On prevention of second hip fracture surgery : epidemiological and biomechanical aspects of elastomer femoroplasty

Demographic changes will result in a tidal wave of hip fractures in the growing group of frail octo- and nonagenarian citizens. These osteoporotic fractures are a major burden to the patients__ quality of life. Despite all preventive measures, predominantly focusing on osteoporosis medication, the total number of second, contralateral hip fractures has not declined over the past decades. Complications and institutionalization after surgery of these second hip fractures are increased and can be held responsible for a decrease in quality of life for these patients and high healthcare costs. In this thesis Elastomer femoroplasty (EF) is introduced as a new modality in the prevention of hip fracture surgey We found that in, in-vitro, cadaver, biomechanical experiments, EF prevents dislocation after fracture and after fracture-loading compared to untreated control femurs. These preventively treated hip fractures can be cyclically loaded with forces that well exceed the loads during normal gait. Elastomer Femoroplasty is a feasible and a readily available, minimal invasive technique to prevent second hip fracture surgery. It can be applied during ipsilateral hip fracture surgery and does not need a separate operation or anesthesia. Furermore, due to the nature of this surgical intervention, patient compliance after EF is 100%.UBL - phd migration 201

Spiral Vein Reconstruction of the Infected Abdominal Aorta Using the Greater Saphenous Vein: Preliminary Results of the Tilburg Experience

AbstractObjectivesThe aim of this study was to evaluate patients, who underwent spiral vein reconstruction of the abdominal aorta to repair infected aneurysms or replace infected aortic grafts.MethodsAll spiral vein reconstructions between March 2005 and May 2010 because of vascular infections of the abdominal aorta were retrospectively included. Diagnosis was determined by clinical examination, laboratory results, computed tomography (CT) and positron emission tomography (PET) scan, and microbiological tests. Spiral vein reconstruction consisted of harvesting the greater saphenous vein (GSV) and construction into a spiral graft, aortic reconstruction and a transmesenteric omentumplasty. Primary outcomes were survival and limb salvage. Secondary outcomes included technical, clinical and ongoing success, re-infection, ongoing infection and patency.ResultsAll five patients survived surgery, and there were no in-hospital deaths. Survival and limb salvage were 100% after median follow-up of 13 months (6–67 months). Further, technical, clinical and continuing success was 100%. There were no re-infections or ongoing infections.ConclusionsSpiral vein reconstruction using the GSV showed good short-term survival and limb salvage. It, therefore, might be considered as an attractive treatment method for vascular infections of the abdominal aorta. Still, more follow-up is needed to evaluate long-term results

Complications and institutionalization are almost doubled after second hip fracture surgery in the elderly patient

Abstract Purpose To determine patient and hip fracture characteristics, early postoperative complication rate and need for institutionalization at time of discharge from the hospital in patients treated for a second, contralateral hip fracture. Methods During a six-year period (2003-2009) seventy-one patients (60 women and 11 men; age range 54 – 94 years) underwent first hip fracture surgery and subsequent contralateral hip fracture surgery at our hospital. Variables including age, gender, American Society of Anesthesiologists Classification (ASA), AO fracture classification, time between both hip fractures, rate and severity of early postoperative complications and destination of discharge were obtained from the electronic medical records. Data from both hospitalization periods were compared. Results Forty-six percent of second hip fractures occurred within

Minor influence of humeral component size on torsional stiffness of the Souter-Strathclyde total elbow prosthesis

The use of Souter-Strathclyde total elbow prostheses is a well-studied replacement therapy for reconstruction of the elbow, but loosening of the humeral component is still of concern at long-term follow-up. In this study we looked at the effect of humeral component size and bone mineral density with respect to the bone size, torsional stiffness and torque to failure in cadaveric bones. Fourteen cadaveric humeri were available for testing purposes and four different humeral component size categories were used. First, we calculated the bone quality using dual-energy X-ray absorptiometry (DEXA). The torsional stiffness of the prosthetic humeri was measured during two mechanical tests: Firstly, the applied torque was recorded during a torsion fatigue test. The change of torsional stiffness between the tenth and last cycle was calculated. Secondly, a simple torsion test was performed and the torque to failure was recorded. No significant differences in outcome were seen between sizes of humeral components, even after correction for the bone size. Torsional stiffness and torque to failure were significantly correlated with bone mineral density and not with component size. In conclusion, bone quality seems to be a major eminent factor in the fixation of the humeral component in elbow replacement surgery

Cyclic loading of fractured cadaveric femurs after elastomer femoroplasty An in vitro biomechanical study

Optimising joint reconstruction management in arthritis and bone tumour patient

Elastomer femoroplasty prevents hip fracture displacement In vitro biomechanical study comparing two minimal invasive femoroplasty techniques

Optimising joint reconstruction management in arthritis and bone tumour patient

Feasibility of osteosynthesis of fractured cadaveric hips following preventive elastomer femoroplasty

Optimising joint reconstruction management in arthritis and bone tumour patient

The effect of short aneurysm neck length on the proximal fixation strength of modern EVAR-grafts. An in vitro study

Study of the normal and pathological locomotory syste

The Proximal Fixation Strength of Modern EVAR Grafts in a Short Aneurysm Neck. An In Vitro Study

Objectives: The study aims to measure the strength of the proximal fixation of endografts in short and long necks. Design: Three types of endografts were compared: Gore Excluder (R), Vascutek Anaconda (R) and Medtronic Endurant (R). Materials and methods: The proximal part of the stent grafts was inserted in bovine arteries and the graft was then attached to a tensile testing machine. The force to obtain dislodgement (DF) from the aorta was recorded for each graft at proximal seal lengths of 10 and 15 mm. Results: The median OF (interquartile range, IQR) for the Excluder, the Anaconda and the Endurant with a seal length of 15 mm was: 11.8 (10.5-12.0) N, 20.8 (18.0-30.1) N and 10.7 (10.4-11.3) N. With the shorter proximal seal of 10 mm, DF was, respectively: 6.0 (4.5-6.6) N, 17.0 (11.2-36.6) N and 6.4 (6.1-12.0) N. Conclusions: The proximal fixation of the Anaconda is superior to the Excluder and the Endurant at short necks of 10 and 15 mm in an experimental set-up. There is a statistically significant decrease of proximal fixation for the Excluder stent graft, when decreasing the length of the proximal neck from 15 to 10 mm. (C) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Influence of aneurysm wall stiffness and the presence of intraluminal thrombus on the wall movement of an aneurysm - an in vitro study

Vascular Surger