What is Phonophoresis?Phonophoresis is the use of ultrasound to enhance the delivery of topically applied drugs. Effectively, medicines contained within or under the ultrasound gel are pushed by the sound waves of the ultrasound and driven deep below the skin. Phonophoretically administered medications can penetrate the body much deeper than those massaged by hand over the surface of the skin.Some medications can be delivered phonophoretically. The process is dependant on many, many factors. For example, the type of drug and its molecule size are critical. The drug molecule has to be just the right size to be picked up by the ultrasound waves and the right size to pass through the body tissue. As well, the medicinal molecule can’t react with the ultrasound gel. It must also be able to survive the thermal and vibrational effects of the ultrasound. The delivery of medications via ultrasound is truly a
Florian-D. Naal, MD*, Nicola A. Maffiuletti, PhD, Urs Munzinger, MD and Otmar Hersche, MDFrom the Joint Center, Schulthess Clinic, Zurich, SwitzerlandPublished on May 1, 2007Background: No information is available concerning patients’ sports activity after hip resurfacing arthroplasty.Hypothesis: Patients treated by hip resurfacing arthroplasty will be able to achieve a high level of sports activity.Study Design: Case series; Level of evidence, 4.Methods: We surveyed 112 patients by postal questionnaire to determine their sporting activities at a mean of 23.5 (range, 9–40) months after hip resurfacing surgery. Data were also analyzed separately for older and younger patients and women and men, respectively.Results: Of 112 patients, 110 participated in an average of 4.6 sport disciplines after surgery, compared with 105 patients pre-operatively engaged in an average of 4.8 disciplines. About 26% performed sports 4 times per week or more—almost 60% for longer than
A more normal gait at higher speeds is attained through hip resurfacing arthroplasty as compared to standard total hip arthroplasty, according to a study presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting.
Anatole V. Wiik, MBBS and his team, performed a case control study with 63 patients – 21 total hip arthroplasty (THA), 21 hip resurfacing arthroplasty (HRA) and 21 healthy controls, all matched for age and gender, with experimental groups all being at least 24 months removed from their arthroplasties – which involved each participant using an instrumented treadmill.
“All patients had a 6-minute acclimatization period at 4 km/hour,” Wiik said. “The speed was then increased incrementally until top walking speed was obtained.”
Speed, cadence, stride length, stop length, impulse, progression angle, base of support, maximum forces at heel strike, mid-stance and push off were all measured, according to the abstract, with the procedure taking
Outcome of hip resurfacing may be dependent on experience
By Gina Brockenbrough February 27, 2009
LAS VEGAS — A new study links outcomes of hip resurfacing to the hospital volume of resurfacing cases and, thereby, the surgeon’s experience.To evaluate the impact of operative volume on hip resurfacing outcomes, Andrew J. Shimmin, MBBS, FAOrthA, and colleagues used the Australian Joint Registry to identify nearly 9,000 hip resurfacings performed at 196 hospitals between September 1999 and December 2006…..They found that 74% of hospitals performed fewer than 30 procedures during the 7-year study period, while 64% of hip resurfacings were performed at 16 “high-volume” hospitals, or those that performed more than 100 cases. Overall, the researchers found that 3.1% of resurfacings were revised……They then compared the cumulative rate of revision at 4 years among the hospital groups. At 4 years, the investigators discovered a 6% revision rate for
Computer-Assisted Vs Conventional
Volume 24, Issue 3, Pages 341-350 (April 2009)
Jose Rafael E. Resubal, MD, FPOA, David A.F. Morgan,
Received 16 June 2007; accepted 17 December 2007.
Updated September 2008
Thomas P. Gross, MD1 and Fei Liu, PhD1
1 Midlands Orthopaedics, 1910 Blanding Street, Columbia, SC 29201
Metal-on-metal hip resurfacing with hybrid fixation has been introduced as an alternative to standard total hip arthroplasty, especially for young and active patients. There are few studies in the literature on the midterm results of cementless femoral side resurfacing. The purpose of this study was to present our seven-year clinical results of a series of twenty cementless
metal-on-metal hip resurfacing procedures.
Methods: Between 1999 and 2000, eighteen patients (twenty hips) underwent primary metal-on-metal hip resurfacing with uncemented femoral and acetabular components. One patient was lost to follow-up. This left eleven men and six women, who had a mean age of forty-five years at the time of surgery. Clinical and radiographic examinations were performed prospectively, and the results were analyzed.
Results: The mean duration of follow-up was … Read the rest
|Link http://proceedings.jbjs.org.uk/cgi/content/abstract/91-B/SUPP_I/66ANALYSIS OF CEMENT PENETRATION IN HIP RESURFACING ARTHROPLASTY R.M. Gillies; J.H. Gan; G.M. Hawdon; and S.J. McMahonMay 2007Introduction: Prevalence of femoral neck fracture in resurfacing hip arthroplasty continues to question if failure is technique-related or due to the inherent bone quality. This study aimed to correlate cement penetration profile during resurfacing hip with inherent bone density. The hypothesis is that osteoporotic bone is unable to support the prosthesis leading to fatigue failure.Methods: Fifteen patients scheduled for total hip replacement (THR) were recruited to undergo resurfacing arthroplasty prior to THR. Each patient was implanted with a resurfacing femoral component (BHR, Smith & Nephew, Memphis, TN). Antibiotic simplex cement was inserted one minute after mixing at 18°C to fill 10% of the femoral component volume. The femoral head-implant section was removed and kept in buffered formalin. The patients then proceeded with standard THR. The femoral head-cement-prosthesis section was|
Analysis of wear of retrieved metal-on-metal hip resurfacing implants revised due to pseudotumours
Kwon YM, Glyn-Jones S, Simpson DJ, Kamali A, McLardy-Smith P, Gill HS, Murray DW.Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. email@example.com
The presence of pseudotumours, which are soft-tissue masses relating to the hip, after metal-on-metal hip resurfacing arthroplasty has been associated with elevated levels of metal ions in serum, suggesting that pseudotumours occur when there is increased wear. We aimed to quantify the wear in vivo of implants revised for pseudotumours (eight) and of a control group of implants (22) revised for other reasons of failure. We found that the implant group with pseudotumours had a significantly higher rate of median linear wear of the femoral component at 8.1 microm/year (2.75 to 25.4) than the 1.79 microm/year (0.82 to 4.15; p = 0.002) of the
|Archive of failed joint replacements provides tips to building a better hip replacementA study by Hospital for Special Surgery researchers has provided the first comprehensive look at just how metal-on-metal total hip replacements are failing in patients around the country. Made possible by what is thought to be the largest archive of failed joint replacements, the research should help doctors develop a better hip replacement for future patients. The study will be reported at the upcoming annual meeting of the American Academy of Orthopaedic Surgeons, Feb. 7-11, 2012.“This paper is the first step in what is a path to try to understand what the problems are with metal-on-metal joints,” said Timothy Wright, Ph.D., Kirby Chair of Orthopedic Biomechanics at Hospital for Special Surgery (HSS). He said that information gleaned from the study should be useful in improving metal-polyethylene implants, the most common hip implant put in patients today.“We|