text:
realmagick.com The shrine of knowledge.
Chanakya Death Of Chanakya
A selection of articles related to chanakya death of chanakya.
Original articles from our library related to the Chanakya Death Of Chanakya. See Table of Contents for further available material (downloadable resources) on Chanakya Death Of Chanakya.
- Select Cross-Cultural and Historical Personifications of Death
- This extensive introduction includes some of the more well known, along with some lesser known Death "incarnations", and I use that term loosely, as in many cultures, the Angel of Death can be quite an adept shapeshifter. We have tried to cull...
Mystic Sciences >> Necromantic Studies
- That Glimmer of Life: Death, The Energy Body & Its Aura
- When persons are nearing death, their auras change dramatically. As a mystic and healer with many years experience, I have probably had more opportunities than most to observe the auras of people with terminal illnesses, in the weeks, days, hours and minutes...
Body Mysteries >> Auras
- Shamanic Death
- What is a Shaman's death, and who's likely to have one? The death itself is a suspension between worlds. States of consciousness. The individual today, who is likely to have a "Shamanic Death" is chasing extinction itself. Through that process the...
Religions >> Native American, Shamanism
- The Aeonic Perspective of the Enochian Temples
- The initiatory system of the Enochian Temples divides the path of initiation into four major stages, distinguished primarily by the types and sources of the influences they are sensitive to. Briefly, these stages are: 1. Lunar-planetary, focused in Yesod and...
Magick >> Enochian
- Baba Yaga: A Demon or A Goddess?
- Growing up in Kiev, Ukraine, I loved reading and listening to fairy tales. These stories, filled with Slavic flavor, were opening up a new world for me, a world where one is to learn lessons and always to succeed, a world in which no matter how many hardships...
Deities & Heros >> Slavic
- The Pagan Origins Of Christian Mythology
- The Judeo-Christian religions were founded in a region of the world where savior religions existed for thousands of years. Much of the symbolism and many of the stories in the Bible may be traced to earlier myths of the Persians, Egyptians, and other people...
Religions >> Christianity & Paganism
- 13 - Death
- The skeleton with the scythe symbolizes the cutting through of old structures in our life, for instance relationships or patterns. By doing so we can move forward, so that death in one form becomes birth in a new form. Meaning: transformation, (sudden)...
Tarot Cards >> The Major Arcana
Chanakya Death Of Chanakya is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Chanakya Death Of Chanakya books and related discussion.
Suggested News Resources
- Ashoka shows arrows to someone! Chakravartin Ashoka Samrat 18th March 2016
- Dharma says it was the wish of Acharya Chankya and Ashoka respected the Acharya Chanakya a lot. Bindu says that he cannot forgive Ashoka, as it is Ashoka who is killer of the Draupad. ...
- Chakravartin Ashoka Samrat 17th March 2016: Ashok Escapes Prison
- Drupad was Samrat that day, so he died. You will become Samrat. No can stop you except me.
- 'Chakravartin Ashoka Samrat': Manoj Joshi, aka Chanakya, Sacked or Quit
- History has nothing to do with how Manoj Joshi, aka Chanakya, is killed off in Colors' popular show "Chakravartin Ashoka Samrat." Sources ... Now that the makers and the actor have decided to call it quits, they have moved the inevitable death before time.
- Not fired enough
- According to Sandeep Gandhi, chairman of Chanakya Tower, the building was constructed in 1992 when there were no fire safety norms in force. The building does not have space for construction of extra water tanks and installation of other equipment.
Great care has been taken to prepare the information on this page. Elements of the content come from factual and lexical knowledge databases, realmagick.com library and third-party sources. We appreciate your suggestions and comments on further improvements of the site.
Chanakya Death Of Chanakya Topics
About - Contact - Advertising
© 2000 - 2016 Realmagick.com, All Rights Reserved.
© 2000 - 2016 Realmagick.com, All Rights Reserved.


text:
realmagick.com The shrine of knowledge.
Erek King
A selection of articles related to erek king.
Original articles from our library related to the Erek King. See Table of Contents for further available material (downloadable resources) on Erek King.
- King James Bible: Genesis, Chapter 14
- Chapter 14 14:1 And it came to pass in the days of Amraphel king of Shinar, Arioch king of Ellasar, Chedorlaomer king of Elam, and Tidal king of nations; 14:2 That these made war with Bera king of Sodom, and with Birsha king of Gomorrah, Shinab king of Admah,...
Old Testament >> Genesis
- King Arthur and the Cymry Heroes
- The Celtic Britons called themselves the Cymry, which meant "fellow countrymen" in their Celtic tongue. Once Roman rule ended in Britain in about 410 A.D., a power vacuum developed, leading to the onslaught of Germanic invasions by Angles and Saxons,...
Saga of Times Past >> Legend and Prehistory
- King James Bible: Numbers, Chapter 21
- Chapter 21 21:1 And when king Arad the Canaanite, which dwelt in the south, heard tell that Israel came by the way of the spies; then he fought against Israel, and took some of them prisoners. 21:2 And Israel vowed a vow unto the LORD, and said, If thou wilt...
Old Testament >> Numbers
- King James Bible: John, Chapter 19
- Chapter 19 19:1 Then Pilate therefore took Jesus, and scourged him. 19:2 And the soldiers platted a crown of thorns, and put it on his head, and they put on him a purple robe, 19:3 And said, Hail, King of the Jews! and they smote him with their hands. 19:4...
New Testament >> John
- King James Bible: Acts, Chapter 26
- Chapter 26 26:1 Then Agrippa said unto Paul, Thou art permitted to speak for thyself. Then Paul stretched forth the hand, and answered for himself: 26:2 I think myself happy, king Agrippa, because I shall answer for myself this day before thee touching all...
New Testament >> The Acts
- Mythic Heroes of Celtic Ireland
- The Celtic mythology of Ireland is best summarized as consisting of four broad cycles. This month's article deals with mythic Celtic mortals, figures who populate the stories in the second and third cycles below. Four Cycles of Irish Mythology Foundation...
Saga of Times Past >> Legend and Prehistory
Erek King is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Erek King books and related discussion.
Suggested News Resources
- WAHS announces honor roll
- Kyle C. Anderson, Jess E. Bishop, Brynn M.
- Thursday's high school roundup
- Erek Lehnen 6-2, 6-3; 3. Andres Fernandez (C) d. Liam McKinney 6-0, 6-0; 4.
- Men's Hoops Plays at Penn State Wednesday
- No. 4/6 Iowa (20-5, 11-2), winners of 13 of its last 15 games, travel to University Park, Pennsylvania Wednesday to compete against Penn State (12-13, 3-9) for the second time in as many weeks. Tipoff is scheduled for 5:31 p.
- Bu hafta ne yapsak?
- Roma MAXXI müzesinde 8 Mayıs'a kadar görülebilen İstanbul Tutku, Neşe, Öfke sergisinin küratörlerinden Ceren Erdem ve katalog yazarlarından sanat tarihçisi Ayşe Erek tarafından 20 Şubat Cumartesi günü saat 16.
- Eine geballte Ladung Musik in Gladenbach
- Neben dem "King of Rock'n'Roll" gehören Neil Diamond und Dean Martin zu den gesanglichen Vorbildern von Uwe Tittl.
Great care has been taken to prepare the information on this page. Elements of the content come from factual and lexical knowledge databases, realmagick.com library and third-party sources. We appreciate your suggestions and comments on further improvements of the site.
Erek King Topics
About - Contact - Advertising
© 2000 - 2016 Realmagick.com, All Rights Reserved.
© 2000 - 2016 Realmagick.com, All Rights Reserved.

subset: commoncrawl


text:
Animals & Pets
How to Build Your Birdhouse
Rating: Rated: 4 times
Format: PDF, ePub, Kindle, TXT
First you must know what birds you would like to attract. That entails a bit of research. Fortunately, everything you need to know to develop this hobby is available in "How to Build Your Birdhouse." Did you know that every species of bird has special preferences about the type of nest or...
Successful Beekeeping A-B-C's
Rating: Rated: 2 times
Format: PDF, ePub, Kindle, TXT
If you're here, then you're probably looking for something to relieve the stress. This is especially true when the economy seems to be pulling us in different directions. So, what does this have to do with Bees? More than you might think. If you have ever given any thought to a hobby...
The Bugs Stop Here Pest Control Guide
Rating: Rated: 7 times
Format: PDF, ePub, Kindle, TXT
Everything you need to know about pest. We cover almost every pest and what they are about
37 Herbs & Remedies for Fabulously Healthy Animals
Rating: Rated: 22 times
Format: PDF, ePub, Kindle, TXT
37 Herbs & Remedies For Fabulously Healthy Animals is all about caring for your animals using natural herbs. Whether your animal has arthritis, skin allergies or suffers from seperation anxiety, herbs can provide an enormous amount of relief. In this day in age people are becoming more in tune...
Crafty Canine's 101 Ways to Foul up Your Family
Rating: Rated: 30 times
Format: PDF, ePub, Kindle, TXT
Canines Rule! A dog is man's best friend... or is he? What about all those nasty little tricks that drive you to the brink of despair, like slobbering all over your guests or chewing up your favourite shoes? In this little book Crafty Canine and his pals take a light-hearted look at...
Don't Screw Up Your Dog - Avoid the Top 12 Mistakes Dog Parent's Make
Rating: Rated: 30 times
Format: PDF, ePub, Kindle, TXT
One of these little mistakes cost a dog parent well over $5,000... So many of my clients come to me with serious dog behavior and health issues, I decided to write the book on the most common mistakes people make with their dogs. Most of the problems people have with their dogs come from...
H.E.R.D Human Equine Relationship Development
Rating: Rated: 15 times
Format: PDF, ePub, Kindle
Tamara Svencer creates a window into the world of horses and how they think and communicate so that you can interact with your horse on a deeper more understandable level. This book teaches you how to avoid and correct bad behaviors and develop a more natural bond with your horse. You will learn...
What to Expect - Puppy to Dog
Rating: Rated: 12 times
Format: PDF, ePub, Kindle, TXT
What to expect when getting a puppy and raising it to a full grown Dog. Things you should know.
A Wolfdog
Rating: Rated: 22 times
Format: PDF, ePub, Kindle, TXT
The evolution of dogs and wolves and their resultant behavior is a fascinating subject well worth exploring. Further reading will not only lead you to a deeper understanding of the issues raised in this booklet, but also increase your appreciation and enjoyment of that unique and wonderful animal...
Secrets on How to Teach Your Cat at Home
Rating: Rated: 10 times
Format: PDF, ePub, Kindle, TXT
Learn how to teach your cat basic tricks to keep your cat healthy and happy stop bad behaviours and teach good behaviour and good house keeping.


text:
A volunteer team of 17 participated in the IREM Care Days event June 8 at the Almost Home Kids facility in Naperville.
Experts Agree Chicago CRE Market Continues to Demonstrate Resounding Resiliency at Mid-Year 2016
Read the council's reports from IREM Spring 2016 Legislative and Leadership Summit
A line up of some 140 golfers, dozens of guests and more than 20 Industry Partners enjoyed premier golf, outstanding food and beverages and great camaraderie August 8 at the 30th Annual IREM Chicago Golf Outing and Silent Auction.
IREM Chicago Chapter No. 23 has nearly 700 members. Our leaders strive to keep members informed on the current industry trends, safety standards, the latest legislative activities, as well as providing education seminars, community service opportunities, a job referral service and candidate assistance services.
Members of IREM Chicago were honored for excellence and outstanding contributions to the property management industry March 4 at the 12h Annual IREM Chicago Premier Awards and Casino Night.
Serving real estate professionals who manage all property types, IREM Chicago has been an integral force in the greater Chicagoland area since 1953. We are dedicated to delivering leading-edge networking and educational offerings for every stage of your career, evolving with you to provide lifelong professional development opportunities.
©Institute of Real Estate Management. All rights reserved. IREM®, the IREM logo, Certified Property Manager®, CPM®, the CPM key logo, Accredited Residential Manager®, ARM®, the ARM torch logo, Accredited Management Organization®, AMO®, the AMO circle logo, Income/Expense Analysis®, Expense Analysis® and JPM® are registered marks of the Institute of Real Estate Management.
IREM encourages diversity. We welcome individuals of all races, genders, creeds, ages, sexual orientations, gender identities, national origins, and individuals with disabilities. Our organization strives to provide an equal opportunity environment among its members, vendors, and staff. Click here to learn more.


text:
Most Cited The Knee Articles
The most cited articles published since 2011, extracted from Scopus.
Infrapatellar fat pad-derived mesenchymal stem cell therapy for knee osteoarthritisYong Gon Koh | Yun Jin Choi
Volume 19, Issue 6, December 2012, Pages 902-907
Purpose: The aim of the study was to determine if isolated mesenchymal stem cells (MSCs) derived from the infrapatellar fat pad could effectively improve clinical results when percutaneously injected into arthritic knees. Level of evidence: Therapeutic case-control study; Level III. Methods: Twenty five stem cell injections combined with arthroscopic debridement were administered to patients with knee OA. A mean of 1.89×106 stem cells were prepared with approximately 3.0mL of platelet-rich plasma (PRP) and injected in the selected knees of patients in the study group. Results: The mean Lysholm, Tegner activity scale, and VAS scores of patients in the study group improved significantly by the last follow-up visit. No major adverse events related to the injections were observed during the treatment and follow-up periods. The results were compared between the study and control groups, in which the patients had undergone arthroscopic debridement and PRP injection without stem cells. Although the preoperative mean Lysholm, Tegner activity scale, and VAS scores of the study group were significantly poorer than those of the control group, the clinical results at the last follow-up visit were similar and not significantly different between the two groups. Conclusions: The short-term results of our study are encouraging and demonstrate that infrapatellar fat pad-derived MSC therapy with intraarticular injections is safe, and provides assistance in reducing pain and improving function in patients with knee OA. © 2012 .
A randomized, double-blind, dose-ranging study comparing wound infiltration of DepoFoam bupivacaine, an extended-release liposomal bupivacaine, to bupivacaine HCl for postsurgical analgesia in total knee arthroplastyKenneth Bramlett | Erol Onel | Eugene R. Viscusi | Kevin Jones
Volume 19, Issue 5, October 2012, Pages 530-536
Introduction: DepoFoam bupivacaine is a novel liposomal formulation of bupivacaine designed to provide prolonged postsurgical analgesia. This dose-ranging study evaluated extent and duration of analgesia following administration of DepoFoam bupivacaine in patients undergoing total knee arthroplasty (TKA). Methods: Efficacy, safety, and pharmacokinetics of DepoFoam bupivacaine doses of 133, 266, 399, or 532. mg were compared with bupivacaine HCl (150. mg) with epinephrine given as single injections via wound infiltration in TKA patients (N=138). Primary efficacy measure was AUC of pain intensity scores assessed by numeric rating scale with activity (NRS-A) through Day 4 postsurgery. Other assessments included pain intensity at rest (NRS-R), postsurgical opioid consumption, and safety, among others. Results: Mean AUC of NRS-A scores through Day 4 were 20.7, 19.5, 18.8, and 19.1 for the 133-mg, 266-mg, 399-mg, and 532-mg DepoFoam bupivacaine groups vs 20.4 for bupivacaine HCl. With DepoFoam bupivacaine 532-mg, differences in NRS-R scores reached statistical significance (. P<. 0.05) vs bupivacaine HCl on Days 1 and 5 and mean AUC NRS-R scores were significantly lower through Days 2-5; a dose-response trend was demonstrated. Mean rating for blinded care provider's satisfaction with analgesia was significantly higher for DepoFoam bupivacaine 532. mg vs bupivacaine HCl (. P≤. 0.05). Other efficacy measures showed no statistically significant differences. Conclusion: Exposure to bupivacaine increased in a dose-related manner, as reflected by mean and maximum plasma bupivacaine concentrations, and AUC0-∞. Treatment with DepoFoam bupivacaine 532mg was associated with statistically significantly greater analgesia while patients were at rest after surgery compared with bupivacaine HCl. © 2011 .
A comparative anatomical study of the human knee and six animal speciesBenedikt L. Proffen | Megan McElfresh | Braden C. Fleming | Martha M. Murray
Volume 19, Issue 4, August 2012, Pages 493-499
Purpose: Animal models are an indispensable tool for developing and testing new clinical applications regarding the treatment of acute injuries and chronic diseases of the knee joint. Therefore, the purpose of this study was to compare the anatomy of the intra-articular structures of the human knee to species commonly used in large animal research studies. Methods: Fresh frozen cow (n = 4), sheep (n = 3), goat (n = 4), dog (n = 4), pig (n = 5), rabbit (n = 5), and human (n = 4) cadaveric knees were used. Passive range of motion and intra-articular structure sizes of the knees were measured, the structure sizes normalized to the tibial plateau, and compared among the species. Results: Statistically significant differences in the range of motion and intra-articular structure sizes were found among all the species. Only the human knee was able to attain full extension. After normalization, only the pig ACL was significantly longer than the human counterpart. The tibial insertion site of the ACL was split by the anterior lateral meniscus attachment in the cow, sheep, and pig knees. The sheep PCL had two distinct tibial insertion sites, while all the other knees had only one. Furthermore, only in human knees, both lateral meniscal attachments were located more centrally than the medial meniscal attachments. Conclusions/clinical relevance: Despite the relatively preserved dimensions of the cruciate ligaments, menisci, and intercondylar notch amongst human and animals, structural differences in the cruciate ligament attachment sites and morphology of the menisci between humans and animals are important to consider when selecting an animal model. © 2011 Elsevier B.V.
Treatment of osteoarthritis with infrapatellar fat pad derived mesenchymal stem cells in RabbitF. S. Toghraie | N. Chenari | M. A. Gholipour | Z. Faghih | S. Torabinejad | S. Dehghani | A. Ghaderi
Volume 18, Issue 2, March 2011, Pages 71-75
Osteoarthritis (OA) is a progressively debilitating disease that affects mostly cartilage, with associated changes in the bone. Increasing incidence of OA and the aging population coupled with insufficient therapeutic choices has led to focus on the potential of stem cells as a novel strategy for cartilage repair. In this study, we used scaffold free mesenchymal stem cells obtained from infrapatellar fat pad in an experimental animal model of OA by direct intraarticular injection. Mesenchymal stem cells isolated from a 2.8. kg White New Zealand rabbit. The cells were expanded and grown in vitro. OA was induced by unilaterally anterior cruciate ligament transection of knee joints. Twelve weeks after operation, a single dose of 1. million cells suspended in 1. ml of medium was delivered to the injured knee by direct intraarticular injection. Control group received 1. ml of medium without cells. The knees were examined after sixteen and twenty weeks from the surgery. Repairing was investigated radiologically, grossly and histologically using haematoxylin and eosin, Safranin-O and toluidine blue staining. Radiological assessment confirmed development of OA changes after 12. weeks. Rabbits receiving mesenchymal stem cells showed lower degree of cartilage degeneration, osteophyte formation, and Subchondral sclerosis than control group at 20. week after surgery. The quality of cartilage was significantly better in cell-treated group compared with control group after 20. weeks. In conclusion, infrapatellar fat pad derived mesenchymal stem cells could be the promising cell sources for the treatment of OA. © 2010 Elsevier B.V.
Is patellar resurfacing superior than nonresurfacing in total knee arthroplasty? A meta-analysis of randomized trialsJi Ye He | Lei Sheng Jiang | Li Yang Dai
Volume 18, Issue 3, June 2011, Pages 137-144
Conflicting results from abundant studies have made it unclear whether the patella should be resurfaced during total knee replacement. A meta-analysis was undertaken to pool the results of randomized controlled studies (RCTs) and to compare the outcomes and postoperative complications after total knee arthroplasty with patellar resurfacing or nonresurfacing. Sixteen RCTs including 3034 knees between 1966 and December 2009 were analyzed. Reoperation for patellofemoral problems was significantly more likely in the nonresurfacing group (P=0.03). There was no difference between the two groups in terms of anterior knee pain rate, knee pain score, knee society score and knee function score. The results indicate that patellar resurfacing would reduce the risk of reoperation after total knee replacement, but it seems that the benefits are limited on other aspects, and the analysis of high-quality studies shows no advantage of resurfacing over nonresurfacoing group, even in the aspect of reoperation risk. More carefully and scientifically designed RCTs are beneficial and necessary to further prove the results. © 2010 Elsevier B.V.
Topical tranexamic acid in total knee replacement: A systematic review and meta-analysisMichalis Panteli | Costas Papakostidis | Ziad Dahabreh | Peter V. Giannoudis
Volume 20, Issue 5, October 2013, Pages 300-309
Background: To examine the safety and efficacy of topical use of tranexamic acid (TA) in total knee arthroplasty (TKA). Methods: An electronic literature search of PubMed Medline; Ovid Medline; Embase; and the Cochrane Library was performed, identifying studies published in any language from 1966 to February 2013. The studies enrolled adults undergoing a primary TKA, where topical TA was used. Inverse variance statistical method and either a fixed or random effect model, depending on the absence or presence of statistical heterogeneity were used; subgroup analysis was performed when possible. Results: We identified a total of seven eligible reports for analysis. Our meta-analysis indicated that when compared with the control group, topical application of TA limited significantly postoperative drain output (mean difference: -. 268.36. ml), total blood loss (mean difference. = -. 220.08. ml), Hb drop (mean difference. = -. 0.94. g/dL) and lowered the risk of transfusion requirements (risk ratio. = 0.47, 95CI. = 0.26-0.84), without increased risk of thromboembolic events. Sub-group analysis indicated that a higher dose of topical TA (>. 2. g) significantly reduced transfusion requirements. Conclusions: Although the present meta-analysis proved a statistically significant reduction of postoperative blood loss and transfusion requirements with topical use of TA in TKA, the clinical importance of the respective estimates of effect size should be interpreted with caution. Level of evidence: I, II. © 2013 Elsevier B.V.
Meniscal scaffolds: Early experience and review of the literatureS. J. Spencer | A. Saithna | M. R. Carmont | M. S. Dhillon | P. Thompson | T. Spalding
Volume 19, Issue 6, December 2012, Pages 760-765
Introduction: Meniscal scaffold implants support the in-growth of new "meniscus like" tissue with the aim of alleviating post-meniscectomy knee pain and preventing further articular cartilage degeneration. Patients and methods: Twenty-three patients underwent meniscal scaffold implantation (14 medial, 9 lateral) with either the Menaflex (ReGen Biologics) (n = 12) or Actifit (Orteq) (n = 11) scaffolds. Minimum follow-up was 1. year with a mean of 24.1. months (18-27) for the Menaflex and 14.7. months (12-18) for the Actifit groups. Mean age at surgery was 35. years (17-47) with a mean Outerbridge grade of 1.9 in the affected compartment. Eight (36%) underwent concurrent osteotomy, ligament reconstruction or microfracture of the tibial plateau. KOOS, Lysholm, Tegner activity and IKDC scores were collected pre-operatively and at six-month interval post-surgery. Assessment of the reconstruction was obtained with MRI scanning and arthroscopy. One scaffold tore and was revised at 19. months post-operatively. Results: Twenty-one out of 23 (91.3%) had a significant improvement in knee scores when compared to pre-surgery levels at latest follow-up. Second-look arthroscopy in 14 at 1-year post-implantation showed variable amounts of regenerative tissue. There was no progression in chondral wear noted on repeat MRI scanning. Conclusion: Treatment with meniscal scaffold implants can provide good pain relief for the post-meniscectomy knee following partial meniscectomy. Longer follow-up is required to ascertain whether they also prevent the progressive chondral wear associated with a post-meniscectomy knee. © 2012 Elsevier B.V.
A meta-analysis of hamstring autografts versus bone-patellar tendon-bone autografts for reconstruction of the anterior cruciate ligamentShuZhen Li | Wei Su | Jinmin Zhao | Yinglong Xu | Zhandong Bo | Xiaofei Ding | Qingjun Wei
Volume 18, Issue 5, October 2011, Pages 287-293
The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability. © 2010 Elsevier B.V.
Improved femoral component rotation in TKA using patient-specific instrumentationThomas J. Heyse | Carsten O. Tibesku
Volume 21, Issue 1, January 2014, Pages 268-271
Background: Patient-specific instrumentation (PSI) was introduced in an attempt to reduce positional outliers of components in total knee arthroplasty (TKA). It was hypothesized that PSI could help with the positioning of femoral components in optimal rotational alignment. Methods: A magnetic resonance imaging (MRI) analysis of 94 patients following TKA was conducted. Of these, 46 operations were performed using PSI and 48 using conventional instrumentation. The rotation of the femoral components was determined in the MRI and deviations >. 3° were considered outliers. Data were analyzed for positional outliers, observer reliability, and a variance comparison between implant groups. Results: There was excellent inter- and intraobserver reliability with low standard deviations for the determination of femoral component rotation. There were significantly more outliers in the conventional (22.9%) group than in the PSI group (2.2%, p. = 0.003). Conclusion: In this setup, PSI was effective in significantly reducing outliers of optimal rotational femoral component alignment during TKA. © 2012 Elsevier B.V.
Dual tunnel medial patellofemoral ligament reconstruction for patients with patellar dislocation using a semitendinosus tendon autograftYukiyoshi Toritsuka | Hiroshi Amano | Tatsuo Mae | Ryohei Uchida | Masayuki Hamada | Kenji Ohzono | Konsei Shino
Volume 18, Issue 4, August 2011, Pages 214-219
The purpose of this study was to describe a safer and more anatomical technique of MPFL reconstruction and to report the short-term results. The subjects included 20 patients with patellar dislocation with a mean age of 23. The operation was performed using a double-looped autogenous semitendinosus tendon graft. Two small bone tunnels were made at the medial edge of the patella, mimicking the wide patellar insertion of the MPFL and a bone tunnel was made at the femoral insertion site. The free ends of the graft attached to the patella and the loop end was fixed to the femoral side. Five patients were available for follow-up interviews by telephone and the remaining 15 were directly examined by physical examination and radiographic evaluation at 2. years or longer postoperatively. The average follow-up period was 30. months. Re-dislocation or patellar fracture was not seen in any patients. The average Kujala's score was 96 with a range from 84 to 100. Six patients were classified as excellent and 14 as good, according to the Crosby and Insall grading system. Radiographically, narrowing of the patellofemoral joint space was observed in 2 cases with previous osteochondral fracture out of those who were directly examined. The dual tunnel MPFL reconstruction produces favorable results in subjective and functional assessment of outcome without complications. © 2010 Elsevier B.V.
Knee joint preservation with combined neutralising High Tibial Osteotomy (HTO) and Matrix-induced Autologous Chondrocyte Implantation (MACI) in younger patients with medial knee osteoarthritis: A case series with prospective clinical and MRI follow-up over 5yearsS. Bauer | R. J K Khan | J. R. Ebert | W. B. Robertson | W. Breidahl | T. R. Ackland | D. J. Wood
Volume 19, Issue 4, August 2012, Pages 431-439
Purpose: There is no ideal treatment for younger patients with medial knee osteoarthritis (OA) and varus malalignment. We have investigated the first case series of combined neutralising high tibial osteotomy (HTO) and Matrix-induced Autologous Chondrocyte Implantation (MACI) with MRI. Treatment goals were clinical improvement and delay of arthroplasty. Methods: Between 2002 and 2005 18 patients (Mean age 47. years) underwent surgery. Exclusion criteria were lateral compartment and advanced patellofemoral OA. The Knee Injury and Osteoarthritis Outcome Score (KOOS), six minute walk test (6MWT) and a validated MRI score were outcome measures. Results: There were significant improvements (p < 0.05) in all five KOOS domains. Four were significantly maintained to 5. years. The domain "symptoms" and results in the 6MWT dropped off at 5. years. MRI results were first significantly improved (24/12) but declined at 60. months. Good quality infill was found in 33% patients at the study endpoint (n = 5/15). Histological investigation of one knee demonstrated full-thickness hyaline-like cartilage (20/12). After 2 early failures and one graft detachment graft fixation was changed (Smart nails instead of sutures in 14 cases). Graft hypertrophy requiring a chondroplasty occurred once. There were no other major complications. Specific minor complications included patellar tendinitis (n = 8). Conclusions: This combined procedure provides a safe treatment option for younger patients with medial knee OA and varus alignment with significant clinical improvement at 5. years. However, overall graft survival and cartilage infill were poor. Larger studies are needed to statistically verify predictors for longer term cartilage repair in these patients. © 2011 Elsevier B.V.
Comparative anatomical measurements of osseous structures in the ovine and human kneeGeorg Osterhoff | Sabine Löffler | Hanno Steinke | Christine Feja | Christoph Josten | Pierre Hepp
Volume 18, Issue 2, March 2011, Pages 98-103
The ovine stifle has been increasingly used as a large animal model for the human knee. Still, comparative anatomical measurements of the knee in sheep and humans are missing. Thus, the purpose of this study was to describe and measure the osseous anatomy of the ovine stifle in comparison to the human knee. Twenty-four stifles of skeletal-mature merino-sheep and 24 human cadaver knees were obtained and distances between selected anatomical structures of the distal femur, the proximal tibia, and the patella were measured digitally and documented. Based on these, intercondylar ratio, tibial aspect ratio, patella aspect ratio and the cortical index were calculated. Regarding epicondylar width, lateral condylar width, medial condylar width and the tibial dimensions, the ovine stifle can be considered as a human knee scaled down by one third. However, sheep have a smaller trochlear width and a narrower femoral intercondylar notch than humans resulting in lower relative values for intercondylar width and intercondylar height. The distal femur's cortical index is the same in both species. In contrast, sheep have a massive bone stock below their tibial plateau and a proximal tibial shaft with remarkably thick cortical bone. The ovine stifle can be regarded as a useful model for the human knee. However, future studies should consider the differences in the femoral intercondylar notch width, the patellofemoral joint's biomechanics and the proximal tibia's cortical bone stock. © 2010 Elsevier B.V.
Evaluation of early-stage osteochondral defect repair using a biphasic scaffold based on a collagen-glycosaminoglycan biopolymer in a caprine modelAlan M J Getgood | Simon J. Kew | Roger Brooks | Harold Aberman | Timothy Simon | Andrew K. Lynn | Neil Rushton
Volume 19, Issue 4, August 2012, Pages 422-430
The aim of this study was to evaluate a new collagen-GAG-calcium phosphate biphasic scaffold for the repair of surgically created osteochondral defects in goats. Comparison of morphological, histological and mechanical performance of the repair tissue was made with defects repaired using a synthetic polymer scaffold. Defects were created in the medial femoral condyle (MFC) and lateral trochlear sulcus (LTS) of Boer Cross goats and evaluated at 12 and 26. weeks. It was found that the total histology score of the collagen-GAG based biomaterial (23.8; SD 1.7) provided a significant improvement (p < 0.05) over the biphasic PLGA material (19;3) and the empty control defect (17.3;1.2) in the LTS. The overall trajectory of histological and morphological improvement between 12 and 26. weeks was found to be higher for the collagen-GAG scaffold compared to the PLGA material. The occurrence of sub-chondral bone cysts was lower for the collagen-GAG scaffold with an incidence of 17% of defects, compared to 67% for the PLGA material at 26. weeks. The cartilage repair tissue for both materials evaluated was superior after 26. weeks implantation than the empty control with 75% of the collagen-GAG-treated defects showing markedly more hyaline-like cartilage and 50% of the PLGA sites exhibiting hyaline-like appearances, compared to 17% for the empty control. These early stage data indicate biphasic scaffolds based on collagen-GAG and PLGA both provide indications of satisfactory development of a structural repair to surgically prepared osteochondral defects. Furthermore, the biomaterial composition of the collagen-GAG may provide a more favourable environment for osteochondral repair. © 2011 Elsevier B.V.
Opening- or closing-wedged high tibial osteotomy: A meta-analysis of clinical and radiological outcomesT. O. Smith | D. Sexton | P. Mitchell | C. B. Hing
Volume 18, Issue 6, December 2011, Pages 361-368
High tibial osteotomy (HTO) has been advocated for the treatment of isolated medial compartment osteoarthritis of the knee. Debate remains over the superiority of performing a medial opening-wedge or lateral closing-wedge HTO. The purpose of this study was to compare the clinical and radiological outcomes, and complications of patients following opening-wedge compared to closing-wedge HTO. A systematic review was undertaken of published and unpublished literature databases from their inception to May 2010. Twelve papers reporting nine clinical trials were found to be suitable for meta-analysis comparing 324 opening-wedge HTOs to 318 closing-wedge HTOs. There was no difference in the incidence of infection, deep vein thrombosis, peroneal nerve palsy, non-union or revision to knee arthroplasty (p> 0.05). There was however a significantly greater posterior tibial slope and mean angle of correction, reduced patellar height and hip-knee-ankle angle following opening-wedge HTO (p< 0.05). No significant difference was found for any clinical outcome including pain, functional score or complications (p> 0.05). © 2010 Elsevier B.V.
Complications following anterior cruciate ligament reconstruction in the English NHSSimon S. Jameson | Daniel Dowen | Philip James | Ignacio Serrano-Pedraza | Mike R. Reed | David Deehan
Volume 19, Issue 1, January 2012, Pages 14-19
Unlike the English National Joint Registry (NJR) for arthroplasty, no surgeon driven national database currently exists for ligament surgery in England. Therefore information on outcome and adverse events following anterior cruciate ligament (ACL) surgery is limited to case series. This restricts the ability to make formal recommendations upon surgical care. Prospectively collected data, which is routinely collected on every NHS patient admitted to hospital in England, was analysed to determine national rates of 90-day symptomatic deep venous thrombosis (DVT), pulmonary thromboembolism (PTE) rate, 30-day wound infection and readmission rates following primary ACL reconstruction between March 2008 and February 2010 (13,941 operations, annual incidence 13.5 per 100,000 English population). 90-day DVT and PTE rates were 0.30% (42) and 0.18% (25) respectively. There were no in-hospital deaths. 0.75% (104) of the consecutive patient cohort had a wound complication recorded. 0.25% (35) underwent a further procedure to wash out the infected knee joint and 1.36% (190) were readmitted to an orthopaedic ward within 30. days. This is the first national comprehensive study of the incidence of significant complications following ACL surgery in England. This should allow meaningful interpretation of future baseline data supporting the development of a national ligament registry. © 2010 Elsevier B.V..
An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom - follow up at one yearD. A. McDonald | R. Siegmeth | A. H. Deakin | A. W G Kinninmonth | N. B. Scott
Volume 19, Issue 5, October 2012, Pages 525-529
The concepts of Enhanced Recovery Programmes (ERP) are to reduce peri-operative morbidity whilst accelerating patient's rehabilitation resulting in a shortened hospital stay following primary joint arthroplasty. These programmes should include all patients undergoing surgery and should not be selective. We report a consecutive series of 1081 primary total knee arthroplasties undergoing an enhanced recovery programme with a one year follow up period. A comparative cohort of 735 patients from immediately prior to the enhanced recovery programme implementation was also reviewed. The median day of discharge home was reduced from post-operative day six to day four (p < 0.001) for the ERP group. Post-operative urinary catheterisation (35% vs. 6.9%) and blood transfusion (3.7% vs. 0.6%) rates were significantly reduced (p. < 0.001). Within the ERP group median pain scores (0 = no pain, 10 = maximal pain) on mobilisation were three throughout hospital stay with 95% of patients ambulating within 24 h. No statistical difference was found in post-operative thrombolytic events (p=0.35 and 0.5), infection (p=0.86), mortality rates (p=0.8) and Oxford Knee Scores (p=0.99) at follow up.This multidisciplinary approach provided satisfactory post-operative analgesia allowing early safe ambulation and expedited discharge to home with no detriment to continuing rehabilitation, infection or complication rates at one year. © 2011 Elsevier B.V.
Results at 10 to 14years after osteochondral autografting (mosaicplasty) in articular cartilage defects in the kneeEirik Solheim | Janne Hegna | Jannike Øyen | Thomas Harlem | Torbjørn Strand
Volume 20, Issue 4, August 2013, Pages 287-290
Purpose: The aim of this study was to evaluate the medium-term (5-9. years) and long-term (10-14. years) outcomes of mosaicplasty in the knee and identify possible risk factors for poor outcome. Methods: We included patients 60. years or younger with symptomatic focal full-thickness chondral lesions. Seventy-three patients (87%) with median age of 34. years were available for analyses. Clinical outcome was evaluated by Lysholm score and VAS of pain. Results: Both the mean Lysholm score and mean VAS pain score improved significantly from baseline, 49 (SD 17) and 58 (SD 23), respectively, to both the mid-term follow-up, 72 (SD18, p<0.001) and 27 (SD 20, p<0.001), respectively, and the long-term follow-up, 72 (SD 21, p<0.001) and 33 (SD 23, p<0.001), respectively. A poor outcome at the long-term follow-up - defined as a Lysholm score of 64 or less or having had a knee replacement - was found in 40%. A poor outcome was more frequent in patients 40years or older (59%), in women (61%) and in defects with an area of 3cm2 or more (57%). Conversely, in a subgroup of male individuals younger than 40years with defect size less than 3cm2 the failure rate was 12.5% and the mean Lysholm score was 82 (SD 16). Conclusion: We conclude that the long-term clinical outcome after mosaicplasty varies greatly depending on age, gender and the size of the lesion. Level of evidence: IV-Retrospective Case Series. © 2012 Elsevier B.V.
Evaluation of tibial rotational stability of single-bundle vs. anatomical double-bundle anterior cruciate ligament reconstruction during a high-demand activity - A quasi-randomized trialGo Misonoo | Akihiro Kanamori | Hirofumi Ida | Syumpei Miyakawa | Naoyuki Ochiai
Volume 19, Issue 2, March 2012, Pages 87-93
The purpose of this study was to compare the tibial rotational stability of anatomical double-bundle anterior cruciate ligament reconstructed knees with single-bundle anterior cruciate ligament reconstructed knees during a high-demand activity. Total of 66 subjects, (22 with double-bundle anterior cruciate ligament reconstruction, 22 with single-bundle anterior cruciate ligament reconstruction, and 22 healthy control individuals) were examined in this study. Using a 9-camera motion analysis system, motion subjects were recorded performing during a drop landing and cutting. Using the point cluster technique, the internal-external tibial rotation of both knees was calculated. The mean maximum range of motion for each knee was evaluated for 3 groups (double-bundle group, single-bundle group, and control group). Clinical assessment, including Tegner score, Lysholm score, and knee arthrometric measurement, revealed restoration of the reconstructed knee stability with no differences between the two anterior cruciate ligament reconstruction groups. The results showed that both groups resulted in tibial rotation values that were significantly smaller than those in the intact legs and those in the healthy controls. There were no significant differences in tibial rotation between the DB group and the SB group. Therefore anatomical double-bundle reconstruction restores normal tibial rotation no more than single-bundle reconstruction during this high-demand dynamic activity. These results suggest a trend towards dynamic overcorrection after the ACL reconstruction. © 2010 Elsevier B.V.
Knee kinematics during walking at different speeds in people who have undergone total knee replacementJodie A. McClelland | Kate E. Webster | Julian A. Feller | Hylton B. Menz
Volume 18, Issue 3, June 2011, Pages 151-155
People who have undergone total knee replacement (TKR) experience difficulties in some daily activities including walking. Walking at faster speeds requires more knee flexion and may therefore present a greater challenge following TKR. The aim of this study was to compare the knee kinematics of patients following TKR and unimpaired controls during comfortable and fast walking speeds. Forty patients (22 women, 18 men) 12. months following TKR and 40 control participants (matched for age and sex) were assessed during walking at self-selected comfortable and fast speeds using three dimensional motion analysis. The group averages of spatiotemporal and peak kinematic characteristics in the sagittal, coronal and transverse movement planes were compared using univariate analysis of variance with walking speed as a co-variate. The TKR group walked with significantly reduced cadence (p<0.001 at both speeds) and reduced stride length (p<0.001 at both speeds), less knee flexion during stance and swing phases (p<0.001 for both speeds) and less knee extension during stance phase (p<0.024 for comfortable speed; p<0.042 for fast speed). The TKR group also walked with less peak knee external rotation than controls at both speeds (p<0.001 for both speeds). Both groups increased their velocity, cadence and stride length by a similar proportion when walking at fast speed. When walking at a faster speed, spatiotemporal gait parameters and knee motion are altered in a similar manner for both TKR patients and controls. However, at both walking speeds, TKR patients exhibit residual deficits 12. months following surgery. © 2010 .
The relationship between trochlear dysplasia and medial patellofemoral ligament rupture location after patellar dislocation: An MRI evaluationT. S. Weber-Spickschen | J. Spang | L. Kohn | A. B. Imhoff | P. B. Schottle
Volume 18, Issue 3, June 2011, Pages 185-188
The medial patellofemoral ligament (MPFL) and the native trochlear geometry represent two of the most critical components of patellofemoral stability. We sought to define the relationship between trochlear dysplasia and MPFL rupture location in patients with documented patellar dislocations. We hypothesized that patients with lower grades of trochlear dysplasia would have patellar based MPFL ruptures, while patients with higher grade dysplasia would have femoral-sided ruptures.We reviewed post-injury MRIs of 59 patients with documented patella dislocation. Information gathered included: type of trochlear dysplasia in the axial plane MRI, location of MPFL rupture, patellar height ratio, tibial tuberosity to trochlear groove distance (TTTG), number of dislocations prior to MRI, and time between the latest patella dislocation and the MRI.Statistical calculations utilized the Chi-Square-Test.We classified 11 cases as a dysplasia type A, 35 as a type B, 11 as a type C, and 2 cases as a trochlear dysplasia type D. In 7 patients (12%) the MPFL rupture was patella based, in 18 patients (31%) intra-ligamentous, in 33 cases (56%) femoral sided and in one case no MPFL could be identified.In contrast to our original hypothesis, the type of trochlear dysplasia does not appear to be related to the rupture location of the MPFL after patellar dislocation. According to our results, it is not possible to presume the location of the MPFL rupture based on assessment of the trochlear morphology. Therefore, a MRI is mandatory for final indication of any surgery. © 2010 Elsevier B.V.
Abnormal tibiofemoral kinematics following ACL reconstruction are associated with early cartilage matrix degeneration measured by MRI T1rhoBryan Haughom | William Schairer | Richard B. Souza | Dana Carpenter | C. Benjamin Ma | Xiaojuan Li
Volume 19, Issue 4, August 2012, Pages 482-487
Purpose: Altered kinematics following ACL-reconstruction may be a cause of post-traumatic osteoarthritis. T 1ρ MRI is a technique that detects early cartilage matrix degeneration. Our study aimed to evaluate kinematics following ACL-reconstruction, cartilage health (using T 1ρ MRI), and assess whether altered kinematics following ACL-reconstruction are associated with early cartilage degeneration. Methods: Eleven patients (average age: 33±9years) underwent 3T MRI 18±5months following ACL-reconstruction. Images were obtained at extension and 30° flexion under simulated loading (125N). Tibial rotation (TR) and anterior tibial translation (ATT) between flexion and extension, and T 1ρ relaxation times of the knee cartilage were analyzed. Cartilage was divided into five compartments: medial and lateral femoral condyles (MFC/LFC), medial and lateral tibias (MT/LT), and patella. A sub-analysis of the femoral weight-bearing (wb) regions was also performed. Patients were categorized as having "abnormal" or "restored" ATT and TR, and T 1ρ percentage increase was compared between these two groups of patients. Results: As a group, there were no significant differences between ACL-reconstructed and contralateral knee kinematics, however, there were individual variations. T 1ρ relaxation times of the MFC and MFC-wb region were elevated (p≤0.05) in the ACL-reconstructed knees compared to the uninjured contralateral knees. There were increases (p≤0.05) in the MFC-wb, MT, patella and overall average cartilage T 1ρ values of the "abnormal" ATT group compared to "restored" ATT group. The percentage increase in the T 1ρ relaxation time in the MFC-wb cartilage approached significance (p=0.08) in the "abnormal" versus "restored" TR patients. Conclusions: Abnormal kinematics following ACL-reconstruction appear to lead to cartilage degeneration, particularly in the medial compartment. © 2011 Elsevier B.V.
Metal hypersensitivity in total knee arthroplasty: Revision surgery using a ceramic femoral component - A case reportPhilipp Bergschmidt | Rainer Bader | Wolfram Mittelmeier
Volume 19, Issue 2, March 2012, Pages 144-147
We present a case involving the revision of a total knee arthroplasty with a metal femoral component using a ceramic implant due to metal hypersensitivity. A 58-year-old female patient underwent total knee arthroplasty (TKA) with a standard metal bicondylar knee system. She suffered from persistent pain and strong limitations in her range of motion (ROM) associated with flexion during the early postoperative period. Arthroscopic arthrolysis of the knee joint and intensive active and passive physical treatment, in combination with a cortisone regime, temporarily increased the ROM and reduced pain. No signs of low grade infection or other causes of implant failure were evident. Histology of synovial tissue revealed lymphoplasmacellular fibrinous tissue, consistent with a type IV allergic reaction. Allergometry (skin reaction) revealed type IV hypersensitivity against nickel-II-sulfate and palladium chloride.Revision surgery of the metal components was performed with a cemented ceramic femoral component (same bicondylar design) and a cemented titanium alloy tibial component. Postoperative evaluations were performed 10. days, and 3 and 12. months after the revision surgery. There was an increased ROM in flexion to 90° at the 12. month follow-up. No swelling or effusion was observed at all clinical examinations after the revision surgery. No pain at rest and moderate walking pain were evident.The presented case demonstrates that ceramic implants are a promising solution for patients suffering from hypersensitivity to metal ions in total knee arthroplasty. © 2011 Elsevier B.V.
Reducing blood loss in primary knee arthroplasty: A prospective randomised controlled trial of tranexamic acid and fibrin sprayJamie S. McConnell | Sandeep Shewale | Niall A. Munro | Kalpesh Shah | Angela H. Deakin | Andrew W G Kinninmonth
Volume 19, Issue 4, August 2012, Pages 295-298
A prospective, randomised controlled trial compared the effects of two medications intended to reduce blood loss from total knee arthroplasty. Patients were randomised to one of the following three treatment groups: 10. mg/kg tranexamic acid at given at induction of anaesthesia, 10. ml of fibrin spray administered topically during surgery, or to a control group receiving neither treatment. Sixty six patients underwent elective cemented total knee arthroplasty; computer navigation was used in all cases. There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups (p = 0.181). There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups(p=0.181). The fibrin spray led to a significant reduction in blood loss compared to control (p=0.007). The effect of tranexamic acid did not reach significance (p=0.173). We conclude that fibrin spray was effective in reducing blood loss but that with a study of this power, we were unable to detect an effect of tranexamic acid in cemented navigated total knee replacement at the dose used. © 2011 Elsevier B.V.
Survivorship of UKA in the middle-agedThomas J. Heyse | Ahmed Khefacha | Geert Peersman | Philippe Cartier
Volume 19, Issue 5, October 2012, Pages 585-591
Background: Unicompartmental knee arthroplasty (UKA) is known to be a viable procedure allowing for preservation of the intact compartments and delivering excellent function at long-term follow-up. The primary purpose of this single-surgeon study was to analyse the survivorship of a fixed bearing UKA in patients younger than 60. years. Methods: From all UKAs implanted between 1993 and 2005 at the senior authors' centre, 223 patients <. 60. years at operation with a minimum follow-up of 5. years were identified including all-poly and metal-backed tibiae. They were evaluated applying the Knee Society Score (KSS) at latest follow-up. Survivorship was calculated using Kaplan-Meier analysis, which considered the following variables: gender, type of tibial implant, medial vs. lateral UKA, and age. Results: Average age at index operation was mean 53.7 (SD 5.8, range 30-60) years at a mean follow-up of 10.8 (SD 3.5, range 5-17) years. From the KSS, the knee score was 94.3 (SD 7.8) and the function score was 94.9 (SD 6.8). At latest follow-up, the implant survival rate was 94.3%. Survivorship for the entire cohort was 93.5% at 10. years (medial UKA 94.1% vs. lateral 91.8%), and 86.3% at 15. years (85.1% medial vs. 91.7% lateral). Conclusion: In conclusion, excellent survival and function outcomes were noted in this subgroup of patients younger than 60. years. Revision rates were comparable to those studies in which UKA was performed on an elderly patient population. UKA can successfully be performed in patients younger than 60. years with appropriate patient selection. © 2011 Elsevier B.V.
Anthropometric measurements of knee joints in Thai population: Correlation to the sizing of current knee prosthesesChaiyos Chaichankul | Aree Tanavalee | Pibul Itiravivong
Volume 18, Issue 1, January 2011, Pages 5-10
Anthropometric data on the distal femoral condyle and the proximal tibia of 200 knees in 200 Thai subjects were measured using magnetic resonance imaging (MRI). The data including the resected femoral anterior-posterior (AP) length, the resected femoral medial-lateral (ML) width, the resected tibial AP length and the resected tibial ML width were measured. A characterization of the aspect ratio (the ML to AP dimensions) was made for the distal part of the femur and the aspect ratio (the AP to ML dimensions) was made for the proximal part of the tibia. All parameters were compared to the size of the total knee prosthesis with four prosthetic systems which currently used in Thailand: NexGen (Zimmer), P.F.C. Sigma (Depuy-Johnson & Johnson), Genesis II (Smith & nephew), and Scorpio (Stryker). The results of this study could provide fundamental data for the design of knee prostheses suitable for the Thai population. © 2009 Elsevier B.V.


text:
realmagick.com The shrine of knowledge.
Anglo Indian
A selection of articles related to anglo indian.
Original articles from our library related to the Anglo Indian. See Table of Contents for further available material (downloadable resources) on Anglo Indian.
- Indian History Rewritten
- The Indian civilisation, considered to be the product of clash and subsequent inter mixture of the white-skinned civilised invaders and the dark savages native to India, has been rightly questioned in recent years, and the mischievously fabricated history of...
History & Anthropology >> Indic / Vedic
- Indian Paint Brush: Correspondences
- Castilleja spp. Folk Names: Snake's Friend, Snake's Matches Gender: Feminine Planet: Venus Element: Water Deity: Power: Love...
Herbalism >> Herbs dictionary I
- Ingwaz
- Welcome to the Rune-of-the-Month Club! Ingwaz is the sixth rune of the third aett, and the twenty-second rune of the Elder Futhark as a whole. Its sound is that of the English "ng." Like Thurisaz, it represents a sound written by two letters in the Roman...
Divination >> Rune Stones
- The Celtic Vedic Connection, Part I
- Of all the great ancient cultures perhaps no two share more parallels than those of the Celtic and Vedic peoples. A deep rooted affinity runs between them, what is present in one is mirrored in the other. Myths, Gods, Goddesses, even fairy tales bear a...
Religions >> Druidism
- Tiwaz
- Welcome to Tyr's Aett, the third and final aett (group of eight) of the Elder Futhark. Tiwaz is the name of this aett's first rune in reconstructed Common Germanic. Its name became first Teiws in Gothic, then later Tiw or Tiu in Anglo-Saxon and Tyr in Old...
Divination >> Rune Stones
- Story of the Celts: The Celts in Britain
- The Celts in Britain [ 27 ] What is obvious when studying the Celts, as when studying anything, is that different experts say different things--there are always men of knowledge who have conflicting views about specifics. The dates of when the Celts came to...
History & Anthropology >> Celtic & Irish
Anglo Indian is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Anglo Indian books and related discussion.
Suggested News Resources
- Phillip, Anglo-Indian member in Assembly
- Hyderabad: Governor ESL Narasimhan nominated Phillip C Tocher as a member, to represent Anglo-Indian community in AP Legislative Assembly. A government order on Tuesday said that in exercise of the powers vested in the Governor under Article 333 ...
- Family life: My parents' Anglo-Indian wedding, The Clapping Song by the Belle
- This photograph of my parents' wedding only came to light after my last surviving aunt (not seen here) died and a cousin was sorting out old albums. My parents – Ida Copland and Hem Gupta, holding hands and wearing button holes – were married in March ...
- Curating Anglo-Indian Cuisine
- Just how difficult can making biryani be? For Chef Meet Singh Malhotra, culinary consultant at House of Commons, a restaurant that launched recently in Connaught Place, it was a tall order. It took more than a few tries before it became the crowning ...
- Anglo Indian Meatball Curry recipe
- Anglo Indian Meatball Curry recipe. You love the meat but do not want it to cook in the usual way you do. If that is the situation you are facing and searching for some unique dish, to prepare with meat, your search ends here.
Great care has been taken to prepare the information on this page. Elements of the content come from factual and lexical knowledge databases, realmagick.com library and third-party sources. We appreciate your suggestions and comments on further improvements of the site.
Anglo Indian Topics
Related searcheskharghar
death symbolizes change
musical film history of the musical
a mind forever voyaging feelies
carry on camping classic quotes
dream symbol bad spirits
steven seagal film career
About - Contact - Advertising
© 2000 - 2016 Realmagick.com, All Rights Reserved.
© 2000 - 2016 Realmagick.com, All Rights Reserved.


text:
Natural Resources Lawyers and Law Firms in Cabrera, Dominican Republic
Natural Resources Lawyers
Quiroz Santroni Abogados Consultores
Environmental and Business Lawyers in the Dominican Republic+1 (809) 338-4200
Quiroz Santroni Abogados Consultores specializes in the development and assessment of investment projects with a focus on business, financing, and environment in several key industries in the Dominican Republic. Our firm deals particularly in the areas of real estate and tourism...
Law Firm's Overview
Aaron Suero & Pedersini
Dominican Full-Service Boutique Law Firm+1 809 532-7223 or +1 866 815-0107
Aaron Suero Pedersini is one of the most recognized full-service boutique law firms in Santo Domingo, Dominican Republic with more than 60 years of combined experience.
We provide personalized, confidential, high quality, concierge, multi-lingual and cost effective legal assistance...
Law Firm's Overview ArticlesFree ConsultationCredit Cards
García Pereyra Leger
Full-Service Law Firm in Dominican Republic+809 476-6707
Garcia, Pereyra, Leger and Associates is a full service law firm located in the Dominican Republic, focusing on business issues and intellectual property cases. This law firm provides a range of legal services for clients in the country and outside the nation. The firm helps clients...
Law Firm's Overview Free ConsultationCredit Cards
Guzmán Ariza, Attorneys at Law
International Business Law Firm in Dominican Republic+1 (809) 255-0980
Guzmán Ariza is an experienced, dedicated law firm located in Dominican Republic. Our firm was founded in 1927, more than 80 years ago. Today, we are the first and only national law firm in the Dominican Republic, with 27 lawyers distributed in seven offices covering the Santo Domingo...
Law Firm's Overview ArticlesVideosFree Consultation
Biaggi & Messina
Corporate, Banking and Mergers & Acquisitions Law Firm in The Dominican Republic+809 535-1414
We make a difference through meticulous and personalized attention that combines direct supervision by full-time practicing partners with the expertise of our lawyers. This allows us to manage lasting relationships with our clients, for whom we provide sound, coherent and honest...
Law Firm's Overview
Castillo & Castillo
Full-Service Legal Firm Serving The Dominican Republic+809 562-3344
Castillo & Castillo established in 1933 in Santo Domingo's old colonial zone advocates a system of open communication available to clients around the clock, every day of the year. With a dedicated team of experienced attorneys, the firm focuses on finding the proper solution...
Other Offices: Bavaro, Santiago
Law Firm's Overview
Distinctive Law
Full Service Lawyers Serving Dominican Republic+809 732-7821
Distinctive Law is a law firm, whose main objective is to address the needs of the global market, providing adequate and innovative legal advice to our clients and seeking to maximize their opportunities through practical solutions. The firm policy is based on a continuous support...
Law Firm's Overview
Headrick Rizik Alvarez & Fernandez
Full Service Law Firm in The Dominican Republic+809 473-4500
Headrick Rizik Alvarez & Fernández was founded in 1985 by William C. Headrick, Roberto Rizik, Francisco Alvarez and Mary Fernández, each of whom is an experienced attorney in a wide range of practice areas. Later, Marisol Vicens, Sarah De León, Tomás Hernández, Kirsys Reynoso,...
Law Firm's Overview
Jiménez Cruz Peña
Multi-Practice Law Office in The Dominican Republic+809 955-2727
Jiménez Cruz Peña's goal is to provide timely and effective solutions that exceed the needs and expectations of our clients. Equipped with internationally-trained lawyers, the firm serves a diverse client base from all over the world in satisfying their business needs on the island....
Law Firm's Overview
Pellerano & Herrera
Full Service Law Firm In Dominican Republic+80 95 415200
Pellerano & Herrera has been the leading law firm in the Dominican Republic for over 25 years. Established in 1952, the firm is typically involved in all major transactions in the country and provides advice to most international players. The firm's multidisciplinary team of...
Law Firm's Overview
Sánchez Raful Sicard & Polanco
Dominican Republic Business Law Firm+809 565-1111
Sanchez Raful Sicard & Polanco aims to be recognized in the Dominican Republic market as a vanguard law firm, sophisticated but also simple, able to manage basic as well as complex legal transactions with the same ease, effectiveness and professionalism that our times require....
Law Firm's Overview
Seibel Dargam Henriquez & Herrera
General Practice Law Firm in The Dominican Republic+809 338-2000
Seibel Dargam Henríquez & Herrera (SDH&H) is a general practice law firm, founded in the city of Santo Domingo, Dominican Republic, in 2005.
The firm, in addition to being an answer to the day-to-day needs of its business clients, is also acknowledged for the success in...
Law Firm's Overview
Squire Sanders
Legal Counsel Worldwide+1 809 4724900
Squire Sanders is one of the most geographically diverse legal practices in the world; the firm's global breadth and local depth serve their clients across the globe. They also have strong working relationships with independent firms in Europe and the Middle East as well as in the...
Law Firm's Overview


text:
Tell us what you need so we can bring you the right pros.
Receive up to five quotes from pros who meet your needs.
Compare quotes, message pros, and hire when ready.
Browse these electricians with great ratings from Thumbtack customers in Columbus, OH.
Very professional. Arrived on time and he did an amazing job on our electrical.(show more)
Installed new service panel and replaced all receptacles and switches. Excellent service and quality installation.(show more)
These guys added an outdoor outlet for me this morning. Simple enough, but they did everything right in my opinion. I will be in touch with Robin any time I need electrical work done. Thanks(show more)
Jake Phelps came out January 28th 2016 to bond the gas line at my house after a home inspector said it needed to be done prior to a sale. After inspection he realized that the gas line had already been bonded at the gas meter. The inspector had made a mistake assuming that the only location for termination of the bonding wire was to the gas manifold. The gas meter is the preferred location for this bond, which is where the current bond installed in original construction of the property has been terminated. This properties CSST gas line is properly bonded per National Electrical Code standards. He wrote a letter for me stating such and did not charge me a dime. I owe you one Jake. I will definitely use Jake on my next electrical Job.(show more)
Nice guy, great work ethic!(show more)
Jeff came out ASAP when we had an electrical issue and quickly identified and fixed the issue. Highly recommended.(show more)
Jarred installed recessed lighting in my basement. The lighting looks great! He was meticulous in his work. His pricing was fair. He was always on time. He communicated very well and did a great job of setting my expectations. I would hire Jarred again for any electrical job.(show more)
j box installed / wires replaced / outlet cover replaced and secured / ballist replaced in flourescent light fixture(show more)
Trever was very professional from the first phone call. He gave accurate arrival times and communicated clearly about the work and all parameters. He is highly personable and refreshingly personable. His work was neat and done well. He treated our home and our time with great respect. I will definitely call him with any electrical needs in the future.(show more)
Adam Bowen was extremely professional and I really appreciated his flexibility to work around my busy schedule and quick communication which allowed the job to get done as fast as possible. He also did a great job unclogging my sink and took care of it within an hour at half the price a plumbing company would have cost.(show more)
New Wave Electric specializes in commercial, residential and industrial electrical work. They are known for excellent customer service, customer loyalty and professional workmanship.
Check out their love of the industry and their goal towards their company's success.
What do you love about your job?
I love giving the customers what they want, whether it is a lighting design or advice for electrical work. We install to satisfy the customers. I also like doing kitchen layouts with under-cabinet lighting. LED is the new thing.
What or who inspired you to start your own business?
My goal was to start my own business. Now, my goal is to expand. The challenge is for me to grow now. I have been doing good, but to have a 10-man crew is what I want to achieve. I think that the time is now while we pick up more work on commercial and residential properties. I think that we are in a good spot to grow New Wave Electric.
Find out the average cost for projects similar to yours
{[{ pricing.estimation }]}
{[{ pricing.estimationDescription }]}
Something went wrong. Give it another try.Try again
Browse other Electricians available for hire on Thumbtack
Accent Kitchens and Baths has a team of licensed electrician present for your wiring needs. Talk to the master electrician and discuss your house plans. You'll be seeing top rated electricians next.
This company has a team of top electricians who offer services to residential buildings. They provide affordable electrician rates as they install panels, lighting, outlets, and ceiling fans.
Howard Greer is amongst the best rated electricians who also develops wine cellars. He also does drywall work, remodeling and more. Check out his electrician reviews.
Don Stepp handles light plumbing and electrical jobs. He is among the electrical contracting professionals who also provide deck and drywall repair, carpentry, masonry services and much more.
Accredited Contractors, LLC is a professional remodeling firm that offers handyman services for residential and commercial clients. They have certified electricians for all kinds of electrical jobs.
Jarrod Simmons handle electrical services including troubleshooting and repair work. He also handles residential and commercial maintenance and remodeling services. See his electric reviews.
These electrical contractors repair and replace fixtures and offer new installation and remodeling services. Their best electricians provide flat-rate pricing and free estimates on larger projects.
This business provides a variety of handyman services, including plumbing and electrical works. These residential electricians also offer painting services. They have been doing electrician jobs for 20 years.
Remod Squad offers reliable electrical troubleshooting services for residential clients. Their fully insured electric contractors also provide kitchen and bath remodeling, flooring, plumbing and more.
David Wear has been providing quality residential and commercial flooring solutions and remodeling services for 27 years. He also offers house electrical repairs, plumbing, drywall work, cabinetry and more.
PTI Electrical and Home Maintenance Services offers quality residential and commercial electrical contracting services at a reasonable price. They also do service upgrades, troubleshooting, and more.
This company has 30 years of experience in offering house electrical maintenance, and interior and exterior painting at affordable rates. They provide hardwood restoration and carpentry, and more.
This company offers local electrician services. They provide service upgrade, replace light switch, troubleshoot electrical problems and more. They also provide one-year warranty on parts and labor.
These reliable and prompt handymen offer affordable repairs. They also provide remodeling, renovation, plumbing, home improvement, as well as electrician services, floor installations, and more.
Get a 3-year labor warranty when you hire this bonded, insured and licensed home improvement company. They specialize in copper and metal fabrication, roofing, fencing, electrical repairs, and more.
Check out Speedy Electric if you're searching for residential electrical work at affordable rates. This electric company also provides wiring and lighting services, among others.
Skills II NV is an electrician contractor offering various services like ceiling fan installation, service conversion, load calculation, lighting design, security system setup, energy saving and more.
Richard Leary provides cost-effective coffee maker, toaster, light and electrical outlet repair services for residential clients. He also fixes leaky faucets and plugged drains.
This local company provides quality home repairs and remodels, including plumbing, electrical work, painting, tile installation, and much more.
Tarrell Mock provides quality exterior and interior residential home repairs and replacement solutions that include electrical work, kitchen and bathroom renovations, roofing, and more.
Ndiaye Electrician has been in the electrical contracting business for 33 years. As commercial and residential electricians, they can work on lighting, wiring of transformers, terminal cable and more.
HandyGirl! provides complete handyman services. They do electrician jobs, light plumbing, drywall installation and finishing, remodeling, power washing, wood fencing, carpentry, and more.
This business handles all types of home and commercial remodeling services. They are among the area's best electricians who offer painting, plumbing, electrical work, and more.
This company specializes in providing insulation, drywall, painting, plumbing and flooring services with free estimates. They also handle electrical jobs as well as patios, doors and windows.
Browse these electricians with great ratings from Thumbtack customers in Columbus, OH.
Reli electric was beyond all expectations. He left the house as clean as he found it. The work area was immaculate and he was very easy to work with. His workmanship was beautiful and his panel change was easily the best I've seen as far as timing and pricing. I'm amazed and will definitely work with this company again.(show more)
Anthony was on time for our appointment. We had him come out to trouble-shoot some electrical issues we were having (fans not running properly and flickering lights). We were worried there was a larger issue. He looked at everything we had a concern with, made the appropriate fixes (tightening of wires, outlets, etc.) and then went around the entire house to check all of our outlets, etc. He gave us good advice on next steps. We were very happy.(show more)
Very professional, friendly & prompt. Would definitely recommend their services.(show more)
See other requests for electricians in Columbus
Cincinnati, OH
Columbus, OH
Columbus, OH
See other types of services provided by Thumbtack professionals


text:
Auburn, N.Y. -- An Auburn woman had 156 oxycodone pills in her possession when she was arrested Tuesday, state police said.
Linda Myers, 54, was charged with third-degree criminal possession of a controlled substance, a felony, and second-degree criminal possession of drug paraphernalia, a misdemeanor.
Myers was arrested Tuesday in the Finger Lakes Mall parking lot in the Town of Aurelius while she was waiting to sell oxycodone to an unknown man. Myers had 156 oxycodone pills in her possession, state police said.
Myers was arraigned and sent to Cayuga County Jail on $1,000 cash or $2,000 bond.


text:
London Punk Stencil Shirt
About this project
CraftsDrawing • Stencilling • Sewing •
Posted By
Taylor.Boles53708Los Angeles, California, US
You'll need:
-A plain t-shirt
-Red and blue fabric paint
-Simple paint brushes
-I like to have a pallet for my paint, so that I don't create a mess.
-Water,to clean the brushes in between colors
-Scissors (Any Kind)
-You can optionally get fabric for the bow tie.
-I used black lace on the bottom.
-A needle and thread or sewing machine
I would make any necessary cuts before I started to paint. You can make the neck lower if you want or shorten the sleeves. Adjust it to where it will be comfortable. Personally, I felt like the neck was choking me. To fringe, find a desirable length of the fringe and start cutting up and down. Tug the fringe when your done cutting. Go ahead and sew your black lace on. Now, I looked at a picture of the flag on the internet and went from there. I used a book to trace the outline of the flag. After, I painted the sketch. I let the shirt set out over night to dry, but it doesn't really take that long. The final step was creating a bow tie. You can use other bow tie that's already sewn if you want to. You must sketch the bow tie on paper ,and cut it out to use as a border when finding the right lengths and widths for your bow tie fabric. Once you have two bow tie fabrics that look pretty much the same size, you can start sewing. I put cotton in mine to hold it up, but it's completely up to you. You can either make the bow tie a necklace type deal or sew it onto your shirt.
For more instructions go to: http://www.youtube.com/watch?v=IpjtMfYoC78&feature=youtu.be.
From Turtleneck Tee To Ruffled Halter
Turn any boring tee into a fabulous ruffled halter for spring and summer!
Basic Tank & Bow Ruffle Top Tutorial
A simple & easy way to make your own sleeveless blouses + bow ruffle embellishment


text:
Description: This silky ITY jersey knit is perfect for creating flowy tops, fuller skirts and drapey dresses with a lining. It has a super smooth hand, fluid drape and about 50% stretch across the grain and 15% vertical stretch for comfort ...
go to product
Description: This lightweight jersey knit fabric features a smooth hand and four-way stretch-50% stretch across the grain and 15% vertical stretch. This versatile fabric is perfect for making T-shirts, loungewear, yoga pants, skirts, dresses and more! Colors include black, pink, red, ...
Description: Designed by Doohikey Designs for Riley Blake, this cotton print fabric is perfect for quilting and apparel. Colors include orange, light yellow, white, shades of grey, shades of pink, shades of aqua, and shades of blue.
Explore Fabric.com
We're here to help
Discover Fabric.com
Sewing Center