Authors:
Publish Date: 2014/04/22
Volume: 43, Issue: 7, Pages: 1023-1023
Abstract
Raised levels of metal ions in the blood following large head metalonmetal total hip replacement such as cobalt and chromium have been well documented Because there has been a paucity of reports of metal ions in the blood following uncemented metalonpolyethylene MOP total hip replacement THR these authors investigated the relationship between modular femoral head diameter and the levels of cobalt and chromium ions following the aforementioned THR combination Sixtynine patients received in 2009 an uncemented TridentAccolade MOP THR Fortythree patients 23 men and 20 women mean age 670 years formed the study group who went on to have cobalt and chromium blood levels of ions measured in 2012 The patients were divided into three groups based femoral head diameter 12 in the 28 mm group 18 in the 36 mm group and 13 in the 40 mm group Four patients had identical bilateral prostheses one each in the 28 mm and 36 mm groups and two in the 40 mm group There was a significant increase in mean levels of cobalt ions in the blood in those with a 36 mm diameter femoral head compared with these with a 28 mm diameter head The authors state the clinical significance is unclear and must await larger sample size However they have stopped using femoral heads with a diameter of 36 mm or largerA prospective study was performed on 60 patients with total ruptures of pectoralis major muscle between 1997 and 2012 with a physical examination every 6 months for the first 12 months and every 12 months thereafter The mean age was 312 years Bench press exercise was associated with 80 of the ruptures 48 patients 41 patients with chronic ruptures were seen after three months There was an equal number of patients in the operative 31 patients and nonoperative group 29 patients who were using anabolic steroids 867 The inclusion criteria were a total rupture of the tendon evident by clinical examination and imaging MRI or US Exclusion criteria were diabetes and smokers 2 partial lesions n33with a normal clavicular portion or lack of MRI or US n5 Acute cases up to 3 weeks after injury were treated by reinsertion of the tendon into the humerus For injuries between 3 weeks and 3 months screws and washers were used those older than 3 months had augmentation using hamstring tendons screws and washers The nonoperative group had a brace for 15 days for pain relief Resisted exercises started at 8 weeks and after 5 months patients returned to sports activities Excellent results were not found in any patients from the nonoperative group and were observed in 21 from the surgical group 677 Poor outcomes were found in nine patients from the nonoperative group 31 and three from the surgical group 97
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