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Orthopedic Surgery

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https://www.readbyqxmd.com/read/28549416/management-of-intra-operative-acute-pulmonary-embolism-during-general-anesthesia-a-case-report
#1
Yuanyuan Mao, Shuai Wen, Gezi Chen, Wei Zhang, Yanqiu Ai, Jingjing Yuan
BACKGROUND: Acute pulmonary embolism (APE) can be life-threatening. Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under general anesthesia a distinctive group. CASE PRESENTATION: We report a case of APE during orthopedic surgery under general anesthesia. A 64-year-old female with atrial fibrillation and surgical history of varicosity underwent total right hip replacement surgery under general anesthesia...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28548597/william-edward-gallie-1882-1959-father-of-the-gallie-wiring-technique-for-atlantoaxial-arthrodesis
#2
Rimal Hanif Dossani, John Shaughnessy, Piyush Kalakoti, Anil Nanda
William Edward Gallie (1882-1959) was a Canadian general surgeon with special expertise in orthopedic surgery. His experience with surgical management of cervical spine subluxation led him to invent a method of cervical wiring of the atlas to the axis. His method of C1-2 wiring has since been modified, but it still remains one of the three most commonly taught wiring techniques in neurosurgical training programs. Gallie is also hailed for instituting the first surgical training program in Canada, a curriculum his pupils memorialized as the "Gallie course" in surgery...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548246/comparison-of-three-different-types-of-scaffolds-preseeded-with-human-bone-marrow-mononuclear-cells-on-the-bone-healing-in-a-femoral-critical-size-defect-model-of-the-athymic-rat
#3
Maren Janko, Julian Sahm, Alexander Schaible, Jan C Brune, Marlene Bellen, Katrin Schröder, Caroline Seebach, Ingo Marzi, Dirk Henrich
Large bone defects often pose major difficulties in orthopedic surgery. The application of long term cultured stem cells combined with a scaffold lead to a significant improvement of bone healing in recent experiments but is strongly restricted by EU-law. Bone marrow mononuclear cells (BMC), however, can be isolated and transplanted within few hours and have been proven effective in experimental models of bone healing. The effectivity of the BMC supported therapy might be influenced by the type of scaffold...
May 26, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28547573/results-of-lumbar-spondylodeses-using-different-bone-grafting-materials-after-transforaminal-lumbar-interbody-fusion-tlif
#4
Nicolas Heinz vonderHoeh, Anna Voelker, Christoph-Eckhard Heyde
PURPOSE: Can a mixture of hydroxyapatite (HA) and autologous bone from decompression sites produce similar results when used for transforaminal lumbar interbody fusion (TLIF)? In the current literature, autologous iliac crest bone grafts (ICBGs) have been reported the gold standard for this procedure. Indeed, to date, no clinical data have confirmed that a mixture of equal volumes of HA and local autologous bone produce similar results in term of fusion as the same volume of autologous ICBG alone...
May 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28546121/prognostic-factors-for-recovery-after-anterior-debridement-bone-grafting-and-posterior-instrumentation-for-lumbar-spinal-tuberculosis
#5
Yuan Yao, Huiyu Zhang, Huan Liu, Zhengfeng Zhang, Yu Tang, Yue Zhou
BACKGROUND: Anterior debridement/bone grafting/posterior instrumentation is a common selection for the treatment of lumbar spinal tuberculosis (LST). To date, no study has focused on the prognostic factors for recovery after this surgery. METHODS: 144 patients experienced anterior debridement/bone grafting/posterior instrumentation for LST were included. The recovery rate based on the Japanese Orthopedic Association (JOA) score was used to assess recovery. The Kaplan-Meier method and Cox regression analysis were used to identify the prognostic factors for recovery postoperatively...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28544422/assessment-of-clinically-relevant-bleeding-as-a-surrogate-outcome-for-major-bleeding-validation-by-meta-analysis-of-randomized-controlled-trials
#6
S Laporte, C Chapelle, L Bertoletti, E Ollier, P Zufferey, J-C Lega, A Merah, H Décousus, S Schulman, G Meyer, M Cucherat, P Mismetti
BACKGROUND: Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials, but its validity for estimating compromise between thrombotic and bleeding events has never been assessed. METHODS: We systematically reviewed randomized phase III trials comparing new anticoagulants with standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates...
May 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28540567/-the-significance-of-biofilm-for-the-treatment-of-infections-in-orthopedic-surgery-2017-update
#7
REVIEW
C Scheuermann-Poley, C Wagner, J Hoffmann, A Moter, C Willy
BACKGROUND: The increase in endoprosthetic and osteosynthetic surgical treatment is associated with a simultaneous increase in implant-associated infections (surgical site infections, SSI). Biofilms appear to play a significant role in the diagnosis and treatment of these infections and heavily contaminated wounds. This article aims to provide a current overview of biofilm and its relevance in orthopedic surgery. MATERIALS AND METHODS: A computer-assisted literature search of MedLine (PubMed) was performed using key word combinations with "biofilm" (as of March 2017)...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540233/international-volunteerism-and-global-responsibility
#8
REVIEW
Gopal Badlani
To review the current status of volunteerism in the field of urology as a global responsibility, a PubMed search was done with keywords: international volunteer, urology, global health, international resident education. Furthermore, internet search using Google and Bing as search engines for the same key words was done. Websites of multinational urological organizations was researched for available information. Expert opinions of key individuals in the arena were obtained. There is a paucity of published literature as to the efforts and outcomes of volunteerism in Urology; most of the information is related to the fistula repair outcomes in medical literature...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28538416/case-report-of-2-sudden-deaths-after-surgery-for-bone-fracture-usefulness-of-immunohistochemical-analysis-of-coronary-artery-for-identifying-acute-myocardial-infarction
#9
Atsushi Kurata, Jun Nishida, Takashi Koyama, Tamotsu Miki, Hirotsugu Hashimoto, Kengo Yamamoto, Masahiko Kuroda
RATIONALE: Death following orthopedic surgery has become rare, but does occur. Acute myocardial infarction (AMI) can be a cause of such death, but diagnosis of AMI is often challenging, even by autopsy. PATIENT CONCERNS: We have recently experienced 2 cases of sudden death after bone fracture surgery, in which AMI and pulmonary thromboembolism were clinically suspected as causes of death. Case 1 was a 60-year-old male with a history of diabetes mellitus who died 7 days after surgery for Lisfranc dislocation fracture...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538081/is-body-mass-index-a-risk-factor-for-revision-procedures-after-minimally-invasive-transforaminal-lumbar-interbody-fusion
#10
Ankur S Narain, Fady Y Hijji, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Kern Singh
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if an association exists between body mass index (BMI) and the rate of revision surgery after single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: MIS TLIF is an effective treatment for lumbar degenerative disease. Previous studies in the orthopedic literature have associated increased BMI with increased postoperative complications and need for revision...
May 19, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28537995/developmental-dysplasia-of-the-hip-a-history-of-innovation
#11
Sandip P Tarpada, Steven J Girdler, Mathew T Morris
Developmental dysplasia of the hip (DDH) is a relatively common malady that has profound consequences in the infant if left untreated. Effective and early treatment of DDH has been praised as one of the most successful ventures of modern pediatric orthopedics. Yet, before the modern management of DDH came into existence, there were extensive technological developments in the field of harnesses, casts, and traction methods. This paper aims to identify the centuries-old history of advancement in DDH treatment and the many important people involved...
May 19, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28537649/what-influences-how-patients-with-depression-rate-hospital-stay-after-total-joint-arthroplasty
#12
Chukwuweike Gwam, Jaydev B Mistry, Nicolas Piuzzi, Morad Chughtai, Anton Khlopas, Melbin Thomas, Randa K Elmallah, George Muschler, Michael A Mont, Steven F Harwin, Ronald E Delanois
BACKGROUND: Recent healthcare reform has spurred important changes to provider reimbursement. With the implementation of the Value Based Purchasing program, significant weight is placed on patient experience of care. The Press Ganey (PG) survey is currently used by over 10,000 hospitals, as it serves to help optimize patient satisfaction. However, confounding factors, such as clinical depression, are not screened against by PG. Thus, arthroplasty surgeons performing lower extremity total joint arthroplasty (TJA) may have difficulty optimizing patient satisfaction while caring for patients with clinical depression...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28537526/composite-biomaterial-as-a-carrier-for-bone-active-substances-for-metaphyseal-tibial-bone-defect-reconstruction-in-rats
#13
Peter Frederik Horstmann, Deepak Raina, Hanna Isaksson, Werner Hettwer, Lars Lidgren, Michael Mørk Petersen, Magnus Tägil
Restoring lost bone is a major challenge in orthopedic surgery. Currently available treatment-strategies all have shortcomings, like risk of infection, non-union and excessive resorption. Our primary aim was to study if a commercially available gentamicin-containing composite calcium sulphate/hydroxyapatite biomaterial (GBM) could serve as a carrier for local delivery of bone morphogenic protein-2 (BMP-2) and zoledronic acid (ZA) in a tibia defect-model in rats. Empty and allograft-filled defects were used as controls...
May 24, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28537348/a-cadaver-study-to-evaluate-the-accuracy-of-a-new-3d-mini-optical-navigation-tool-for-total-hip-arthroplasty
#14
Jonathan M Vigdorchik, Michael B Cross, Eric A Bogner, Theodore T Miller, Jeffrey M Muir, Ran Schwarzkopf
BACKGROUND: Accurate measurement of acetabular cup position (CP), changes in leg length (LL), and offset (OS) are paramount in ensuring proper sizing and implantation of components during total hip arthroplasty (THA). LL/OS inaccuracies can cause low back pain, neurological deficits, and patient dissatisfaction, while inaccurate positioning of the acetabular cup can lead to instability, dislocation, and, ultimately, revision surgery. The objective of this study was to evaluate the accuracy of a mini-navigation tool in measuring CP and LL/OS differential during THA...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28535941/-anesthetic-management-of-two-patients-with-alkaptonuric-ochronosis-for-total-knee-arthroplasty
#15
Betul Kozanhan
The current case report describes two cases of alkaptonuric ochronosis for anesthetic management. Alkaptonuria is a rare genetic orphan disease of tyrosine metabolism characterized by an accumulation of homogentisic acid in cartilage and connective tissues. Patients present most commonly for orthopedic joint surgery due to progressive arthropathy that can be misdiagnosed many a times. However respiratory, airway, cardiovascular and genitourinary systems complications can occur with age progressing. Restricted range of motion of cervical spine may lead to difficulty with airway management...
May 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28533694/the-improved-quality-of-postoperative-analgesia-after-intrathecal-morphine-does-not-result-in-improved-recovery-and-quality-of-life-in-the-first-6-months-after-orthopedic-surgery-a-randomized-controlled-pilot-study
#16
Nilufar Foadi, Matthias Karst, Anika Frese-Gaul, Niels Rahe-Meyer, Stefan Krömer, Christian Weilbach
OBJECTIVE: In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. STUDY DESIGN: A randomized, double-blind trial. SETTING: Academic medical center. SUBJECTS: Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#17
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28529866/which-orthopaedic-patients-are-infected-with-gram-negative-non-fermenting-rods
#18
Omid Jamei, Shpresa Gjoni, Besa Zenelaj, Benjamin Kressmann, Wilson Belaieff, Didier Hannouche, Ilker Uçkay
Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Results: Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to Pseudomonas aeruginosa...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#19
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#20
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
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