Bmc Musculoskel Dis
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The quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture. ⋯ Multiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.
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Bmc Musculoskel Dis · Jan 2010
Predictors of pain and use of pain medications following primary Total Hip Arthroplasty (THA): 5,707 THAs at 2-years and 3,289 THAs at 5-years.
Study pain and use of pain medications and their predictors after primary Total Hip Arthroplasty (THA). ⋯ Higher BMI and depression impacted moderate-severe pain; and female gender, higher BMI and depression predicted use of pain medications at 2- and 5-years post-primary THA.
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Bmc Musculoskel Dis · Jan 2010
Decreasing medical complications for total knee arthroplasty: effect of critical pathways on outcomes.
Studies on critical pathway use have demonstrated decreased length of stay and cost without compromise in quality of care. However, pathway effectiveness is difficult to determine given methodological flaws, such as small or single center cohorts. We studied the effect of critical pathways on total knee replacement outcomes in a large population-based study. ⋯ Medicare patients undergoing total knee replacement surgery in hospitals that used critical pathways had fewer postoperative complications than patients in hospitals without pathways, even after adjusting for patient and hospital related factors. This study has helped to establish that critical pathway use is associated with lower rates of postoperative mortality and complications following total knee replacement after adjusting for measured variables.
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Bmc Musculoskel Dis · Jan 2010
Modular titanium alloy neck adapter failures in hip replacement--failure mode analysis and influence of implant material.
Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery.The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68) of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years) postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years) and the average weight 102.3 kg (75 to 130 kg). The failures of neck adapters were divided into 66% with small CCD of 130 degrees and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. ⋯ Failure of modular titanium alloy neck adapters can be initiated by surface micromotions due to surface contamination or highly loaded implant components. In the present study, the patients at risk were men with an average weight over 100 kg. Modular cobalt chrome neck adapters provide higher safety compared to titanium alloy material.
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Bmc Musculoskel Dis · Jan 2010
Maintaining a balance: a focus group study on living and coping with chronic whiplash-associated disorder.
There is little qualitative insight into how persons with chronic Whiplash-Associated Disorder cope on a day to day basis. This study seeks to identify the symptoms persons with Whiplash-Associated Disorder describe as dominating and explore their self-initiated coping strategies. ⋯ Neck and head pain, sensory hypersensitivity, and cognitive dysfunction were reported as participants' main complaints. A constant notion of balancing between their three main coping strategies; rest, exercise, and social withdrawal, was described.