View details for PubMedID 24453790
The clinical results of semiconstrained total elbow arthroplasty have been encouraging, especially in rheumatoid arthritis. This article presents medium-term clinical results, revision rates, and reasons for revision of a semiconstrained linked total elbow device (Solar Total Elbow; Stryker, Mahwah, New Jersey). We retrospectively reviewed 17 consecutive total elbow arthroplasty patients operated on between February 1994 and March 2001. Thirteen patients were available for clinical evaluation with an average follow-up of 8.4 years (range, 4-12.6 years). The presenting diagnosis was posttraumatic arthritis in 6 patients, rheumatoid arthritis in 6, and gouty arthritis in 1, with an average patient age of 63.4 years. The results were analyzed with regard to complications following the procedure, functional outcome using the Mayo Elbow Performance Score (MEPS), and radiological evaluation at latest follow-up. The mean MEPS improved from 32.1 to 65 at latest follow-up. Three patients had excellent results, 5 had good results, 1 had a fair result, and 4 had poor results. Seven patients required at least 1 revision surgery, including 2 with humeral component loosening, 2 with ulnar component loosening, and 2 with bushing failure. One patient required resection arthroplasty for deep periprosthetic infection. Three patients eventually sustained periprosthetic fractures. Five patients with rheumatoid arthritis and 2 patients with posttraumatic arthritis underwent revision surgery. Poor clinical outcomes and a high revision rate were noted in patients with posttraumatic arthritis. Further comparative studies with other semiconstrained devices are necessary to determine their clinical effectiveness in patients with rheumatoid arthritis.
View details for PubMedID 19472967
To identify the genetic abnormality responsible for osteoarthritis (OA), avascular necrosis (AVN) of the femoral head, and Legg-Calvé-Perthes disease in a single family, and to determine factors responsible for the distinct phenotypes manifested by different family members.Forty-two members of a 5-generation family were recruited and investigated. Diagnosis was made by independent orthopedic surgeons and radiologists. Histopathologic changes of the diseased tissue were examined. Linkage analysis was performed with markers spanning the COL2A1 locus. Haplotypes were constructed and mutation of the gene was detected. Structures of the wild-type and mutant proteins were modeled.Sixteen affected members were identified (5 with isolated precocious hip OA, 6 with AVN of the femoral head, and 5 with Legg-Calvé-Perthes disease). A p.Gly1170Ser mutation of COL2A1 cosegregated with the 3 diseases and was absent in controls. Of note, age at onset in relation to the closure status of the femoral head epiphysis was associated with the diseases, with Legg-Calvé-Perthes disease presenting prior to closure (at ages 6-14 years), AVN of the femoral head presenting during closure (at ages 15-18 years), and precocious OA of the hip presenting after closure (at ages 21-34 years). Molecular modeling predicted that the serine-to-glycine substitution loosens the helical structure of the protein.The p.Gly1170Ser mutation of COL2A1 in the family described is responsible for pathology confined to the hip joint, which presents as isolated precocious hip OA, AVN of the femoral head, or Legg-Calvé-Perthes disease. Age at onset in relation to closure of the femoral head epiphysis appears to be a critical factor in determining disease pattern.
View details for DOI 10.1002/art.23491
View details for Web of Science ID 000256724900017
View details for PubMedID 18512791
View details for Web of Science ID 000447491500001
Scar cosmesis is one of the proposed benefits of mini-incision total hip replacement as opposed to standard-incision procedures; however, there has been no scientific proof of this clinical outcome. The cosmetic appearances of healed incisions of 34 primary total hip replacement procedures done by one surgeon using either a mini-incision (20 procedures) or a standard-length incision (14 procedures) were compared at an average of 2 years postoperatively. Each scar's appearance was graded independently by two plastic surgeons using a standardized rating system. Patients answered a questionnaire regarding their subjective assessment of their scar. The blinded observers found that more mini-scars (six of 20) were rated poor than standard scars (one of 14) and that more standard-incision patients had scars that were rated good. More mini-incision patients (two of 20 versus zero of 14) had wound-healing problems. All the patients thought that their hip scar was acceptable in appearance, but 30 of 31 patients rated the relief of pain and total hip replacement longevity as higher priorities than scar cosmesis. The cosmesis of mini-incision total hip replacement scars may be inferior to standard-incision scars because of skin and soft tissue damage produced by high retractor pressures needed for exposure using a limited skin incision. Level of Evidence: Therapeutic study, Level II-2 (prospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.
View details for DOI 10.1097/01.blo.0000191317.85422.c3
View details for Web of Science ID 000233794700015
View details for PubMedID 16330988
Primary total hip replacement performed through an incision that is
View details for Web of Science ID 000222475900001
Primary total hip replacement performed through an incision that is
View details for PubMedID 15252080
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Recover, Restore and Re-open framework is a tool to guide communities as they reestablish operations during different stages of the COVID-19 pandemic.
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Latest information on COVID-19
Stanford Medicine is closely monitoring the outbreak of novel coronavirus (COVID-19). A new page is dedicated to the latest information and developments about COVID-19.
Racism and discrimination are direct affronts to Stanford Medicine?s values. Read our leaders? pledge on racial equity.
A leader in the biomedical revolution, Stanford Medicine has a long tradition of leadership in pioneering research, creative teaching protocols and effective clinical therapies.
An at-home COVID-19 test, designed by Stanford researchers to be easy to use and provide results within 30 minutes, will be the focus of a study funded by the Stanford Medicine Catalyst Program.
Our scientists have launched dozens of research projects as part of the global response to COVID-19. Some aim to prevent, diagnose and treat the disease; others aim to understand how it spreads and how people?s immune systems respond to it.
We are here for you and with your help, we will get through this together.
Recover, Restore and Re-open framework is a tool to guide communities as they reestablish operations during different stages of the COVID-19 pandemic.
A look at Stanford Medicine?s response to the new coronavirus, as well as outside perspectives on the pandemic.
