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  1. Article ; Online: Long-term follow-up of an uncemented proximally hydroxyapatite-coated femoral stem in total hip arthroplasty.

    Yee, Andy H F / Chan, Vincent W K / Fu, Henry / Chan, Ping-Keung / Chiu, Kwong Y

    The bone & joint journal

    2024  Volume 106-B, Issue 3 Supple A, Page(s) 110–114

    Abstract: Aims: The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years.: Methods: We reviewed the results of 165 THAs using the Omnifit ...

    Abstract Aims: The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years.
    Methods: We reviewed the results of 165 THAs using the Omnifit HA system in 138 patients, performed between August 1993 and December 1999. The mean age of the patients at the time of surgery was 46 years (20 to 77). Avascular necrosis was the most common indication for THA, followed by ankylosing spondylitis and primary osteoarthritis. The mean follow-up was 22 years (20 to 31). At 20 and 25 years, 113 THAs in 91 patients and 63 THAs in 55 patients were available for review, respectively, while others died or were lost to follow-up. Kaplan-Meier analysis was performed to evaluate the survival of the stem. Radiographs were reviewed regularly, and the stability of the stem was evaluated using the Engh classification.
    Results: A total of seven stems (4.2%) were revised during the study period: one for aseptic loosening, three for periprosthetic fracture, two for infection, and one for recurrent dislocation. At 20 years, survival with revision of the stem for any indication and for aseptic loosening as the endpoint was 96.0% (95% confidence interval (CI) 92.6 to 99.5) and 98.4% (95% CI 96.2 to 100), respectively. At 25 years, the corresponding rates of survival were 94.5% (95% CI 89.9 to 99.3) and 98.1% (95% CI 95.7 to 99.6), respectively. There was radiological evidence of stable bony fixation in 86 stems (76.1%) and evidence of loosening in four (3.5%) at 20 years. All patients with radiological evidence of loosening were asymptomatic.
    Conclusion: The Omnifit HA femoral stem offered promising long-term survival into the third decade.
    MeSH term(s) Humans ; Middle Aged ; Arthroplasty, Replacement, Hip/methods ; Durapatite ; Follow-Up Studies ; Hip Prosthesis ; Prosthesis Design ; Prosthesis Failure ; Reoperation ; Treatment Outcome ; Young Adult ; Adult ; Aged
    Chemical Substances Durapatite (91D9GV0Z28)
    Language English
    Publishing date 2024-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.106B3.BJJ-2023-0844.R1
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  2. Article ; Online: Radiomics analysis of patellofemoral joint improves knee replacement risk prediction: Data from the Multicenter Osteoarthritis Study (MOST).

    Zhang, Jiang / Jiang, Tianshu / Chan, Lok-Chun / Lau, Sing-Hin / Wang, Wei / Teng, Xinzhi / Chan, Ping-Keung / Cai, Jing / Wen, Chunyi

    Osteoarthritis and cartilage open

    2024  Volume 6, Issue 2, Page(s) 100448

    Abstract: Objective: Knee replacement (KR) is the last-resort treatment for knee osteoarthritis. Although radiographic evidence of tibiofemoral joint has been widely adopted for prognostication, patellofemoral joint has gained little attention and may hold ... ...

    Abstract Objective: Knee replacement (KR) is the last-resort treatment for knee osteoarthritis. Although radiographic evidence of tibiofemoral joint has been widely adopted for prognostication, patellofemoral joint has gained little attention and may hold additional value for further improvements. We aimed to quantitatively analyse patellofemoral joint through radiomics analysis of lateral view radiographs for improved KR risk prediction.
    Design: From the Multicenter Osteoarthritis Study dataset, we retrospectively retrieved the initial-visit lateral left knee radiographs of 2943 patients aged 50 to 79. They were split into training and test cohorts at a 2:1 ratio. A comprehensive set of radiomic features were extracted within the best-performing subregion of patellofemoral joint and combined into a radiomics score (RadScore). A KR risk score, derived from Kellgren-Lawrence grade (KLG) of tibiofemoral joint and RadScore of patellofemoral joint, was developed by multivariate Cox regression and assessed using time-dependent area under receiver operating characteristic curve (AUC).
    Results: While patellofemoral osteoarthritis (PFOA) was insignificant during multivariate analysis, RadScore was identified as an independent risk factor (multivariate Cox p-value < 0.001) for KR. The subgroup analysis revealed that RadScore was particularly effective in predicting rapid progressor (KR occurrence before 30 months) among early- (KLG < 2) and mid-stage (KLG ​= ​2) patients. Combining two joints radiographic information, the AUC reached 0.89/0.87 for predicting 60-month KR occurrence.
    Conclusions: The RadScore of the patellofemoral joint on lateral radiographs emerges as an independent prognostic factor for improving KR prognosis prediction. The KR risk score could be instrumental in managing progressive knee osteoarthritis interventions.
    Language English
    Publishing date 2024-02-24
    Publishing country England
    Document type Journal Article
    ISSN 2665-9131
    ISSN (online) 2665-9131
    DOI 10.1016/j.ocarto.2024.100448
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  3. Article ; Online: Adaptive Fusion of Deep Learning with Statistical Anatomical Knowledge for Robust Patella Segmentation from CT Images.

    Zhao, Jiachen / Jiang, Tianshu / Lin, Yi / Chan, Lok-Chun / Chan, Ping-Keung / Wen, Chunyi / Chen, Hao

    IEEE journal of biomedical and health informatics

    2024  Volume PP

    Abstract: Knee osteoarthritis (KOA), as a leading joint disease, can be decided by examining the shapes of patella to spot potential abnormal variations. To assist doctors in the diagnosis of KOA, a robust automatic patella segmentation method is highly demanded ... ...

    Abstract Knee osteoarthritis (KOA), as a leading joint disease, can be decided by examining the shapes of patella to spot potential abnormal variations. To assist doctors in the diagnosis of KOA, a robust automatic patella segmentation method is highly demanded in clinical practice. Deep learning methods, especially convolutional neural networks (CNNs) have been widely applied to medical image segmentation in recent years. Nevertheless, poor image quality and limited data still impose challenges to segmentation via CNNs. On the other hand, statistical shape models (SSMs) can generate shape priors which give anatomically reliable segmentation to varying instances. Thus, in this work, we propose an adaptive fusion framework, explicitly combining deep neural networks and anatomical knowledge from SSM for robust patella segmentation. Our adaptive fusion framework will accordingly adjust the weight of segmentation candidates in fusion based on their segmentation performance. We also propose a voxel-wise refinement strategy to make the segmentation of CNNs more anatomically correct. Extensive experiments and thorough assessment have been conducted on various mainstream CNN backbones for patella segmentation in low-data regimes, which demonstrate that our framework can be flexibly attached to a CNN model, significantly improving its performance when labeled training data are limited and input image data are of poor quality.
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2695320-1
    ISSN 2168-2208 ; 2168-2194
    ISSN (online) 2168-2208
    ISSN 2168-2194
    DOI 10.1109/JBHI.2024.3372576
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  4. Article: Radiomics signature of osteoarthritis: Current status and perspective.

    Jiang, Tianshu / Lau, Sing-Hin / Zhang, Jiang / Chan, Lok-Chun / Wang, Wei / Chan, Ping-Keung / Cai, Jing / Wen, Chunyi

    Journal of orthopaedic translation

    2024  Volume 45, Page(s) 100–106

    Abstract: Osteoarthritis (OA) is one of the fast-growing disability-related diseases worldwide, which has significantly affected the quality of patients' lives and brings about substantial socioeconomic burdens in medical expenditure. There is currently no cure ... ...

    Abstract Osteoarthritis (OA) is one of the fast-growing disability-related diseases worldwide, which has significantly affected the quality of patients' lives and brings about substantial socioeconomic burdens in medical expenditure. There is currently no cure for OA once the bone damage is established. Unfortunately, the existing radiological examination is limited to grading the disease's severity and is insufficient to precisely diagnose OA, detect early OA or predict OA progression. Therefore, there is a pressing need to develop novel approaches in medical image analysis to detect subtle changes for identifying early OA development and rapid progressors. Recently, radiomics has emerged as a unique approach to extracting high-dimensional imaging features that quantitatively characterise visible or hidden information from routine medical images. Radiomics data mining via machine learning has empowered precise diagnoses and prognoses of disease, mainly in oncology. Mounting evidence has shown its great potential in aiding the diagnosis and contributing to the study of musculoskeletal diseases. This paper will summarise the current development of radiomics at the crossroads between engineering and medicine and discuss the application and perspectives of radiomics analysis for OA diagnosis and prognosis.
    The translational potential of this article: Radiomics is a novel approach used in oncology, and it may also play an essential role in the diagnosis and prognosis of OA. By transforming medical images from qualitative interpretation to quantitative data, radiomics could be the solution for precise early OA detection, progression tracking, and treatment efficacy prediction. Since the application of radiomics in OA is still in the early stages and primarily focuses on fundamental studies, this review may inspire more explorations and bring more promising diagnoses, prognoses, and management results of OA.
    Language English
    Publishing date 2024-03-16
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 2747531-1
    ISSN 2214-031X
    ISSN 2214-031X
    DOI 10.1016/j.jot.2023.10.003
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  5. Article: Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series.

    Ramasamy, Boopalan / Hammat, Aaron Scott / Nelson, Renjy / Callary, Stuart Adam / Chan, Ping Keung / Solomon, Lucian Bogdan

    Arthroplasty today

    2023  Volume 23, Page(s) 101218

    Abstract: Hip prosthetic joint infection management is complex and expensive, especially in severe bone loss. Reducing the price of interval prosthesis when performing staged revision could minimize costs without compromising outcomes. We present 2 similar ... ...

    Abstract Hip prosthetic joint infection management is complex and expensive, especially in severe bone loss. Reducing the price of interval prosthesis when performing staged revision could minimize costs without compromising outcomes. We present 2 similar techniques developed independently that use an antibiotic-coated cephalomedullary nail with a total hip arthroplasty bearing (head and cemented acetabular component) attached to it as an interval proximal femoral replacement prosthesis. Using this technique, the femoral implant cost was reduced up to 10-fold. All patients have recovered well with resolution of infection and functional recovery similar to patients undergoing proximal femoral replacement. In one case, the lag screw (femoral neck) fractured at 5 months prompting the second-stage revision. This complication should be considered when deciding the timing of second-stage revisions in these cases.
    Language English
    Publishing date 2023-10-03
    Publishing country United States
    Document type Journal Article
    ISSN 2352-3441
    ISSN 2352-3441
    DOI 10.1016/j.artd.2023.101218
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  6. Article: Two-stage Partial Component Retention and Interim Cemented Liner for Infected Total Hip Arthroplasty: A Case Report.

    Luk, Michelle Hilda / Fu, Henry / Chan, Ping Keung / Ng, Fu Yuen / Chiu, Kwong Yuen

    Journal of orthopaedic case reports

    2023  Volume 13, Issue 10, Page(s) 6–10

    Abstract: Introduction: There is interest in partial exchange for infected total hip arthroplasty, as an alternative to complete removal of components in a traditional two-stage revision. Partial exchange avoids the difficulty of removing a well-fixed component ... ...

    Abstract Introduction: There is interest in partial exchange for infected total hip arthroplasty, as an alternative to complete removal of components in a traditional two-stage revision. Partial exchange avoids the difficulty of removing a well-fixed component and its associated bone loss.
    Case report: We report a case of a 61-year-old male patient with an infected total hip arthroplasty, who underwent a two-stage partial exchange, with retention of the well-fixed femoral stem, and an interim cemented liner. He had excellent function and no infection recurrence at 4 years of follow-up.
    Conclusion: Two-stage partial exchange with interim cemented liner could be an effective option for infected total hip arthroplasty.
    Language English
    Publishing date 2023-10-11
    Publishing country India
    Document type Case Reports
    ZDB-ID 2658169-3
    ISSN 2250-0685
    ISSN 2250-0685
    DOI 10.13107/jocr.2023.v13.i10.3914
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  7. Article ; Online: Risk factors associated with surgical site infections following joint replacement surgery: a narrative review.

    Li, Tao / Zhang, Haining / Chan, Ping Keung / Fung, Wing Chiu / Fu, Henry / Chiu, Kwong Yuen

    Arthroplasty (London, England)

    2022  Volume 4, Issue 1, Page(s) 11

    Abstract: Background: Surgical site infection following joint replacement surgery is still a significant complication, resulting in repeated surgery, prolonged antibiotic therapy, extended postoperative hospital stay, periprosthetic joint infection, and increased ...

    Abstract Background: Surgical site infection following joint replacement surgery is still a significant complication, resulting in repeated surgery, prolonged antibiotic therapy, extended postoperative hospital stay, periprosthetic joint infection, and increased morbidity and mortality. This review discusses the risk factors associated with surgical site infection.
    Related risk factors: The patient-related factors include sex, age, body mass index (BMI), obesity, nutritional status, comorbidities, primary diagnosis, living habits, and scores of the American Society of Anesthesiologists physical status classification system, etc. Surgery-related factors involve preoperative skin preparation, prolonged duration of surgery, one-stage bilateral joint replacement surgery, blood loss, glove changes, anti-microbial prophylaxis, topical anti-bacterial preparations, wound management, postoperative hematoma, etc. Those risk factors are detailed in the review.
    Conclusion: Preventive measures must be taken from multiple perspectives to reduce the incidence of surgical site infection after joint replacement surgery.
    Language English
    Publishing date 2022-05-01
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2524-7948
    ISSN (online) 2524-7948
    DOI 10.1186/s42836-022-00113-y
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  8. Article ; Online: A Randomized Controlled Study on the Use of Tourniquet in Primary Total Knee Arthroplasty.

    Zhang, Chaofan / Yan, Chun Hoi / Chan, Ping Keung / Fu, Henry / Chiu, Kwong Yuen

    The journal of knee surgery

    2022  Volume 35, Issue 6, Page(s) 698–706

    Abstract: Background:  The use and the optimal timing of tourniquet during primary total knee arthroplasty (TKA) is controversial. Most previous studies failed to show clinically significant differences in different strategies. The aim of this study was to ... ...

    Abstract Background:  The use and the optimal timing of tourniquet during primary total knee arthroplasty (TKA) is controversial. Most previous studies failed to show clinically significant differences in different strategies. The aim of this study was to determine how three strategies of tourniquet application affect the outcome in TKA patients.
    Methods:  This was a prospective randomized controlled study. Patients who undergo TKA were randomized into one of the three groups (1:1:1 ratio): tourniquet inflated from skin incision to cement hardening, tourniquet from cement application to hardening, and tourniquet from skin incision to skin closure. The perioperative blood loss, limb swelling, and complications were recorded. The level of hemoglobin, hematocrit, C-reactive protein (CRP), interleukin (IL)-6, creatine kinase (CK), and lactate dehydrogenase (LDH) were determined. Patients' thigh and TKA wound pain, Knee Society knee score (KSKS) and Knee Society functional assessment (KSFA) scores, and rehabilitation parameters were evaluated.
    Results:  A total of 90 patients were enrolled. The baseline characteristics were comparable. We only found significant difference in the intraoperative blood loss (skin to cement: 58.7 ± 36.1 mL, cement-only: 147.8 ± 107.9 mL, skin to skin: 16.3 ± 13.1 mL,
    Conclusion:  Our results revealed that there was no best tourniquet strategy in TKA. Different tourniquet methods can be utilized based on surgeon preference without affecting outcomes.
    MeSH term(s) Arthroplasty, Replacement, Knee/adverse effects ; Blood Loss, Surgical/prevention & control ; Bone Cements ; Hemoglobins ; Humans ; Knee Joint/surgery ; Prospective Studies ; Tourniquets/adverse effects
    Chemical Substances Bone Cements ; Hemoglobins
    Language English
    Publishing date 2022-01-03
    Publishing country Germany
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/s-0041-1740926
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    Zs.A 3867: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  9. Article ; Online: Prediction of Total Knee Arthroplasty Sizes with Demographics, including Hand and Foot Sizes.

    Chan, Vincent W K / Chan, Ping Keung / Fu, Henry / Cheung, Man Hong / Cheung, Amy / Tang, Thomas C M / Chiu, Kwong Yuen

    The journal of knee surgery

    2023  

    Abstract: Anticipating implant sizes before total knee arthroplasty (TKA) allows the surgical team to streamline operations and prepare for potential difficulties. This study aims to determine the correlation and derive a regression model for predicting TKA sizes ... ...

    Abstract Anticipating implant sizes before total knee arthroplasty (TKA) allows the surgical team to streamline operations and prepare for potential difficulties. This study aims to determine the correlation and derive a regression model for predicting TKA sizes using patient-specific demographics without using radiographs. We reviewed the demographics, including hand and foot sizes, of 1,339 primary TKAs. To allow for comparison across different TKA designs, we converted the femur and tibia sizes into their anteroposterior (AP) and mediolateral (ML) dimensions. Stepwise multivariate regressions were performed to analyze the data. Regarding the femur component, the patient's foot, gender, height, hand circumference, body mass index, and age was the significant demographic factors in the regression analysis (R-square 0.541,
    Language English
    Publishing date 2023-11-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/a-2198-7983
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  10. Article ; Online: Metal-on-crosslinked polyethylene in total hip arthroplasty - an excellent combination at fifteen to twenty years of follow-up.

    Cheung, Amy / Chan, Ping Keung / Fu, Henry / Cheung, Man Hong / Chan, Vincent Wai Kwan / Luk, Michelle Hilda / Chiu, Kwong-Yuen

    International orthopaedics

    2023  Volume 47, Issue 10, Page(s) 2547–2552

    Abstract: Purpose: Cross-linked polyethylene (PE) has been used with great clinical success in total hip arthroplasty (THA) since its debut in the late 1990's. However, reports regarding this bearing couple near the end of its second decade of service are still ... ...

    Abstract Purpose: Cross-linked polyethylene (PE) has been used with great clinical success in total hip arthroplasty (THA) since its debut in the late 1990's. However, reports regarding this bearing couple near the end of its second decade of service are still scant. The aim of this study was to first determine the long term clinical and radiological results and second Investigate what factors affect wear rates using a metal-on-crosslinked PE bearing articulation.
    Methods: 55 THAs using a single brand of cross-linked liner, cementless cup and 28 mm hip ball were performed in 44 patients. Age, sex, Charlson Comorbidity Index (CCI) and need for revision surgery were recorded. Linear and volumetric wear was determined using the Martell method.
    Results: Mean age at operation was 51.2 (29-73 ± 12.1) years. Mean duration of follow-up was 16.9 years (range 15.0-20.1 ± 1.1 years). Osteolysis was not present in the latest follow-up radiographs. Median linear and volumetric wear rate was 0.038 mm/year (95% CI 0.032-0.047) and 7.115mm3/year (95% CI 6.92-17.25) respectively. Acetabular component position was not found to be related to both linear and volumetric wear. No significant difference was found in the linear and volumetric wear rates of thinner and thicker liners (8 mm or below and > 8 mm) (p = 0.849 and p = 0.64 respectively).
    Conclusion: Metal-on-crosslinked PE is associated with low linear and volumetric wear rates which has virtually obviated osteolysis and has translated to excellent survivorship even at long term follow up. In-vivo oxidation does not appear to be of clinical concern at this point.
    Language English
    Publishing date 2023-05-29
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 80384-4
    ISSN 1432-5195 ; 0341-2695
    ISSN (online) 1432-5195
    ISSN 0341-2695
    DOI 10.1007/s00264-023-05844-4
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