Search results for "Trial"
showing 10 items of 10525 documents
A controlled trial of intra-articular corticosteroids with or without methotrexate in oligoarticular juvenile idiopathic arthritis
2014
In contrast with the numerous controlled trials conducted in polyarticular or systemic juvenile idiopathic arthritis (JIA), little evidence-based information is available for oligoarticular JIA. As a result, the management of children with this subtype, which is the most prevalent in Western countries, is largely empiric. Intra-articular corticosteroid (IAC) injection is the therapy of first choice for oligoarthritis in many pediatric rheumatology centers. However, although IAC injections are usually highly efficacious, relapses of synovitis are common and sometimes occur only a few months after the procedure. It is still unclear whether concomitant administration of methotrexate (MTX) may …
Numerical experimental analysis of hybrid double lap aluminum-CFRP joints
2015
Abstract Due to their reliability and ease of assembly, both the adhesively bonded and the mechanical joints are commonly used in different fields of modern industrial design and manufacturing, to joint composite materials or composites with metals. As it is well known, adhesively bonded joints are characterized by high stiffness and good fatigue life, although delamination phenomena localized near the free edges may limit their use, especially for applications where corrosive environments and/or moisture can lead to premature failure of the bonding. In these cases, a possible alternative is given by the well-known mechanical joints. On the contrary, these last joints (bolted, riveted) requ…
Influence of sutures configuration on the strength of tendon-patch joints for rotator cuff tears treatment
2019
Abstract Purpose Massive rotator cuff tears are common in the aging population. The incidence of failed rotator cuff repairs is still quite high, especially in the treatment of full-thickness tears or revision repairs. In this context, natural and synthetic meshes can be used as augmentation scaffolds or as devices to close the gap between a retracted tendon and the bone. The purpose of this work is to evaluate the ultimate tensile strength of different tendon-patch joints in order to consider their use in the treatment of massive cuff tears. Materials and methods Porcine tendons and a synthetic low-density polypropylene mesh have been used. A preliminary study on the tensile strength of te…
Biomechanical Analysis of a New Elbow Prosthesis
2019
Total elbow arthroplasty (TEA) is an effective and frequently used treatment for patients with debilitating elbow pathology. Total elbow prostheses have lagged behind those of the knee, hip and shoulder for different reasons, such as the high failure rate of the early designs. Concern remains regarding the longevity of TEA implants, especially in younger patients. The main cause of revision of the implant is usually related to the phenomenon of aseptic loosening mainly due to the cement-bone interface failure. Aim of this work is the biomechanical analysis of a new elbow prosthesis to investigate the mechanical behaviour at the cement-bone interface. For this reason, a musculoskeletal model…
Improving the cementation of the tibial component in knee arthroplasty : a study of four techniques in the cadaver.
2021
Aims The main objective of this study is to analyze the penetration of bone cement in four different full cementation techniques of the tibial tray. Methods In order to determine the best tibial tray cementation technique, we applied cement to 40 cryopreserved donor tibiae by four different techniques: 1) double-layer cementation of the tibial component and tibial bone with bone restrictor; 2) metallic cementation of the tibial component without bone restrictor; 3) bone cementation of the tibia with bone restrictor; and 4) superficial bone cementation of the tibia and metallic keel cementation of the tibial component without bone restrictor. We performed CT exams of all 40 subjects, and mea…
Optimal positioning of the humeral component in the reverse shoulder prosthesis.
2014
Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert. The main goal o…
Two different posterior-stabilized mobile-bearing TKA designs: navigator evaluation of intraoperative kinematic differences
2020
Purpose: The purpose of this study was to compare two types of posterior-stabilized (PS) mobile-bearing (MB) total knee arthroplasties (TKAs). The hypothesis was that no major differences were going to be found among the two TKA designs. Methods: Two cohorts of patients who were divided according to implant design (Cohort A, new design gradually reducing radius PS MB TKA; Cohort B, traditional dual-radius PS MB TKA) were analyzed by means of intraoperative navigation. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during the following kinematic tests: passive range of motion (PROM), varus–va…
CRT-727 Percutaneous Balloon Atrial Septostomy for Direct Left Heart Decompression in Patients on Extra Corporeal Membrane Oxygenation
2014
Severe myocardial dysfunction and added afterload from the Extra Corporeal Membrane Oxygenation (ECMO) arterial cannula may lead to significant rise in left ventricular (LV) end-diastolic and left atrial (LA) pressures. This may result in ischemia, lower likelihood of ventricular recovery and hence
Intra-articular corticosteroids versus intra-articular corticosteroids plus methotrexate in oligoarticular juvenile idiopathic arthritis: a multicent…
2017
Summary Background Little evidence-based information is available to guide the treatment of oligoarticular juvenile idiopathic arthritis. We aimed to investigate whether oral methotrexate increases the efficacy of intra-articular corticosteroid therapy. Methods We did this prospective, open-label, randomised trial at ten hospitals in Italy. Using a concealed computer-generated list, children younger than 18 years with oligoarticular-onset disease were randomly assigned (1:1) to intra-articular corticosteroids alone or in combination with oral methotrexate (15 mg/m 2 ; maximum 20 mg). Corticosteroids used were triamcinolone hexacetonide (shoulder, elbow, wrist, knee, and tibiotalar joints) o…
Is time to joint replacement a valid outcome measure in clinical trials of drugs for osteoarthritis?
2003
The rate of radiographic joint space narrowing is commonly used today as a structural outcome measure in clinical trials evaluating potential disease-modifying drugs in patients with hip osteoarthritis, but this results in a continuous variable. Among the methods proposed to circumvent this problem, it has been suggested that the incidence of total hip arthoplasty (THA) provides a hard outcome measure. It is a dichotomized variable, easy to measure and sensitive to change, with acceptable intrinsic validity. However, because this measure is limited by the variability of factors underlying the decision to perform surgery and the length of waiting lists, it has been suggested that time to ful…