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Journal of Long-term Effects of Medical Implants

Marine Coste, Jared M Newman, Neil V Shah, Ahmed M Eldib, Preston W Grieco, Aditya V Maheshwari
Quadriceps tendon ruptures are rare complications of total knee arthroplasty (TKA) and may be associated with preexisting tendon degeneration, vascular injuries during surgery, damage to the quadriceps tendon with over resection of the patella, or incomplete healing after a particular surgical approach. Moreover, postoperative causes include tissue necrosis due to component malalignment, trauma, and infection. Patient factors such as chronic systemic diseases, medications, increased body weight, and sedentary lifestyle could also be responsible...
2018: Journal of Long-term Effects of Medical Implants
Arie G Trouw, Ashish Patel, Andrew Yang, Julio Jauregui, Daniel Caligiuri, Jack Choueka
Carpal tunnel syndrome (CTS) has multiple implications on patient quality of life. In particular, CTS may affect quality of sleep, causing sleep deprivation in extreme cases. Carpal tunnel release (CTR) surgery may aid in resolving these disturbances. The purpose of our study was to investigate whether patients who have undergone CTR have improved sleep quality and to determine the timeline for such improvement. Twenty-one patients were prospectively enrolled and followed-up for two years. They were asked to complete a Pittsburgh Sleep Quality Index (PSQI), a pain visual analog scale (VAS), a sleep perception VAS, and both components Symptom Severity and Functional Status Scale from the Levine-Katz carpal tunnel questionnaire...
2018: Journal of Long-term Effects of Medical Implants
Andrew J Hayden, Srinivas Kolla, Adele L Boskey, Steven Burekhovich, Chuanyong Lu, Michael Stracher, Aditya V Maheshwari
Milwaukee Shoulder Syndrome (MSS) is a painful progressive arthropathy in which hydroxyapatite crystal deposition in synovial tissue induces lysosomal release of collagenase and neutral proteases. These enzymes are destructive to periarticular tissue, including the synovium, articular cartilage, rotator cuff muscles, and the intrasynovial cortical bone. MSS predominantly occurring in women (90%) over the age of 70 years of age with a clinical history marked by recurrent joint effusions and pain, which classically worsens at night...
2018: Journal of Long-term Effects of Medical Implants
David B Frumberg, Qais Naziri, Robert Pivec, Lee Bloom, Barbara Freeman, Jaime A Uribe
The routine workup of hallux valgus includes measurements of the distal metatarsal articular angle (DMAA). However, this angle may not be a reliable measurement when rotational deformities occur. Eight matched cadaveric feet were evaluated radiographically using fluoroscopy. The intermetatarsal angle (IMA), hallux valgus angle, and DMAA were evaluated as a baseline. Then, we assessed whether axial rotation of 15°, 30°, 45°, and 60° affected the accuracy of the IMA and the DMAA significantly. Statistical evaluation was performed using Student's t tests and analysis of variance...
2018: Journal of Long-term Effects of Medical Implants
Aditya V Maheshwari, Robert Pivec, Roby Abraham, Qais Naziri
The standard of care for chronic deep peri-prosthetic hip infection is a two-stage exchange with placement of a temporary antibiotic cement spacer and treatment with intravenous antibiotics. Several commercially available cement spacer options exist. We report on a novel antibiotic spacer that may be an efficient, cost-effective alternative. Medical records of all patients treated for deep peri-prosthetic hip infection after total hip arthroplasty between 2004 and 2012 were reviewed. Each antibiotic spacer was constructed from a 12- to 16-hole recon plate bent to provide adequate soft tissue tension and a cement ball that matched the acetabulum...
2018: Journal of Long-term Effects of Medical Implants
Alexander Tejani, Qais Naziri, Preston W Grieco, Robert Pivec, Damon Greene, Bhaveen V Kapadia, Dipal Chatterjee, William P Urban
Prior studies have not found significant differences in meniscal parameters between patients with meniscal and ligamentous injury and those without. The purpose of this study was to determine whether such relationships exist. Clinical records and magnetic resonance images of three subject groups were reviewed. Group 1 solely had meniscal tears (medial/lateral), Group 2 had meniscal tears with concurrent ACL tears, and Group 3 had healthy knees. The mean age of subjects included was 35.9 years (range 8.2-72...
2018: Journal of Long-term Effects of Medical Implants
Qais Naziri, Jadie Detolla, Westley Hayes, Steven Burekhovich, Andrew Merola, Chibukem Akamnanu, Carl B Paulino
The scoliometer is an inclinometer commonly used in scoliosis screening. The device is used during an Adam's forward bend test, in which a patient bends forward at the hips to measure deformity of the rib cage and spinal column. If a sufficient angle of rotation is measured, then the appropriate referrals and x-rays can be made and taken. This ubiquitous screening tool allows for a quick and simple scoliosis screening and is a mainstay of scoliosis management. With the advent and rapid improvement of smart phone technology, many scoliometer applications have become readily accessible...
2018: Journal of Long-term Effects of Medical Implants
Paul W Perdue, Allison B Spitzer, Dipal Chatterjee, Srinivas Kolla, Aditya V Maheshwari
A 53 year old-female patient with lupus had undergone a cephalo-medullary nailing for a femur shaft fracture 30 years ago. This was complicated by osteomyelitis, requiring multiple debridement procedures and hardware removal. Recently, she developed a painful soft tissue mass in the same region, which was ultimately diagnosed as pyomyositis. Because of chronic bone changes due to her past history, traditional imaging could not differentiate between osteomyelitis infarction and pseudotumor. A combined indium-labeled leukocyte scan with a technetium-99 sulfur colloid marrow scan ruled out osteomyelitis and guided proper treatment without osseous debridement and thus prevented unnecessary cross-contamination of the bone...
2018: Journal of Long-term Effects of Medical Implants
Eric Denes, Guislaine Barrière, Evelyne Poli, Guillaume Lévêque
Alumina (Al2O3) ceramic is widely used for medical devices and its biocompatibility is well known and is reported in articles and textbooks. However, finding proof of this assertion gathered over more than 40 years can be challenging. We performed a literature review about alumina biocompatibility to compile data from the literature. We searched for articles on the biocompatibility of alumina in relation to the ISO 10993-1 International Standard, which defines the biocompatibility of biomaterials. For every biological effect listed in the norm, such as cytotoxicity, sensitization, implantation, and genotoxicity, in vitro and in vivo tests in animals and humans did not reveal any abnormal biological response...
2018: Journal of Long-term Effects of Medical Implants
Sara Soheilifar, Mohsen Bidgoli, Ehsan Houshyar, Maryam Farhadian, Ali Ghamari
The objective of this study was to compare the effects of preparing for implant site osteotomy with conventional drilling or piezosurgery on the stability of oral implants after a 5 month follow-up period. Thirty patients participated in this randomized clinical trial and received two implants in posterior mandible in bone of the same quality. All surgical procedures were performed by the same surgeon. Implant stability amounts were measured by resonance frequency analysis using the Osstell Mentor device and are reported in the format of implant stability quotient (ISQ) values at baseline and 90 and 150 days after surgery...
2018: Journal of Long-term Effects of Medical Implants
Richard Edlich, Lisa G Hill, Freddie M Williams
Infection with human T-cell lymphotrophic virus-I (HTLV-I) is now a global epidemic, affecting 10 to 20 million people. This virus has been linked to life-threatening, incurable diseases, adult T-cell leukemia/lymphoma (ATLL), and HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP), as well as several chronic illnesses, such as uveitis and dermatitis. The cumulative lifetime risk of developing these incurable diseases is approximately 5% in asymptomatic patients. For operating room personnel performing surgery among patients from high-risk groups, HTLV-I and its associated diseases are presenting an increasing challenge...
2017: Journal of Long-term Effects of Medical Implants
Richard Edlich, Tyler C Wind, Cynthia L Heather, John G Thacker
During operative procedures, operating room personnel wear sterile surgical gloves designed to protect them and their patients against transmissible infections. The Food and Drug Administration (FDA) has set compliance policy guides for manufacturers of gloves. The FDA allows surgeons' gloves whose leakage defect rates do not exceed 1.5 acceptable quality level (AQL) to be used in operating rooms. The implications of this policy are potentially enormous to operating room personnel and patients. This unacceptable risk to the personnel and patient could be significantly reduced by the use of sterile double surgical gloves...
2017: Journal of Long-term Effects of Medical Implants
Robin R Szarmach, Jean Livingston, George T Rodeheaver, John G Thacker, Richard Edlich
This report describes an innovative suture and needle clinical evaluation program jointly designed by hospital representatives of Consorta, Inc., a healthcare resource management and group purchasing organization, and United States Surgical/Davis & Geck Sutures (USS/D&G), manufacturer of surgical biomaterials. Nineteen Consorta shareholder hospitals enrolled 699 surgeons to participate in Phase I of this nonexperimental observational study of the clinical performance of surgical needles and sutures...
2017: Journal of Long-term Effects of Medical Implants
William D Steers, Tyler C Wind, Elizabeth V Jones, Richard Edlich
The purpose of this collective review is to examine the use of functional electrical stimulation for incontinence. The Finetech-Brindley bladder system enhances voiding through stimulation via electrodes implanted around the ventral sacral roots. Detrusor hyperreflexia is eliminated through complete dorsal rhizotomy, which results in loss of reflex defecation and reflex erection/reflex lubrication. Consequently, a new system is being devised in which functional electrical stimulation for incontinence in spinal cord injury can be achieved without dorsal rhizotomy...
2017: Journal of Long-term Effects of Medical Implants
Gregory G Degnan, Tyler C Wind, Elizabeth V Jones, Richard Edlich
The purpose of this collective review is to describe a new form of functional electrical stimulation called neuroprosthesis. This unique technology has been devised to produce lateral pinch and palmar grasp in persons with C5 and C6 motor level spinal cord injuries. This neuroprosthesis includes external as well as implanted components. First, a receiver is surgically implanted into the patient's chest above a pectoralis major muscle. The receiver stimulator is then connected to 8 surgically implanted epimysial or intramuscular electrodes...
2017: Journal of Long-term Effects of Medical Implants
Robert P Wilder, Elizabeth V Jones, Tyler C Wind, Richard Edlich
The purpose of this collective review on functional electrical stimulation (FES) cycle ergometer training is to describe the pathologic effects of spinal cord injury (SCI) and the structure and function of the FES cycle ergometers, which reverse the devastating systemic and life-threatening effects of SCI. The pathophysiologic consequences of SCI include diminished cardiopulmonary and circulatory function as well as lower extremity muscle atrophy and bone mass reduction. Clinical studies have demonstrated that the two FES cycle ergometers offer promise in reversing these devastating consequences of SCI, which can shorten patients' lives...
2017: Journal of Long-term Effects of Medical Implants
Robert P Wilder, Tyler C Wind, Elizabeth V Jones, Brenda E Crider, Richard Edlich
The purpose of this collective review is to study the techniques, usage, methods, and clinical results of functional electrical stimulation applied to the peroneal nerve in the treatment of dropped foot. When stimulation is applied through surface electrodes, clinical reports have documented the therapeutic and orthotic benefits of functional electrical stimulation. Clinical trials are now being undertaken in which implantable electrodes are being used to stimulate the peroneal nerve in patients with dropped foot...
2017: Journal of Long-term Effects of Medical Implants
Harold J Brandon, V Leroy Young, Marla E Watson, Clarence J Wolf, Kenneth L Jerina
The Center for Implant Retrieval and Analysis has been established at Washington University's Division of Plastic and Reconstructive Surgery for the purpose of studying implantable devices retrieved after surgery or autopsy and assessing their condition after implantation. Since the early 1990s, significant experience has been gained in testing and analyzing silicone gel breast implants and, to a lesser extent, saline-filled devices. However, there has been no systematic method reported for collecting and evaluating these implants in a way that would permit di...
2017: Journal of Long-term Effects of Medical Implants
Andrew L Lewis, Peter W Stratford
Stainless steel stents have been developed to perform their primary purpose of providing sufficient physical support to an artery following percutaneous transluminal coronary angioplasty (PTCA) in order to prevent vessel recoil. Early clinical problems, largely caused by subacute thrombosis (SAT), have been significantly reduced with a new generation of antiplatelet agents. Despite improved pharmacological control of SAT in many patients, the potential for stent occlusion remains a life-threatening problem for those with more complex lesions...
2017: Journal of Long-term Effects of Medical Implants
R G Pearson, R Bhandari, R A Quirk, Kevin M Shakesheff
Tissue formation within the body, as part of a development or repair process, is a complex event in which cell populations self-assemble into functional units. There is intense academic, medical, and commercial interest in finding methods of replicating these events outside the body. This interest has accelerated with the demonstration of the engineering of skin and cartilage tissue in the laboratory and there is now worldwide activity in the in vitro regeneration of tissues including nerve, liver, bone, heart valves, blood vessels, bladder, and kidney...
2017: Journal of Long-term Effects of Medical Implants
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