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Advances in Orthopedics

Britta K Krautwurst, Jürgen R Paletta, Sylvia Mendoza, Adrian Skwara, Melvin Mohokum
Objective: Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data: A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods: Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48...
2018: Advances in Orthopedics
Jackson Rucker Staggers, Thomas Elliot Niemeier, William E Neway, Steven Michael Theiss
Objective: Blunt spinal trauma classification systems are well established and provide reliable treatment algorithms. To date, stability of the spine after civilian gunshot wounds (CGSWS) is poorly understood. Herein, we investigate the validity of trauma classification systems including the Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification and Severity Score (SLIC), and Denis' three-column model when applied to spinal penetrating trauma from gunshots, while secondarily evaluating stability of these injuries...
2018: Advances in Orthopedics
Jennifer J Beck, Dai Sugimoto, Lyle Micheli
Introduction: Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in young patients. Authors hypothesized long-term outcomes are comparable to reported mid-term outcomes. Methods: A single institution, longitudinal cohort study design combining medical record review and outcome surveys was used...
2018: Advances in Orthopedics
Brian T Grisez, Andrew E Hanselman, Karim W Boukhemis, Trapper A J Lalli, Brock A Lindsey
Traditional above-the-knee amputation prosthetics utilize a stump-socket interface that is well-known for skin/socket problems, sitting difficulty, disuse osteopenia, and increased work of ambulation. As a result, we evaluated a novel osseointegrated transcutaneous implant in a large animal. The implant was designed to promote osseointegration at the bone-implant interface and minimize complications. As proof of concept, four Dorset sheep underwent a two-stage surgery for forelimb placement of an osseointegrated transcutaneous implant utilizing Compress® technology (Biomet, Inc...
2018: Advances in Orthopedics
J M Wilson, C A Staley, A L Boden, A R Boissonneault, A M Schwartz, M L Schenker
Introduction: On-call orthopedic clinicians have long speculated that daily consult volume is closely correlated with weather. While prior studies have demonstrated a relationship between weather and certain fracture types, the effect of weather on total orthopaedic consult volume has not yet been examined. The aim of this study was to investigate this relationship. Methods: We retrospectively reviewed orthopaedic consult data from 405 consecutive days at an urban, level one trauma center...
2018: Advances in Orthopedics
Abdulrahman D Algarni, Hassan M Al Moallem
Objective: Femoral head osteonecrosis is a progressive clinical condition with significant morbidity and long-term disability. Several treatment modalities including both surgical and nonsurgical options have been used with variable levels of success. High-energy extracorporeal shock wave therapy is a nonoperative treatment option that has been described for early-stage disease. We aimed to assess the functional and radiological outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of osteonecrosis of the femoral head (ONFH)...
2018: Advances in Orthopedics
Panagiotis Korovessis, Vasileios Syrimpeis, Vasileios Tsekouras, Konstantinos Vardakastanis, Peter Fennema
Purpose: A retrospective study that aims to report Adjacent Segment Degeneration (ASD) incidence and spinopelvic balance in short lumbosacral instrumentation for degenerative lumbar spinal stenosis. Although ASD is a common complication following lumbar fusion, the effect of an interspinous spacer (IS) in the supradjacent segment in short lumbosacral instrumented fusion and its interaction with spinopelvic balance has not been studied adequately. Methods: From 55 consecutive age-, diagnosis-, and gender-matched patients aged 60±11 years, 17 (Group R) received PEEK IS; 18 (Group S) received Silicon IS compared with 20 controls (Group C) without receiving any IS...
2018: Advances in Orthopedics
Frank W M Faber, Monique J L Mastboom, Sabine T van Vliet-Koppert, Ilse C E Bouman, Paulien M van Kampen
While ankle arthrodesis was traditionally the gold standard method of treatment for disabling end-stage ankle arthritis, total ankle replacement (TAR) has been an acceptable alternative. The satisfaction rate of patients with TAR however differs. The purpose of our study is to investigate whether implant survival and results with special emphasis on the satisfaction rate of patients treated with a TAR implanted by a single surgeon were comparable to the literature. This was a retrospective cohort study in a teaching hospital...
2018: Advances in Orthopedics
Eric W Edmonds, John W Kemppainen, Joanna H Roocroft, John Munch, Tracey P Bastrom
Maintenance of certification (MOC) within a medical society requires continuing medical education that demonstrates life-long learning, cognitive expertise, and practice-based self-assessment. This prospective study sought to evaluate whether a self-directed Practice Improvement Module (PIM) would improve pediatric orthopedic patient outcomes, thus demonstrating evidence of life-long learning (Part II MOC credit) in treating supracondylar humerus fractures. Six surgeons and 113 patients were included. There was no significant difference in actual fracture outcome before or after PIM at any level of surgeon experience regarding radiographic appearance or need for reoperation ( p > 0...
2018: Advances in Orthopedics
Riccardo Luigi Alberio, Matteo Del Re, Federico Alberto Grassi
Background: The aim of this study was to evaluate the clinical and radiographic results after minimally invasive plate osteosynthesis (MIPO) for proximal humerus fractures. Potential advantages of this approach include the easier exposure of the greater tuberosity and the limited surgical dissection around the fracture site. Materials and Methods: From October 2011 to March 2016, thirty-nine patients (32 women, 7 men) with a mean age of 64.9 years (range: 48-80) were surgically treated with the MIPO technique for proximal humeral fractures...
2018: Advances in Orthopedics
Daniel A Müller, Giovanni Beltrami, Guido Scoccianti, Pierluigi Cuomo, Francesca Totti, Rodolfo Capanna
Introduction: Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods: In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft. Results: The mean follow-up was 6...
2018: Advances in Orthopedics
Hideto Irifune, Suguru Hirayama, Nobuyuki Takahashi, Mitsumasa Chiba, Toshihiko Yamashita
Background: Herein, we demonstrate the clinical results of closed reduction in a hyperextended supine position with transsacral-transiliac (TSTI) and iliosacral (IS) screw fixations for Denis zone III sacral fractures. Patients and Methods: Sixteen consecutive patients with Denis zone III sacral fractures who were treated between January 2009 and September 2016 were evaluated. All patients were treated using percutaneous TSTI/IS screw fixation during closed reduction performed with patients placed in a hyperextended supine position with body manipulation...
2018: Advances in Orthopedics
Takanori Miura, Hiroaki Kijima, Noriyuki Ishikawa, Toshihito Ebina, Takayuki Tani, Shuichi Chida, Tetsuya Suzuki, Satoshi Yumto, Hiroshi Tazawa, Naohisa Miyakoshi, Yoichi Shimada
Background: In atypical femoral fractures, owing to the high rates of complications and delayed healing that accompany the plate fixation, the most favorable treatment is intramedullary nailing. Although there is insufficient evidence, plate fixation is chosen due to anterolateral bowing of the femur. This study compared the bone healing time and rates of complications in atypical femoral shaft fractures and osteoporotic femoral shaft fractures. Methods: We searched the medical records of 3 institutions in Japan for patients with femoral shaft fractures who visited between 1 January 2010 and 31 December 2015...
2018: Advances in Orthopedics
Jeffrey M Pearson, Thomas E Niemeier, Gerald McGwin, Sakthivel Rajaram Manoharan
Introduction: Spinopelvic dissociation injuries are historically treated with open reduction with or without decompressive laminectomy. Recent technological advances have allowed for percutaneous fixation with indirect reduction. Herein, we evaluate outcomes and complications between patients treated with open reduction versus percutaneous spinopelvic fixation. Methods: Retrospective review of patients undergoing spinopelvic fixation from a single, level one trauma center from 2012 to 2017...
2018: Advances in Orthopedics
Freyja Hálfdanardóttir, Dan K Ramsey, Kristín Briem
The purpose of this study was to examine the influence of trunk lean and contralateral hip abductor strength on the peak knee adduction moment (KAM) and rate of loading in persons with moderate medial knee osteoarthritis. Thirty-one males (17 with osteoarthritis, 14 controls) underwent 3-dimensional motion analysis, strength testing of hip abductors, and knee range of motion (ROM) measures, as well as completing the knee osteoarthritis outcome score (KOOS). No differences were found between groups or limbs for gait cycle duration, but the osteoarthritis group had longer double-limb support during weight acceptance ( p < 0...
2018: Advances in Orthopedics
Panagiotis Korovessis, Eva Mpountogianni, Vasileios Syrimpeis, Andreas Baikousis, Vasileios Tsekouras
Introduction: Polymethacrylate (PMMA) is commonly used in vertebroplasty and balloon kyphoplasty, but its use has been associated with complications. This study tests three hypotheses: (1) whether strontium hydroxyapatite (Sr-HA) is equivalent to PMMA for restoring thoracolumbar vertebral body fractures, (2) whether the incidence of PMMA leakage is similar to that of Sr-HA leakage, and (3) whether Sr-HAis is resorbed and substituted by new vertebral bone. Materials and Methods: Two age- and sex-matched groups received short percutaneous pedicle screw fixation plus PEEK implant (Kiva, VCF Treatment System, Benvenue Medical, Santa Clara, CA, USA) filled with either Sr-HA (Group A) or PMMA (Group B) after A2- and A3/AO-type thoracolumbar vertebral body fractures...
2018: Advances in Orthopedics
Nobuhiro Tanaka, Kivanc Atesok, Kazuyoshi Nakanishi, Naosuke Kamei, Toshio Nakamae, Shinji Kotaka, Nobuo Adachi
Traumatic cervical syndrome comprises the various symptoms that occur as a result of external force such as that of a traffic accident. In 1995, the Quebec Task Force on whiplash-associated disorders (WAD) formulated the Quebec classification, with accompanying clinical practice guidelines. These guidelines were in accordance with the stated clinical isolated or combined symptoms of the syndrome: neck pain, headaches, dizziness, numbness of head or face, eye pain, vision loss, double vision, tinnitus, hearing loss, nausea, and numbness and/or weakness of extremities...
2018: Advances in Orthopedics
P Koenen, M M Schneider, T R Pfeiffer, B Bouillon, H Bäthis
Background: Restoration of the mechanical axis is a main objective in total knee replacement (TKR). Aim of this study was to analyse the verification tool of a pinless navigation system in conventional TKR (cTKR). Methods: In a prospective study, 147 TKR were performed by conventional technique. Using the "pinless verification" mode of a smartphone based navigation system, the cutting block position and final resection plane for distal femur and proximal tibial resection were measured...
2018: Advances in Orthopedics
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
Michael Schlegelmilch, Saifee Rashiq, Barbara Moreau, Patricia Jarrín, Bach Tran, Anderson Chuck
Background: Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. Methods: We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY...
2017: Advances in Orthopedics
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