Why do Hong Kong patients need total hip arthroplasty? An analysis of 512 hips from 1998 to 2010

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Do diabetic patients have an increased risk of deep surgical infection after total knee replacement?

Free Paper Presentation Session 6 – Adult Joint Reconstruction: no. 6.4INTRODUCTION: Diabetes mellitus has been linked to an increase risk of surgical site infection (SSI). Deep SSI after total knee replacement (TKR) is the most devastating complication, which often requires repeated operations and prolongs hospital stay. This study aimed at evaluating the effect of diabetes mellitus on rate of deep SSI after primary ...postprin

Why do Hong Kong Patients need Total Hip Arthroplasty? An analysis of 529 hips from 1998 to 2010

Conference Theme: Defying the Aging SpineConcurrent Free Papers 9: Hips and Knees 2Introduction: Limited updates on the demographic data and disease pattern leading to total hip replacement (THR) in Hong Kong were published in 1998 after the review on primary THR in Hong Kong Chinese from 1972 to 1997. This study aimed to review such information for patients undergoing primary THR from 1998 to 2010 in Queen Mary Hospital (QMH). Materials and Methods: Data from the prospective joint registry on all patients with primary THR done in QMH from 1998 to 2010 were reviewed. Age, sex, diagnosis, preoperative and latest follow-up Harris Hip Score (HHS) were analysed. Results: A total of 529 primary THRs were performed on 428 patients (188 males, 240 females) in the study period with clinical follow-up of at least 2 years. Their mean (± standard deviation) age was 57.7 ± 16.6 (range, 22-96) years. For males, the main aetiologies were avascular necrosis (50.2%), ankylosing spondylitis (18.8%), and post-traumatic arthritis (8.2%). For females, those were avascular necrosis (32.4%), primary osteoarthritis (20.1%), and post-traumatic arthritis (15.8%). Among the causes of avascular necrosis, alcoholic-induced (51.2%) and idiopathic (40.2%) were most common among male and female patients, respectively. The mean preoperative and latest follow-up HHS were 43.9 ± 18.4 and 90 ± 11.3, respectively. Discussion and Conclusion: Avascular necrosis is still the most common aetiology leading to THR. The underlying causes, however, are different in both sexes. The clinical result in terms of HHS was good in our patients requiring THR

Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomised controlled trial

Free Paper Session 10 - Adult Joint Reconstruction 2: no. 10.10INTRODUCTION: Recently introduced barbed suture allows continuous knotless suturing, provides faster closure, and distributes tension evenly. Research on barbed sutures in total knee arthroplasty (TKA) is limited and yield conflicting results. The primary objective of this study was to compare barbed and traditional sutures in terms of wound closure time and cost. The secondary objective was to compare differences in wound complications, cosmesis, and clinical outcomes. MATERIALS AND METHODS: This was a randomised controlled study approved by Institutional Review Board. Patients with osteoarthritis requiring primary TKA were randomised into 2 groups. For traditional group, interrupted and continuous suturing of Vicryl was used for arthrotomy and subcutaneous closure, respectively. For barbed group, continuous knotless suturing of Stratafix was used for arthrotomy and subcutaneous closure. Wound closure time, leak test, and any other intra-operative events were recorded. Wound complications, cosmesis rating, Knee Society Score (KSS), and range of motion (ROM) were measured at 2 weeks, 6 weeks, and 3 months. RESULTS: A total of 24 TKAs in barbed group and 23 in traditional group were included. Both arthrotomy and subcutaneous closure time were significantly shorter in barbed than traditional group (arthrotomy 309.8 vs. 467.4 seconds [p<0.01]; subcutaneous 277.3 vs. 398.7 seconds [p<0.01]). Four positive leak test in traditional group, while none in barbed group were noted (p<0.05). No significant difference was noted in wound complication, cosmesis, ROM, and KSS. DISCUSSION AND CONCLUSION: Our study demonstrated that bidirectional barbed suture shortens arthrotomy and subcutaneous closure time, reduces cost, and improves efficiency of TKA. We also showed that barbed suture provides a more robust arthrotomy closure, with comparable wound complications and clinical outcomes

Prediction of surgical outcome using plasma epstein-barr virus dna and 18F-FDG PET-CT scan in recurrent nasopharyngeal carcinoma

Background This study was carried out to determine the role of plasma Epstein-Barr virus (pEBV)-DNA and positron-emission tomography (PET)-CT scan in predicting the outcome of nasopharyngectomy and cervical lymphadenectomy for recurrent nasopharyngeal carcinoma (NPC). Methods Between 2007 and 2009, we recruited patients who had local or regional recurrent NPC after radiotherapy. The relationship between preoperative pEBV-DNA level, maximal standard uptake value (SUVmax), and surgical outcome was analyzed. Results Forty-two patients had local tumor recurrence. Their median pEBV-DNA level and SUVmax were 348 copies and 4.7, respectively. Both values were significantly lower than those with palliative nasopharyngectomy. Twenty-two patients had regional failure. Their mean pEBV-DNA level and tumor SUVmax were 626 copies and 7.6, respectively. The metastatic lymph nodes with extracapsular spread had a significantly higher mean SUVmax. Conclusions Preoperative pEBV-DNA and PET-CT predict the surgical outcome of nasopharyngectomy for recurrent NPC. Similarly, PET-CT scan predicts the presence of extracapsular spread of metastatic lymph nodes. These patients may warrant further postoperative adjuvant therapy. Copyright © 2011 Wiley Periodicals, Inc.link_to_subscribed_fulltextThe 4th World Congress of International Federation of Head and Neck Oncologic Societies (IFHNOS 2010), Seoul, Korea, 15-19 June 2010. In Head & Neck, 2012, v. 34 n. 4, p. 541-54

Recipient body size dose not matter in paediatric liver transplantation

Oral Presentations - All Short Oral (SO): no. SO1BACKGROUND/PURPOSE: It is controversial whether small-sized recipient is associated with adverse outcome in liver transplantation. This study aims to evaluate the outcomes of paediatric liver transplantation according to the body weight of recipients METHODS: Liver transplant recipients (age 10kg) RESULTS: A total of 113 patients (83 LDLTs and 30 DDLTs) were studied. Thirteen (11.5%) belonged to group A; 56 (49.6%) belonged to group B and 44 (38.9%) belonged to group C. The best graft and patient survivals were found in group A and none of the patients required re-laparotomy for general surgical complications while 32 (32%) in group B and C did. Regarding transplant-related complications, although group A patients had the highest incidence of biliary stricture (30.7%, n=4), the incidence of vascular complications (hepatic artery : 7%; portal vein: 0% and hepatic vein: 0%) was the lowest among the three groups. CONCLUSIONS: Outcomes of small-sized recipients are not inferior. Less technical-related vascular complications, which may lead to early graft loss, were observed. This could be patient-related (less advanced cirrhosis) or surgeon-related (additional attention paid)

Clinical outcome of micrometastasis in the lung in stage IA persistent gestational trophoblastic disease

Background. Computed tomography (CT) of the thorax can be used in the staging of persistent gestational trophoblastic disease (PGTD). However, the prognostic significance of micrometastasis in the lung detected by CT of the thorax has not been well documented. The aim of the study is to define the effect of micrometastasis on the clinical course of the disease. Methods. Thirty-five patients who had nonmetastatic GTD underwent CT thorax examination before treatment in the Department of Obstetrics and Gynaecology, University of Hong Kong. All patients had workups which showed no evidence of metastasis and were diagnosed as FIGO stage IA. They all received methotrexate (MTX) infusion therapy. Results. Three groups of patients were identified based on the thorax CT findings. Sixteen patients (45.7%) showed no evidence of micrometastasis on CT thorax. Two of them (12.5%) had poor response to MTX with unsatisfactory fall in serum hCG levels requiring change of chemotherapy to actinomycin D. Nine patients had suspicious micrometastasis and one (11.1%) of them needed change of MTX. Ten patients had micrometastasis and one (10%) of them needed change of MTX. There was only one recurrence and it was in the suspicious micrometastasis group (11.1%). There was no statistically significant difference in the rate of poor drug response or recurrence among the three groups of patients. Conclusions. Micrometastases in the lung do not affect the clinical outcome of patients with FIGO stage IA disease. CT thorax is not essential in the staging of GTD.link_to_subscribed_fulltex

Relative validity of a short food frequency questionnaire for disadvantaged families in Hong Kong

202307 bcchVersion of RecordOthersProjects of RISA CD69;Start-up Fund for RAPs under the Strategic Hiring Scheme BD8HPublishe

A questionnaire survey on attitudes and understanding towards mental disorders

OBJECTIVES. To obtain information about basic knowledge towards mental disorders and to evaluate public attitudes towards mental disorders in the Hong Kong Chinese population. METHODS. Questionnaires which collected basic demographic information, opinions about potential stigmas and myths, and knowledge on case vignettes depicting fictional characters with symptoms of mental illness were delivered to subjects in a secondary school, 2 homes for the elderly, a private housing estate, and a public housing estate in Hong Kong. RESULTS. Completed questionnaires were collected from 1035 subjects. In general, the participants' acceptance of mental illness was good. Regular contacts with such patients were associated with better knowledge (t = -2.71, p < 0.01) and better acceptance (t = 2.77, p < 0.01) of mental illness. Younger participants aged 15 to 19 years had a lower level of knowledge about mental health problems compared with other age-groups (p < 0.001). CONCLUSIONS. Personal contact with people with mental illness may help to improve knowledge and acceptance. Younger people in secondary school should be the target and prioritised group for mental health education. Apart from the delivery of mental health knowledge, strategies to increase social contact of the public with people having mental illness could be considered in the design and implementation of anti-stigma programmes.link_to_OA_fulltex

Artificial intelligence in diagnosis of knee osteoarthritis and prediction of arthroplasty outcomes : a review

202212 bckwVersion of RecordPublishe