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  1. Article ; Online: Safe Sex After Total Hip Arthroplasty: Using Computed Tomography-Based Robotics to Evaluate "At-Risk" Sexual Positions.

    Stegelmann, Samuel D / Butler, Justin T / Hiatt, John L / Bullock, Matthew W

    The Journal of arthroplasty

    2023  Volume 39, Issue 2, Page(s) 433–440.e4

    Abstract: Background: Total hip arthroplasty (THA) can improve sexual satisfaction, but fear of dislocation can lead to sexual difficulties following this procedure. Previous kinematic research identified 4 sexual positions in women and 2 in men that were ... ...

    Abstract Background: Total hip arthroplasty (THA) can improve sexual satisfaction, but fear of dislocation can lead to sexual difficulties following this procedure. Previous kinematic research identified 4 sexual positions in women and 2 in men that were considered at risk for impingement. This study aimed to validate these findings using current robotic THA simulations.
    Methods: The 3-dimensional renderings from 12 patients who received computed tomography (CT)-based robotic THA were used to assess for prosthetic and/or bony impingement among 12 popular sexual positions. There were 9 cup orientations tested for each position (a combination of anteversion [0 °, 15 °, and 30 °] and inclination [40 °, 45 °, and 60 °]). The at-risk positions were tested again using the unique hip positions and cup orientations where previous geometric modeling data found impingement to occur.
    Results: Using mean hip positions, impingement occurred in at least 1 patient in 1 of the 12 positions for women (position 5) and 5 of the 12 positions for men (positions 1, 5, 8, 10, and 11). Among the at-risk positions, impingement occurred in none of the 2 at-risk women positions (0 of 17 cup orientations) and in both at-risk men positions (9 of 9 cup orientations for position 8 and 1 of 1 for position 11).
    Conclusion: Recreating popular and at-risk sexual positions following THA with a CT-based robotics system yielded results that were inconsistent with previous geometric modeling data. Resolving these discrepancies is crucial for surgeons to provide accurate postoperative patient education. The CT-based robotic systems may provide necessary input to feasibly individualize such recommendations, but current limitations in CT-based robotics require continued attention and innovation.
    MeSH term(s) Male ; Humans ; Female ; Arthroplasty, Replacement, Hip/methods ; Hip Joint/diagnostic imaging ; Hip Joint/surgery ; Hip Prosthesis ; Safe Sex ; Tomography, X-Ray Computed
    Language English
    Publishing date 2023-08-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2023.08.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Chronic Exertional Compartment Syndrome in the Forearm of a Collegiate Softball Pitcher.

    Cole, Austin / Hiatt, John L / Arnold, Christopher / Sites, Terry / Ylanon, Ramon

    Sports medicine - open

    2017  Volume 3, Issue 1, Page(s) 11

    Abstract: Background: Chronic exertional compartment syndrome (CECS) is a recognized condition in the lower limb, with many reports in the literature. However, very few instances include CECS of the upper limb. This article presents the case of a collegiate ... ...

    Abstract Background: Chronic exertional compartment syndrome (CECS) is a recognized condition in the lower limb, with many reports in the literature. However, very few instances include CECS of the upper limb. This article presents the case of a collegiate softball pitcher presenting with CECS in her right forearm. To our knowledge, this is the first case report of a softball player with CECS, with only one similar incident in a major league baseball player.
    Purpose: The rarity of this condition normally places it low on the differential diagnosis. However, we hope that the presentation of this case and the review of the literature will aid in making swift and accurate diagnoses of CECS in future patients. We discuss the importance of three specific modalities in the diagnosis of this patient, what diagnostic criteria proved less conclusive, and the paradoxical course the syndrome presented with.
    Study design: Case Review RESULTS: Over a six-month period, the patient presented with peculiar presentations and exam results. A broad list of differential diagnoses had to be narrowed down through the presence or absence of relevant findings. These included cessation of exercise for 1 month, physical therapy, anti-inflammatory medicines, an electromyography/electromyogram (EMG), nerve conduction study (NCS), non-exercise magnetic resonance imaging (MRI) of the forearm, cervical MRI, and cervical computed tomography (CT) angiogram. After the above interventions were attempted and the relative findings of three important modalities were summarized, a fasciotomy and release of the dorsal, volar, and mobile wad compartments was performed. The patient's symptoms were relieved, and she eventually returned to full play in softball at the university.
    Conclusions: The three diagnostic criteria we believed to be most helpful in this case, and for future cases of CECS in the forearm, include the clinical presentation, pre- and post-exercise MRI, and pre- and post-exercise compartment pressure measurements.
    Clinical relevance: Chronic exertional compartment syndrome of the forearm is extremely rare, especially in the female athlete. This case report and review of the literature may be helpful to the clinician facing similar cases. It describes which clinical tests are most helpful for diagnosis and which findings may be distracting.
    Language English
    Publishing date 2017-03-17
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2809942-4
    ISSN 2198-9761 ; 2199-1170
    ISSN (online) 2198-9761
    ISSN 2199-1170
    DOI 10.1186/s40798-017-0080-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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