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Developmental hip dysplasia is a common cause for secondary osteoarthritis and in the past it was considered impossible to do hip arthroplasty surgery for this group of patients. We aim at introducing our results and arthroplasty technique in management of such technically demanding and challenging cases. 22 patients with 25 hips suffer from hip dysplasia Crowe type IV were operated by total cementless unconstrained hip arthroplasty with subtrochentric derotation osteotomy without fixation of osteotomy site, The mean age group was 37.9. All patients were operated through lateral approach. The acetabular component is located in the true acetabulum. Postoperatively the patient can weight bear fully unaided within 3 months. The preoperative limb length discrepancy improved from a mean 46.36 mm to 7.3 mm. One case of stem subsidence occurred and underwent revision to cemented stem 1years later. The Harris hip score improved to 85.9 at end of follow up in comparison to38.09 preoperatively. The osteotomy site healed within 5.1months in average .No cases of osteotomy non union occurred. The mean follow up was 28.3 months. We concluded that hip arthroplasty in patients with hip dysplasia Crowe type IV is technically demanding surgery. Recreation of normal biomechanics and anatomy through implantation of acetabular component in the true acetabulum and femoral shortening and derotation offers the patient painless and adequately functioning hip

These are the .stl files of the molds used in phabricateing the breast phantom using Solidwork softawre.

This item contains the Figures of the research article "Heterogeneous breast phantom for computed tomography and magnetic resonance imaging".

To assess the effect of the patient's posture (erect or supine) during rehabilitation sessions on pain, function, and the coracoclavicular (CC) distance after arthroscopic treatment of acromioclavicular joint dislocation.Sixty patients with acute type III or V acromioclavicular dislocation injuries were randomly allocated into 2 groups according to their posture during the rehabilitation phase: supine rehabilitation group (SRG) or erect rehabilitation group (ERG). Arthroscopic stabilization with a suspensory fixation device was used in all patients. The visual analog scale (VAS) score was assessed on the first postoperative day and at 1, 3, and 6 months postoperatively. The Constant-Murley score (CMS) was recorded preoperatively and at 3, 6, 12, and 24 months postoperatively. The CC distance was assessed preoperatively; on the first postoperative day; and at 6, 12, and 24 months postoperatively.No significant differences were found between the 2 groups in terms of the VAS score, CMS, and CC distance changes. A significant improvement over the follow-up phase was identified in the VAS score and CMS in both groups. The CC distance in both groups was significantly reduced from preoperatively (29.34 mm in the ERG and 28.65 mm in the SRG) to the first postoperative day (10.44 mm and 10.11 mm, respectively). However, a statistically significant re-widening of the CC distance (P.001) occurred within the first 6 months after surgery (13.55 mm in the ERG and 13.50 mm in the SRG) and at 12 months (15.51 mm and 15.80 mm, respectively).The patient's posture during early postoperative rehabilitation does not affect the CC distance changes.Level I, randomized prospective comparative study.

Back ground: In this Randomized Controlled Trials clinical study, we report results of the effect of tranexamic acid intravenous administration and local injection on transfusion rate and perioperative blood loss in primary total hip replacement.Aim of the Study: The aim of this study is to evaluate the effect of tranexamic acid intravenous administration and local injection on transfusion rate and perioperative blood loss in primary total hip replacementPatients and methods: The study will include 30 patients in each of the 2 groups.Group (1) Including 30 cases (control group).Group (2) Including 30 cases managed by I.V and local TXA injection. We compare between both group as regard transfusion rate and perioperative blood loss.Results: Patients in the TXA group had significantly higher postoperative hemoglobin (10.34 vs 9.78 g/dl, P

Background: The annual rate of primary THA has been increasing with new designs promoting THA in the younger population, therefore increasing rates and complexity of hip revision surgeries. Different types of acetabular defects in hip revisions, usually make the use of primary cementless cups quite difficult. In complex defects, using cages with cemented cups or combining cementless cups with metal augments, are possible reconstruction solutions. The Delta TT acetabular revision system provides a solution to complex defects combining the advantages of both cage construct and primary implants, with modularity that helps restore anatomical hip centre and biomechanics. The aim of this study is to evaluate the short-term results of the use of the Delta TT revision system in acetabular revision surgeries. Type of the study: A retrospective case series. Methods: 24 patients underwent acetabular revision using (Delta TT) revision system, from 2018 to 2021. The mean follow-up was 20.75 months. Clinical and functional outcomes were assessed using Harris Hip Score. Results: The use of the Delta TT revision system in acetabular revision surgery provided adequate pain relief, and early patient mobilization. The preoperative HHS mean of 29.88 improved to a mean of 85.21, at the last, follow-up. None of the patients developed periprosthetic infection or loosening or nerve palsy during the follow-up period. Conclusion: Short-term clinical outcomes for the use of the Delta TT revision cup system in acetabular revision are encouraging with good functional outcomes and patient satisfaction.

Background Total hip arthroplasty (THA) is considered one of the most successful surgical procedures providing pain relief and improvement of function in patients with end-stage hip arthritis that does not respond to non-operative treatments. As health care continues to improve and life expectancy increases, the demand for total joint replacement will grow to reflect this more active, aging population. Objectives This study aims to review early complications of dual mobility cup arthroplasty. The objective is to perform a systematic review of early complications of dual mobility cup arthroplasty for primary and revision cases. Methodology Types of studies we will include randomized control trails (RCTs), controlled clinical trials, retrospective cohort studies, and we will exclude case reports, case series studies, cross sectional studies, non English studies. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. We will search the MED-LINE database, PubMed, Cochrane Bone and Muscle Trauma Group Specialized Register, Cochrane Register of Controlled Trails (The Cochrane Library) using the following keywords related to: THA, Dual mobility cup, complications, intraprosethetic dislocation. Results Early complication rate in dual mobility cups is significantly higher in revision cases compared to primary cases, with the exception of IPD which was significantly lower in revision cases. Early complication rate of conventional THA was significantly higher than both primary and revision dual mobility cups. Conclusion Dual mobility THAs are a good alternative to traditional bearing surfaces with long survivorship and low rates of instability after primary and revision THA. The rate of complications which are unique to the procedure, including intraprosthetic dislocation, is relatively low and limited mainly to earlier designs. High-quality, prospective, comparative studies are needed to further evaluate the use of dual mobility in primary and revision THA.

Purpose To evaluate the effect of the coracoclavicular distance widening in athletes after arthroscopic acromioclavicular (AC) stabilization using a suspensory button fixation device in terms of function, athletic performance, or isokinetic assessment. Methods Sixty-eight athletes with a minimum 6-month follow-up after AC stabilization using suspensory button fixation were allocated in 2 groups, the widening group and non-widening group, according to the measured coracoclavicular distance after 6 months from the operation. The assessment was done every 6 months by Subjective Patient Outcome for Return to Sports (SPORTS) score, Athletic Shoulder Outcome Scoring System (ASOSS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant–Murley score (CMS), and the coracoclavicular distance. Isokinetic testing was performed at 24 months postoperatively to evaluate shoulder abduction and external rotation strength. Results No statistically significant differences were found between the 2 groups in terms of the DASH, ASOSS, SPORTS, and the CMS, in addition to the isokinetic testing (P > .05). A statistically significant improvement in both groups over the follow-up stage was identified in the DASH, ASOSS, SPORTS, and the CMS (P Conclusions Coracoclavicular distance widening following arthroscopic suspensory button fixation for AC joint dislocation did not affect function, athletic performance, or isokinetic evaluation in athletes. Level of Evidence III; nonrandomized, comparative trial.

Background: Chronic osteomyelitis of long bones are common in daily clinical practice, however, the treatment of these diseases has still been a challenge and difficult for orthopedic surgeons. Gunshot injuries lead to damage to bone and soft tissues that can complicate with bacterial invasion and cause bone infection. Many ways can overcome of bone infection, surgical debridement, bone fixation and antibiotic are used in management of chronic osteomyelitis. The objective of this systematic review was to review available studies reporting in management of chronic osteomyelitis following gunshot injuries and compare the methods used into the treatment. Methods: A comprehensive literature search was performed from the electronic databases Medline, PubMed, Google scholar, and Cochrane collaboration between 1995 and 2016. References were analyzed from included studies, inclusion criteria included (1) English literatures, (2) Humans clinical trials, (3) Orthopedic Journals only, (3) Definitive treatment strategy for management chronic osteomyelitis. In total, 5 articles were included in the systematic review. Results: A total of 278 patients from 5 studies were included in this systematic review. The mean age of the patients is all studies were 33.84 year, the ratio male to female is 6:1. The most of patients were classified as Gaustilio type lllB and CiernyMader type lllB. The result of all different studies shows a good outcome in 260 patients but 7 patients had poor outcome who were still had bone infection and one patient end by amputation. Radiographic X-ray did postoperative follow up every two weeks. The mean follow up duration was 40 months and all patients responsible for keep the fixator clean. Conclusion: Our systematic review showed that the patients with chronic osteomyelitis were treated by surgical debridement and bone fixation had a good result. But, this research lost the randomized trials methods, risk factors of patients, compare control groups and good statistical analysis. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious.

High Impedance Surface – Electromagnetic Band Gap (HIS-EBG) structures are one class of Metamaterials with unique and useful electromagnetic properties. This thesis proposes the first application of EBG structures for Magnetic Resonance Imaging (MRI) applications, with the aim of improving effectiveness of coils in creating RF magnetic flux density inside the patient or a phantom. The anti-phase currents in the metallic ground planes placed underneath transmit RF coils for ultrahigh field MRI represent the main reason for the reduction in RF magnetic flux density above these coils (inside the load). In addition, they support the propagation of surface waves which radiate from edges and corners wasting power in the back hemisphere. The objective of this thesis is to investigate the potential of improving the efficiency of a well-established RF coil for 7 Tesla MRI by replacing the standard ground planes with specially designed EBG structures which exhibit novel electromagnetic properties: The reflection of such structures exhibits a frequency range over which an incident electromagnetic wave does not experience a phase reversal, and the image currents appear in-phase rather than out of phase as they do on the standard ground planes. Due to this, the EBG structure is termed an artificial magnetic conductor. Furthermore, it suppresses the propagation of surface waves.. In this thesis, novel EBG structures are proposed and fabricated, and their electromagnetic properties are characterized analytically, numerically, and are validated by measurements. The RF coil backed by our proposed EBG ground planes exhibits improvement in the magnetic flux density inside phantoms compared to the case when it is backed by conventional ground planes of the same dimensions.. A novel multilayer offset stacked polarization dependent EBG structure is designed to work as a soft surface with anisotropic surface impedance. The designed structure solves the problem of the limited space available in MRI magnet bores. The RF coil backed by the proposed soft surface exhibits stronger magnetic field inside the phantom, while the electric field and the specific energy absorption rate values are reduced. High Impedance Surface – Electronic Band Gap (HIS-EBG) Strukturen bilden eine Klasse von Metamaterialien mit einzigartigen elektromagnetischen Eigenschaften, welche nicht ohne weiteres in der Natur vorkommen. In dieser Arbeit werden zum ersten Mal EBG Strukturen für den Einsatz in Ultra-Hochfeld Magnetresonanz-Tomographie Anwendungen vorgeschlagen, mit dem Ziel die Effektivität von Spulen, welche für die Erzeugung von hochfrequenten magnetischen Flussdichten in Patienten oder Phantomen verwendet werden, zu erhöhen. Gegenphasige Ströme in den metallischen Masseflächen unterhalb der HF Sende-Spulen sind der Hauptgrund für die Reduzierung der hochfrequenten magnetischen Flussdichten oberhalb dieser Spulen. Ferner kommt es zur Anregung von Oberflächenwellen auf den metallischen Masseflächen und zur Abstrahlung an den Kanten und Ecken, wodurch Leistung in eine unerwünschte Richtung abgestrahlt wird.. Das Ziel dieser Arbeit ist die Untersuchung der Möglichkeiten zur Verbesserung des Wirkungsgrads von gängigen HF Spulen für 7 Tesla MRT, bei welchen die Standard- Massefläche durch speziell entworfene EBG Strukturen ersetzt wurde. Bei der Reflektion an solchen Strukturen erfährt die einfallende elektromagnetische Welle in einem bestimmten Frequenzbereich keine Umkehrung der Phase. Im Gegensatz zur Standard-Massefläche, in welcher gegenphasige Ströme entstehen, sind die Ströme in der EBG Struktur gleichphasig. Auf Grund dessen werden die EBG Strukturen als künstliche magnetische Leiter bezeichnet. Des Weiteren wird die Ausbreitung von Oberflächenwellen in EBG Strukturen unterdrückt.. In dieser Arbeit, werden einige neuartige EBG Strukturen vorgestellt. Die elektromagnetischen Eigenschaften dieser Strukturen werden sowohl analytisch als auch nummerisch beschrieben und messtechnisch validiert. Die HF Spulen über der EBG Struktur weisen, im Vergleich zum Aufbau über einer herkömmlichen Massefläche, eine deutlich erhöhte magnetische Flussdichte im inneren des Phantoms auf.. Des Weiteren wurde eine neuartige, versetzt aufgebaute und polarisationsabhängige Multilagen-EBG Struktur entworfen mit reduzierten Abmessungen um als anisotrope „Soft“-Oberflächenimpedanz fungieren zu können. Die HF Spule über dieser vorgeschlagenen „Soft“ Oberflächenimpedanz führt im inneren des Phantoms zu einer Erhöhung der magnetischen Feldstärke, wobei die Elektrische Feldstärke und die Spezifische Absorptionsrate reduziert werden.