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ABSTRACTObjectiveBreaking has gained public attention as a form of sports activity. The associated intense movements of the hip joints are possibly linked to the development of femoroacetabular impingement (FAI). Therefore, this study aimed to assess clinical and radiographic FAI measures in professional breakers compared to hobby athletes.MethodsThe study cohort consisted of professional breakers with persisting hip pain who were 1:1 matched to a cohort of FAI patients without professional sports careers from our outpatient clinic. The primary endpoint assessed on standardized plain radiographs was the alpha angle (AA). Further measures were the acetabular index (AI), lateral center-edge angle (LCEA), crossover sign, ischial spine sign, and femoral head extrusion index (FHEI). The modified Harris Hip Score (mHHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were used to obtain patient-reported measures.ResultsWe recruited ten professional breakers and matched them to ten hobby athletes. The median AA was significantly higher in the breakers compared with the hobby athletes (73° [IQR 66.5°, 84.2°]) vs. 61.8° [IQR 59.5°, 64.8°], p = 0.0004). There was a significant reduction in weekly training hours in breakers after diagnosis (13.0 hours [interquartile range [IQR] 9.5, 32.4] to 1.5 hours [IQR 0, 4.8], p = 0.0039). There were no inter-group differences regarding mHHS, WOMAC, and additional radiographic measurements.ConclusionBreakers have higher AA in cam-type FAI compared to nonprofessional athletes. The corresponding hip pain significantly reduced training hours and caused the end of their breaking career. The potentially high prevalence of FAI in breakers and the corresponding consequences need to be considered early when athletes present with hip pain.

Background: Periacetabular osteotomy (PAO) has become a popular procedure for re-orientation of the acetabulum in patients with a developmental pathomorphology. Since its first description by Reinhold Ganz in 1988, many institutions worldwide have adopted the procedure for the treatment of developmental hip dysplasia (DDH) and have subsequently reported their results. The aim of this study was to provide a meta-analysis of the likelihood of long-term survival of a dysplastic hip after PAO.Methods: A systematic literature review was conducted using Medline, Cochrane and “Web of Science” databases to identify articles reporting survival estimates for PAO in patients with DDH. To be included in the analysis, studies had to include patient cohorts aged <40 years, with Osteoarthritis grade < Tönnis III and no form of neuromuscular dysplasia. Adjustment for cohort overlap was performed. Quality assessment included level of evidence (LOE) according to the oxford center for LOE criteria and the “Methodological index for non-randomized studies (MINORS)”. After data extraction, a random-effects meta-analytical model was applied to provide weighted mean estimates of survival at 5 years, 10 years, 15 years and 20 years.Results: Nine relevant articles included 2268 dysplastic hips that underwent PAO in 9 institutions. Of the included studies, 5 presented level III evidence and 4 presented level IV evidence. The MINORS score was 11 for 3 studies, 12 for 4 studies and 13 for 2 studies. The 5-year survival after PAO was 96.1% (95% CI, 94.9–97.3), the 10-year survival was 91.3% (95% CI, 87.7–94.8), 15-year survival 85.0% (95% CI, 78.9–91.1), 20-year survival 67.6% (95% CI, 53.9–81.3).Conclusions: The results provide a representative survival estimate of a dysplastic hip after PAO based on global evidence. This should provide clinicians and patients with an adequate reflection of prognostic expectations after this kind of surgery.

Study Design: Retrospective comparative study.Objectives: To assess the effect of vertebral body lavage (VBL) on (1) systemic blood pressure, (2) heart rate, and (3) oxygen saturation following cement augmentation procedures for acute vertebral compression fractures (VCFs).Methods: A total of 145 consecutive patients undergoing cement augmentation for acute VCF (mean age 74 ± 12 years, age range 42-96 years; 70% female; 475 levels treated) were allocated to the “lavage group” (n = 61 patients; VBL prior to cement application) and to the “control group” (n = 84 patients, no VBL). Mean arterial blood pressure (MAP), heart rate, and oxygen saturation were monitored immediately prior and 3 minutes after cement injection. Logistic regression analysis was performed with ΔMAP ≥10 mm Hg before and after cement injection as the dependent outcome variable and demographic, radiographic, and procedural factors as independent variables.Results: MAP decreased by mean 3 ± 7.3 mm Hg before and after cement injection in the “lavage group” and 9 ± 10.5 mmHg in the control group (P< .001). There were no significant differences in terms of heart rate and oxygen saturation before and after cement application within each group, or between the 2 groups. Multivariate logistic regression analyses revealed VBL as an independent factor influencing MAP (adjusted odds ratio: 3.49 [confidence interval, 1.16-10.50], P= .03).Conclusion: VBL prior to cement augmentation procedures reduces the hemodynamic response, most likely resulting from decreased amounts of bone marrow substance displaced into the circulation thereby decreasing the risk of pulmonary fat embolism syndrome.

Background The aim of this study was to identify the 100 most cited classics in the field of hip research analysing their qualities and characteristics.Methods Hip joint related articles were identified and the hundred most cited selected for subsequent analysis of citation count, current citation rate, citation density (citations/article age), authorship, geographic origin institution, and level of evidence (LOE).Results In a total of 121 journals, 1,311,851 articles were published between 1945 and 2013, of which 1,287 (0.1%) possessed 250 citations or more. Total citations per article for the 100 most-cited ranged from 290 to 3,144 citations. The most common areas of research were degenerative disease and arthroplasty, followed by hip preserving surgery for which the leading authors were William H. Harris and Reinhold Ganz respectively. All articles were published in 8 journals and originated from 9 countries. 10 institutes published 48/100 of the articles. There was a significant negative correlation between both citation rate, citation density and article age. Total citation count was highest for articles published in the decade of 1970. Although 5% (2,103 articles) of hip literature comprised randomised trials (RCTs), only 1 (1%) of the citation classics was an RCT.Conclusions The study provides intellectual milestones in hip research, reflecting on the qualities and characteristics of the research. Degenerative hip disease and arthroplasty research take up the greatest proportion of citations, followed by hip preserving research. LOE was low and there was only one RCT amongst the classics, emphasising that high LOE is not a prerequisite for a high citation count.

This paper presents a model of electro-viscosity considering effects of electric double layer on thin film lubrication with partial slip. The apparent viscosity and modified Reynolds equation are derived with consideration of electric double layer with partial slip. The apparent viscosity includes the combined effects of the electro-viscosity, the viscosity of bulk fluid and slip length. The electro-viscosity depends on the zeta potential. The effects of electric double layer with partial boundary slip on load capacity are analyzed for one-dimensional slider bearing. The electric double layer leads to an increase in apparent viscosity of lubricant and hence load capacity in thin film lubrication. Electric double layer with partial slip on parallel bearing surfaces increases the bearing load capacity.

•Gender trends in authorship showed an increase in female authors from 1976 to 2020.•In 2020, Europe had the highest and Asia the lowest proportion of female authors.•The Netherlands had the highest proportion of women and Japan the lowest.

We optimized photocatalytic hydrogen production over TiO2-based photocatalyst by varying the dopant (nickel and copper oxide), thin film active area, nature and concentration of sacrificial agents, and light intensity in a photoelectrochemical (PEC) cell/dye-sensitized solar cell (DSSC). Various characterization techniques have been used to investigate the structural, morphological, optical, and PEC behavior of single and codoped TiO2. The TiO2decorated with both Cu and Ni oxides with active area of 1 cm2in a mixture of 5 vol % glycerol and 1 M KOH under light intensity of 100 mWcm−2produced the maximum hydrogen of 338.4 μmol cm−2for 2 h. The superior photocatalyst performance of this photocatalyst is attributed to its small crystallite size and large pore size, as confirmed by X-ray diffractometer, Transmission electron microscopy (TEM), and surface area of Brunauer-Emmet-Teller (SBET). The absorption edges of this photocatalyst had the highest red shift compared with single doped and pure TiO2because of more indirect transitions of the photoexcited electrons, greater charge carrier separation, and lower recombination rate. The photoanode active area of 1 cm2with better photocatalytic performance correlated with the number of defects and grain boundaries. Glycerol shifted the conduction band of the photocatalyst to more negative flat potential compared with others. Increasing the concentration of glycerol further than 5 vol% saturated the photocatalyst active sites, increased photooxidation intermediates of glycerol, and reduced the hydrogen production. The light intensity had the maximum impact on the hydrogen production and could strongly control the number of charge carriers in both the PEC cell and the DSSC.

With the development of hip arthroscopy (HA), a shift away from surgical hip dislocation(SHD) is becoming a noticeable reality. It was the aim of this study to examine whether SHD provides a benefit over HA regarding its corrective power in the treatment of femoroacetabular impingement (FAI).

Prosthetic joint infection(PJI) is deemed to be the most serious complication following total hip arthroplasty. Obesity and smoking are known risk factors for PJI. However, the influence of these variables on infection free survival, of septic revision hip arthroplasty, is yet to be explored. The aim of this study was to determine the effect of obesity and smoking on the outcome of two-stage prosthetic exchange surgery.