Displaying publications 21 - 40 of 140 in total

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  1. Fulltext In defence of Girdlestone excision arthroplasty: a comment on 'Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis'
    Sinha NK, Bhardwaj A, Poduval M, Rao BS
    J Postgrad Med, 2014 Apr-Jun;60(2):222-3.
    PMID: 24823541 DOI: 10.4103/0022-3859.132388
    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  2. Fabrication of low-cost, cementless femoral stem 316L stainless steel using investment casting technique
    Baharuddin MY, Salleh ShH, Suhasril AA, Zulkifly AH, Lee MH, Omar MA, et al.
    Artif Organs, 2014 Jul;38(7):603-8.
    PMID: 24404766 DOI: 10.1111/aor.12222
    Total hip arthroplasty is a flourishing orthopedic surgery, generating billions of dollars of revenue. The cost associated with the fabrication of implants has been increasing year by year, and this phenomenon has burdened the patient with extra charges. Consequently, this study will focus on designing an accurate implant via implementing the reverse engineering of three-dimensional morphological study based on a particular population. By using finite element analysis, this study will assist to predict the outcome and could become a useful tool for preclinical testing of newly designed implants. A prototype is then fabricated using 316L stainless steel by applying investment casting techniques that reduce manufacturing cost without jeopardizing implant quality. The finite element analysis showed that the maximum von Mises stress was 66.88 MPa proximally with a safety factor of 2.39 against endosteal fracture, and micromotion was 4.73 μm, which promotes osseointegration. This method offers a fabrication process of cementless femoral stems with lower cost, subsequently helping patients, particularly those from nondeveloped countries.
    Matched MeSH terms: Arthroplasty, Replacement, Hip/economics
  3. Fulltext Outpatient pre-operative assessment in joint replacement surgery
    Chan CY, Nam HY, Raveenthiran R, Choon SK, Tai CC
    Med J Malaysia, 2008 Jun;63(2):100-3.
    PMID: 18942292 MyJurnal
    An anaesthetist-led outpatient pre-operative assessment (OPA) clinic was introduced in our unit in an effort to improve patient care and cost-effectiveness. To assess the efficiency of the clinic, 112 patients who attended the OPA clinic (attendance rate 98%) during the first year were assessed prospectively and compared with 118 patients who did not undergo OPA the year before. There were fewer cancellations among those who attended the OPA clinic (13.6% compared to 3.6%), and the hospital stay was shortened from an average of 10.7 days to 7.0 days. This has resulted in more efficient utilization of operating theatre, reduced hospital costs and improved patient satisfaction. More extensive use of the pre-admission clinic is recommended and should be explored in other clinical settings.
    Study site: Outpatient Preoperative Assessment (OPA) clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthroplasty, Replacement*
  4. Fulltext The Use of PROSTALAC in Two-stage Reimplantation of Septic Total Knee and Hip Arthroplasty
    Wam, B.L., Chee, E.K., Ewe, T.W.
    Malays Orthop J, 2010;4(3):11-15.
    MyJurnal
    The PROSTALAC (PROSThesis Antibiotic Loaded Acrylic Cement) functional spacer is made with antibiotic-loaded acrylic cement. We use it as an interim spacer in two-stage exchange arthroplasty in cases of infected total knee or total hip replacement. PROSTALAC allows continuous rehabilitation between stages as it maintains good alignment and stability of the joint with a reasonable range of movement. It also helps to maintain the soft-tissue planes, thereby facilitating the second-stage procedure. We report here early outcomes of the use of PROSTALAC in 5 patients - 3 in total knee replacements, 1 in a total hip replacement and 1 in a bipolar hemiarthroplasty.
    Matched MeSH terms: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee
  5. Long-term wear failure analysis of uhmwpe acetabular cup in total hip replacement
    Shahemi N, Liza S, Abbas AA, Merican AM
    J Mech Behav Biomed Mater, 2018 11;87:1-9.
    PMID: 30031358 DOI: 10.1016/j.jmbbm.2018.07.017
    A revision of a metal-on-ultra high molecular weight (UHMWPE) bearing couple for total hip replacement was performed due to aseptic loosening after 23 years in-vivo. It is a major long-term failure identified from wear generation. This study includes performing failure analysis of retrieved polyethylene acetabular cup from Zimmer Trilogy® Acetabular system. The UHMWPE acetabular cup was retrieved from a 61 years old male patient with ability to walk but limited leg movement when he presented to hospital in early 2016 with complaint left thigh pain. It was 23 years after his primary total hip replacement procedure. Surface roughness and morphology condition were measured using 3D laser microscope and Scanning Electron Microscope (SEM) to evaluate and characterize the wear features on polyethylene acetabular cup surface. ATR-Fourier Transform Infra-Red (ATR-FTIR), differential scanning calorimetry (DSC) and gel permeation chromatography (GPC) were used to characterize the chemical composition of carbon-oxygen bonding, crystallinity percentage and molecular weight of the polymer liner that might changes the mechanical properties of polyethylene. Nano indentation is to measure hardness and elasticity modulus where the ratio of hardness to elastic modulus value can be reflected as the degradation of mechanical properties. A prominent difference of thickness between two regions resulted from acentric loading concentration was observed and wear rate were measured. The linear wear rate for thin side and thick side were 0.33 mm/year and 0.05 mm/year respectively. Molecular weight reduction of 57.5% and relatively low ratio of hardness to elastic modulus (3.59 × 10-3) were the indicator of major mechanical properties degradation happened on UHMWPE acetabular cup. This major degradation was contributed by oxidation and polishing wear feature accompanied with delamination, craters, ripple and cracks were the indication of extensive usage of UHMWPE from the suggested life span of acetabular cup application.
    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  6. Fulltext The morphology of proximal tibia geometry amongst the Igbos of South East Nigeria and its implication in total knee replacement
    Katchy AU, Agu AU, Ikele IT, Esom E, Nto NJ
    Niger J Clin Pract, 2019 Oct;22(10):1423-1429.
    PMID: 31607734 DOI: 10.4103/njcp.njcp_93_19
    Background: The morphological parameters of the proximal tibia play a major role in total knee replacement and there are ethnic and gender variations to these parameters.

    Aim: To evaluate parameters of the proximal tibia geometry amongst the Igbos of South Eastern Nigeria and discuss the clinical implications in total knee replacement.

    Methods: The proximal tibia parameters of 558 adult tibiae bones, 300 right-sided and 258 left-sided, collected from the osteological unit of the department of anatomy University of Nigeria Enugu campus were measured using a Venier calipers.

    Results: The values of the determined parameters are as follows: anterior posterior dimension (APD): 5.50 cm, medial lateral dimension (MLD):7.53 ± 5.56 cm, proximal length (PL): 7.32 ± 0.67 cm, proximal width (PW) CM: 4.10 ± 0.30 cm, medial tibia posterior slope (MTPS):11.36 ± 4.15° and lateral tibia posterior slope (LTPS):5.65 ± 2.72°. The correlation test between these parameters of the proximal tibia shows a strong significant correlation between LPTS and MPTS (r =0.814, P < .001). The comparison of the means of the MPTS of both sides using independent samples t test shows a mean difference that is not significant (p =0.628). A comparison of the values with other populations shows significant mean difference for MLD with that of Chinese and American populations (p < .05). The mean difference between the APD of this study and the Chinese is significant (p =0.007). A comparison of MPTS and LPTS for Malaysian, Chinese, and white Americans shows a significance difference for all the three populations (p

    Matched MeSH terms: Arthroplasty, Replacement, Knee*
  7. Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease
    Dwan LN, Gibbons P, Jamil K, Little D, Birke O, Menezes MP, et al.
    Hip Int, 2023 Mar;33(2):323-331.
    PMID: 34180253 DOI: 10.1177/11207000211027591
    BACKGROUND: Hip dysplasia is a lack of femoral head coverage and disruption of hip and acetabular alignment and congruency, with severity ranging from mild subluxation in nascent at-risk hips to complete dislocation. Presentation of hip dysplasia in neuromuscular conditions can be sub-clinical or associated with a limp with or without hip pain, abductor and flexor weakness and reduced hip range of motion. Untreated hip dysplasia leads to early onset osteoarthritis requiring hip arthroplasty in early adulthood. Hip dysplasia occurs in 6-20% of children with Charcot-Marie-Tooth disease, however little is known about the reliability and sensitivity of detection on plain film pelvic radiographs.

    METHODS: 14 common measures of hip dysplasia on anteroposterior pelvis radiographs were independently assessed by 2 orthopaedic specialists in 30 ambulant children with Charcot-Marie-Tooth disease. Hip health was also categorised based on clinical impression to assess the sensitivity of radiographic measures to identify hip dysplasia status.

    RESULTS: 8 measures (acetabular index, head width, lateral centre-edge angle, lateral uncoverage, medial joint width, migration percentage, neck shaft angle, triradiate status) exhibited 'excellent' reliability between clinical evaluators. 5 of the 30 patients (17%) were identified as having nascent hip dysplasia. Reliable radiographic measures that significantly distinguished between nascent hip dysplasia and healthy hips were acetabular index, lateral centre edge angle, medial joint width and migration percentage.

    CONCLUSIONS: We have identified a subset of reliable and sensitive radiographic hip measures in children with Charcot-Marie-Tooth disease to prioritise during hip screening to mitigate the deleterious effects of hip dysplasia, pain and disability in adulthood.

    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  8. Fulltext Dislocation after total knee arthroplasty
    Wazir NN, Shan Y, Mukundala VV, Gunalan R
    Singapore Med J, 2007 May;48(5):e138-40.
    PMID: 17453086
    Two cases of dislocation of total knee arthroplasty presented to us within the same week. The first patient is a 71-year-old woman who underwent bilateral primary total knee arthroplasty. The left knee dislocated three weeks after the surgery. Due to failure of conservative measures, she underwent revision total knee arthroplasty. The other patient is a 72-year-old woman presenting ten years after primary total knee arthroplasty, with a traumatic dislocation of the knee joint. She was treated as an outpatient with closed manipulative reduction.
    Matched MeSH terms: Arthroplasty, Replacement, Knee*
  9. Downsizing and minimising medialisation of the acetabular component: Novel technique to preserve bone in THA
    Raj JJ, Thompson M, Whitehouse SL, Jaiprakash A, Varughese I, Crawford RW
    Proc Inst Mech Eng H, 2023 Mar;237(3):368-374.
    PMID: 36734414 DOI: 10.1177/09544119231152351
    Standard practice for acetabular component placement in total hip arthroplasty (THA) is to medialise the acetabular component. Bone preservation techniques during primary THA are beneficial for possible future revisions. The goal of this study is to examine the effect of downsizing and minimising medialisation of the acetabular component on bone resection volume. The volume of bone resected during acetabular preparation for different sizes of components was calculated and the volume of bone preserved by downsizing the cup was determined. Minimising medialisation of the acetabular component by 1-3 mm from the true floor was calculated. Absolute values and percentage of bone volume preserved when acetabular components are downsized or less medialised is presented. Downsizing the acetabular component by one size (2 mm) preserves between 2.6 cm3 (size 40 vs 42) and 8.4 cm3 (size 72 vs 74) of bone volume and consistently reduces resected bone volume by at least 35% (range 35.2%-37.5%). Similarly, reducing medialisation of a 56 mm acetabular cup (as an example of a commonly implanted component) by 3 mm reduces bone loss by 5.9 cm3- 44% less bone volume resection. Downsizing and minimising medialisation of the cup in THA substantially preserves bone which may benefit future revision surgeries. Surgeons could consider implanting the smallest acceptable acetabular shell to preserve bone without compromising on head size.
    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  10. Fulltext Can intra-articular therapies prior to total knee arthroplasty increase the risk of periprosthetic infection?
    Yeo QY, Lye DC, Sathappan SS
    Med J Malaysia, 2015 Feb;70(1):54-6.
    PMID: 26032534
    Intra-articular therapies, such as steroid injection, viscosupplement injection and acupuncture, are common non-surgical options for patients with osteoarthritis of the knee. With any intra-articular injection or acupuncture procedure, there is a potential for inoculation with bacteria leading to possible knee infection. The authors report a patient who incurred an acute infection found after a total knee arthroplasty attributed to prior acupuncture procedure done as part of conservative treatment.
    Matched MeSH terms: Arthroplasty, Replacement
  11. Fulltext A Modified Method for Reconstruction of Chronic Rupture of the Quadriceps Tendon after Total Knee Replacement
    Singh, S., Choon, S.K., Tai, C.C.
    Malays Orthop J, 2008;2(2):34-36.
    MyJurnal
    We describe herein a modified technique for reconstruction of chronic rupture of the quadriceps tendon in a patient with bilateral total knee replacement and distal realignment of the patella. The surgery involved the application of a Dacron graft and the ‘double eights’ technique. The patient achieved satisfactory results after surgery and we believe that this technique of reconstruction offers advantages over other methods.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  12. Fulltext In vitro Analysis of Antimicrobial Properties of CefuroximeImpregnated Bone Cement
    Suhail,A., Gunalan, Sabarul, A ., Shahril, Y., Salasawati, H., Masbah, O.
    Malays Orthop J, 2008;2(2):1-5.
    MyJurnal
    Infection after joint replacement surgery is problematic and difficult to treat. The utility of antibiotic laden bone cement for reduction of risk of infection in primary and revision joint replacement surgery has already been established in many studies. In this study, we examined the efficacy of bone cement containing cefuroxime, employing a modified in vitro Kirby-Bauer susceptibility model for investigation of 13 strains of organisms that are found in orthopaedic infections. Organisms investigated were broad spectrum and effective for Gram-positive, Gram-negative, aerobic organisms and anaerobes. Simplex P with added cefuroxime was effective against 8 out of 13 strains. Cefuroxime is stable during exothermic polymerisation of the cement, and is released from the cement at concentrations high enough to inhibit the growth of most organisms encountered after joint arthroplasty.


    Matched MeSH terms: Arthroplasty, Replacement
  13. Fulltext Outcome of traumatic intracapsular neck of femur fractures in patients aged above 60 years treated by total hip arthroplasty
    Yazid DM, Lim CY, Chopra S
    Malays Orthop J, 2010;4(3):7-10.
    MyJurnal
    This study was undertaken to investigate the outcome of traumatic intracapsular neck of femur fractures treated with total hip arthroplasty (THA). Patients aged >=60 years who underwent THA for traumatic intracapsular neck of femur fractures from January 2005 to March 2009 were included in the study. Telephone or personal interviews were conducted. There were 49 patients identified within the study period. The mean age was 74.12 years. Most patients were females 81.6%), with a male: female ratio of 1: 4.4. In total, 29 patients were available for outcome scoring. The one-month mortality rate was 4.1%, and the one-year mortality rate was 20.5%. Of the 29 patients 82.8% obtained a Zukerman Functional Outcome Score of good (80 – 100) and 13.8% obtained a score of fair (60 – 80). THA for the treatment of traumatic neck of femur fractures in elderly is a good option with 96.6% of patients obtaining a satisfactory functional outcome, with acceptable morbidity and mortality statistics.
    Matched MeSH terms: Arthroplasty, Replacement, Hip
  14. Fulltext Causative Factors for Femoral Pin Track Fractures inNavigated Total Knee Arthroplasty
    Ewe, T.W., Chee, E.K., Chooi, Y.S., Ng, W.M.
    Malays Orthop J, 2010;4(1):8-11.
    MyJurnal
    This retrospective radiographic analysis of 57 patients (62 knees) examined two possible factors involved in pin tract fractures of the femur due to navigated total knee arthroplasty (TKA): the angle of the tracker pin with respect to the lateral femoral cortex, and the distance between the tracker pin and the lateral joint line. Our findings demonstrate a relationship between postoperative pin tract induced stress fractures (3 patients), with pin tract angles exceeding 15°. Pin placement at a site more than 10cm from the lateral joint line, did not show any significant association with risk of fracture. These findings lead to enhanced understanding of the causative factors underlying pin track femoral fractures in TKAs.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  15. Fulltext A comparison between subvastus and midvastus approaches for staged bilateral total knee arthroplasty: a prospective, randomised study
    Masjudin, T., Kamari, Z.H.
    Malays Orthop J, 2012;6(2):31-36.
    MyJurnal
    This prospective randomised study was undertaken to compare surgical parameters as well as clinical and radiological outcomes of subvastus (SV) to midvastus (MV) approaches in staged bilateral total knee arthroplasty (TKA). Twenty-three patients, aged 55–76 years, who underwent staged bilateral TKAs, were followed up for 6 months. The SV approach was used on one knee and MV approach on the other. We found similar lateral retinacular release rates and patellar resurfacing rates between the two approaches .The SV approached knees had a more significant blood loss and increased operative time compared to the MV approached knees but they achieved significantly earlier active straightleg raises (SLR) postoperatively (p
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  16. Fulltext Use of Cement Gun for Fixation of Tibia Component in Total Knee Arthroplasty
    Yoga, R., Sivapathasundaram, N., Suresh, C.
    Malays Orthop J, 2009;3(1):72-77.
    MyJurnal
    We evaluated the efficacy of a cement gun to improve the depth of cement penetration in total knee arthroplasty. Ninety-one consecutive patients from two hospitals were recruited for this study. For Group I cement was applied to the tibial baseplate and the proximal tibia with fingers. Group 2 had similar application of cement to the tibial baseplate but cement was pressurized into the proximal tibia using a cement gun.. The knee was kept extended until the cement hardened. Standard post-operative x-rays were reviewed to assess cement penetration into the proximal tibia. The mean cement penetration was 2.1 mm in Group 1 and 3.1 mm in Group 2 and the difference was statistically significant. The use of the cement gun improves cement penetration into the proximal tibia and facilitates early stability of the implant fixation to the bone.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  17. Fulltext Five Year Follow-up of One Stage Bilateral Total Hip Arthroplasty
    Tai, C.C., Abbas, A.A., Varaprasad, M., Choon, S.K.
    Malays Orthop J, 2007;1(1):22-25.
    MyJurnal
    We report on the medium term outcome of five patients (ten hips) who underwent one stage bilateral total hip arthroplasty. Both Harris Hip Scores and Oxford Hip Scores improved postoperatively as did range of motion. There was no radiographic evidence of loosening in any hip arthroplasty involved in this study, however one revision surgery was needed due to periprosthetic fracture. There were no increased medical complications. Based on our limited experience, we believe that one stage bilateral total hip arthroplasty is safe in selected patients.
    Matched MeSH terms: Arthroplasty, Replacement, Hip
  18. Fulltext Pneumocephalus Following Combined Spinal Epidural Anaesthesia for Total Knee Arthroplasty: A Case Report
    Chew YW, Suppan VK, Ashutosh SR, Tew MM, Jimmy-Tan JH
    Malays Orthop J, 2017 Nov;11(3):42-44.
    PMID: 29326765 MyJurnal DOI: 10.5704/MOJ.1711.001
    The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  19. Fulltext Revision total hip arthroplasty using impaction bone grafting technique
    Nisar A, Choon DS, Varaprasad M, Abbas AA
    Med J Malaysia, 2006 Feb;61 Suppl A:100-2.
    PMID: 17042242
    A variety of reconstructive options exist for revision of both femoral and acetabular components in total hip replacement surgery. The use of impaction bone grafting with morsellised allograft has shown promising results in revision total hip arthroplasty. It works as a biologic reconstitution of bone stock defects and provides a solid construct with stable fixation. We present a case of bilateral revision total hip arthroplasty with poor bone stock where reconstructive surgery was done by using impaction bone grafting, mesh and C-stem implants.
    Matched MeSH terms: Arthroplasty, Replacement, Knee/instrumentation; Arthroplasty, Replacement, Knee/methods*
  20. Fulltext Risk factors for infection in total knee replacement surgery at Hospital Kuala Lumpur
    Syahrizal AB, Kareem BA, Anbanadan S, Harwant S
    Med J Malaysia, 2001 Dec;56 Suppl D:5-8.
    PMID: 14569758 MyJurnal
    One hundred primary TKR surgeries done between January 1994 and December 1999 were reviewed after a mean follow-up of 37.4 months. The rate of superficial and deep wound infection were 2% and 9% respectively. The most common organism in wound infection was Staphylococcus aureus. The factors that were significantly associated with superficial wound infection were diabetes mellitus (p = 0.005) and rheumatoid arthritis (p = 0.0000). The factors that were significantly associated with deep wound infection were diabetes mellitus (p = 0.000). There was no significant difference between duration of surgery, and the mean age among patients with and without wound infections.
    Matched MeSH terms: Arthroplasty, Replacement, Knee/adverse effects*; Arthroplasty, Replacement, Knee/statistics & numerical data
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