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Orthopedic Surgery

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https://www.readbyqxmd.com/read/28735803/transfusion-thresholds-for-major-orthopedic-surgery-a-systematic-review-and-meta-analysis
#1
Matthew D Mitchell, Joel S Betesh, Jaimo Ahn, Eric L Hume, Samir Mehta, Craig A Umscheid
BACKGROUND: More than a million surgeries are performed annually in the United States for hip or knee arthroplasty or hip fracture stabilization. One-fifth of these patients have blood transfusions during their hospital stay. Increases in transfusion rates have caused concern about increased adverse events from unnecessary transfusions. METHODS: We systematically reviewed randomized trials examining the effect of restrictive vs liberal transfusion thresholds on patients having major orthopedic surgery...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734854/pulse-pressure-variation-as-a-guide-for-volume-expansion-in-dogs-undergoing-orthopedic-surgery
#2
Denise T Fantoni, Keila K Ida, André M Gimenes, Matheus M Mantovani, Jacqueline R Castro, Geni C F Patrício, Aline M Ambrósio, Denise A Otsuki
OBJECTIVE: To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. STUDY DESIGN: Prospective clinical study. ANIMALS: Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. METHODS: Fluid challenge with lactated Ringer's solution (15 mL kg(-1) in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg(-1)) with hypotension [mean arterial pressure (MAP) < 65 mmHg]...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28730263/unicameral-bone-cyst-of-the-calcaneus-minimally-invasive-endoscopic-surgical-treatment-case-report
#3
Ioan Cristian Stoica, Doina Mihaela Pop, Florin Grosu
The role of arthroscopic surgery for the treatment of various orthopedic pathologies has greatly improved during the last years. Recent publications showed that benign bone lesion may benefit from this minimally invasive surgical method, in order to minimize the invasiveness and the period of immobilization and to increase visualization. Unicameral bone cysts may be adequately treated by minimally invasive endoscopic surgery. The purpose of the current paper is to present the case report of a patient with a unicameral bone cyst of the calcaneus that underwent endoscopically assisted treatment with curettage and bone grafting with allograft from a bone bank, with emphasis on the surgical technique...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#4
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28724382/activation-of-cannabinoid-receptor-type-2-attenuates-surgery-induced-cognitive-impairment-in-mice-through-anti-inflammatory-activity
#5
Lingling Sun, Rui Dong, Xin Xu, Xi Yang, Mian Peng
BACKGROUND: Neuroinflammation plays a major role in postoperative cognitive dysfunction (POCD). Accumulated evidence indicates that cannabinoid receptor type 2 (CB2R) can mediate anti-inflammatory and immunomodulatory effects in part by controlling microglial activity. However, the impact of CB2R on postoperative cognition has not been investigated. We hypothesized that CB2R is involved in surgery-induced cognitive impairment in adult mice. METHODS: Adult C57BL/6 mice were subjected to intramedullary fixation surgery for tibial fracture under isoflurane anesthesia and CB2R agonist (JWH133) or CB2R antagonist (AM630) treatment...
July 19, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#6
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28723737/how-to-choose-when-implants-of-adjacent-height-both-fit-the-disc-space-properly-in-single-level-cervical-artificial-disc-replacement
#7
Xin Rong, Jigang Lou, Huibo Li, Yang Meng, Hao Liu
In cervical artificial disc replacement (C-ADR), sometimes we encountered with such cases that implants of adjacent height both fit the target disc space properly. No study was available discussing the choice of implant height and the clinical outcomes under such circumstance. The purpose of this study was to evaluate the impact of different implant heights on the clinical outcomes and radiographic results when the implants of adjacent height both fit the disc space properly. This retrospective study included 34 patients underwent single-level C-ADR at the C5-C6 level at our institution...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723700/pediatric-supracondylar-humerus-fractures-is-surgeon-experience-a-surrogate-for-the-need-of-open-reduction
#8
Mauricio Silva, Maria Kazantsev, Bianka Aceves Martin, Erin M Delfosse
Although there are many factors that are likely to influence the need for open reduction and percutaneous pinning (ORPF) in the treatment of pediatric supracondylar humerus fractures (SCHFs), the role of surgeon's experience (as represented by the total number of surgically treated SCHFs) on the need for ORPF has seldom been investigated. We reviewed the data on all completely displaced, pediatric SCHFs that were treated surgically by a single, fellowship-trained, pediatric orthopedic surgeon over the first 10 years of the surgeon's clinical practice...
July 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28722489/treatment-of-die-punch-fractures-with-3d-printing-technology
#9
Chunhui Chen, Leyi Cai, Chuanxu Zhang, Jianshun Wang, Xiaoshan Guo, Yifei Zhou
PURPOSE: We evaluated the feasibility, accuracy and effectiveness of applying three-dimensional (3D) printing technology for preoperative planning for die-punch fractures. METHODS: A total of 107 patients who underwent die-punch fracture surgery were enrolled in the study. They were randomly divided into two groups: 52 cases in the 3D model group and 55 cases in the routine group. A 3D digital model of each die-punch fracture was reconstructed in the 3D group. The 3D digital model was imported to a 3D printer to build the full solid model...
July 19, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28720423/undergraduate-clinical-teaching-in-orthopedic-surgery-a-randomized-control-trial-comparing-the-effect-of-case-based-teaching-and-bedside-teaching-on-musculoskeletal-osce-performance
#10
Martin Kelly, Iain Feeley, Fiona Boland, John M O'Byrne
INTRODUCTION: Musculoskeletal (MSK) complaints are the second most common reason for a hospital outpatient appointment in the US, and account for 19.5% of general practice consultations. Previous studies have shown that passive teaching in medical school does not imbue students with an adequate degree of confidence in MSK evaluation. The aim of this study was to conduct a randomized control trial to compare the effect of the gold standard small group tutorial of bedside teaching against case-based teaching (CBT) in relation to orthopedic surgery in medical students...
July 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28720091/clinical-and-imaging-outcome-of-osteochondral-lesions-of-the-talus-treated-using-autologous-matrix-induced-chondrogenesis-technique-with-a-biomimetic-scaffold
#11
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Carmelo Messina, Francesco Malerba, Luca Maria Sconfienza
BACKGROUND: The purpose of our study was to assess the clinical and imaging outcome of autologous matrix-induced chondrogenesis (AMIC) technique consisting of microfractures followed by the filling of osteochondral lesions of the talus (OLTs) with a cell-free biphasic collagen-hydroxyapatite osteochondral scaffold (MaioRegen). METHODS: Sixteen patients (eight males, age: 42.6 ± 18.4, range 14-74) with OLT repaired using AMIC technique, with implantation of MaioRegen, were clinically evaluated through the American Orthopedic Foot and Ankle Society Score (AOFAS) and a 10-point Visual Analogue Scale (VAS) pain score after a mean follow-up of 30 ± 16...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28720040/distal-radius-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-level-i-trauma-center
#12
James C Kyriakedes, Eugene Y Tsai, Douglas S Weinberg, Charles C Yu, Harry A Hoyen, Kevin Malone, Blaine T Bafus
BACKGROUND: The aim of this study is to determine whether the American Academy of Orthopaedic Surgeons' (AAOS) Appropriate Use Criteria (AUC) for distal radius fractures correlates with actual treatment by orthopedic hand surgeons at a level I trauma center. METHODS: ICD-9 codes were used to retrospectively identify patients who presented with wrist fractures over 1 year. Patients with isolated distal radius fractures were evaluated using the AAOS AUC application for distal radius fractures...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719860/liposome-modified-titanium-surface-a-strategy-to-locally-deliver-bioactive-molecules
#13
Vincenzo De Leo, Monica Mattioli-Belmonte, Maria Teresa Cimmarusti, Annamaria Panniello, Manuela Dicarlo, Francesco Milano, Angela Agostiano, Elvira De Giglio, Lucia Catucci
Titanium and its alloys are widely employed materials for implants in orthopedic or dental surgery due to their mechanical properties, resistance to corrosion and osseointegration capability. However adverse reactions at the tissue/implant interface may occur, which limit the success of the osseointegration process. Therefore, different strategies have to be used to overcome these drawbacks. In this work, we developed two different liposome-based coatings on titanium surfaces as drug or bioactive molecule deposits for dental/orthopedic implant applications...
July 8, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#14
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28718317/hand-surgeons-and-orthopedic-trauma-surgeons-call-coverage-of-acute-upper-extremity-injuries-where-should-the-line-be-drawn
#15
Matthew B Cantlon, Andrew J Miller, Asif M Ilyas
BACKGROUND: There is a lack of consensus as to which subspecialty service should cover acute upper extremity injuries in the emergency department (ED). The purpose of the present study is to understand how upper extremity injuries are currently triaged to specialists and to assess the current opinion among hand and orthopedic trauma specialists as to how these injuries should be best triaged based on injury location and severity. METHODS: The American Association for Hand Surgery (AAHS) membership and Orthopaedic Trauma Association (OTA) membership were surveyed using a 28-item online questionnaire...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718058/cultural-biases-in-current-medical-practices-with-a-specific-attention-to-orthopedic-surgery-a-review
#16
Gracia Etienne, Todd P Pierce, Anton Khlopas, Morad Chughtai, Carlos J Lavernia, Teva Y Vogelstein, Craig M Thomas, Charles S Modlin, Michael A Mont
Due to the increasing diversity within the United States population, there is an ever-increasing need for increased education on cultural literacy and tolerance in medical schools and residency programs. The purpose of this article was to review how a person's culture can play a substantive role in effecting and influencing (1) medical diagnosis, (2) patient and health provider medical decision-making, (3) the patient's perception of disease, and (4) the doctor-patient relationships. Many of the decisions we make as orthopedic surgeons must account for the patient's cultural needs, as much of our work impacts patients' daily activities and function...
July 17, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28717976/-trauma-surgery-in-pacific-small-island-developing-states-sids
#17
REVIEW
H Oberli, C Martin
BACKGROUND: The small developing countries in the Pacific are grouped together as Small Island Development States (SIDS) because they face similar problems which they cannot cope with nationally. They are developing countries, so-called low and lower middle income countries (LMIC), are economically weak and the islands of the different nations are widely scattered. Approximately 80% of the 10 million inhabitants live in rural regions. EPIDEMIOLOGY AND SURGICAL CAPACITY: Over 40% of patients in the surgical departments of hospitals are hospitalized for injuries, and this tendency is increasing...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28717409/influence-of-the-microstructure-and-silver-content-on-degradation-cytocompatibility-and-antibacterial-properties-of-magnesium-silver-alloys-in-vitro
#18
Zhidan Liu, Ronald Schade, Bérengère Luthringer, Norbert Hort, Holger Rothe, Sören Müller, Klaus Liefeith, Regine Willumeit-Römer, Frank Feyerabend
Implantation is a frequent procedure in orthopedic surgery, particularly in the aging population. However, it possesses the risk of infection and biofilm formation at the surgical site. This can cause unnecessary suffering to patients and burden on the healthcare system. Pure Mg, as a promising metal for biodegradable orthopedic implants, exhibits some antibacterial effects due to the alkaline pH produced during degradation. However, this antibacterial effect may not be sufficient in a dynamic environment, for example, the human body...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#19
Aleksi Reito, Lari Lehtovirta, Olli Lainiala, Keijo Mäkelä, Antti Eskelinen
Background and purpose - Orthopedics and especially joint replacement surgery have had more than their fair share of unsuccessful innovations that have violated widely endorsed principles for the introduction of new surgical innovations. We aimed to investigate (1) the trends in the use of the Birmingham Hip Resurfacing (BHR), the ASR hip resurfacing (ASR HRA) and the ASR XL total hip replacement (ASR XL THR) system with very different market approval processes and (2) whether their use was corroborated by clinical trials published in the peer-reviewed literature...
July 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28714830/efficiency-of-inpatient-orthopedic-surgery-in-japan-a-medical-claims-database-analysis
#20
Yoshinori Nakata, Tatsuya Yoshimura, Yuichi Watanabe, Hiroshi Otake, Giichiro Oiso, Tomohiro Sawa
Purpose The purpose of this paper is to determine the characteristics of healthcare facilities that produce the most efficient inpatient orthopedic surgery using a large-scale medical claims database in Japan. Design/methodology/approach Reimbursement claims data were obtained from April 1 through September 30, 2014. Input-oriented Banker-Charnes-Cooper model of data envelopment analysis (DEA) was employed. The decision-making unit was defined as a healthcare facility where orthopedic surgery was performed...
July 10, 2017: International Journal of Health Care Quality Assurance
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