OBJECTIVES To examine how comorbid diseases (cardiovascular diseases, hypertension, diabetes, cancer, pulmonary diseases, depression, psychotic disorders and neurodegenerative diseases) affect survival of hip and knee replacements. METHODS Data for this register-based study were collected by combining data from five nationwide health registers. 43 747 primary total hip and 53 007 primary tota...

BACKGROUND There is no universal hip implant suitably fills all femoral types, whether prostheses of porous short-stem suitable for Hip Arthroplasty is to be measured scientifically. METHODS Ten specimens of femurs scanned by CT were input onto Mimics to rebuild 3D models; their *stl format dataset were imported into Geomagic-Studio for simulative osteotomy; the generated *.igs dataset were i...

Late infections with Actinomyces israelii have been described for prosthetic hip joints but not in association with intravenous drug use. We present a case of a 43-year-old intravenous drug user who developed A. israelii infection in connection with a hip prosthesis 11 years after implantation, and we review four previously reported cases of Actinomyces prosthetic joint infections.

This case report describes a patient who had a metal-on-metal hip prosthesis implanted 37 years ago. The hip function and X-ray are presented. The levels of cobalt and chromium ions in blood are analyzed and found to be about 40 times higher than normal. Consequences are discussed.

Total hip arthroplasty (THA) is currently one of the most widely performed procedures in orthopedic practice. Over recent years, THA gained much improvement in terms of prosthesis design, availability of suitable component materials and manufacturing techniques, and a better understanding of hip mechanics. In a previous study, we reported results at a mean 3.2 years following implantation of th...

There is increasing recognition that decision modelling is central to health technology assessment and, in particular, to analyses to support formal decision making regarding the funding of the use of new technologies. In part, the key role of decision analysis stems from the need to handle multiple sources of uncertainty in the available evidence. The use of probabilistic decision analysis is ...

574 www.thelancet.com Vol 383 February 8, 2014 In May, 2012, a 55-year-old man was referred to our clinic for severe heart failure (New York Heart Association class IV). He had raised brain natriuretic peptide of 1053 ng/L (normal <55 ng/L) and his estimated ejection fraction by echocardiography was 25%. His medical history was mostly uneventful, apart from the fact that he had had both hips re...

BACKGROUND Metal ion toxicity, metal hypersensitivity, and metal carcinogenicity are causes for concern for patients with metal-on-metal hip replacements. Thus, understanding the biological fate of metal ions, and consequently their long-term systemic effects, is of great interest to patients and surgeons alike. METHODS Inductively coupled plasma mass spectrometry was used to measure the leve...

The length of the lower limb prosthesis was compared with the length of the contralateral lower extremity in 113 Finnish war-disabled amputees by a radiological weight bearing method developed by the author. Considering a shortening of 10 mm for above-knee prostheses and of 5 mm for below-knee prostheses as tolerance limits, the length of the prosthesis was acceptable only in 17 cases (15% of t...

People with a transtibial amputation using passive-elastic prostheses exhibit reduced prosthetic ankle power and push-off work compared to non-amputees and compensate by increasing their affected leg (AL) hip joint work and unaffected leg (UL) ankle, knee, and hip joint and leg work during level-ground walking. Use of a powered ankle–foot prosthesis normalizes step-to-step transition work durin...