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Niemann-Pick type C (NPC) disease is a rare inherited disease, with progressive neurodegeneration as the main symptom. It is a lysosomal storage disorder caused by mutations in NPC1 or NPC2 genes, leading to a lysosomal cholesterol trafficking impairment. Disease indicators are the clinical suspicion and biomarker levels. However, a genetic study is mandatory for the diagnosis, which is complicated due to the different variants with unknown significance. The aim of this work was to identify the variants responsible for NPC in our pediatric population. Twenty-two samples from non-related infants believed to have NPC disease were analyzed during the last 3 years. Surrogate biomarkers of the disease were evaluated whenever possible. Sanger sequencing for both genes is reported for all samples. Complementary genetic studies were performed when necessary. NPC disease was confirmed in 31.8% of subjects due to homozygous or compound heterozygous genetic variants in NPC1. The following four novel variants were identified: a gross deletion variant composed of the gene promoter and the first exon, NM_000271.3:c.385delT, NM_000271.3:c.1553+1342_1655-291del, and NM_000271.3:c.1757delA. None had functional activity and all resulted in important structural changes in the protein.

Quadratus lumborum block has been shown to provide satisfactory analgesia after caesarean section performed under neuraxial anaesthesia. However, its efficacy has not been demonstrated in patients who have received intrathecal morphine. The aim of this study was to assess the efficacy of quadratus lumborum block as part of a multimodal analgesic regimen including intrathecal morphine. This was a prospective, double-blind, placebo-controlled trial. Participants were randomly allocated to receive bilateral quadratus lumborum block (40 ml levobupivacaine 0.25%) or sham block (control) after undergoing elective caesarean section under spinal anaesthesia. The primary outcome was 24-h morphine consumption measured by patient-controlled analgesia. Secondary outcomes included pain scores and quality of recovery. Data from 86 women were analysed. Median (IQR [range]) 24-h morphine consumption was similar in patients receiving quadratus lumborum block and sham block (12 (8-29 [0-68]) mg vs. 14 (5-25 [0-90]) mg, respectively; p = 0.986). There was a reduction in median (IQR [range]) visual analogue scale pain scores at 6 h with quadratus lumborum block compared with sham block both at rest (6 (0-14 [0-98]) mm vs. 14 (3-23 [0-64]) mm (p = 0.019); and on movement: 23 (10-51 [0-99]) mm vs. 44 (27-61 [2-94]) mm; (p = 0.014)). There was no difference in pain scores at any other time-point up to 48 h. When used in conjunction with intrathecal morphine and spinal anaesthesia, bilateral quadratus lumborum block does not reduce 24-h morphine consumption after caesarean section., (© 2019 Association of Anaesthetists.)

Congenital lactic acidosis (CLA) is a rare condition in most instances due to a range of inborn errors of metabolism that result in defective mitochondrial function. Even though the implementation of next generation sequencing has been rapid, the diagnosis rate for this highly heterogeneous allelic condition remains low. The present work reports our group's experience of using a clinical/biochemical analysis system in conjunction with genetic findings that facilitates the taking of timely clinical decisions with minimum need for invasive procedures. The system's workflow combines different metabolomics datasets and phenotypic information with the results of clinical exome sequencing and/or RNA analysis. The system's use detected genetic variants in 64% of a cohort of 39 CLA-patients; these variants, 14 of which were novel, were found in 19 different nuclear and two mitochondrial genes. For patients with variants of unknown significance, the genetic analysis was combined with functional genetic and/or bioenergetics analyses in an attempt to detect pathogenicity. Our results warranted subsequent testing of antisense therapy to rescue the abnormal splicing in cultures of fibroblasts from a patient with a defective GFM1 gene. The discussed system facilitates the diagnosis of CLA by avoiding the need to use invasive techniques and increase our knowledge of the causes of this condition.

Asthma is a common non-communicable disease, often characterized by activity limitation, negative effects on social life and relationships, problems with finding and keeping employment, and poor quality of life. The objective of the present study was to conduct a systematic review of the literature investigating the potential factors impacting quality of life (QoL) in asthma. Electronic searches were carried out on: MEDLINE, EMBASE, PsycINFO, the Cochrane Library, and Web of Science (initial search April 2017 and updated in January 2019). All primary research studies including asthma, psychological or physical health factors, and quality of life were included. Narrative synthesis was used to develop themes among findings in included studies in an attempt to identify variables impacting QoL in asthma. The search retrieved 43 eligible studies that were grouped in three themes: psychological factors (including anxiety and depression, other mental health conditions, illness representations, and emotion regulation), physical health factors (including BMI and chronic physical conditions), and multifactorial aspects, including the interplay of health and psychological factors and asthma. These were found to have a substantial impact on QoL in asthma, both directly and indirectly, by affecting self-management, activity levels and other outcomes. Findings suggest a complex and negative effect of health and psychological factors on QoL in asthma. The experience of living with asthma is multifaceted, and future research and intervention development studies should take this into account, as well as the variety of variables interacting and affecting the person.

The present work describes the value of genetic analysis as a confirmatory measure following the detection of suspected inborn errors of metabolism in the Spanish newborn mass spectrometry screening program. One hundred and forty-one consecutive DNA samples were analyzed by next-generation sequencing using a customized exome sequencing panel. When required, the Illumina extended clinical exome panel was used, as was Sanger sequencing or transcriptional profiling. Biochemical tests were used to confirm the results of the genetic analysis. Using the customized panel, the metabolic disease suspected in 83 newborns (59%) was confirmed. In three further cases, two monoallelic variants were detected for two genes involved in the same biochemical pathway. In the remainder, either a single variant or no variant was identified. Given the persistent absence of biochemical alterations, carrier status was assigned in 39 cases. False positives were recorded for 11. In five cases in which the biochemical pattern was persistently altered, further genetic analysis allowed the detection of two variants affecting the function of BCAT2, ACSF3, and DNAJC12, as well as a second, deep intronic variant in ETFDH or PTS. The present results suggest that genetic analysis using extended next-generation sequencing panels can be used as a confirmatory test for suspected inborn errors of metabolism detected in newborn screening programs. Biochemical tests can be very helpful when a diagnosis is unclear. In summary, simultaneous genomic and metabolomic analyses can increase the number of inborn errors of metabolism that can be confirmed following suggestive newborn screening results.

Case Report: we present an 85-year-old patient with polydipsia, polyuria and severe hypertriglyceridemia of 27 years of evolution, without pancreatitis, resistant to dietary and pharmacological treatments. He was diagnosed of hyperglycerolemia due to glycerol kinase deficiency (GKD) based on: transparent non-lipemic serum, with glycerol increase in plasma and urine, without glycerol 3 phosphate increase, and a deletion, not previously described, in the glycerol kinase gene., Discussion: a correct dietary treatment with frequent meals and rich in complex carbohydrates, without medication, improved the symptomatology.

This paper describes a method for rapid measurements of the specular X-ray reflectivity signal using an area detector and a monochromatic, well collimated X-ray beam (divergence below 0.01°), combined with a continuous data acquisition mode during the angular movements of the sample and detector. In addition to the total integrated (and background-corrected) reflectivity signal, this approach yields a three-dimensional mapping of the reciprocal space in the vicinity of its origin. Grazing-incidence small-angle scattering signals are recorded simultaneously. Measurements up to high momentum transfer values (close to 0.1 nm -1 , also depending on the X-ray beam energy) can be performed in total time ranges as short as 10 s. The measurement time can be reduced by up to 100 times as compared with the classical method using monochromatic X-ray beams, a point detector and rocking scans (integrated reflectivity signal).

MnAs epitaxial thin films on GaAs(001) single crystalline substrates crystallize at room temperature (RT) in a mixture of two crystalline phases with distinct magnetic properties, organized as stripes along the MnAs [0001] direction. This particular morphology is driven by anisotropic epitaxial strain. We elucidate here the physical mechanisms at the origin of size reduction effect on the MnAs crystalline phase transition. We investigated the structural and magnetic changes in MnAs patterned microstructures (confined geometry) when the lateral dimension is reduced to values close to the periodicity and width of the stripes observed in continuous films. The effects of the microstructure's lateral size, shape and orientation (with respect to the MnAs [Formula: see text] direction) were characterized by local probe synchrotron X-ray diffraction (μ-XRD) using a focused X-ray beam, X-ray Magnetic Circular Dichroïsm - Photo Emission Electron Microscopy (XMCD-PEEM) and Low Energy Electron Microscopy (LEEM). Changes in the transition temperature and the crystalline phase distribution inside the microstructures are evidenced and quantitatively measured. The effect of finite size and strain relaxation on the magnetic domain structure is also discussed. Counter-intuitively, we demonstrate here that below a critical microstructure size, bulk MnAs structural and magnetic properties are restored. To support our observations we developed, tested and validated a model based on the size-dependence of the elastic energy and strain relaxation to explain this phase re-distribution in laterally confined geometry.

Inoculation with arbuscular mycorrhizal (AM) fungi is known to increase the species diversity of plant communities. One mechanism that can increase the likelihood of species co-existence, and thus species diversity, is a trade-off between competitive ability and the magnitude of plant growth response to AM fungal inoculation. By suppressing the growth of strong competitors while simultaneously enhancing the growth of weak competitors, this trade-off would cause the competitive hierarchy to be less pronounced in soil inoculated with AM fungi relative to non-inoculated conditions. To test whether such a trade-off exists, we quantified competitive abilities and mycorrhizal growth response (MGR) among 21 species that co-occur in old fields in southern Ontario. Competitive ability was determined by calculating competitive effect (CE), or the degree to which each species suppressed the biomass of a common phytometer species, Plantago lanceolata. Higher CE values represent stronger competitive ability. Old-field species varied in their ability to suppress the biomass of the phytometer and MGR was generally positive. There was a statistically significant negative correlation between CE in non-inoculated soil and MGR (r = -0.49, P = 0.02). In addition, variance in CE was 73% lower in soil inoculated with AM fungi compared to non-inoculated soil (P = 0.0023). These findings support the hypothesis that AM fungi weaken strong competitors while enhancing the performance of weak competitors. Because this trade-off compressed the competitive hierarchy among old-field species in soil inoculated with AM fungi, it may be a mechanism by which mycorrhizal fungi enhance species evenness and diversity.

The HERMES beamline (High Efficiency and Resolution beamline dedicated to X-ray Microscopy and Electron Spectroscopy), built at Synchrotron SOLEIL (Saint-Auban, France), is dedicated to soft X-ray microscopy. The beamline combines two complementary microscopy methods: XPEEM (X-ray Photo Emitted Electron Microscopy) and STXM (Scanning Transmission X-ray Microscopy) with an aim to reach spatial resolution below 20 nm and to fully exploit the local spectroscopic capabilities of the two microscopes. The availability of the two methods within the same beamline enables the users to select the appropriate approach to study their specific case in terms of sample environment, spectroscopy methods, probing depth etc. In this paper a general description of the beamline and its design are presented. The performance and specifications of the beamline will be reviewed in detail. Moreover, the article is aiming to demonstrate how the beamline performances have been specifically optimized to fulfill the specific requirements of a soft X-ray microscopy beamline in terms of flux, resolution, beam size etc. Special attention has been dedicated to overcome some limiting and hindering problems that are usually encountered on soft X-ray beamlines such as carbon contamination, thermal stability and spectral purity.

X-ray diffraction techniques are used in imaging mode in order to characterize micrometre-sized objects. The samples used as models are metal-oxide tunnel junctions made by optical lithography, with lateral sizes ranging from 150 µm down to 10 µm and various shapes: discs, squares and rectangles. Two approaches are described and compared, both using diffraction contrast: full-field imaging (topography) and raster imaging (scanning probe) using a micrometre-sized focused X-ray beam. It is shown that the full-field image gives access to macroscopic distortions (e.g. sample bending), while the local distortions, at the micrometre scale (e.g. tilts of the crystalline planes in the vicinity of the junction edges), can be accurately characterized only using focused X-ray beams. These local defects are dependent on the junction shape and larger by one order of magnitude than the macroscopic curvature of the sample.

The newly built MagSAXS (magnetic small-angle X-ray scattering) set-up dedicated to the direct two-dimensional measurement of magnetic scattering using polarized synchrotron radiation in extreme sample environments is presented. Pure optical transport of the image is used to record the magnetic scattering with a two-dimensional CCD visible-light camera. The set-up is able to probe magnetic correlation lengths from the micrometer down to the nanometer scale. A detailed layout is presented along with preliminary results obtained at several beamlines at Synchrotron SOLEIL. The presented examples underline the wide range of possible applications spanning from correlation lengths determination to Fourier transform holography.

Magnetic atoms at surfaces are a rich model system for solid-state magnetic bits exhibiting either classical or quantum behaviour. Individual atoms, however, are difficult to arrange in regular patterns. Moreover, their magnetic properties are dominated by interaction with the substrate, which, as in the case of Kondo systems, often leads to a decrease or quench of their local magnetic moment. Here, we show that the supramolecular assembly of Fe and 1,4-benzenedicarboxylic acid molecules on a Cu surface results in ordered arrays of high-spin mononuclear Fe centres on a 1.5 nm square grid. Lateral coordination with the molecular ligands yields unsaturated yet stable coordination bonds, which enable chemical modification of the electronic and magnetic properties of the Fe atoms independently from the substrate. The easy magnetization direction of the Fe centres can be switched by oxygen adsorption, thus opening a way to control the magnetic anisotropy in supramolecular layers akin to that used in metallic thin films.

An experimental setup has been developed to perform soft x-ray coherent scattering at beamline ID08 of the European Synchrotron Radiation Facility. An intense coherent beam was obtained by filtering the primary beam with the monochromator and a circular pinhole. A pinhole holder with motorized translations was installed inside the UHV chamber of the diffractometer. The scattered intensity was recorded in reflection geometry with a back-illuminated charge coupled device camera. As a demonstration we report experimental results of resonant magnetic scattering using coherent beam. The degree of coherence is evaluated, and it is shown that, while the vertical coherence is much higher than the horizontal one at the source, the situation is reversed at the diffractometer. The intensity of the coherent beam is also discussed.

Eight sectioned specimens and 8 cadavers were used to evaluate the location of the vertebral artery in the cervicothoracic junction. The results of the measurements showed that there was no significant difference between either sides at the C7-T1 junction in terms of all distances taken. The mean width of the vertebral artery was 2.9 mm at the levels of the C-7 and T-1. The sagittal distance between the vertebral artery and the posterior cortex was 16.8+/-3.0 mm at the C7 and 21.7+/-2.8 mm at T-1. The coronal distance between the vertebral artery and the midline of the vertebra was 17.5+/-1.8 mm at the C7 and 22.3+/-2.9 mm at the T-1. The mean angle between the line connecting the lateral border of the vertebral artery with the posterior midway of the lateral mass and the parasagittal line at C-7 was 14.1+/-6.1 degrees. The mean angle of the vertebral artery with respect to the midline was 22.8+/-6.4 degrees. This study suggests that the vertebral artery has closer anatomic relationship to the C-7 lateral mass. Care should be taken to avoid injury to the vertebral artery if lateral mass screw fixation at the C-7 is intended.

Seven adult cadaver lumbopelvises were harvested to study the anatomic relationship of the L4 and L5 nerves to S1 dorsal screw placement and the location of the L4, L5, and S1 nerves on plain radiographs. The mean lateral angle of S1 screw trajectory toward the L4 nerve was 31+/-8 degrees, and the mean screw trajectory length was 53+/-8 mm. The mean lateral angle of the screw trajectory toward the L5 nerve was 21+/-8 degrees, and the mean screw trajectory length was 38+/-4 mm. On both inlet and outlet radiographs, the lateral angle of the nerves increased from L4 to S1. The L4 nerve coursed over the middle third of the superior ala in the inlet view and the middle third of the lateral mass in the outlet view. The L5 nerve coursed over the inner third of the superior ala and inner third of the lateral mass. On the lateral view, the mean distances from the sacral promontory to the L4, L5, and S1 nerves along the anterior border of the sacrum were 4+/-7 mm, 12+/-5 mm, and 28+/-8 mm, respectively. This study suggests that S1 sacral screws be directed between 30 degrees and 40 degrees lateral to avoid compromising the lumbosacral trunk and sacroiliac joint.

Because dimensions of the upper sacral cortexes vary greatly among individuals, preoperative computed tomographic (CT) evaluation of individual sacrum may help surgeons choose sacral screw insertion techniques. Axial CT scans were performed on 40 dry sacrum specimens to quantitatively evaluate the internal structure of the lateral sacral mass in the first and second segments. The results showed that the greatest cortical thickness in the S1 vertebra was found in the anterior cortex (3.4+/-0.9 mm), followed by the anterolateral (3.2+/-1.2 mm), and anteromedial (2.9+/-1 mm). The greatest cortical thickness in the S2 region was noted in the anteromedial cortex (2.4+/-0.5 mm), followed by the anterior and anterolateral (2.2+/-0.9 mm). The mean percentage of the anterior cortex thickness versus the lateral sacral mass depth was 12.8+/-3.7 for S1 and 11.1+/-2.8 for S2. Bicortical screw placement is recommended to achieve stronger fixation, but care should be taken not to violate the vital structures anterior to the sacrum.

Eight cervical specimens were transversely sectioned with slices approximately 2 mm to 3 mm in thickness to evaluate the anatomic relationship of the spinal nerves to the lateral masses. Results showed that the spinal nerve either does not appear or, when it does, is situated anteromedially to the superior facet on the cross sections through the upper portion of the superior facet. The anterolateral aspect of the superior facet is free from the spinal nerve. Cross sections through the lower pedicle of the vertebra showed that the spinal nerve rested on the transverse process anterolateral to the lateral mass. The mean distances between the posterior midline of the lateral mass and the posterior border of the spinal nerve measured 15 degrees in the lateral direction were 16.1+/-1.7 mm for C3, 16.5+/-1.8 mm for CA, 16.8+/-1.2 mm for C5, 16.3+/-2.0 mm for C6, and 8.5+/-0.9 mm for C7. This study suggests that the anterolateral corner of the superior facet and the anterior aspect of the lateral mass lateral to the origin of the transverse process would be safer zones for screw exit. Attention should therefore be paid to the screw orientation for the Magerl technique and to the screw length for the Roy-Camille technique. Care should be taken to insert the screw into the C7 lateral mass.

Axial computed tomography scans with a slice thickness of 2 mm taken from 12 cervical spines were used to study the internal structure of the lateral mass. Images representing the middle of zone I (Heller's classification) and the top of zone III were analyzed. The measurement of zone I involved anterior cortex thickness (ACT) while measurements of zone III included ACT, lateral cortex thickness (LCT), posterior cortex thickness (PCT), lateral mass thickness (LMT), and lateral mass width (LMW). The percentage of the ACT and PCT with respect to the LMT (ACT/LMT and PCT/LMT) were calculated. Results showed the average ACT in zone I ranged from 1.6 to 1.8 mm. In zone III, the average LMT and LMW ranged from 8 to 9 mm and 13 to 15 mm, respectively. The smallest LMT was found at C7. The average ACT and PCT for all levels ranged from 1.8 to 2 mm. The ACT with respect to the LMT (ACT/LMT) was approximately 17% to 19% for C3 to C5 and C7, and 15% for C6 separately. The PCT with respect to the LMT (PCT/LMT) was approximately 16% to 18% for C3 to C6, and 20% for C7. These results show the ventral cortex of the lateral mass is relatively thicker and support the concept of bicortical screw purchase.

Thirty-three cadaveric dissections were performed to identify radial nerve branching patterns to the triceps brachii. Radial innervation of the long head of the triceps originated in the axilla in 88% of the cases and the brachio-axillary angle in 12%. Innervation of the medial head of the triceps originated in the spiral groove in 52% of the cases, the brachio-axillary angle in 39%, and the axilla in 9%. The lateral head was innervated by branches arising in the spiral groove in 70% of the cases, the brachio-axillary angle in 24%, and the axilla in 6%. On average, the radial nerve crossed the midline in the proximal 45% of the arm, 3 cm superior to the level of the deltoid insertion. An intramuscular tendon was present in the medial head of the triceps. The tendon, located medial to the midline of the arm, was seen in all specimens. This tendon serves as an interneural plane with nerve branches descending on either side, but never crossing from one side to the other. Due to the complexity of radial nerve branching, this tendon may be used as a reference plane for longitudinal splitting of the medial head minimizing the risk of nerve damage.

Study Design: This study analyzed anatomic parameters between the midpoint of cervical vertebral lateral masses as seen on the superficial, posterior aspect of the mass and cervical nerve roots. Posterior cervical dissection was performed, with the midpoint of the lateral masses kept intact and the nerve roots exposed., Objective: To quantitatively determine the location of the cervical nerve roots and the transverse foramina, indicating vertebral artery placement relative to the posterior aspect of the cervical spine., Summary of Background Data: Posterior plate-screw fixation of the cervical spine has been widely used to treat unstable fractures of the cervical spine. However, injury to the spinal nerve roots during the procedure remains an important concern. No previous anatomic study regarding the location of the cervical nerve roots relative to the posterior aspect of the cervical spine has been reported., Methods: Fifteen specimens were obtained for study of the cervical spine. Laminectomy and partial removal of the superior and inferior articular facets then were performed on C2-C3 through C7-T1 to expose the nerve roots and dura. Photographs, containing a reference scale, were taken simultaneously perpendicular to the sagittal and transverse planes of the specimen. Using enlarged versions of the photographs, independent measurements by several observers were taken from the superficial, posterior center of each lateral mass to the nerve root superiorly and inferiorly, and to the lateral limits of the dura. Vertebrae from an additional 20 spines were examined to determine the position of the transverse foramina relative to the lateral mass of the vertebrae., Results: The results showed that for C3-C7, the average distance from the superficial, posterior center of the lateral mass to the nerve root superiorly was 5.7 +/- 1.5 mm. Inferiorly, the average distance was 5.5 +/- 0.8 mm. The average distance from the lateral mass to the spinal cord dura was 9.2 +/- 1.4 mm, and the average medial angle of the nerve root was 76.3 degrees +/- 4.4 degrees. For cervical vertebrae C3-C5, the transverse foramina were situated medial to the posterior center of the lateral mass. At the C6 level, the transverse foramina were situated anterior to the posterior midpoint of the lateral mass., Conclusion: This study demonstrates that the posterior midpoint of the lateral mass is a safe point for initiating screw insertion.

Study Design: This study analyzed the anatomic relationships between bony structures and soft tissues of the cervicothoracic junction., Objectives: To provide composite reference data for intrasegmental and intersegmental gradients of anatomic variation within the cervical-thoracic junction., Summary of Background Data: Because the risk of soft tissue damage during posterior spinal stabilization, an understanding of bony and soft tissue changes in the cervicothoracic junction is necessary., Methods: Three-hundred-twenty-four cross-sectional spinal segments from nine spines were analyzed to characterize cervicothoracic junctional anatomy., Results: There were predictable cranial-to-caudal alterations in both bone and soft tissue anatomy of the cervicothoracic junction. Neural and vascular structures directly anterior to the lateral mass or transverse process and lateral to the pedicle tend to decrease in frequency, whereas measured parameters of the vertebrae increase in size from C5-T3, except for pedicle dimensions that tend to increase at the C7-T1 junction., Conclusion: The anatomic changes that occur within the cervicothoracic junction are consistent and predictable, and their recognition should lead to a better appreciation of their clinical implications.

Study Design: Linear and angular measurements were performed on 128 vertebrae (16 spines) from C5 to T5., Objectives: Vertebrae were studied to characterize vertebral shape and size changes in the cervico-thoracic region., Summary of Background Data: Analysis of vertebral anatomy has been extensive and well characterized. Regions of transitional anatomy necessitate further study due to the often abrupt changes in anatomic relationships., Methods: Two observers performed linear and angular measurements including pedicle width, height, and length, as well as pedicle-body, pedicle-lamina, lamina-transverse process, and pedicle-lamina angular measurements. Pedicle axis projection on the posterior aspect of the lamina was also calculated., Results: The mean pedicle width ranged from 7.8 mm (T1) to 4.4 mm (T5). The body-pedicle angle decreased > 4 degrees per level in the transverse plane, from 50 degrees (C5) to 11 degrees (T5). The axial projection of the pedicle changed throughout the region (compared with level above) and was significant for T1., Conclusions: Because of the complexities of the cervico-thoracic junction, additional characterization increases the knowledge of the anatomic relationships in this region.

One hundred eighty-four cemented primary total articular replacement arthroplasty (TARA) resurfacing total hip procedures were performed by a single surgeon from 1981 to 1985. One hundred seventy-four hips had a mean follow-up period of eight years (range, 3.5-10.4 years). Osteoarthrosis was the predominant diagnosis (79%). Failure was defined as a hip needing additional surgery because of an implant failure and occurred in 13.2% of the patients. No statistically significant difference was found between preoperative etiology, patient gender, or the side of the hip involved between the revised and unrevised patients. The revised group was seven years younger at the time of TARA implantation than the group that was not revised (55.7 versus 65.3 years), with significance to the p < 0.01 level. Survival analysis demonstrated an 87.1% chance of survival at seven years, decreasing to 84.5% at ten years. The cemented TARA hip replacement has a better intermediate-to long-term success than other resurfacing designs reported using cemented fixation. However, this does not compare favorably with the longevity of cemented Charnley total hip replacements reported at similar intervals.