Cup Group Research Articles

Comparison of the short-term functional results after surface replacement and total shoulder arthroplasty for osteoarthritis of the shoulder: a matched-pair analysis

The purpose of this clinical study with a matched-pair design was to compare the functional short-term results obtained in patients with primary osteoarthritis of the shoulder treated with cementless surface replacement of the humeral head (CUP) with those obtained after total shoulder replacement (TSR). Twenty-two patients (average age 61.4 years; 11 men, 11 women) with primary osteoarthritis who obtained surface replacement of the humeral head were matched to a control group of 22 patients (average age 61.1 years, 11 men, 11 women) with the same in- and exclusion criteria that were treated with a total shoulder arthroplasty. Preoperative status, perioperative results and postoperative status (Constant score and subcategories, subjective status, range of motion, radiographic evaluation) were compared in all patients and controls. Non-parametric analyses were used to compare the results in both groups. Patients in the CUP group showed significantly better perioperative results (time of surgery, blood loss, days of inpatient treatment) compared to the patients in the TSR group. Results at 6 and 12 months revealed significant improvement of clinical function, significant pain reduction, and high subjective satisfaction rates in both groups. Concerning the absolute values, there were tendencially better results obtained in the TSR group compared to the CUP group at 12 months follow-up (Constant score 67.23 +/- 11.71 vs. 59.25 +/- 14.53), but only the criteria "mobility" and "abduction" revealed statistical significance. Regarding the relative improvement at 12 months compared to the baseline status, patients treated with TSR showed a significant better benefit in the total Constant score (+41.32 +/- 0.04 vs. +26.16 +/- 8.82) and in range of motion. Regarding the subjective assessment, there was no statistically significant difference in patients with TSR (mean value 1,5 (+/-0.55)) and patients with CUP (mean value 2,3 (+/-0.92)). Two CUP implants had to be removed during the follow-up period owing to secondary glenoidal erosion. At short-term follow-up, surface replacement as a technically less demanding technique provided only slightly inferior results to TSR. We therefore believe that CUP arthroplasty is a therapeutic option and can be recommended in patients with primary osteoarthritis when limited to strictly defined indications.

Sonohysterography: Is the Hysterosalpingographic Vacuum Cup a Valid Alternative Device for Cannulation of the Cervical Os?

To determine whether sonohysterography (SHG) should be performed with Plexiglas hysterosalpingographic vacuum cups instead of standard catheters. In a prospective setting, 226 women randomly classified into 2 groups underwent SHG. The method used for cervical cannulation was a two-way catheter in the first group (n = 108) and a Plexiglas hysterosalpingographic vacuum cup in the second one (n = 118). Diagnostic reliability, easy applicability for the physician, discomfort for the patients and cost of the instruments were assessed for both devices. 226/226 (100 %) complete sonohysterographic examinations were performed. As regards uterine cavity distension the same diagnostic reliability was reported for vacuum cups and two-way catheters. The standard catheter obscured the cervical canal because of the dilation of the balloon. Both methods were judged as easy to use, and no statistically significant difference was found as far as the time required for cervical cannulation (p > 0.05). A little more discomfort was recorded by women who underwent sonohysterography with standard balloon catheters but a greater interpersonal variability was noticed in this group (SD 3.65 vs. 1.13 in the vacuum cup group). Vacuum cups were by far the most economical devices (unit cost: 16.70 euro vs. catheter unit cost 46.20 euro). Vacuum cups allow sonohysterography to be correctly performed. As they are inexpensive, easy to use, better tolerated by the patients and more helpful for visualisation of the lower third of the uterine cavity, vacuum cups should be considered a serious alternative to standard catheters in the performance of SHG.

A randomised controlled trial of a new handheld vacuum extraction device

To evaluate the effectiveness of a new handheld vacuum delivery device. Randomised controlled trial. Southmead Hospital, Bristol, UK. One hundred and ninety-four women requiring delivery with vacuum extraction. Women were recruited into the study while still in early labour. If during delivery, vacuum extraction was indicated they were then randomly allocated to either a new handheld vacuum device, the Kiwi Omnicup, or to a 'standard' vacuum cup selected by the obstetrician. The 'standard group' consisted of the silastic (66/98, 67%) or the metal cups (32/98, 33%). Study data were recorded at completion of the delivery and at 24-48 hours. An additional brief symptom questionnaire was completed by the mother at 10 days postnatally. Statistical analyses were done on an 'intention-to-treat' basis. The primary outcome was the successful completion of delivery with the allocated instrument. Secondary outcomes were substantial fetal scalp trauma and substantial maternal trauma. The Omnicup was associated with a significantly higher failure rate than the standard cup [34%vs 21%, odds ratio (OR) = 1.9 (1.01-3.6)]. This difference persisted after adjusting for confounding factors [adjusted OR = 2.25 (1.01-5.0)] and resulted in significantly more forceps deliveries in the Kiwi Omnicup group [22%vs 10%, unadjusted OR = 2.5 (1.1-5.5)]. The caesarean section rates were similar in both groups [9.4%vs 8.2%, OR = 1.2 (0.4-3.2)]. Rates of substantial scalp trauma and maternal trauma were similar in both groups. However, there were more cases of jaundice in the standard cup group [2.3%vs 12.0%, unadjusted OR = 0.18 (0.04-0.82) and adjusted OR = 0.10 (0.01-0.88)]. The Omnicup is not as successful at achieving a vaginal delivery as the combination of the currently used vacuum cups.

Offset acetabular cups: A solution to wear?

Change of tribological properties has been the main goal in the effort to augment the longevity of total hip arthroplasty, while the reduction of forces acting across the artificial joint space has received little attention. Spurred by recent reports of wear behaviour and good clinical results of the offset low friction arthroplasty cups, the authors, using the simplified free body technique, estimated the resultant hip joint reaction force and the angle of its application on 100 individual anteroposterior pelvic radiographs, by templating on the same hip a conventional concentric cup and an offset eccentric one. The results showed a highly significant reduction (p<0.0001) of the resultant hip joint reaction force in the offset group by 28.8% or 1.02 body weight and of the angle of the hip joint reaction force by 2.8 degrees. The authors believe that the reduction of the resultant hip joint reaction force in the offset cup group is the result of lowering and medialising the centre of rotation of the hip, a previously reported fact on non-clinically applicable conditions. They are also tempted to propose the generalized use of the offset type acetabular cup, since adverse events are not anticipated. (Hip International 2005; 15: 149-54).

Offset acetabular cups: A solution to wear?

Change of tribological properties has been the main goal in the effort to augment the longevity of total hip arthroplasty, while the reduction of forces acting across the artificial joint space has received little attention. Spurred by recent reports of wear behaviour and good clinical results of the offset low friction arthroplasty cups, the authors, using the simplified free body technique, estimated the resultant hip joint reaction force and the angle of its application on 100 individual anteroposterior pelvic radiographs, by templating on the same hip a conventional concentric cup and an offset eccentric one. The results showed a highly significant reduction (p<0.0001) of the resultant hip joint reaction force in the offset group by 28.8% or 1.02 body weight and of the angle of the hip joint reaction force by 2.8 degrees. The authors believe that the reduction of the resultant hip joint reaction force in the offset cup group is the result of lowering and medialising the centre of rotation of the hip, a previously reported fact on non-clinically applicable conditions. They are also tempted to propose the generalized use of the offset type acetabular cup, since adverse events are not anticipated. (Hip International 2005; 15: 149-54).

Acupuncture treatment of 51 cases of menopausal perspiration

Fifty-one cases of menopause syndrome were randomly divided into three groups, 21 cases in the acupuncture and cupping group, 10 cases in the acupuncture group, and 20 cases in the ear acupuncture group, and were respectively treated by acupuncture plus cupping therapy, acupuncture, and ear acupuncture. The total effective rate was respectively 80.9%, 20.0% and 80.0%. The therapeutic effect was better in the treatment of menopause syndrome by acupuncture plus cupping therapy than by single acupuncture treatment or ear acupuncture (P<0.05).

Long-term in vivo wear performance of porous-coated acetabular components sterilized with gamma irradiation in air or ethylene oxide

This study evaluated the long-term in vivo wear performance of 2 groups of well-functioning cementless acetabular cups sterilized by different methods. The first group included 31 hips that were implanted with AML TriSpike cups (DePuy, Warsaw, IN) sterilized by γ-irradiation in air. The second group included 28 hips implanted with Arthropor cups (Joint Medical Products, Stamford, CT) that were sterilized with ethylene oxide. Time-dependent variations in the radiographic wear rates were compared within each group. Changes in the wear rates between 4- and 16-year follow-up times for the TriSpike cups were not significant ( P=.09), and there was no evidence to suggest a trend toward substantially increasing wear rates with longer follow-up times. Among the Arthropor cups, the wear rates remained relatively constant between 2 and 14 years of follow-up evaluation. Although clinically apparent late increases in radiographic head penetration rates were not evident, we will continue to monitor all patients for evidence of accelerated wear at late follow-up.

Randomized Clinical Trial of Pacifier Use and Bottle-Feeding or Cupfeeding and Their Effect on Breastfeeding

To enhance breastfeeding practices, the World Health Organization discourages pacifiers and bottle-feeding. However, the effect of artificial nipples on breastfeeding duration is poorly defined. The effects of 2 types of artificial nipple exposure on breastfeeding duration were evaluated: 1) cupfeeding versus bottle-feeding for the provision of in-hospital supplements and 2) early (2-5 days) versus late (>4 weeks) pacifier introduction. A total of 700 breastfed newborns (36-42 weeks, birth weight >or=2200 g) were randomly assigned to 1 of 4 intervention groups: bottle/early pacifier (n = 169), bottle/late pacifier (n = 167), cup/early pacifier (n = 185), or cup/late pacifier (n = 179). The cup/bottle intervention was invoked for infants who received supplemental feedings: cup (n = 251), bottle (n = 230). Data were collected at delivery and at 2, 5, 10, 16, 24, 38, and 52 weeks' postpartum. Intervention effects on breastfeeding duration were evaluated with logistic regression and survival analyses. Supplemental feedings, regardless of method (cup or bottle), had a detrimental effect on breastfeeding duration. There were no differences in cup versus bottle groups for breastfeeding duration. Effects were modified by the number of supplements; exclusive and full breastfeeding duration were prolonged in cup-fed infants given >2 supplements. Among infants delivered by cesarean, cupfeeding significantly prolonged exclusive, full, and overall breastfeeding duration. Exclusive breastfeeding at 4 weeks was less likely among infants exposed to pacifiers (early pacifier group; odds ratio: 1.5; 95% confidence interval: 1.0-2.0). Early, as compared with late, pacifier use shortened overall duration (adjusted hazard ratio: 1.22; 95% confidence interval: 1.03-1.44) but did not affect exclusive or full duration. There was no advantage to cupfeeding for providing supplements to the general population of healthy breastfed infants, but it may have benefitted mother-infant dyads who required multiple supplements or were delivered by cesarean. Pacifier use in the neonatal period was detrimental to exclusive and overall breastfeeding. These findings support recommendations to avoid exposing breastfed infants to artificial nipples in the neonatal period.

Use of a paper disposable cup as a spacer is effective for the first-aid management of asthma

Objective: There are many settings in which a spacer device is not available for the administration of bronchodilator. Therefore, we tested whether a paper disposable cup is as effective as a commercially produced spacer to administer bronchodilator. Methodology: Randomised controlled trial. 50 subjects aged 16–50 years who had wheeze and a greater than 10% decrease in FEV 1 after histamine inhalation test (HIT). Subjects were randomised to either the 150 ml paper disposable cup group (CUP) or the commercially produced spacer group (SPACER). Twenty minutes after 400μg salbutamol was administered FEV 1 was measured. The recovery index measured post-bronchodilator FEV 1 as a percentage of baseline FEV 1. Also, analysis of covariance tested whether recovery of FEV 1 was related to the magnitude of the fall following the HIT. Results: There were no statistically significant differences between CUP and SPACER groups in any characteristics. There was no difference for the recovery index ( t 48=1.14, P =0.26). Regression analyses showed that the relation between the magnitude of the fall in FEV 1 during the HIT and the percent recovery was not different between the CUP and SPACER groups ( t=−1.2, P <0.23). Conclusions: A paper disposable cup was effective for the reversal of mild to moderate bronchoconstriction. Therefore, a paper disposable cup can be used for the first-aid management of asthma when there is concern about cross-infection and a commercially produced spacer is not available.

Early Failure of Acetabular Component after Total Hip Arthroplasty in Irradiated Hip

Purpose : The treatment of the osteonecrosis in the acetabulum and femoral head after irradiation has not been well estabilished. The early failure of acetabular component after total hip arthroplasty (THA) is the main concern in osteonecrosis after irradiation. Materials and Methods : Our study included 18 patients with post-radiation osteonecrosis of 26 hips who had a THA, mean age 54.2 years. Average irradiation dosage was 4611 cGy and interval between irradiation and primary total hip replacement was 64.3 months. The cementless acetabular components were used in 16 hips (group one) and acetabular reinforcement rings were used in 10 hips (group two: Muller cup 6 cases, Ganz cup 4 cases). Results : Acetabular loosenings were occurred at 8 of 16 hips (Group 1: 50%) during the mean follow-up 46 months. The cases of M ller cup (Group 2: 33%) was failed in 2 of 6 hips at postoperative 12 months and 22 months. Conclusion : Although follow up duration is short and cases are small, the use of cemented cup with acetabular reinforcement ring was better than non-cemented cup for THA in irradiated hip in terms of preventive of early failure of acetabular component.

Physiologic Stability of Newborns During Cup- and Bottle-feeding

To prevent breastfeeding problems, cup-feeding has been recommended as a method of providing medically necessary supplemental feedings to breastfed infants. To compare amounts ingested, administration time, and infant physiologic stability during cup-, bottle-, and breastfeeding. A total of 98 term, healthy newborns were randomized to either cup-feeding (n = 51) or bottle-feeding (n = 47). The heart (HR), respiratory (RR), and oxygen (O(2)) saturation rates were monitored on these infants and 25 breastfed newborns during 1 feeding. Differences in amounts ingested and administration times were evaluated with t tests and physiologic data with repeat measures analysis of variance. There were no significant differences in administration time, amounts ingested or overall HR, RR, and (O(2)) saturation rates, between cup and bottle groups. Breastfed infants had longer administration times and lower overall HR, RR, and higher O(2) saturation as compared with cup- and bottle-fed infants. Administration times, amounts ingested, and infant physiologic stability do not differ with cup- and bottle-feeding. Breastfeeding takes longer than cup- or bottle-feeding, but infants experience less physiologic variability. These data support cup-feeding as an alternative to bottle-feeding for supplying supplements to breastfed infants.

Acetabular cup migration. Prediction of aseptic loosening

We measured the proximal migration of 265 acetabular cups over seven years and correlated the findings with clinical outcome and acetabular revision for aseptic loosening. Cups which eventually became aseptically loose were shown to migrate more rapidly than successful cups. The average proximal migration at two years postoperatively for four groups of cups showed a monotonic relationship to the acetabular revision rate for aseptic loosening at 6.5 years. We conclude that acetabular cups which develop aseptic loosening as evidenced by pain, revision or screw fracture show increased proximal migration by one year, and that the 'migration rate' at two years can be used to predict the acetabular revision rate from aseptic loosening at 6.5 years.

Comparison of the results of cemented, porous-ingrowth, and threaded acetabular cup fixation: A meta-analysis of the orthopaedic literature

A meta-analysis of the orthopaedic literature was performed to evaluate the clinical performance of cementless, threaded acetabular cups. The hypothesis for the study was that the clinical performance of the cementless, threaded acetabular cup is equivalent to that of the cemented and porous-ingrowth acetabular cups. Ninety-five articles were included in the study. There were 1,269 cases in the threaded cup group, 1,979 in the porous control group, and 10,230 in the cemented control group. The primary outcome variable tested was the rate of aseptic loosening of the acetabular components as measured by the revision rates following the index total hip arthroplasty procedure. Other measures of acetabular component loosening that were analyzed included clinical rating scores, pain scores, frequency of radiolucencies according to location and size, frequency of radiolucencies as a separately defined outcome variable, progressive radiolucencies, and component migration. The threaded cup group was found to have a significantly higher rate of revision, clinical and pain score failures, progressive radiolucencies and migrations when compared with the cemented and porous control groups ( P < .05). Despite the many limitations of meta-analyses and the poor state of the orthopaedic literature database, this study provides a reasonable comparison of the clinical performance of threaded acetabular cups with that of cemented and porous-ingrowth acetabular cups.

A randomized prospective study comparing delivery with metal and silicone rubber vacuum extractor cups

Objective To determine the relative benefits and complications of assisted vaginal delivery with metal and silicone rubber vacuum extractor cups. Design Prospective randomized controlled study. Setting A busy referral maternity hospital in Kathmandu, Nepal. Subjects 101 women were assigned to delivery with the Silc-cup and 98 to delivery with the metal cup. Main outcome measures Success rate at achieving delivery with the assigned Instrument and incidence of neonatal trauma. Analysis was by ‘intention to deliver’ with women remaining in their original group regardless of the eventual mode of delivery. Results Randomization resulted in two groups of women similar in respect of age, parity, gestation and indication for delivery. The overall success rate was similar for the two instruments (Silc-cup 85% and metal cup 87%). The Silc-cup was more likely to fail if there was excessive caput (seven failures compared with one in the metal cup group). The frequency of clinically significant maternal trauma was low in both groups. There were fewer babies with clinically significant scalp trauma in the Silc-cup group (22%), compared with the metal cup group (37%). Conclusions The data indicate a greater tendency for the Silc-cup to fail when excessive caput is present but that metal cups are associated with increased scalp injuries.

Comparison between metal cup and silicone rubber cup vacuum extractor

A total of 400 primiparous patients who were delivered by vacuum extractor were studied. The patients were divided in two groups: Group A included 200 patients who were delivered by metal cup vacuum extractor and Group B consisted of 200 patients who were delivered by rubber cup vacuum extractor. There were no statistically significant differences in the mean maternal age, mean gestational age, mean neonatal birth weight, indications for operative delivery, occipital positions and head stations between the two groups. No differences were found in the rates of birth canal trauma (11% vs. 12.5%), major neonatal scalp trauma (6.5% vs. 5.5%), neonatal jaundice (15.5% vs. 13.5%) and Apgar score. From this study we can conclude that both metal and silicone cups are equally satisfactory for vacuum extraction.

Mechanical stability of porous-coated acetabular components in total hip arthroplasty

Five different porous-coated acetabular prosthetic configurations underwent in vitro testing to assess mechanical stability in embalmed cadaver hemipelves: Harris Galante II cup with three cancellous screws, Biomet Universal cup, Whiteside cup with peripheral pegs, Whiteside cup with two cancellous screws, and plain Whiteside cup. Following implantation in a neutral frame, cyclic load testing was done using 33 specimens at 100-kg load for 100,000 cycles using an MTS machine (MTS Systems Corp., Minneapolis, MN). Subsequently, static load-to-failure testing was done in all specimens. Subsidence and micromovement were determined for each specimen using linear variable differential transformers. With cyclic testing, overall cup subsidence revealed a significant increase, from 500 to 100,000 cycles. Overall cup micromovement revealed a significant decrease, and all cup groups demonstrated less than 125 μm (125 mm) of average mean micromotion at the completion of cyclic testing. The best cup configuration was a 1-mm, oversized, press-fit cup using two 6.5 cancellous screws for additional fixation, which revealed an average mean of 60 μm (.06 mm) of micromovement. Static load testing revealed unacceptable micromovement over 150 μm (.150 mm) in most cups with 300-kg loads

Cup products and group extensions

AbstractLet G be a finitely generated group and let R be a commutative ring, regarded as a G-module with G acting trivially. We shall determine when the cup product of two elements of H1(G, R) is zero. Our method will use the interpretation of H2(G, R) as extensions of G by R. This will give an alternative demonstration of results of Hillman and Würfel.

Establishing the Relationship between Complement Activation and Stimulation of Phagocyte Oxidative Metabolism in Hemodialyzed Patients: A Randomized Prospective Study

The present prospective study was conducted in order to establish the relationship between complement activation and stimulation of phagocyte oxidative metabolism observed in long-term hemodialysis (HD) patients during the early phase of dialysis with cellulosic membranes. Two groups of 10 randomized (HD) patients treated with cellulosic (Cuprophan, CUP) or synthetic polyacrilonitrile (PAN AN-69) membranes were studied. Leukocyte counts, C3a antigen plasma concentration and whole blood basal and stimulated chemiluminescence (CL) production were determined in blood samples drawn from the fistula before dialysis (T0) and from both the afferent and efferent lines of the dialyser at 15 min (T15) and at the end (Tend) of the dialysis session. This study confirms that, coincident with the nadir of leukopenia observed at T15, dialysis with CUP but not PAN membranes induces a marked rise in C3a antigen levels and profound alterations in whole blood CL production consisting of a dramatic increase in basal CL and a significant loss in CL response capacity to stimulating agents. It further demonstrates that a direct relationship exists between the variations in C3a antigen plasma levels and whole blood CL production observed in the CUP group of patients from T0 to T15 (delta 15) of dialysis. This relationship is characterized by a positive correlation between delta 15 C3a and delta 15 basal CL levels in afferent and efferent lines, and a negative correlation between delta 15 C3a and delta 15 CL response capacity values in the efferent but not afferent line. In contrast, no significant correlation with the type of dialysis membrane could be demonstrated between the variations in polymorphonuclear neutrophil counts and C3a antigen levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlation of color vision deficits and observable changes in the optic disc in a population of ocular hypertensives.

Both glaucomatous cupping and the presence of acquired color vision deficits have been reported to be precursors to the onset of visual field defects in patients with suspected glaucoma. To examine the relationship between early glaucomatous cupping and acquired color vision anomalies, we performed anomaloscope (Pickford-Nicholson) and Farnsworth-Munsell 100-Hue color vision tests in 48 ocular hypertensive eyes with either clinical evidence of early glaucomatous cupping (group 1) or no evidence of glaucomatous cupping (group 2). All patients had normal visual fields, as determined by extensive static perimetry of the central visual field and kinetic perimetry of the peripheral visual field. Although the overall incidence of blue and blue-green color vision anomalies in the ocular hypertensives was comparable with that reported in previous studies, we found no clear association between early glaucomatous cupping and color vision anomalies. The relationship between these two precursors to visual field loss remains unclear.

Some Variations in Ulocrinus and Hydreionocrinus

In furtherance of an intention expressed in a former paper (Geol. Mag., Vol. LXIII, 1926, p. 143), I propose, in this communication, to give some statistics of the anal variations in 542 cups, all of which are referred to the genus Ulocrinus. Additional details are also given of similar variations in 130 cups referred to Hydreionocrinus. Fifty of the latter have already been dealt with elsewhere (Trans. Geol. Soc. Glasgow, vol. xvi, pt. iii, 1917–18, p. 383), but to complete the survey of the anal area in the four groups of cups for the present, it is thought advisable to include them here. The classification here adopted is the same as that given for Eupachycrinus calyx and Zeacrinus konincki, namely:—