Total hip replacement. Results of a postal survey of current practice on the cement fixation of the acetabular cup in the UK

Previous finite element studies and laboratory investigations on reconstructed acetabulum joints show that long-term fixation of the acetabular cup in total hip replacements (THRs) is influenced by surgical fixation techniques. The aim of this study is to determine and understand the reasons of current practice in the cement fixation of the acetabular cup in THRs in the UK. Following a pilot study, a postal survey was carried out among 1350 orthopaedic consultants. Response rate was 40% and data obtained from the returned questionnaires provided information about the current practice of 431 consultants with an average of 16.5 years of experience and who perform an average of 55 cemented THR operations annually. The survey showed wide variations in the fixation methods of the acetabular component. 95% of the respondents use cement to fix the acetabular cup, 46% maintain the subchondral bone and 63 % use a flanged acetabular cup. The numbers of anchorage holes drilled vary from zero to thirty-six and drill diameters vary from 2 to 15 mm. Anchorage hole depths vary from 3 to 20 mm. Given the variability of surgical fixation methods, further studies need to be carried out to determine how fixation techniques could be improved to increase the longevity of the acetabular component in THRs. Further investigations could lead to a better understanding of the factors that contribute to the stability of THRs

Minimally invasive and computer-navigated total hip arthroplasty: a qualitative and systematic review of the literature

ABSTRACT: BACKGROUND: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) for total hip arthroplasty (THA) have gained popularity in recent years. We conducted a qualitative and systematic review to assess the effectiveness of MIS, CAS and computer-assisted MIS for THA. METHODS: An extensive computerised literature search of PubMed, Medline, Embase and OVIDSP was conducted. Both randomised clinical trials and controlled clinical trials on the effectiveness of MIS, CAS and computer-assisted MIS for THA were included. Methodological quality was independently assessed by two reviewers. Effect estimates were calculated and a best-evidence synthesis was performed. RESULTS: Four high-quality and 14 medium-quality studies with MIS THA as study contrast, and three high-quality and four medium-quality studies with CAS THA as study contrast were included. No studies with computer-assisted MIS for THA as study contrast were identified. Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA, with no difference in complication rates and risk for acetabular outliers. Strong evidence exists that there is no difference in physical functioning, measured either by questionnaires or by gait analysis. Moderate evidence was found for a shorter length of hospital stay after MIS THA. Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period, but that effect diminished after three months postoperatively. Strong evidence was found for an increase in operative time for CAS THA, and limited evidence was found for a decrease in intraoperative blood loss. Furthermore, strong evidence was found for no difference in complication rates, as well as for a significantly lower risk for acetabular outliers. CONCLUSIONS: The results indicate that MIS THA is a safe surgical procedure, without increases in operative time, blood loss, operative complication rates and component malposition rates. However, the beneficial effect of MIS THA on functional recovery has to be proven. The results also indicate that CAS THA, though resulting in an increase in operative time, may have a positive effect on operative blood loss and operative complication rates. More importantly, the use of CAS results in better positioning of acetabular component of the prosthesis

Navigated cup implantation in hip arthroplasty: A meta-analysis

Background and purpose Many studies have suggested that navigation-based implantation can improve cup positioning in total hip arthroplasty (THA). We conducted a systematic review and meta-analysis to compile the best available evidence, and to overcome potential shortcomings because of small sample sizes in individual studies

Electromagnetic Field Effect or Simply Stress? Effects of UMTS Exposure on Hippocampal Longterm Plasticity in the Context of Procedure Related Hormone Release

Harmful effects of electromagnetic fields (EMF) on cognitive and behavioural features of humans and rodents have been controversially discussed and raised persistent concern about adverse effects of EMF on general brain functions. In the present study we applied radio-frequency (RF) signals of the Universal Mobile Telecommunications System (UMTS) to full brain exposed male Wistar rats in order to elaborate putative influences on stress hormone release (corticosteron; CORT and adrenocorticotropic hormone; ACTH) and on hippocampal derived synaptic long-term plasticity (LTP) and depression (LTD) as electrophysiological hallmarks for memory storage and memory consolidation. Exposure was computer controlled providing blind conditions. Nominal brain-averaged specific absorption rates (SAR) as a measure of applied mass-related dissipated RF power were 0, 2, and 10 W/kg over a period of 120 min. Comparison of cage exposed animals revealed, regardless of EMF exposure, significantly increased CORT and ACTH levels which corresponded with generally decreased field potential slopes and amplitudes in hippocampal LTP and LTD. Animals following SAR exposure of 2 W/kg (averaged over the whole brain of 2.3 g tissue mass) did not differ from the sham-exposed group in LTP and LTD experiments. In contrast, a significant reduction in LTP and LTD was observed at the high power rate of SAR (10 W/kg). The results demonstrate that a rate of 2 W/kg displays no adverse impact on LTP and LTD, while 10 W/kg leads to significant effects on the electrophysiological parameters, which can be clearly distinguished from the stress derived background. Our findings suggest that UMTS exposure with SAR in the range of 2 W/kg is not harmful to critical markers for memory storage and memory consolidation, however, an influence of UMTS at high energy absorption rates (10 W/kg) cannot be excluded

The Society for Environmental Geochemistry and Health (SEGH): building for the future.

The challenges of sustainable development are ever more pressing, and the skills, interests and capabilities of the SEGH member are well-placed to continue to make more meaningful contributions to the environment, society and well-being. We reflect on the historical development of the society, its response to the dynamic international research landscape and the great opportunities ahead. In 2018, SEGH implemented a new board structure after 2–3 years of consultation, with approval of a new constitution and a new strategy across the large number of international board members. While regions were represented by sections in Europe, Asia/Pacific and the USA, the structure required renewal in order to be more representative of the distribution of members and website traffic that had evolved in preceding years. In addition, the society wanted to improve its position for future growth opportunities across rapidly developing regions