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Purpose: Objectives in scoliosis corrective surgery include restoration of normal sagittal and coronal parameters to achieve patient satisfaction. HRQLs improvements remain limited after corrective surgery. The aim of this study was to evaluate the HRQL subclass variability specific to the sagittal and coronal correction in adult scoliosis surgery. Methods: This multi-centre prospective analysis of consecutive adult spinal deformity (ASD) patients, from five European centres, only included multilevel instrumentation for scoliosis. d-(delta) values for each parameter represented pre to post-operative changes. Parameters included demographics, baseline, 1- and 2-year. HRQL outcomes (Oswestry disability index (ODI), Scoliosis Research Society (SRS)-22 and Short Form (SF36)), sagittal correction including relative spinopelvic alignment (dRSA) and coronal correction including major Cobb (dCobb) angles. Results: A total of 353 patients reached 1-year and 2-year follow up. All HRQL total scores significantly improved postoperatively, including ODI, SRS-22 and SF36. HRQL subclasses which displayed persistent improvements correlated to dRSA included sex-life, self-image, fatigue, vitality, social functioning. The only HRQL subclass improvement that correlated with dCobb was self-image. Conclusion: Adult scoliosis surgery improves overall HRQL, having a minimal effect on each variable. Importantly, greater coronal deformity correction affects only greater self-image scores, whereas with greater sagittal correction there are many greater HRQL sub-class impacts. Correction and restoration of coronal balance is one of the surgical goals in adult scoliosis but the degree to which Cobb angle is corrected, apart from self-image, does not correlate with gains in sub-classes of HRQL. These results need to be taken into account when planning surgery. [ABSTRACT FROM AUTHOR]

The growth of ferrite was observed in situ under confocal scanning laser microscope in Fe-Ni and Mn alloys containing less than 0.01 mass pct C. The advancements of α/γ boundary during cooling at 2 and 20 °C/s were measured in the paraequilibrium α single-phase region in Fe-2Ni and 2Mn alloys and near the paraequilibrium α/(α + γ) phase boundary in an Fe-5Ni alloy. The growth rates obtained from the boundary displacement vs time plots were almost constant and were considerably greater than those calculated under long-range carbon diffusion control, and thus, the ferrite growth is likely to have occurred in a massive manner, albeit a carbon spike may develop ahead of the boundary. The mobility of massive α/γ boundary was calculated to fall between those proposed by Hillert and Wits et al. irrespective of the assumption as to the formation of carbon spike in front of the boundary. [ABSTRACT FROM AUTHOR]

The mechanical properties of duplex stainless steel (DSS) are known to display embrittlement due to ageing effects. Knowledge of the micro behaviour of aged DSS is important for understanding the mechanisms of deformation and failure, but it has proved difficult to obtain due to the complex effects created by the duplex structure. Lattice strain measurements of DSS aged under various conditions of temperature and time have been performed in order to determine the strain behaviour of individual (hkl) planes in the α- and γ-phases using white synchrotron radiation X-rays at SPring-8. It was found that the lattice strain of α-Fe(200) depends strongly on the ageing conditions and that the lattice strain behaviour in the γ-phase is more stable than that in the α-phase. These results suggest that the changes in macro mechanical properties, including yield strength and ultimate strength, which are revealed by standard tensile tests, are solely due to ageing effects in the α-phase. The results further suggest that the lattice strain of α-Fe(200) can be used as an index to evaluate 475 °C ageing effects in DSS. [ABSTRACT FROM PUBLISHER]

PurposeTo prospectively examine changes in the central visual field (VF) in patients with advanced open-angle glaucoma (OAG) with advanced late stage after trabeculectomy for 12 months.DesignProspective interventional case series.MethodsIn all, 27 eyes of 27 OAG patients at a single center with a best-corrected visual acuity (BCVA) of ≥40/200 and a mean total deviation of test locations of the 10-2 program of the Humphrey VF analyzer of ≤−20 dB preoperatively were enrolled. Intraocular pressure (IOP), VF parameters of the 10-2 program, and BCVA were examined for 12 months after trabeculectomy with mitomycin C. Slopes of VF parameters and their correlation with presumed risk factors were studied.ResultsIOP decreased from 19.7±5.8 to 9.7±2.6 mm Hg (P<0.001) over postoperative 1 year. The slopes of all VF parameters did not significantly differ from zero (P>0.33), and none of the presumed factors significantly correlated with the slopes of those parameters (P>0.14). There were two eyes (7%) and one eye (4%) with ≥2 lines of deterioration in BCVA (decimal fraction) at 1 and 12 months, respectively, after surgery with no apparent causes.ConclusionsTrabeculectomy resulted in little change in the central 10-degree VF, but significant decrease in BCVA without apparent causes might occur approximately 5% of the cases. [ABSTRACT FROM AUTHOR]

BACKGROUND: Substantial bone loss and bone defects increase the amount of allografting required in hip revision surgery. Thus, the use of a synthetic material to limit the amount of allograft tissue required for impaction grafting is desirable. We evaluated the potential of hydroxyapatite (HA) mixtures to provide initial mechanical stability to a polished tapered femoral stem. MATERIAL AND METHODS: We determined the initial stability of a polished tapered femoral stem after reconstructing a cavitary femoral bone defect by impaction bone grafting with cement in Sawbones composite femurs. Three types of graft material were tested for their ability to improve initial rotational stability. The graft materials investigated were pure allograft, a mixture of 50% allograft and 50% hydroxyapatite (HA), and pure HA. RESULTS: We found a statistically significant difference between the three groups as regards torsional micromotion and failure load. INTERPRETATION: Our findings suggest that reconstruction of femoral bone defects with pure HA or a mixture of allograft and HA provides adequate initial stability for femoral revision arthroplasty using impaction grafting. [ABSTRACT FROM AUTHOR]