Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.1 (ERK)
 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite ongoing evolution in total knee arthroplasty (TKA) prosthesis design, restricted flexion continues to be common postoperatively. Compressive tibiofemoral force during flexion is generated through the interaction between soft tissues and prosthesis geometry. In this study, we compared the compressive tibiofemoral force in vitro of four commonly used prostheses: fixed-bearing PCL (posterior cruciate ligament)-retaining (PFC), mobile-bearing posterior-stabilized (PS), posterior-stabilized with a High Flex femoral component (HF), and mobile-bearing PCL-sacrificing (LCS). Fourteen fresh-frozen cadaver knee joints were tested in a passive motion rig, and tibiofemoral force measured using a modified tibial baseplate instrumented with six load cells. The implants without posterior stabilization displayed an exponential increase in force after 90 degrees of flexion, while PS implants maintained low force throughout the range of motion. The fixed-bearing PFC prosthesis displayed the highest peak force (214 +/- 68 N at 150 degrees flexion). Sacrifice of the PCL decreased the peak force to a level comparable with the LCS implant. The use of a PCL-substituting post and cam system reduced the peak force up to 78%, irrespective of whether it was a high-flex or a standard PS knee. However, other factors such as preoperative range of motion, knee joint kinematics, soft tissue impingement, and implantation technique play a role in postoperative knee function. The present study suggests that a posterior-stabilized TKA design might be advantageous in reducing soft tissue tension in deep flexion. Further research is necessary to fully understand all factors affecting knee flexion after TKA.
 ...
PMID:Tibiofemoral force following total knee arthroplasty: comparison of four prosthesis designs in vitro. 1756 18

Authors of the article present the results of TKR by LCS cementless prosthesis manufactured by DePuy.This system is aimed at reducing stress concentration between femoral and tibial components in order to minimise the polyethylene wear. This is achieved by the increase of constraint between polyethylene insert and femoral component and at the same time by facilitating the defined motion between the insert and the metal tibial component by the system of mobile bearings. In the period 1992 through 1997 the implant was used at 1 st Orthopaedic Clinic of 1 st Medical Faculty, Charles University in Prague as a joint replacement in 63 cases in 56 patients. In 12 cases (19 %) we used prosthesis retaining posterior cruciate ligament with meniscal bearings and in 51 cases (81 %) a PCL sacrificing system, with a rotating platform. The evaluation of results started minimum one year after the surgery, in seven patients the period of follow-up was 5 years. The resulting average motion range in the group of patients is 0 degrees -105 degrees . After arthroplasty the joint is classified as stable in 61 cases, in two cases slight instability is persisting. Radiograph does not show in any of the patients signs of loosening of components or infection. In 5 patients there persists patellar pain. No other complications were encountered. We also evaluated our results using New Jersey Orthopaedics Hospital Knee Evaluation System: the result of surgeries was evaluated in the multicentric study of LCS system in the USA. Excellent result was achieved in 51 cases (80,9 %), good in 10 cases (15,8 %) and satisfactory in 2 patients (3,3 %).The authors consider the LCS system as one of the best among the existing TKR systems. Key words: total Replacement, LCS.
 ...
PMID:[Outcomes of TKR by Cementless LCS Total Endoprosthesis.]. 2049 83

This report aimed to provide the full results of QoL assessment in INFORM study. QoL was assessed by FACT-L questionnaire. QoL improvement ratio in gefitinib arm was higher than placebo arm (FACT-L: 46% vs. 22%, p < 0.001; TOI: 41% vs. 18%, p < 0.001; LCS: 46% vs. 22%, p < 0.001). Gefitinib prolonged time-to-worsening of QoL (FACT-L: 2.8 m vs 1.4 m, p = 0.019; TOI: 3.5 m vs 1.4 m, p = 0.006; LCS: 2.8 vs 1.4 m, p = 0.028). Patients with an improvement in QoL had longer PFS (FACT-L: 9.4 m vs. 2.8 m vs. 2.7 m, P < 0.001; TOI: 9.9 m vs. 2.8 m vs. 2.1 m, P < 0.001; LCS: 9.4 m vs. 2.9 m vs. 2.1 m, P < 0.001) and OS (FACT-L: 25.4 m vs. 19.9 m vs. 14.4 m, P = 0.003; TOI: 25.7 m vs. 19.0 m vs. 12.7 m, P = 0.002; LCS: 25.4 m vs. 19.3 m vs. 14.7 m, P = 0.004) compared with patients with stable or worsened QoL. Furthermore, in patients with good QoL at baseline, the treatment of gefitinib couldn't improve OS compared to placebo, whereas patients with low QoL experienced marginal significant improvement in OS (20.6 m vs 14.4, p = 0.051). Our study indicated that gefitinib could improve patients' QoL, confirmed the prognostic value of QoL changes during treatment, and implied patients with low QoL at baseline may be the potential population which will gain OS benefit from maintenance EGFR-TKI therapy.
 ...
PMID:QoL analyses from INFORM study, a phase III study of gefitinib versus placebo as maintenance therapy in advanced NSCLC. 2613 16