'Watch' cites concerns with intraprosthetic dislocation of dual-mobility hip implants

Be wary of mixing and matching

2013-09-26

(Press-News.org) Needham, MA.–JBJS Case Connector, an online case journal published by The Journal of Bone and Joint Surgery, has issued a "Watch" regarding early intraprosthetic dislocation with dual-mobility hip implants. The "Watch" is based on two case reports published in the September 25th issue, in addition to recent cases in the orthopaedic literature pointing to similar problems.

In both cases of early intraprosthetic dislocation described in this issue of JBJS Case Connector, surgeons chose a mix-and-match strategy to minimize surgical complexity and bone loss and to maximize hip stability. Despite these sound clinical objectives, both cases suggest that combining dual-mobility components with components from manufacturers of non-dual-mobility systems may increase the risk of adverse events.

To enhance clinical outcomes and improve patient safety, JBJS Case Connector is committed to alerting the orthopaedic community about potentially problematic devices or therapeutic approaches. When two or more such cases with similar mechanisms appear, our editors will identify the procedure or implant as a "watchable" intervention to sharpen the focus of clinicians on the potential for similar problems and enhance clinical outcomes and patient safety.

"The publication of 'Watches' helps fulfill our mission to serve the orthopaedic community," commented Marc Swiontkowski, MD, editor of JBJS Case Connector. "The 'Watch' designation may encourage the orthopaedic community to either demonstrate that these are isolated, unrelated cases or sharpen the focus further by rigorously evaluating the intervention and/or reporting related cases."

Study Details:

In a case study titled "Complete Dissociation of the Polyethylene Component in a Newly Available Dual-Mobility Bearing Used in Total Hip Arthroplasty," Ward, et al. report on the intraprosthetic dislocation of a dual-mobility implant where the polyethylene component ended up in in the patient's gluteal soft tissue. The second case study, "Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing" by Riviere, et. al., reviewed the implantation of a dual-mobility bearing to revise a large-diameter metal-on-metal implant. Surgeons left the well-fixed monoblock cup in place to preserve bone and minimize surgical complexity. At fourteen months postrevision, the patient presented with acute, intense groin pain. Radiographs revealed dislocation. During revision surgery, extensive wear of the mobile polyethylene component was apparent, with loose polyethylene particles in the joint and scratches on the dome of the metal head.

Key Findings:

Case Study #1: The authors surmise that the metal and polyethylene components had separated during an attempt at closed reduction of the dislocation when the patient had first presented. They suggest further that early intraprosthetic dislocations may be "generalizable to dual-mobility bearings and not related to the products of specific companies." Case Study #2: In this case, the authors speculate that the mobile polyethylene ball and existing acetabular cup were incompatible in shape and design. Surgeons replaced the existing acetabular cup with a modular trabecular metal cup and implanted a ceramic modular bearing.

INFORMATION:

About JBJS Case Connector

JBJS Case Connector is an online, cross-referenced journal containing thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs and to mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. For more information, visit caseconnector.jbjs.org.

About JBJS

JBJS, Inc., is a not-for-profit publisher specializing in orthopaedic information. It publishes the Journal of Bone & Joint Surgery, which has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field -- a core journal and essential reading for orthopaedic surgeons worldwide. Other publications include JBJS Case Connector and JBJS Essential Surgical Techniques. For more information, visit http://www.jbjs.org.

ELSE PRESS RELEASES FROM THIS DATE:

Aphasia and bilingualism: Using one language to relearn another

2013-09-26

This news release is available in French. In the era of globalization, bilingualism is becoming more and more frequent, and it is considered a plus. However, can this skill turn into a disadvantage, when someone acquires aphasia? More precisely, if a bilingual person suffers brain damage (i.e. stroke, head trauma, dementia) and this results in a language impairment called aphasia, then the two languages can be disrupted, thus increasing the challenge of language rehabilitation. According to Dr. Ana Inés Ansaldo, researcher at the Research Centre of the Institut universitaire ...

Can traumatic brain injury impair a child's working memory?

2013-09-26

New Rochelle, NY, September 26, 2013—Traumatic brain injury (TBI) during childhood can have long-term effects on cognitive and psychosocial functioning, including poor academic achievement. Pediatric TBI can cause significant deficits in working memory, as demonstrated in a study published in Journal of Neurotrauma, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Neurotrauma website at http://www.liebertpub.com/neu. Working memory is the ability to collect, retain, and use information needed to perform ...

Beautiful brushstrokes drawn from data

2013-09-26

A good painter uses simple strokes of a brush to bring texture, contrast and depth to a blank canvas. In comparison, computer programs can have difficulty reproducing the complex and varied forms of brushstrokes, and often require painstaking effort to mimic a brief sweep of paint. Now, a team of researchers including scientists at Princeton University has developed a program that allows graphic artists to quickly and easily produce realistic brushstrokes on their computers. Called RealBrush, the program combines graphics algorithms with "Big Data" storage and retrieval ...

Penn researchers use Facebook data to predict users' age, gender and personality traits

2013-09-26

In the age of social media, people's inner lives are increasingly recorded through the language they use online. With this in mind, an interdisciplinary group of University of Pennsylvania researchers is interested in whether a computational analysis of this language can provide as much, or more, insight into their personalities as traditional methods used by psychologists, such as self-reported surveys and questionnaires. In a recent study, published in the journal PLOS ONE, 75,000 people voluntarily completed a common personality questionnaire through a Facebook application ...

NASA views a transitioning Tropical-Storm Pabuk

2013-09-26

Typhoon Pabuk weakened and the core of the storm was changing from a warm core tropical system to a cold core low pressure system as it continued paralleling the coast of Japan on Sept. 26. NASA's Aqua satellite provided a visible image of the transforming storm that had lost its eye. On Sept. 26, 2013 at 03:55 UTC/Sept. 25 at 11:55 p.m. EDT, the Moderate Resolution Imaging Spectroradiometer or MODIS instrument aboard NASA's Aqua satellite captured a visible image of Tropical Storm Pabuk skirting eastern Japan. MODIS imagery also showed a steady influx of cold air stratocumulus ...

Future sea level rises should not restrict new island formation in the Maldives

2013-09-26

The continued accumulation of sand within the iconic ring-shaped reefs inside Maldivian atolls could provide a foundation for future island development new research suggests. Islands like the Maldives are considered likely to be the first to feel the effects of climate change induced sea level rise, with future island growth essential to counter the threat of rising sea levels. The study published in the journal Geology, and carried out by researchers from the University of Exeter in collaboration with the University of Auckland, James Cook University, the National Institute ...

Scripps research institute scientists discover important wound-healing process

2013-09-26

LA JOLLA, CA -- September 26, 2013 -- Scientists at The Scripps Research Institute (TSRI) have discovered an important process by which special immune cells in the skin help heal wounds. They found that these skin-resident immune cells function as "first responders" to skin injuries in part by producing the molecule known as interleukin-17A (IL-17A), which wards off infection and promotes wound healing. "This appears to be a critical and unique component of mammals' defense against skin wounds, and we hope that it will point the way towards better therapies for people ...

Microbes facilitate the persistence and spread of invasive plant species by changing soil chemistry

2013-09-26

Invasive species are among the world's greatest threats to native species and biodiversity. Once invasive plants become established, they can alter soil chemistry and shift nutrient cycling in an ecosystem. This can have important impacts not only on plant composition, diversity, and succession within a community, but also in the cycling of critical elements like carbon and nitrogen on a larger, potentially even global, scale. Clearly, both native and exotic plants form intimate relationships with bacteria in the soil that facilitate the extraction and conversion of elements ...

Colorectal surgeons develop a novel tool for measuring quality and outcomes

2013-09-26

Since the publication in 2000 of a report titled "To Err is Human" by the Institute of Medicine which called for a reduction in preventable medical errors, there has been an increasing demand for making improvements in the quality and measurement of health care outcomes. Although many measures have been developed, they tend to be complex, labor intensive, have an unclear relationship with improved outcomes, and concentrate on processes of care rather than clinical outcomes. In a new paper published online by the Annals of Surgery, physician-researchers at University Hospitals ...

First long temperature reconstruction for the eastern Mediterranean based on tree rings

2013-09-26

For the first time a long temperature reconstruction on the basis of stable carbon isotopes in tree rings has been achieved for the eastern Mediterranean. An exactly dated time series of almost 900 year length was established, exhibiting the medieval warm period, the little ice age between the 16th and 19th century as well as the transition into the modern warm phase. Moreover, Ingo Heinrich from the GFZ German Research Centre for Geosciences and colleagues revealed that the modern warming trend cannot be found in the new chronology. "A comparison with seasonal meteorological ...

'Watch' cites concerns with intraprosthetic dislocation of dual-mobility hip implants

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: