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Background: Most studies report high survivorship rates for TKAs, however, we observed higher than anticipated rates of dislocation and femoral component loosening after implanting a Columbus posterior stabilized prosthesis.Questions/purpose: We therefore determined (1) the incidence of dislocation and aseptic loosening that occurred after implantation of posterior stabilized high-flexion prostheses in TKAs, (2) the causative factors of dislocation and aseptic femoral component loosening when comparing two designs of prostheses, and (3) the mechanisms of dislocation.Methods: We retrospectively reviewed 319 patients who underwent 384 TKAs from May 2007 to July 2008. These patients had been assigned alternately to receive a Scorpio posterior stabilized knee prosthesis (Group I, 158 patients, 187 knees) or a Columbus posterior stabilized knee prosthesis (Group II, 161 patients, 197 knees). We followed the patients with clinical and radiographic evaluations for a minimum of 24 months (mean, 26 months; range, 24-38 months). Ten retrieved prostheses were examined visually.Results: Ten dislocations (5.1%; 10 of 197 knees) and seven aseptic loosenings of femoral components (3.6%; seven of 197 knees) occurred in Group II at a mean of 10.9 months postoperatively. However, no dislocation or loosening occurred in patients in Group I. Most dislocations were associated with varus flexion or flexion rotation movements during normal daily activities. The cam jump distance at 90º flexion for the Columbus prosthesis was lower than for the Scorpio prosthesis.Conclusions: We observed a high rate of early failure during short-term followup after implantation of a Columbus posterior stabilized prosthesis. It appears that early failures of the Columbus design were related to a different cam-post design attributable to a low jump distance during knee flexion. We no longer recommend using this device.Level Of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Syndecan-1 (SDC-1), a transmembrane heparin sulphate proteoglycan predominantly expressed on epithelial cells, also exists in a soluble form through ectodomain shedding. SDC-1 expression and shedding may be modulated in the inflammatory milieu of primary Sjögren's syndrome (SS). We investigated SDC-1 expression in minor salivary glands (MSGs) and analysed the association between salivary or plasma levels of SDC-1 and clinical parameters in SS. We measured salivary and plasma SDC-1 levels via an enzyme-linked immunosorbent assay and assessed the salivary flow rates (SFRs) in 70 patients with SS and 35 healthy subjects. Disease activity indices, serological markers, salivary gland scintigraphy, and MSG biopsy were evaluated in patients with SS. SDC-1 expression was upregulated on ductal epithelial cells in inflamed salivary glands. Salivary SDC-1 levels in patients significantly exceeded those in healthy subjects [median (interquartile range) 49.0 (20.7–79.1) vs 3.7 (1.7–6.3) ng/mL, p < 0.001] and inversely correlated with SFRs (r = −0.358, p = 0.032) and ejection fractions of the parotid (r = −0.363, p = 0.027) and submandibular (r = −0.485, p = 0.002) glands in salivary gland scintigraphy. Plasma SDC-1 levels were significantly correlated with the EULAR Sjögren's Syndrome Disease Activity Index (r = 0.507, p < 0.001) and EULAR Sjögren's Syndrome Patient Reported Index (r = 0.267, p = 0.033). Focus scores were correlated with salivary SDC-1 levels (r = 0.551, p = 0.004). Salivary and plasma SDC-1 levels may constitute potential biomarkers for salivary gland function and disease activity, respectively, in SS. [ABSTRACT FROM AUTHOR]

Objective: This study sought to identify seasonal and environmental determinants of scrub typhus, murine typhus, and leptospirosis in small mammals trapped at Dagmar North training area, Gyeonggi Province, South Korea.Methods: Small mammals received titer assays to the aforementioned diseases. Logistic regression analyses were conducted to determine whether associations existed between risk of small-mammal infection and independent variables such as season of capture, habitat, small-mammal species, and sex.Results: Murine typhus was not detected among the animals assayed. Risk of scrub typhus infection was associated with season, habitat, and small-mammal species. Risk of leptospirosis infection was associated with season and habitat.Conclusions: These findings indicate determinants of infection exist for scrub typhus and leptospirosis at this training site. This information can be used for developing appropriate preventive medicine plans and coordinating troop activity during periods of reduced exposure decreasing the likelihood of disease transmission to humans. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective review of clinical and radiological parameters. Objective: To assess for at least 2 years the radiological and clinical outcomes of patients who underwent polymethylmethacrylate (PMMA) vertebroplasty to treat osteoporotic vertebral compression fractures with avascular necrosis. Summary Of Background Data: Recently, osteoporotic vertebral compression fractures with avascular osteonecrosis have been treated with percutaneous vertebroplasty. However, there have been no previous multiyear, clinical, and radiological studies of the results of vertebroplasty in the vertebral body with noninfected avascular osteonecrosis. Methods: Thirty patients were followed for at least 2 years after vertebroplasty. We retrospectively reviewed several parameters, including visual analogue scale score, Oswestry Disability Index, compression ratio, kyphotic angle, injection pattern of PMMA (interdigitation and solid mass), and morphological changes of the PMMA-cemented vertebral bodies. RESULTS.: The vertebral height and kyphotic angle were significantly corrected after vertebroplasty. However, the restored vertebral height recollapsed (P < 0.05), and the kyphotic angle became aggravated (P < 0.05) during the 2 years or longer of postoperative follow-up. Visual analogue scale and Oswestry Disability Index were significantly decreased at postoperative day 1. However, visual analogue scale and Oswestry Disability Index were significantly increased at 24 months postoperatively. There were 4 kinds of morphological changes of the injected PMMA-cemented vertebral body, including heterotopic ossification, fusion with the adjacent vertebral body, bone cement fragmentation and migration, and development of a radiolucent line around the PMMA mass in the vertebral body. Conclusion: After vertebroplasty, the compression and kyphosis of avascular necrotic vertebral bodies progressed continuously for 2 years or longer. Vertebroplasty may not provide sufficient stability. Therefore, we strongly recommend that strict observation and follow-up be used after vertebroplasty. [ABSTRACT FROM AUTHOR]