Search

Unlabelled: The outcome of isolated patellar component revisions after metal-backed patellar failure is variable with satisfactory results reported from 78% to 100%. To supplement information in the literature we determined the failure rate and the functional outcome based on the Knee Society clinical and roentgenographic evaluation systems of isolated patellar component revisions after metal-backed patellar component failure. We retrospectively reviewed 27 patients with 28 isolated patellar component revisions for metal-backed patellar component failure performed between 1988 and 2005. Twenty-five knees in 24 patients were available for review with a minimum followup of 24 months (mean, 90 months; range, 24-210 months). All knees were revised with a cemented all-polyethylene patellar component and all tibial polyethylene components were routinely exchanged. One failure (4%) occurred 122.6 months after the isolated patellar component revision secondary to femoral and tibial component loosening. The average Knee Society knee score improved from 73 to 89 points, whereas the average Knee Society function score improved from 56 to 65. Our data confirm those in the literature suggesting a successful outcome can be achieved with an isolated patellar component revision for metal-backed patellar component failure.Level Of Evidence: Level IV, retrospective case series. See the Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Inhibitors of specific tyrosine kinases are attractive lead compounds for development of targeted chemotherapies for many tumors, including osteosarcoma. We asked whether inhibition of specific tyrosine kinases would decrease the motility, colony formation, and/or invasiveness by human osteosarcoma cell lines (TE85, MNNG, 143B, SAOS-2, LM-7). An EGF-R inhibitor reduced motility of all five cell lines by 50% to 80%. In contrast, an IGF-1R inhibitor preferentially reduced motility by 42% in LM-7 cells and a met inhibitor preferentially reduced motility by 80% in MNNG cells. The inhibitors of EGF-R, IGF-1R, and met reduced colony formation by more than 80% in all tested cell lines (TE85, MNNG, 143B). The EGF-R inhibitor reduced invasiveness by 62% in 143B cells. The JAK inhibitor increased motility of SAOS-2 and LM7 cells without affecting colony formation or invasiveness. Inhibitors of HER-2, NGF-R, and PDGF-Rs did not affect motility, invasiveness, or colony formation. These results support the hypothesis that specific tyrosine kinases regulate tumorigenesis and/or metastasis in osteosarcoma. [ABSTRACT FROM AUTHOR]

Introduction: Patients with right bundle branch block (RBBB) are controversial candidates for cardiac resynchronization therapy (CRT). Systolic stretch index (SSI) is a novel marker developed by computer modeling that may identify concealed left ventricular delay in RBBB patients who may respond to CRT. Hypothesis: We hypothesized that SSI can discriminate a patient subgroup with RBBB responsive to CRT. Methods: From 3 centers, we studied 109 heart failure patients with RBBB morphology, ejection fraction < or= 35%, and QRS width ≥120 ms who underwent CRT. SSI was assessed pre-CRT using speckle tracking strain from the apical 4-chamber view. SSI was calculated as (% lateral pre-stretch + % septal rebound stretch). The primary predefined outcome variable was all-cause death, heart transplant or left ventricular (LV) assist device. Results: There were 93 patients, after excluding 11 patients due to inadequate strain imaging or uncertainty of RBBB. Median SSI was 1.8% (0.0% - 11.2%). Patients with high SSI (>1.8%: n = 45) had very similar patient characteristics to those with low SSI (n = 48); there was no significant difference in age, gender, the prevalence of ischemic etiology, QRS duration, and conventional LV volumes and ejection fraction. Global longitudinal strain was also similar between groups (7.7 ± 2.6% vs. 7.0 ± 2.8%, p = 0.19). Kaplan-Meier analysis revealed that RBBB patients with high SSI had significantly better event-free rate (p = 0.032). Multivariate analysis showed SSI was predictive (hazard ratio 2.1 per %, p = 0.030) even after adjusted for covariates including QRS duration and global longitudinal strain. Conclusions: RBBB patients with high SSI indicative of concealed LV electrical delay have potential to respond to CRT. SSI was significantly and independently associated with clinical outcome after CRT. This pilot study suggests that SSI may be useful to identify RBBB patients responsive to CRT and future study is warranted. [ABSTRACT FROM AUTHOR]

A response from the authors of the article "Hip Resurfacing Does Not Improve Proprioception Compared With THA" in a 2013 issue is presented.