Introduction
Metal-on-metal hip resurfacing improves health related quality of life (1), post-operative function (2-5) and activity (6). Increasing number of hip resurfacing arthroplasties is being undertaken with good to excellent outcomes (4). Published reports show significant advantages of hip resurfacing as compared to total hip arthroplasty. Studies have shown improved gait parameters (7) and increased range of motion (8), but others have reported no difference when compared with standard hip arthroplasty (9, 10).
Despite these advantages there are concerns which affect patient’s and surgeon’s decision to undertake metal-on-metal hip resurfacing arthroplasty. These issues range from being technically demanding, stringent patient selection criteria (11), high early incidence of femoral neck fractures(12, 13) and reported risk of high circulating metal ions(14-17). There are theoretical concerns about cancers following exposure to high levels of cobalt and chromium ions (18).
With improvement in post-operative quality of life, activity level and function, hip resurfacing may influence mortality. Secondly, studies suggest that high levels of cobalt and chromium in circulation contribute to increased risk of cancers (19). Mortality and cause of death following total hip arthroplasty has been reported low as compared to general population. In a study by the Finnish joint registry (20), the overall SMR was 0.69(CI 0.67 -0.70) in a cohort of 24,638 patients undergoing total hip arthroplasty. The cancer mortality was also low with SMR of 0.54(CI 0.50 – 0.57).
Published literature lacks evidence regarding mortality and cause of death after metal-on-metal hip resurfacing. We present an epidemiological analysis of cause of death...
... middle of paper ...
... disparity. Our study reports epidemiological results from a single cohort. The clinical significance of these results can be improved by a prospective study comparing total hip arthroplasty and metal-on-metal hip resurfacing. The present project was limited to hip resurfacing arthroplasty but we emphasis that future studies should include a control group.
Our results provide a preliminary insight in to the effects of hip resurfacing on mortality and cause of death with special reference to death from cancers and cardiovascular diseases. This study has shown a low risk of mortality following metal-on-metal hip resurfacing in multicenter cohort. We emphasize that above results must be viewed with caution and suggest increasing participation of operating surgeons and centers towards longer follow-up of a larger cohort so that more conclusive results can be obtained.
Iturralde v. Hilo Medical Center (HMC) is a medical malpractice case brought about by a representative for the Estate of Arturo Iturralde. The plaintiff, Rosalind Iturralde, is suing both HMC and Dr. Ricketson individually and as a representative for Arturo Iturralde’s Estate. The Defendants are HMC, Medtronic Sofamor Danek and Robert Ricketson, M.D. This case was brought about as a result of gross negligence and malpractice on the parts of HMC and Dr. Ricketson. During spinal surgery on January 29, 2001, Dr. Ricketson implanted a portion of a stainless steel, surgical screwdriver shaft into the spine of Aurturo Iturralde. This screwdriver shaft was not intended or approved for human implantation. HMC staff failed to inventory the surgical
I carried out this case study on Mrs. Casey (Pseudonym), any 86 year old woman who underwent an elective left total hip replacement (THR). After the OT student studied Mrs. Casey's past medical history in her medical chart, it was noted that she had previously undergone a right THR in 2011, which had been successful and free from complications. Ms. Casey had no other significant past medical history and had been an independent and active woman before the progression of her arthritis. Ms. Casey was required to have total hip replacements carried out on both hip joints as a result of severe Osteoarthritis (OA), which lead to stiffness, pain, and an eventual decrease in mobility, affecting her quality of life and involvement in meaningful occupations.
Although this is the case, a vast portion of plated patients find that the rubbing of the screws against the tissue is uncomfortable, which eventually leads to a secondary surgery for removal. This presents a big
Recent research has been focused on distinguishing the most successful augmentation surgery for restoring deficient bone (4, 16-18). Surgical techniques and survival of the bone graft has been vastly highlighted in the literature. ,However, the importance of recipient site on success rate of augmentation procedure has been less issued (16).
There are many different diseases that can affect our skeletal system and Osteoporosis is one of them. Osteoporosis lessens bone strength and bone density (amount of bone mineral in bone tissue), which will lead to fragile bones. It mainly affect the hips, ribs, spine, and wrists. Male or female, at any age, can get this but it is mostly occurs in older women (Team, 2016). Osteoporosis is very common, there are more than 3 million cases a year. There are many causes/risk factors, symptoms, and some treatment cases. About 54 million Americans have Osteoporosis and low bone mass (Foundation, 2016).
For this scope of this assignment a study in the surface modification of a titanium alloy stem, used in a hip joint implant is going to be studied. A total hip joint implant consists of an articulating bearing basically the femoral head and cup and the stem. The stem is made from titanium alloy - Ti- 6Al- 4V where titanium is alloyed with aluminium and vanadium. When titanium is alloyed with these materials excellent properties are achieved such as high strength-to-weight ratio and exceptional corrosion resistance.2 However, this alloy gives poor tribological properties and tends to seize when it is subjected to sliding motion due to its low hardness of 36HRC.3 Several surface modification techniques are done on ti...
Metal alloys and precious metals are also used to make certain aspects of a cochlear implant. The electrode arrays that provide electrical stimulation in order to excite neurons are made out of platinum because they have very high corrosion resistance, good biocompatibility, easier to work with than iridium and have low chemical reactivity. On the other hand, metallic alloys like titanium are used to make the casing for the receiver/stimulator. Titanium is suitable for such an application because it is a light material with high corrosion resistance and rigidity and these properties are essential for the material that is going to be used to make the casing (Stöverl and Lenarz, 2009).
Osteoporosis is a disease in which the bones become so weak and brittle that even a cough can cause enough stress on the bone that it will cause the bone to facture. The most commonly broken bones are the hip, wrist, and the spine. Although it affects men and women of all races, post-menopausal Caucasian and Asian women are more commonly affected than those of other ethnicities and sexes. In fact, thirty percent of all post-menopausal women in the US and Europe will be diagnosed with Osteoporosis and at least 40 percent of those will suffer from a fracture in their lifetime.
These kinds of polymers have both some advantages and disadvantages. Although they are bioactive and biodegradable and provide high comppressive strength, Degradation of such polymers leads to undesired tissue response due to producing acid formation in degradation process. Metallic scaffolds are another method for bone repair and regenaration. They provide high compressive strength and enormous permanent strength. Metallic scaffolds are mainly made of titanium and talium metals. The main disadvantages of metallic scaffolds are not biodegradable and also discharge metal ions. Recent studies in metallic scaffolds mainly focus on biodegradable materials which can be used improve bioactivity of metals such as titanium.
This Preusser (2008) case study involves a 75 year old female, S.P., who fell at home and is admitted to the orthopedic ward for an intracapsular fracture of the hip at the femoral neck (p. 183). Assessment data includes her height is 5’3”, weight is 118 lbs, blood pressure...
Due to such safety concerns, the manufacturers are facing device recalls for the device such as DePuy Synthes, Stryker, Smith &Nephew, Biomet and Zimmer [2]. As the knee surgery is most common now a day i.e. around 7 million of Americans are living with the surgery. Moreover, the regulatory issues with the devices are leading to the serious issues to the public health with the implantable device. Considering the regulatory aspects, the knee joint prostheses were the post-amendments device classified into class III under section 513(f)(2) of the act. After the petition submitted by Orthopedic Surgical Manufacturers Association (OSMA), the Panel recommended that this device can be reclassified from class III to class II at the public meeting
Lee, M. J. (2013). The patient protection and affordable care act: Better coverage, worse access. Will it really improve patient safety? The association of Bone and Joint Surgeon. Doi 10.1007/s11999-013-3315-x
Accidents and problems engendered in sweatshops have caught people’s attention and more people are trying to efface them. The Real Cost of Cheap Fashion states, “After the accident, many big brands pledged to improve garment factory conditions…. trained about 2 million workers in safety procedures…. hired engineers to inspect their factories.” This claim supports that enhancing garment factory conditions can give people some time off of work, can give people better tools, to make things go faster and easier, and could also, make sure people get paid more. Also, training people in safety procedures can make sure that things like the Triangle fire never happens again. Finally, having people inspect the factories can insure that people are safe, and procedures are set in place to make sure that if anything bad happens, people know what to do. Lastly, major companies are starting to realize the dangers of cobalt mining, and therefore, they are looking into how to fix, get rid of the dangers. New York Times Upfront says, “Some tech companies promised to reexamine their cobalt suppliers. Earlier this year, Apple announced that it had stopped buying cobalt mined by hand in the DRC until could verify that the element was being collected safely” This also shows that , by limiting their products using hand mined cobalt, they are limiting the cobalt mining jobs, which limits the dangers, and health concerns. As you can see, although many people’s lives lives are put in danger, many people have started to recognize it and are taking very serious action to try and fix
A primary care physician is one who has specialized education and training in general internal medicine, family practice, or another first-level-of-care area. Primary care physicians are those who provide patients with any/all of the following:
Since the beginning of time, man has attempted to avoid the inevitable. In his endless pursuit of perfection, man has tried to dodge the grim reaper. Death is certain; life is not. Yet through technological interventions, man is attempting to be godlike and live eternally. Through these same interventions, man is becoming transformed into a cyborg. Currently, the technology has not arrived so that a man will be able to have more metal in his body than he would have flesh. But if one could be a cyborg , if one could live longer, jump higher, store more info, and become more efficient would they? Would one become a cyborg if it meant no more pain, no more suffering, but in exchange would require thousands of dollars worth of hardware and hundreds of hours’ worth of surgery. Today I will explore some of the pros and cons of becoming a cyborg. I will also explore how people today like Stelarc have already taken steps and modified their own bodies to become cyborgs. I will also define some of the ethical and morals issues supporting and criticizing the transformation from flesh to metal, with the end result becoming a cyborg.