Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary...Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.展开更多
Background The SYNTAX score was developed to assess the severity and complexity of coronary artery disease and was determined to be effective in predicting contrast-induced nephropathy（CIN） in patients with STelevat...Background The SYNTAX score was developed to assess the severity and complexity of coronary artery disease and was determined to be effective in predicting contrast-induced nephropathy（CIN） in patients with STelevation myocardial infarction（STEMI） and non-STEMI（NSTEMI）. However, the relationship between SYNTAX score and CIN of patients with CTO undergoing PCI has been unclear. Methods We retrospectively enrolled 667 patients with CTO who underwent our institution′s basic PCI protocol between January 2010 and September 2012. The patients were divided into 3 groups： a low-risk group（SYNTAX score 〈 23; n = 231）, a moderate-risk group（SYNTAX score = 23-32; n = 214）, and a high-risk group（SYNTAX score〉32; n = 222）. CIN was defined as an absolute increase in SCr of ≥ 0.5 mg/d L over baseline values within 48-72 h after administration of contrast medium. We observed the correlation between SYNTAX score and the CIN rates. Results CIN developed in 74（11.09%） of the 667 study patients. The CIN rate showed a positive trend in the 3 groups based on the SYNTAX score, the higher SYNTAX score corresponds to the higher incidence of CIN（6.93%,13.08%,13.51%P = 0.044）. In the multivariate analysis, SYNTAX score was identified as an independent predictor of CIN（OR：1.956,95% CI： 1.014-3.773; P = 0.045; OR： 1.942,95% CI： 1.005-3.752; P = 0.048）. The incidence of in-hospital（1.3% vs. 4, 21% vs. 5.86%, P = 0.035） and long-term MACE（4.59% vs. 7.88% vs. 11.66%, P = 0.046） rates were more frequent in the higner SYNTAX score groups. Conclusions SYNTAX score is an independent predictor of CIN among patients with CTO undergoing PCI.展开更多
<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cros...<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.展开更多
考虑系数矩阵含非随机元素和不同位置含相同随机元素的结构化特征,PEIV (partial errors-in-variables)模型较一般的EIV模型更为严格。现有PEIV模型加权整体最小二乘(weighted total least squares,WTLS)估计算法需多次迭代,影响计算效...考虑系数矩阵含非随机元素和不同位置含相同随机元素的结构化特征,PEIV (partial errors-in-variables)模型较一般的EIV模型更为严格。现有PEIV模型加权整体最小二乘(weighted total least squares,WTLS)估计算法需多次迭代,影响计算效率。通过利用观测值误差和系数矩阵误差的统计性质构造非线性目标函数,并以此推导了新的PEIV模型WTLS估计的计算公式,同时设计了相应的Fisher-Score算法。算例分析结果表明,相比较而言,Fisher-Score算法迭代次数较少,计算效率得到大大提升。展开更多
目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3...目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3.0 T MRI评价CSVD影像学总负荷评分。比较2组患者基线资料、Lp-PLA2水平、MRI总负荷,Logistic回归分析CSVD患者认知障碍的影响因素,受试者工作特征(ROC)曲线评估Lp-PLA2水平联合MRI总负荷评分对CSVD患者认知障碍的预测价值。结果与认知正常组相比,认知障碍组Lp-PLA2水平、MRI总负荷评分、白细胞介素(IL)-6水平均升高(P<0.05),多因素Logistic回归分析结果显示,Lp-PLA2水平、MRI总负荷升高为CSVD患者认知障碍的危险因素(P<0.05),ROC曲线分析结果显示,Lp-PLA2水平联合MRI总负荷评分预测CSVD患者认知障碍的曲线下面积为0.905(95%CI:0.861~0.948),敏感度为86.5%,特异度为79.8%。结论认知障碍患者的Lp-PLA2水平、MRI总负荷评分升高,两者联合可作为CSVD患者认知障碍的早期预测指标。展开更多
Obesity (Ob) is an accepted major risk factor for the metabolic syndrome (MetS), a combination of at least three of five risk factors, which predispose to high oxidative stress (OS), but all obese do not show symptoms...Obesity (Ob) is an accepted major risk factor for the metabolic syndrome (MetS), a combination of at least three of five risk factors, which predispose to high oxidative stress (OS), but all obese do not show symptoms of MetS. There is dearth of data comparing OS homeostasis of severely obese adults with and without MetS, and need for biomarkers to help in differential diagnosis. Erythrocytic lipid and protein damage markers, malondialdehyde (MDA) and protein carbonyl (PCO), antioxidant enzymes erythrocytic superoxide dismutase(SOD), catalase (CAT), plasma glutathione peroxidase (GPX), and total antioxidant capacity (TAC) as ferric-reducing-ability-of-plasma (FRAP) were compared to understand OS homeostasis among 102 severely Ob (body mass index > 30), 102 Ob with severe (z-score > 2) MetS as per National Cholesterol Education Program-Adult Treatment Panel III guidelines and 100 healthy non-obese Controls. MDA/PCO and all antioxidant enzymes were lowest for ObMetS, followed by Ob, indicating greater damage to protein moieties of the erythrocytic membrane. Multiple regression analysis confirmed z-scores > 2 as significant predictor of lowered enzymes and TAC. Receiver Operator Curve analysis predicted that TAC was the most potential biomarker for the diagnosis and prognosis of MetS with an Odds Ratio of 88.5 indicating the high probability that FRAP would be low for ObMetS (z-score > 2) than for Ob with BMI > 30, but z-scores < 1. TAC is qualified as the most effective biomarker to distinguish between severely obese respondents with and without metabolic syndrome, and as a useful candidate for study of homeostatic breakdown in metabolic syndrome and the importance of z-score in assessment of MetS in obese respondents.展开更多
Background: Intra articular elbow fractures are considered to be one of the most complex injuries in orthopedic trauma. Some are too comminuted for open reduction and internal fixation. Recently total elbow replacemen...Background: Intra articular elbow fractures are considered to be one of the most complex injuries in orthopedic trauma. Some are too comminuted for open reduction and internal fixation. Recently total elbow replacement (TER) had gained popularity for the treatment of comminuted elbow trauma when other treatment options are not possible. Methods: Since 2007-2013 we treated 18 patients with TER due to comminuted distal humeral fractures. We used the Disabilities of the Arm, Shoulder and Hand scoring system (DASH) to evaluate the patient’s satisfaction. In addition, we evaluated the elbow range of motion and collateral stability. Results and Conclusions: Functional range of motion was achieved with high patient’s satisfaction. Based on the results, we conclude that TER is a reasonable option for complex elbow fractures when open reduction and internal fixation is not suitable.展开更多
AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who ...AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.展开更多
The standalone Global Positioning System (GPS) does not meet the higher accuracy requirements needed for approach and landing phase of an aircraft. To meet the Category-I Precision Approach (CAT-I PA) requirements of ...The standalone Global Positioning System (GPS) does not meet the higher accuracy requirements needed for approach and landing phase of an aircraft. To meet the Category-I Precision Approach (CAT-I PA) requirements of civil aviation, satellite based augmentation system (SBAS) has been planned by various countries including USA, Europe, Japan and India. The Indian SBAS is named as GPS Aided Geo Augmented Navigation (GAGAN). The GAGAN network consists of several dual frequency GPS receivers located at various airports around the Indian subcontinent. The ionospheric delay, which is a function of the total electron content (TEC), is one of the main sources of error affecting GPS/SBAS accuracy. A dual frequency GPS receiver can be used to estimate the TEC. However, line-of-sight TEC derived from dual frequency GPS data is corrupted by the instrumental biases of the GPS receiver and satellites. The estimation of receiver instrumental bias is particularly important for obtaining accurate estimates of ionospheric delay. In this paper, two prominent techniques based on Kalman filter and Self-Calibration Of pseudo Range Error (SCORE) algorithm are used for estimation of instrumental biases. The estimated instrumental bias and TEC results for the GPS Aided Geo Augmented Navigation (GAGAN) station at Hyderabad (78.47°E, 17.45°N), India are presented.展开更多
Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissu...Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissue reactions. This study was conducted to analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion®ceramic-on-ceramic (COC) hip articulation, with special emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise and revision surgery. Material and Methods: 150 consecutive hips were operated for primary cementless Total Hip Replacement (THR) using DeltaMotion®at a tertiary care center in Mumbai, India, between January 2010 and January 2015. Clinico-radiological outcome was assessed using the Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. Results: 108 (74.5%) patients were males and 37 (25.5%) were females with an average age of 50.87 years. Mean follow-up was 54 months (range: 37 - 86 months). The mean ROM was 120° in flexion, 10° in extension, 30° in adduction, 45° in abduction, 25° in internal rotation and 25° in external rotation. The mean HHS showed a statistically significant improvement of 64.5% (from 54.66 ± 6.42 pre-operatively to 89.95 ± 4.32 post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications (superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. Conclusion: We infer that DeltaMotion large head COC bearing allows scope for using larger head size in relatively smaller Indian hips due to factory fitted ceramic lining. At 6-year follow-up, high activity level was observed with excellent clinical-radiological outcomes and component longevity in relatively young Indian population.展开更多
文摘Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.
文摘Background The SYNTAX score was developed to assess the severity and complexity of coronary artery disease and was determined to be effective in predicting contrast-induced nephropathy（CIN） in patients with STelevation myocardial infarction（STEMI） and non-STEMI（NSTEMI）. However, the relationship between SYNTAX score and CIN of patients with CTO undergoing PCI has been unclear. Methods We retrospectively enrolled 667 patients with CTO who underwent our institution′s basic PCI protocol between January 2010 and September 2012. The patients were divided into 3 groups： a low-risk group（SYNTAX score 〈 23; n = 231）, a moderate-risk group（SYNTAX score = 23-32; n = 214）, and a high-risk group（SYNTAX score〉32; n = 222）. CIN was defined as an absolute increase in SCr of ≥ 0.5 mg/d L over baseline values within 48-72 h after administration of contrast medium. We observed the correlation between SYNTAX score and the CIN rates. Results CIN developed in 74（11.09%） of the 667 study patients. The CIN rate showed a positive trend in the 3 groups based on the SYNTAX score, the higher SYNTAX score corresponds to the higher incidence of CIN（6.93%,13.08%,13.51%P = 0.044）. In the multivariate analysis, SYNTAX score was identified as an independent predictor of CIN（OR：1.956,95% CI： 1.014-3.773; P = 0.045; OR： 1.942,95% CI： 1.005-3.752; P = 0.048）. The incidence of in-hospital（1.3% vs. 4, 21% vs. 5.86%, P = 0.035） and long-term MACE（4.59% vs. 7.88% vs. 11.66%, P = 0.046） rates were more frequent in the higner SYNTAX score groups. Conclusions SYNTAX score is an independent predictor of CIN among patients with CTO undergoing PCI.
文摘<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.
文摘考虑系数矩阵含非随机元素和不同位置含相同随机元素的结构化特征,PEIV (partial errors-in-variables)模型较一般的EIV模型更为严格。现有PEIV模型加权整体最小二乘(weighted total least squares,WTLS)估计算法需多次迭代,影响计算效率。通过利用观测值误差和系数矩阵误差的统计性质构造非线性目标函数,并以此推导了新的PEIV模型WTLS估计的计算公式,同时设计了相应的Fisher-Score算法。算例分析结果表明,相比较而言,Fisher-Score算法迭代次数较少,计算效率得到大大提升。
文摘目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3.0 T MRI评价CSVD影像学总负荷评分。比较2组患者基线资料、Lp-PLA2水平、MRI总负荷,Logistic回归分析CSVD患者认知障碍的影响因素,受试者工作特征(ROC)曲线评估Lp-PLA2水平联合MRI总负荷评分对CSVD患者认知障碍的预测价值。结果与认知正常组相比,认知障碍组Lp-PLA2水平、MRI总负荷评分、白细胞介素(IL)-6水平均升高(P<0.05),多因素Logistic回归分析结果显示,Lp-PLA2水平、MRI总负荷升高为CSVD患者认知障碍的危险因素(P<0.05),ROC曲线分析结果显示,Lp-PLA2水平联合MRI总负荷评分预测CSVD患者认知障碍的曲线下面积为0.905(95%CI:0.861~0.948),敏感度为86.5%,特异度为79.8%。结论认知障碍患者的Lp-PLA2水平、MRI总负荷评分升高,两者联合可作为CSVD患者认知障碍的早期预测指标。
文摘Obesity (Ob) is an accepted major risk factor for the metabolic syndrome (MetS), a combination of at least three of five risk factors, which predispose to high oxidative stress (OS), but all obese do not show symptoms of MetS. There is dearth of data comparing OS homeostasis of severely obese adults with and without MetS, and need for biomarkers to help in differential diagnosis. Erythrocytic lipid and protein damage markers, malondialdehyde (MDA) and protein carbonyl (PCO), antioxidant enzymes erythrocytic superoxide dismutase(SOD), catalase (CAT), plasma glutathione peroxidase (GPX), and total antioxidant capacity (TAC) as ferric-reducing-ability-of-plasma (FRAP) were compared to understand OS homeostasis among 102 severely Ob (body mass index > 30), 102 Ob with severe (z-score > 2) MetS as per National Cholesterol Education Program-Adult Treatment Panel III guidelines and 100 healthy non-obese Controls. MDA/PCO and all antioxidant enzymes were lowest for ObMetS, followed by Ob, indicating greater damage to protein moieties of the erythrocytic membrane. Multiple regression analysis confirmed z-scores > 2 as significant predictor of lowered enzymes and TAC. Receiver Operator Curve analysis predicted that TAC was the most potential biomarker for the diagnosis and prognosis of MetS with an Odds Ratio of 88.5 indicating the high probability that FRAP would be low for ObMetS (z-score > 2) than for Ob with BMI > 30, but z-scores < 1. TAC is qualified as the most effective biomarker to distinguish between severely obese respondents with and without metabolic syndrome, and as a useful candidate for study of homeostatic breakdown in metabolic syndrome and the importance of z-score in assessment of MetS in obese respondents.
文摘Background: Intra articular elbow fractures are considered to be one of the most complex injuries in orthopedic trauma. Some are too comminuted for open reduction and internal fixation. Recently total elbow replacement (TER) had gained popularity for the treatment of comminuted elbow trauma when other treatment options are not possible. Methods: Since 2007-2013 we treated 18 patients with TER due to comminuted distal humeral fractures. We used the Disabilities of the Arm, Shoulder and Hand scoring system (DASH) to evaluate the patient’s satisfaction. In addition, we evaluated the elbow range of motion and collateral stability. Results and Conclusions: Functional range of motion was achieved with high patient’s satisfaction. Based on the results, we conclude that TER is a reasonable option for complex elbow fractures when open reduction and internal fixation is not suitable.
文摘AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.
文摘The standalone Global Positioning System (GPS) does not meet the higher accuracy requirements needed for approach and landing phase of an aircraft. To meet the Category-I Precision Approach (CAT-I PA) requirements of civil aviation, satellite based augmentation system (SBAS) has been planned by various countries including USA, Europe, Japan and India. The Indian SBAS is named as GPS Aided Geo Augmented Navigation (GAGAN). The GAGAN network consists of several dual frequency GPS receivers located at various airports around the Indian subcontinent. The ionospheric delay, which is a function of the total electron content (TEC), is one of the main sources of error affecting GPS/SBAS accuracy. A dual frequency GPS receiver can be used to estimate the TEC. However, line-of-sight TEC derived from dual frequency GPS data is corrupted by the instrumental biases of the GPS receiver and satellites. The estimation of receiver instrumental bias is particularly important for obtaining accurate estimates of ionospheric delay. In this paper, two prominent techniques based on Kalman filter and Self-Calibration Of pseudo Range Error (SCORE) algorithm are used for estimation of instrumental biases. The estimated instrumental bias and TEC results for the GPS Aided Geo Augmented Navigation (GAGAN) station at Hyderabad (78.47°E, 17.45°N), India are presented.
文摘Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissue reactions. This study was conducted to analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion®ceramic-on-ceramic (COC) hip articulation, with special emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise and revision surgery. Material and Methods: 150 consecutive hips were operated for primary cementless Total Hip Replacement (THR) using DeltaMotion®at a tertiary care center in Mumbai, India, between January 2010 and January 2015. Clinico-radiological outcome was assessed using the Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. Results: 108 (74.5%) patients were males and 37 (25.5%) were females with an average age of 50.87 years. Mean follow-up was 54 months (range: 37 - 86 months). The mean ROM was 120° in flexion, 10° in extension, 30° in adduction, 45° in abduction, 25° in internal rotation and 25° in external rotation. The mean HHS showed a statistically significant improvement of 64.5% (from 54.66 ± 6.42 pre-operatively to 89.95 ± 4.32 post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications (superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. Conclusion: We infer that DeltaMotion large head COC bearing allows scope for using larger head size in relatively smaller Indian hips due to factory fitted ceramic lining. At 6-year follow-up, high activity level was observed with excellent clinical-radiological outcomes and component longevity in relatively young Indian population.
