Purpose: In the existing literature, isolated femoral head and polyethylene liner exchange is commonly performed in revision total hip arthroplasty (THA) for a variety of indications with mixed outcomes. The purpose of this study is to investigate patient outcomes following head-liner exchange and risk factors associated with failure in THA. Materials and Methods: A retrospective chart review from May 2016 to November 2023 was conducted on patients who underwent isolated head-liner exchange at two institutions. Patients had minimum 1-year follow-up periods. For each patient, data such as indication for revision, surgical approach, revision head size, immediate and short-term complications, postoperative disposition, 90-day readmissions, and re-operations were recorded. Results: Out of 175 patients, there were 24 readmissions/emergency department visits within 90 postoperative days (13.7%), 21 subsequent revision surgeries (12.0%), 21 postoperative dislocations (12.0%), and 20 immediate postoperative complications (11.4%). A statistically significant association was demonstrated between indication for revision and postoperative instability (P=0.04). Patients operated upon for instability had higher rates of postoperative instability. Furthermore, patients with reported preoperative dislocation events had higher incidences of postoperative dislocations. Patients discharged to skilled nursing facilities (SNF) were associated with an increased number of hospital readmissions within 90 days of surgery, reoperation, and postoperative dislocation (P<0.05). No statistically significant associations were found between surgical approach and complications. Conclusion This study suggests that, in the context of isolated head-liner exchanges, factors such as preoperative dislocation history, indication for revision, and discharge to SNF are associated with poorer outcomes and complications.

Background: and Purpose Infarcts in acute ischemic stroke (AIS) patients may continue to grow even after reperfusion, due to mechanisms such as microvascular obstruction and reperfusion injury. We investigated whether and how much infarcts grow in AIS patients after near-complete (expanded Thrombolysis in Cerebral Infarction [eTICI] 2c/3) reperfusion following endovascular treatment (EVT), and to assess the association of post-reperfusion infarct growth with clinical outcomes. Methods: Data are from a single-center retrospective observational cohort study that included AIS patients undergoing EVT with near-complete reperfusion who received diffusion-weighted magnetic resonance imaging (MRI) within 2 hours post-EVT and 24 hours after EVT. Association of infarct growth between 2 and 24 hours post-EVT and 24-hour National Institutes of Health Stroke Scale (NIHSS) as well as 90-day modified Rankin Scale score was assessed using multivariable logistic regression. Results: Ninety-four of 155 (60.6%) patients achieved eTICI 2c/3 and were included in the analysis. Eighty of these 94 (85.1%) patients showed infarct growth between 2 and 24 hours post-reperfusion. Infarct growth ≥5 mL was seen in 39/94 (41.5%) patients, and infarct growth ≥10 mL was seen in 20/94 (21.3%) patients. Median infarct growth between 2 and 24 hours post-reperfusion was 4.5 mL (interquartile range: 0.4–9.2 mL). Post-reperfusion infarct growth was associated with the 24-hour NIHSS in multivariable analysis (odds ratio: 1.16 [95% confidence interval 1.09–1.24], P<0.01). Conclusion Infarcts continue to grow after EVT, even if near-complete reperfusion is achieved. Investigating the underlying mechanisms may inform future therapeutic approaches for mitigating the process and help improve patient outcome.

Benzene, a recognized hematotoxicant and carcinogen, can damage the human immune system. We studied the association between single nucleotide polymorphisms (SNPs) in genes involved in innate immunity and benzene hematotoxicity in a cross-sectional study of workers exposed to benzene (250 workers and 140 controls). A total of 1,236 tag SNPs in 149 gene regions of six pathways were included in the analysis. Six gene regions were significant for their association with white blood cell (WBC) counts (MBP, VCAM1, ALOX5, MPO, RAC2, and CRP) based on gene-region (P < 0.05) and SNP analyses (FDR < 0.05). VCAM1 rs3176867, ALOX5 rs7099684, and MPO rs2071409 were the three most significant SNPs. They showed similar effects on WBC subtypes, especially granulocytes, lymphocytes, and monocytes. A 3-SNP block in ALOXE3 (rs7215658, rs9892383, and rs3027208) showed a global association (omnibus P = 0.0008) with WBCs even though the three SNPs were not significant individually. Our study suggests that polymorphisms in innate immunity genes may play a role in benzene-induced hematotoxicity; however, independent replication is necessary.
Adult ; Arachidonate 5-Lipoxygenase/genetics/*metabolism ; Benzene/toxicity ; Cell Count ; Cross-Sectional Studies ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; Hematologic Diseases/chemically induced/genetics/*metabolism/pathology ; Humans ; Immunity, Innate/genetics ; Leukocytes/*drug effects/metabolism/pathology ; Male ; Occupational Exposure/adverse effects ; Peroxidase/genetics/*metabolism ; Polymorphism, Single Nucleotide ; Vascular Cell Adhesion Molecule-1/genetics/*metabolism