementactivation in vivo in utero and predicting placental insufficiency and abnormal foetal neurodevelopment that leads toneuropsychiatric disorders

ANTERIOR LONGITUDINAL OSTEOTOMY OF THE GREATER TROCHANTER IN TOTAL HIP ARTHROPLASTY: SHORT-TERM FOLLOW-UP

BACKGROUND Early dislocation is a foremost complication of total hip arthroplasty through a postero-lateral approach. The extra-articular impingement of the anterior part of the great trochanter with ileum bone, with or without soft tissue interposition is a well recognized but underestimated etiopathogenetic cause reported in literature. In this retrospective study through the assessment of clinical and radiographic follow-up at a minimum of six months, the effectiveness of an antero- longitudinal osteotomy of the great trochanter for early dislocation prevention is evaluated. MATERIALS AND METHODS 209 patients (48.3% males and 51,7% females) underwent a total hip arthroplasty from June 2011 to September 2015, with surgery being performed by the same surgeon. A modified posterolateral approach was used according to the tissue-sparing criteria, in all the cases an anterior longitudinal osteotomy of the great trochanter has been performed at 90\ub0 to the antiversion angle of the implant and aligned posteriorly with the prosthesis. All the patients underwent a clinical and radiological follow up at one, three, and six months. RESULTS In this study, only one patient reported dislocation of THA. One patient suffered from a wound infection which was subsequently treated with antibiotics and had complete remission. All patients demonstrated a fast recovery of ROM and walking, starting from pre-op Harris Hip Score 42.24pts and obtaining a score of 81.52pts at three months, and 92.03 at six months post-op. After surgery and during the follow up period, there were no trochanteric fractures detected. DISCUSSION The correct positioning of the implants, the head diameter, offset, soft tissues repair, absence of impingement, and patients compliance are all elements that define the prosthetic stability. Literature shows and incidence of primary total hip arthroplasty dislocation between 0.80% to 10%. The incidence of dislocation reported in a preliminary study in our Institute is 0.48%, demonstrating the effectiveness of the trochanteric osteotomy. CONCLUSIONS The osteotomy of the great trochanter is an effective surgical technique used to decrease the anterior impingement and early dislocation incidence. It is particularly effective on patients with good compliance and correctly implanted prosthetic components