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ABSTRACT: Fractional resurfacing is gaining acceptance as a preferred method for skin resurfacing. Experience in treating photoaging, acne scars, and melasma is reviewed. 相似文献
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作为全髋置换术(THR)的一种替代技术,全髋表面置换术(THSR)通过保留股骨头、颈骨块而恢复髋关节正常的生物力学特性及关节的稳定性,并由于未破坏股骨髓腔结构而具有易翻修的潜力。在其发展长达半个多世纪的三个技术时期中,通过不断积累经验,使得假体系统在材料、设计及固定方法等技术参数方面获得长足改进。但仍存在尚待解决的问题。新一代金-金全髋表面假体系统的问世是髋关节置换术的一个重要历程碑,在不到10年的临床随访中其早期疗效非常满意,但中、长期疗效尚不确定,需待与其它方法作进一步长期的、随机化对照性研究。 相似文献
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《The Knee》2021
BackgroundWhile patellar resurfacing can affect patellofemoral kinematics, the effect on tibiofemoral kinematics is unknown. We hypothesized that patellar resurfacing would affect tibiofemoral kinematics during deep knee flexion due to biomechanical alteration of the extensor mechanism.MethodsWe performed cruciate-retaining TKA in fresh-frozen human cadaveric knees (N = 5) and recorded fluoroscopic kinematics during deep knee flexion before and after the patellar resurfacing. To simulate deep knee flexion, cadaver knees were tested on a dynamic, quadriceps-driven, closed-kinetic chain simulator based on the Oxford knee rig design under loads equivalent to stair climbing. To measure knee kinematics, a 2-dimensional to 3-dimensional fluoroscopic registration technique was used. Component rotation, varus-valgus angle, and anteroposterior translation of medial and lateral contact points of the femoral component relative to the tibial component were calculated over the range of flexion.ResultsThere were no significant differences in femoral component external rotation (before patellar resurfacing: 6.6 ± 2.3°, after patellar resurfacing: 7.2 ± 1.8°, p = 0.36), and less than 1° difference in femorotibial varus-valgus angle between patellar resurfacing and non-resurfacing (p = 0.01). For both conditions, the medial and lateral femorotibial contact points moved posteriorly from 0° to 30° of flexion, but not beyond 30° of flexion. At 10° of flexion, after patellar resurfacing, the medial contact point was more anteriorly located than before patellar resurfacing.ConclusionDespite the potential for alteration of the knee extensor biomechanics, patellar resurfacing had minimal effect on tibiofemoral kinematics. Patellar resurfacing, if performed adequately, is unlikely to affect postoperative knee function. 相似文献
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Brian Darrith Nicholas B. Frisch Matthew W. Tetreault Michael P. Fice Chris N. Culvern Craig J. Della Valle 《The Journal of arthroplasty》2019,34(2):221-227
Background
Although some prior work supports the safety of same-day arthroplasty performed in a hospital, concerns remain when these procedures are performed in a free-standing ambulatory surgery center. The purpose of this study is to compare 90-day complication rates between matched cohorts that underwent inpatient vs outpatient arthroplasty at an ambulatory surgery center.Methods
A single-surgeon cohort of 243 consecutive patients who underwent outpatient arthroplasty was matched with 243 inpatients who had the same procedure. One-to-one nearest-neighbor matching with respect to gender, age, American Society of Anesthesiologists Score, and body mass index was utilized. The 486 primary arthroplasties included 178 unicondylar knees (36.6%), 146 total hips (30.0%), 92 total knees (18.9%), and 70 hip resurfacings (14.5%). Ninety-day outcomes including reoperation, readmission, unplanned clinic or emergency department visits, and major and minor complications were compared using a 2-sample proportions test.Results
The 2 cohorts were similar in distribution of demographic variables, demonstrating successful matching. The inpatient and outpatient cohorts both had readmission rates of 2.1% (P = 1.0). With the number of subjects studied, there were no statistically significant differences in rates of major complications (2.1% vs 2.5%, P = 1.0), minor complications (7.0% vs 7.8%, P = .86), reoperations (0.4% vs 2.1%, P = .22), emergency department visits (1.6% vs 2.5%, P = .52), or unplanned clinic visits (3.3% vs 5.8%, P = .19).Conclusion
This study suggests that arthroplasty procedures can be performed safely in an ambulatory surgery center among appropriately selected patients without an increased risk of complications. 相似文献9.
We reviewed 148 consecutive hip resurfacings in order to assess the clinical outcomes of the BHR at midterm follow-up and to compare the accuracy of the navigation in the positioning of femoral component. We retrospectively analyzed 85 hips using the conventional jig to implant the femoral component and we prospectively followed 63 hips operated on by navigation. At a mean follow-up of 50.54 months, the Harris hip score improved significantly from 44.66 preoperatively to 98.45 postoperatively without any differences between the groups. Radiologically, we classic navigated group. Our clinical outcomes are excellent at midterm follow-up and the navigation definitely improves the implant position in both planes. 相似文献
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