19 results on '"Clinical failure"'
Search Results
2. S0358 Role of Endoscopic Functional Luminal Imaging Probe (EndoFLIP) for the Management of Post Myotomy Clinical Failure
- Author
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Andrew Canakis, Yervant Ichkhanian, Rishi Pawa, Kenneth L. Koch, Mouen A. Khashab, Michael B. Ujiki, Robert Dorrell, Sabine Roman, Bailey Su, and In Kyung Yoo
- Subjects
Myotomy ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Medicine ,Clinical failure ,business ,Surgery - Published
- 2020
3. Abstract WP339: Herniation Despite Decompressive Hemicraniectomy in Large Hemispherical Ischemic Stroke Patients
- Author
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Dongxia Feng, Rohan Samant, Yousef Hannawi, and Archana Hinduja
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Decompressive hemicraniectomy ,Decompression ,business.industry ,medicine.disease ,Surgery ,Ischemic stroke ,Medicine ,Neurology (clinical) ,Clinical failure ,Cardiology and Cardiovascular Medicine ,business ,Stroke - Abstract
Background: Despite timely decompressive hemicraniectomy (DHC), clinical failure or progressive herniation requiring a second decompression procedure and mortality has been reported in acute middle cerebral artery (MCA) strokes. Hypothesis: Our objective was to determine the stroke and surgical parameters measured on head CT scan that are associated with progressive herniation despite DHC in patients with large hemispheric MCA strokes. Methods: Retrospective chart review of all medical records and imaging features of patients with malignant hemispheric infarction who underwent DHC for cerebral edema from July 2010 to June 2015, was performed. Patients who died from postoperative hemorrhagic complications were excluded. Infarct volume was calculated using ABC/2 method on CT scans within 48 hours of symptom onset (Kostov et al, 2012, World Neurosurg). Radiologic parameters of the craniectomy bone flap (length, width, area) and brain volume protruding out of the skull (height and volume) were measured (Chung et al, 2011, Neurologist). Images were reviewed by a board certified neuroradiologist to determine whether the craniectomy bed was sufficiently centered on the stroke bed (Zweckberger et al, 2014, Cerebrovasc Dis) and the brain volume not included in the craniectomy bed. Groups were compared using Fisher exact test for categorical variables and T-test or Mann-Whitney U test for continuous variables, as appropriate. Results: Out of 41 patients who underwent DHC for cerebral edema (mean age 53.1 ±12, 48.7% females, 36.5% African Americans) 7 had progressive herniation leading to mortality. Radiographic parameters that were significantly different between both groups were presence of malignant edema (p=0.047), insufficient centering of the craniectomy bed on the stroke bed (p=0.03), large infarct volume not centered on the craniectomy bed (p=0.011), presence of anterior cerebral artery infarction (p=0.047), and smaller craniectomy length (p=0.05). There was a trend in protruding brain volume (p=0.056). Conclusion: Besides the craniectomy length, sufficient centering of the craniectomy over the stroke bed may be required to prevent progressive herniation.
- Published
- 2017
4. PS1249 EXTRANODAL AND SPLEEN DISEASE DETECTED BY FDG-PET/CT IS ASSOCIATED WITH EARLY CLINICAL FAILURE IN UNTREATED FOLLICULAR LYMPHOMA
- Author
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Betsy LaPlant, Carrie A. Thompson, Ivana N. Micallef, Stephen M. Broski, S. M. Ansell, G.S. Nowakowski, T. E. Witzig, Thomas M. Habermann, Matthew J. Maurer, William R. Macon, Kay M. Ristow, and Frederique St-Pierre
- Subjects
Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,medicine ,Follicular lymphoma ,Spleen ,Fdg pet ct ,Hematology ,Disease ,Clinical failure ,business ,medicine.disease - Published
- 2019
5. MP74-09 P2PSA AND DERIVATIVES (%P2PSA AND PHI) ACCURATELY PREDICT PROSTATE CANCER IN OBESE MEN FROM A MULTICENTER PROSPECTIVE EUROPEAN STUDY
- Author
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Massimo Lazzeri, Giuliana Lista, Joan Palou Redorta, Ella Kinzikeeva, Markus Graefen, Giovanni Lughezzani, Nicolò Maria Buffi, Giulio Maria Gadda, Massimo Freschi, Nicola Fossati, Thomas McNicholas, Alessandro Larcher, Francesco A. Mistretta, Alberto Abrate, Paolo Dell'Oglio, Giorgio Guazzoni, Alexander Haese, Vittorio Bini, and Alexandre de la Taille
- Subjects
medicine.medical_specialty ,business.industry ,Prostatectomy ,Urology ,medicine.medical_treatment ,Therapeutic effect ,Salvage therapy ,medicine.disease ,Surgery ,Androgen deprivation therapy ,Prostate cancer ,Clinical recurrence ,Medicine ,Clinical failure ,business - Abstract
be a more robust determinant of patient outcome compared with the American Society for Therapeutic Radiology and Oncology (ASTRO) definition (three consecutive increases of PSA). However, the Phoenix definition is not suitable for comparing BF of BT and that of radical prostatectomy (RP) because BF after RP is diagnosed when PSA >0.2ng/mL and a large portion of the patients undergo salvage therapy before PSA reaches 2.0 ng/mL. The objective of this study is to compare a new definition of BF, PSA>0.2ng/mL with three consecutive increases (NTMC definition), with the Phoenix definition and the ASTRO definition. METHODS: A total of 1442 patients with clinically localized PCa were treated with BT between September 2003 and October 2010 at our institution, and followed at least 36 months (22 to 118, median 70.0 months). The patients were treated with seed implantation using I-125 with or without EBRT combination. The patients may have neoadjuvant androgen deprivation therapy (ADT), but ADT after BT was not performed in any of the cases before the diagnosis of disease recurrence. Sesitivity and specificity of each definition are calculated and compared. True failure is confirmed by clinical failure. Possible failure (PF) is defined as rising PSA toward the end of observation without clear evidence of clinical recurrence. There were 46 PF cases and they were excluded from the study. RESULTS: Sensitivity and specificity of the Phoenix, the ASTRO, and our definition are shown in a table. NTMC definition showed much higher sensitivity and slightly lower specificity compared to the Phoenix definition. NTMC definition had similar sensitivity and higher specificity to the ASTRO definition. Neoadjuvant ADT lowered sensitivity of the Phoenix definition, and raised specificity of the Phoenix and our definition. CONCLUSIONS: NTMC definition of BF after BT such as PSA>0.2ng/mL with three consecutive increases showed sufficiently high sensitivity and specificity. The definition is useful especially the cases with neoadjuvant ADT, or when comparing therapeutic effect of BT and RP.
- Published
- 2014
6. Transcutaneous Monitoring of Carbon Dioxide Tension After Cardiothoracic Surgery in Infants and Children
- Author
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Joseph D. Tobias, Wilson Wr, and Meyer Dj
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Cardiovascular Surgical Procedures ,Infant, Newborn ,Infant ,Blood gas monitoring ,Thoracic Surgical Procedures ,Co2 monitoring ,Anesthesiology and Pain Medicine ,Cardiothoracic surgery ,Child, Preschool ,Recien nacido ,Anesthesia ,Humans ,Regression Analysis ,Medicine ,Female ,Postoperative Period ,Prospective Studies ,Clinical failure ,Child ,business ,Prospective cohort study ,Blood Gas Monitoring, Transcutaneous - Abstract
In this prospective investigation, we evaluated the efficacy and accuracy of transcutaneous monitoring of CO2 (TC-CO2) in infants and children after cardiothoracic surgery. Cardiothoracic surgery patients whose ETCO2 and arterial CO2 values did not correlate (gradientor = 5 mm Hg) during the first postoperative hour underwent placement of the TC electrode (30 of 33 patients). If the TC-CO2 to arterial difference wasor = 5 mm Hg, the TC-CO2 electrode was recalibrated and reapplied on another site. If the discrepancy was stillor =5 mm Hg, the case was considered a clinical failure and no further data were collected (3 of 30 patients). If the arterial to TC gradient was5 mm Hg, the patient was included in the data collection (27 of 30 patients). One to five sample sets (TC and arterial CO2) were collected from these patients. Statistical analysis included linear regression analysis and Bland-Altman analysis. The cohort for the study included 27 patients ranging in age from 2 days to 9 yr and in weight from 3.2 to 25 kg. A total of 101 sample sets were analyzed. The mean +/- SD absolute difference between the TC-CO2 and arterial CO2 was 1.7 +/- 1.4 mm Hg (range 0-9 mm Hg). The TC-CO2 to arterial CO2 difference was 0-2 mm Hg in 82 of 101 values (81%), 35 mm Hg in 18 of 101 values (18%), and6 mm Hg in 1 of 101 values (1%). Linear regression analysis revealed a slope of 0.90, an r value of 0.9410, and an r2 value of 0.8854 (P0.0001). Bland-Altman analysis revealed a bias of 0.58 mm Hg with a precision of +/- 2.1 mm Hg when comparing the TC-CO2 with the arterial CO2.We conclude that, with certain caveats in mind, including the need to correlate the transcutaneous CO2 with an initial arterial CO2 value, transcutaneous CO2 monitoring can be used to estimate arterial CO2 in most neonates and children after cardiothoracic surgery.
- Published
- 1999
7. Vergence Facility: Establishing Clinical Utility
- Author
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Bruce Wick, Harold E. Bedell, and Ronald Gall
- Subjects
Adult ,Male ,Cycles per minute ,Adolescent ,genetic structures ,Vision Disorders ,Snellen acuity ,Vision disorder ,Predictive Value of Tests ,Reference Values ,medicine ,Humans ,Computer vision ,Clinical failure ,Vision, Binocular ,business.industry ,Vision Tests ,Reproducibility of Results ,Fusional vergence ,Equipment Design ,Convergence, Ocular ,Control subjects ,Ophthalmology ,Optometry ,Female ,Artificial intelligence ,Prism ,medicine.symptom ,business ,Psychology ,Binocular vision - Abstract
Purpose Vergence facility testing attempts to assess the ability of the fusional vergence system to respond rapidly and accurately to changing vergence demands over time [defined as the number of cycles per minute (cpm) that a stimulus can be fused through, alternating base-in (BI) and base-out (BO) prisms]. Decisions to use vergence facility as a clinical test are hampered by a lack of systematically gathered normative data. Methods Twenty symptomatic and 20 control subjects with ages between 18 to 35 years of either sex and any race were pooled, based on vision-symptom level determined by a self-report questionnaire. Inclusion/exclusion criteria included vision correctable to 6/6 (20/20) Snellen acuity or better in each eye and normal phorias. Vergence facility response was tested over a 1-min period, using 16 combinations of BI/BO flip prisms at 4.0 and 0.4 m, based on Morgan's norms and pilot data. Results Horizontal vergence facility responses were not the same among those with and without symptoms, and not all magnitudes of BI/BO flip prisms produced the same response difference. A single flip prism, 3 delta BI/12 delta BO, was found to differentiate optimally between groups at distance and near. Repeatability of test results (with the 3 delta BI/12 delta BO prism) was poor at distance and good at near. Conclusions In addition to providing valuable normative data, this study indicates that the vergence system nearly resets its "zero point" at any distance and sheds further light on the results of dynamic convergence and divergence stimulation on the accommodative-vergence system. From a clinical standpoint, the results improve the diagnosis of binocular vision abnormalities. The recommended near vergence facility test is easily implemented, using a commonly available flip prism (3 delta BI/12 delta BO) and having a clinical failure criterion that is easily recalled (15 cpm, sum of the BI and BO magnitudes).
- Published
- 1998
8. 2226 LET-7B IS DOWN-REGULATED IN HIGH RISK PROSTATE CANCER AND AN INDEPENDENT PREDICTOR FOR CLINICAL FAILURE
- Author
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Hubertus Riedmiller, Pia Bader, Claus Juergen Scholz, Hein Van Poppel, Detlef Frohneberg, Burkhard Kneitz, Susanne Kneitz, Steven Joniau, M. Schubert, and Martin Spahn
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Psa density ,Mean age ,Independent predictor ,medicine.disease ,Mean difference ,Prostate cancer ,medicine.anatomical_structure ,Prostate ,Internal medicine ,Medicine ,In patient ,Clinical failure ,business - Abstract
groups there were significant differences in mean age (50.0i3⁄49.7yr (MS) vs. 48.9i3⁄49.4yr (C), p 0.001), prostate volume (33.0i3⁄49.9cm3 (MS) vs. 30.4i3⁄49.6cm3 (C), p 0.001) and PSA (1.004i3⁄40.727ng/ml (MS) vs. 1.037i3⁄40.753ng/ml (C), p 0.004). The mean difference in PSA between groups was 0.33ng/ml. After adjusting for age, prostate volume was still significantly larger in group MS than group C (difference (D) 2.21cm3, p 0.001), and the difference in PSA between groups increased to -0.047 ng/ml (CI 0.069 0.025, p 0.001). Group MS had lower age-adjusted PSA density than group C (difference 0.0061ng/ml/cm3 (CI 0.0085 0.0037)). On linear regression analysis, age, prostate volume and MS were significant independent factors that influence PSA level. PSA increased with age (0.009ng/ml/yr CI 0.005 0.009) and prostate volume (0.030ng/ml/cc CI 0.026 0.033), but decreased with MS (difference 0.180ng/ml, CI 0.260 0.101). CONCLUSIONS: Patients with MS have larger prostate volumes and lower PSA levels than patients without MS. Larger prostate volumes in patients with MS hide the PSA lowering effect of MS. These results may be helpful for consultation of PSA results on patients with MS.
- Published
- 2012
9. Early and late loosening of the acetabular cup after low-friction arthroplasty
- Author
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Eduardo Garcia-Cimbrelo and L. Munuera
- Subjects
musculoskeletal diseases ,Average duration ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Acetabular fracture ,General Medicine ,Low friction ,musculoskeletal system ,equipment and supplies ,medicine.disease ,Acetabulum ,Arthroplasty ,Prosthesis ,Surgery ,surgical procedures, operative ,medicine ,Orthopedics and Sports Medicine ,Clinical failure ,business - Abstract
Between 1971 and 1979, 680 low-friction arthroplasties of the hip were performed in 598 patients. The average duration of follow-up was twelve years and eight months. Sixty-one acetabular cups had loosening as seen on roentgenograms eighteen years postoperatively, resulting in a total cumulative probability of loosening of 19 per cent, according to survivorship analysis. In twenty-nine cups, the loosening appeared within ten years after the operation (early loosening) and in thirty-two, more than ten years after the operation (late loosening). Early loosening was associated with deficient structure of the bone of the acetabulum, a previous congenital dislocation of the hip, acetabular fracture, or acetabular protrusion in all instances (p < 0.01). Late loosening was associated with the depth of acetabular wear. Of the thirty-two cups that had more than two millimeters of wear, eighteen (56 per cent) had loosening on the roentgenograms (p < 0.001). In hips that had early loosening, migration was the most frequent finding, and its rate of progression was higher than in hips that had late loosening (p < 0.001). In late loosening, a complete bone-cement radiolucency of more than two millimeters was the most frequent finding. Clinical failure was seen in twenty-two (76 per cent) of the twenty-nine cups that loosened early and in nine (28 per cent) of the thirty-two cups that loosened late. The probability of extensive resorption of bone necessitates close observation of patients who have early loosening, while a reasonable period of observation is possible for those who have late loosening.
- Published
- 1992
10. 1136: Which Definition of Biochemical Failure after Post-Operative Radiotherapy Predicts Best for Clinical Failure? A Multi-Institutional Analysis
- Author
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Deborah A. Kuban, Howard M. Sandler, Theodore L. DeWeese, Jeff M. Michalski, Alexandra L. Hanlon, Patrick A. Kupelian, Thomas M. Pisansky, Larry L. Kestin, Richard K. Valicenti, Charles Catton, Micfulel J. Zelefsky, and Alan Pollack
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Biochemical failure ,medicine ,Institutional analysis ,Clinical failure ,Intensive care medicine ,business ,Post operative radiotherapy - Published
- 2005
11. Angiographic embolization for upper gastrointestinal bleeding: predictors of clinical failure
- Author
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Frank C. Lynch, Heidi L. Frankel, Robert N. Cooney, Kazuhide Matsushima, and Jessica A. Lundgren
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Radiology ,Upper gastrointestinal bleeding ,Clinical failure ,Angiographic embolization ,medicine.disease ,business - Published
- 2010
12. CORRELATION OF BIOCHEMICAL EVENTS AND CLINICAL FAILURE FOLLOWING HIGH INTENSITY FOCUSED ULTRASOUND OF THE PROSTATE: THE STUTTGART DEFINTION
- Author
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Stefan Thueroff, Giario Conti, Andreas Blana, James A. Eastham, Cary N. Robertson, Roman Ganzer, F.J. Murat, John C. Rewcastle, Xavier Rebillard, John F. Ward, Stephen C.W. Brown, Christian Chaussy, and Albert Gelet
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Prostate ,Urology ,medicine.medical_treatment ,Medicine ,Stuttgart ,Radiology ,Clinical failure ,business ,High-intensity focused ultrasound - Published
- 2009
13. The Effects of Shelf Life on Clinical Outcome for Gamma Sterilized Polyethylene Tibial Components
- Author
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A. S. Greenwald, Jennifer Bohl, Paul Postak, and William Bohl
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,General Medicine ,Shelf life ,Prosthesis ,Surgery ,Orthopedic surgery ,Medicine ,Orthopedics and Sports Medicine ,Implant ,Femoral component ,Clinical failure ,business ,Survival rate ,Gamma irradiation - Abstract
Tibial component shelf life was examined as a contributory factor of the in vivo failure of gamma sterilized prosthetic knee replacements. One hundred eighty-eight Synatomic total knee replacements sterilized by gamma irradiation in air were implanted by one surgeon into 147 patients between May 1985 and December 1994. Of these, 135 knees in 105 patients with a mean followup of 5.8 years (range, 2.1-11.3 years) were included in the study. The mean shelf life of the implants was 3.6 years (range, 0.1-10.7 years). Clinical failure for this study was defined as component retrieval resulting from polyethylene degradation. The knee components were divided into three different groups determined by their shelf storage durations of 0 to 4 years (Group 1, 93 components), between 4 and 8 years (Group 2, 21 components), or greater than 8 to 11 years (Group 3, 21 components). Six prostheses were revised because of polyethylene degradation after a mean implantation time of 2.5 years (range, 1.1-3.8 years). The mean shelf life of these six prostheses was 8.4 years (range, 5.8-9.6 years). Five years after implantation, prostheses that had shelf lives of less than 4 years had a 100% survival rate. Those that had shelf lives of 4 to 8 years before implantation had an 88.6% survival rate, and those prostheses that had shelf lives greater than 8 to 11 years had a 79.2 % survival rate.
- Published
- 1999
14. Cemented Acetabular Reconstruction With the M$uUller Support Ring
- Author
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Patrick Haentjens, P. Opdecam, F. Handelberg, Casteleyn Pp, and H. De Boeck
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,business.industry ,Radiography ,Acetabular reconstruction ,medicine.medical_treatment ,Follow up studies ,Dentistry ,General Medicine ,Acetabulum ,Prosthesis ,Surgery ,Clinical investigation ,Medicine ,Orthopedic fixation devices ,Orthopedics and Sports Medicine ,Clinical failure ,business - Abstract
In a previous study, the results of cemented acetabular reconstruction with a Muller support ring were reported after a mean follow-up period of 40 months. The current report concerns a minimum five-year follow-up study of the same 43 patients. Two early failures at four months and at 17 months were related to poor surgical technique. The latest overall functional results, according to the Merle d'Aubigne rating scale, were excellent, very good, or good in 81.82% of the hips: a drop from 86.67% since the previous report. Sequential roentgenographic analysis demonstrated a high incidence of nonprogressive radiolucencies at the cement-bone interface. These nonprogressive radiolucencies did not correlate with the overall functional results. The progression of a radiolucency at the cement-bone interface, however, or the appearance of radiolucencies around the screw threads, always resulted in clinical failure.
- Published
- 1993
15. Surgical Stabilization of Thoracic and Lumbar Spine Fractures
- Author
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Markus Kornberg, Theodore E. DuPuy, Glenn R. Rechtine, Charles M. Reinert, and William A. Herndon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Radiography ,Bone Screws ,Population ,Bone healing ,Critical Care and Intensive Care Medicine ,Thoracic Vertebrae ,Military medicine ,Fractures, Bone ,Postoperative Complications ,Fracture Fixation ,Fracture fixation ,Humans ,Medicine ,Kyphosis ,Clinical failure ,Military Medicine ,education ,education.field_of_study ,Braces ,Lumbar Vertebrae ,business.industry ,Retrospective cohort study ,Middle Aged ,Surgery ,Female ,Lumbar spine ,business - Abstract
Twenty-two patients underwent surgical stabilization of thoracic and lumbar spine fractures. Twenty patients were operated on within 4 weeks of the injury and two patients more than 1 year following injury. Harrington rods were used in 21 and Dwyer instrumentation in one. The presenting neurological deficits were: four complete, five incomplete, and 13 intact. Clinical failure was noted in four patients, two of whom underwent posterior instrumentation more than 1 year following the initial injury. The most important contributing factor to failure was use of instrumentation in deviation from standard practice. The aim of operative treatment to maintain fracture reduction, decompress neural elements, promote fracture healing, and shorten hospitalization was achieved.
- Published
- 1984
16. Herbert total knee prosthesis
- Author
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David G. Murray, David A. Foster, AH Wilde, and Frederick W. Werner
- Subjects
musculoskeletal diseases ,Orthodontics ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Knee replacement ,General Medicine ,musculoskeletal system ,Prosthesis ,Laboratory testing ,Total knee ,Design characteristics ,Surgery ,Knee simulator ,Knee prosthesis ,medicine ,Orthopedics and Sports Medicine ,Clinical failure ,business ,human activities - Abstract
We tested the Herbert knee prosthesis, which was designed to restore intrinsic stability with limited degrees of freedom for rotation to severely damaged or deformed knees, in a knee simulator. These tests indicated a tendency for the prosthesis to fracture through the medial femoral housing after cycling for the equivalent of one to three years of normal use. In a clinical series of thirty-five knees treated with the prosthesis, there were five failures similar to those produced by laboratory testing. On the basis of this combined study, the Herbert prosthesis appears to have design characteristics that seriously limit its usefulness for long-term knee replacement. Testing in a knee simulator in this case appeared to be a valid predictor of clinical failure.
- Published
- 1977
17. A Clinical and Histologic Analysis of Failed Fresh Osteochondral Allografts
- Author
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Kenneth P.H. Pritzker, R. D. Oakeshott, F Langer, I. Farine, and Allan E. Gross
- Subjects
medicine.medical_specialty ,Hyaline cartilage ,business.industry ,Adverse conditions ,Cartilage ,Incidence (epidemiology) ,Retrospective cohort study ,General Medicine ,Osteoarthritis ,Knee Joint ,medicine.disease ,Surgery ,medicine.anatomical_structure ,medicine ,Orthopedics and Sports Medicine ,Clinical failure ,business - Abstract
Fresh small osteochondral allografts were implanted in 108 patients. A clinical and histologic analysis was undertaken in 18 patients whose grafts failed and were excised. Twelve of these patients had evidence of viable hyaline cartilage despite adverse conditions. If careful attention is given to patient selection, age, appropriate timing for correction of alignment, and meticulous technique associated with graft positioning, size, and thickness, then the incidence of clinical failure should be minimized.
- Published
- 1988
18. Nimodipine and The ???No-Reflow Phenomenon??????Experimental Triumph, Clinical Failure?
- Author
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Curt D. Furberg and Donald S. Prough
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,business.industry ,Internal medicine ,No reflow phenomenon ,Cardiology ,medicine ,Clinical failure ,business ,medicine.disease ,Nimodipine ,medicine.drug - Published
- 1989
19. A Correlation of Radiographic ???Modes of Failure??? with Clinical Failure of Cemented Stem-type Femoral Components
- Author
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McNeice Gm and Cameron Hu
- Subjects
Surgical approach ,Medullary cavity ,business.industry ,Radiography ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,General Medicine ,Anatomy ,Clinical failure ,business ,Failure mode and effects analysis ,Fixation (histology) - Abstract
Four modes of failure of cemented stem type femoral components are: pistoning within the medullary canal (mode I); medial migration of the proximal stem and lateral migration of the distal stem (mode II); medial lateral toggle of the distal stem tip (mode III); loss of proximal support with firm fixation of the distal end (mode IV). These radiographic failure patterns have been correlated with clinical findings at revision of 51 loose femoral components. The findings at revision correlated well with the radiographic findings indicating the accuracy of this nomenclature, which simplifies discussion of stem failures. Mode I was found to be the most common, and mode IV the most difficult to revise. Neither age, nor weight nor surgical approach influenced the failure mode. The overall results of revision were poor, with most hips rapidly assuming a IB type of appearance.
- Published
- 1980
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