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Background: Impingement of an artificial hip joint because of limited range of motion (RoM) during human activity is one of the main sources of hip joint failure. The aim of this article is to simulate the RoMs of hip joints during salat, the practice of formal worship in Islam., Methods: Salat consists of several stages which can be represented with a cycle (raka'ah). Every raka'ah consists of standing, bowing (ruku'), straightening up (i'tidal), transition of standing toward prostrating, prostrating (sujud), and sitting. A virtual skeleton model was used to analyze the motion during salat for the possibility of the impingement occurrence., Results: The results of the simulation were presented in terms of maximum flexion, abduction, and internal or external rotation. The results also showed that the prostration position is similar in RoM with the Japanese zarei position and similar in RoM to pick up an object while sitting on a chair., Conclusion: Specific aspects of salat such as the difference in position of the 2 legs at the last sitting position create an extreme RoM which in turn results in a high risk of impingement., (Copyright © 2017 Elsevier Inc. All rights reserved.)

INTRODUCTION: Periprosthetic joint infection (PJI) of the hip due to methicillin-resistant bacteria is difficult to treat and remain a challenge for arthroplasty surgeon. MATERIALS AND METHODS: Retrospective review was done to the patients who received two-stage revisions with an antibiotic loaded cement-spacer for PJI of the hip between January 2010 to May 2015. We found 65 patients (65 hips) with positive culture findings. Eight patients were lost to follow-up and excluded from the study. Among the rest of the 57 patients, methicillin-resistant infection (MR Group) was found in 28 cases. We also evaluate the 29 other cases that caused by the other pathogen as control group. We compared all of the relevant medical records and the treatment outcomes between the two groups. RESULTS: The mean of follow-up period was 33.7 months in the methicillin-resistant group and 28.4 months in the control group (p = 0.27). The causal pathogens in the methicillinresistant group were: Methicillin-resistant Staphylococcus aureus (MRSA) in 10 cases, Methicillin-resistant Staphylococcus epidermidis (MRSE) in 16 cases and Methicillin-resistant coagulase-negative Staphylococcus (MRCNS) in two cases. The reimplantation rate was 92.8% and 89.6% in the methicillin-resistant and control group, respectively (p= 0.66). The rates of recurrent infection after reimplantation were 23.1% (6/26) in the methicillin-resistant group and 7.6% (2/26) in the control group (p= 0.12). The overall infection control rate was 71.4% (20/28) and 89.6% (26/29) in the methicillin-resistant and control group, respectively (p = 0.08). Both groups showed comparable baseline data on mean age, BMI, gender distribution, preoperative ESR/CRP/WBC and comorbidities. CONCLUSION: Two-stage revision procedure resulted in low infection control rate and high infection recurrency rate for the treatment of methicillin-resistant periprosthetic joint infection (PJI) of the hip. Development of the treatment strategy is needed to improve the outcome of methicillinresistant periprosthetic joint infection (PJI) of the hip.