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Orthopaedic review

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https://www.readbyqxmd.com/read/28332422/effect-of-methotrexate-on-bone-and-wound-healing
#1
Ippokratis Pountos, Peter V Giannoudis
INTRODUCTION: Methotrexate (MTX) is one of the most commonly used disease modifying drugs administered for wide spectrum of conditions. Through the expansion of the indications of MTX use, an increasing number of patients nowadays attend orthopaedic departments receiving this pharmacological agent. The aim of this manuscript is to present our current understanding on the effect of MTX on bone and wound healing. AREAS COVERED: The authors offer a comprehensive review of the existing literature on the experimental and clinical studies analysing the effect of MTX on bone and wound healing...
March 23, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28328995/effectiveness-of-interceptive-treatment-of-class-iii-malocclusions-with-skeletal-anchorage-a-systematic-review-and-meta-analysis
#2
Jorge Rodríguez de Guzmán-Barrera, Carla Sáez Martínez, Montserrat Boronat-Catalá, Jose María Montiel-Company, Vanessa Paredes-Gallardo, José Luís Gandía-Franco, José Manuel Almerich-Silla, Carlos Bellot-Arcís
Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching...
2017: PloS One
https://www.readbyqxmd.com/read/28328564/variation-in-national-acgme-case-log-data-for-pediatric-orthopaedic-fellowships-are-fellow-coding-practices-responsible
#3
Philip K McClure, Marcella Woiczik, Lori Karol, Wudbhav N Sankar
BACKGROUND: The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28327166/arthroscopic-findings-of-a-diagnostic-dilemma-hip-pathology-with-normal-imaging
#4
Joel Glenn Buikstra, Camdon Fary, Phong Tran
BACKGROUND: Patients with groin, hip and pelvic pain but normal findings on MRI and minimal changes on x-ray can be a diagnostic problem. This paper looks at the arthroscopic findings of patients who have had hip pain and a positive response to an intra-articular anaesthetic but have non-contributory imaging. We hypothesized that standard MRI's were missing significant pathology and if there was a response to intra-articular local anaesthesia, pathology found during arthroscopy was likely...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28326347/the-insufficiencies-of-risk-analysis-of-impending-pathological-fractures-in-patients-with-femoral-metastases-a-literature-review
#5
Emir Benca, Janina M Patsch, Winfried Mayr, Dieter H Pahr, Reinhard Windhager
PURPOSE: Pathologic fractures in patients with bone metastases are a common problem in clinical orthopaedic routine. On one hand recognition of metastatic lesions, which are at a high risk of fracture, is essential for timely prophylactic fixation, while on the other hand patients with a low risk of pathologic fractures should be spared from overtreatment. The purpose of this review is to identify all methods for fracture risk evaluation in patients with femoral metastases in the literature and to evaluate their predictive values in clinical applications...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28326303/current-role-and-application-of-teriparatide-in-fracture-healing-of-osteoporotic-patients-a-systematic-review
#6
Sang-Min Kim, Kyung-Chung Kang, Ji Wan Kim, Seung-Jae Lim, Myung Hoon Hahn
BACKGROUND: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. METHODS: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab]. RESULTS: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#7
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28319248/cyclic-tensile-strain-enhances-human-mesenchymal-stem-cell-smad-2-3-activation-and-tenogenic-differentiation-in-anisotropic-collagen-glycosaminoglycan-scaffolds
#8
W G Grier, A S Moy, B A Harley
Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. However, few reliable clinical studies have been published, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system...
March 20, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28316262/tribute-to-dr-jacques-rogge-muscle-activity-and-fatigue-during-hiking-in-olympic-dinghy-sailing
#9
Jan G Bourgois, Jasmien Dumortier, Margot Callewaert, Bert Celie, Carlo Capelli, Gisela Sjøgaard, Dirk De Clercq, Jan Boone
'A tribute to Dr J. Rogge' aims to systematically review muscle activity and muscle fatigue during sustained submaximal quasi-isometric knee extension exercise (hiking) related to Olympic dinghy sailing as a tribute to Dr Rogge's merits in the world of sports. Dr Jacques Rogge is not only the former President of the International Olympic Committee, he was also an orthopaedic surgeon and a keen sailor, competing at three Olympic Games. In 1972, in fulfilment of the requirements for the degree of Master in Sports Medicine, he was the first who studied a sailors' muscle activity by means of invasive needle electromyography (EMG) during a specific sailing technique (hiking) on a self-constructed sailing ergometer...
March 19, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/28314997/clinical-and-microbiological-outcomes-in-haematogenous-spondylodiscitis-treated-conservatively
#10
Tiziana Ascione, Giovanni Balato, Sigismondo Luca Di Donato, Pasquale Pagliano, Francesco Granata, Gianluca Colella, Carlo Ruosi
INTRODUCTION: Spondylodiscitis refers to infections of the intervertebral disc and the adjacent vertebral body. Although it is still considered a rare condition, its rate is projected to increase. Mortality rate is considered to be low, but an estimated one third of the survivors experience residual disabilities. Literature shows that uncomplicated spondylodiscitis can be adequately treated by early antibiotic therapy and immobilization. The aim of the study is to evaluate the outcome of conservative treatment in patients with haematogenous spondylodiscitis...
March 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28314891/revision-total-knee-arthroplasty-with-porous-coated-metaphyseal-sleeves-provides-radiographic-ingrowth-and-stable-fixation
#11
Catherine J Fedorka, Antonia F Chen, Michael R Pagnotto, Lawrence S Crossett, Brian A Klatt
PURPOSE: Porous-coated metaphyseal sleeves are designed to fill bone defects and facilitate osseointegration when bone loss in encountered during revision total knee arthroplasty (TKA). The purpose of this study is to evaluate short-term results of porous-coated metaphyseal sleeves with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on 50 patients (79 sleeves-49 tibial and 30 femoral) who had a press-fit metaphyseal sleeve with revision TKA...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#12
REVIEW
James P Gavin, Tikki Immins, Thomas Wainwright
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation intervention it appears to be rarely used. AIM: The review purpose was to investigate the effectiveness of stair climbing as a rehabilitation intervention for THR and TKR patients...
October 20, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28298051/a-systematic-review-and-appraisal-of-clinical-practice-guidelines-for-musculoskeletal-soft-tissue-injuries-and-conditions
#13
Daniel Pincus, John E Kuhn, Ujash Sheth, Katie Rizzone, Kristi Colbenson, Tim Dwyer, Ashley Karpinos, Paul H Marks, David Wasserstein
BACKGROUND: Clinical practice guidelines (CPGs) are published by several sports medicine institutions. A systematic evaluation can help identify the highest quality CPGs for clinical use and identify any deficiencies that remain. PURPOSE: To identify and appraise CPGs relevant to clinical sports medicine professionals. STUDY DESIGN: Systematic review. METHODS: Predetermined selection criteria were utilized by 2 reviewers who independently identified published CPGs before January 1, 2014...
October 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28291414/is-cervical-disc-arthroplasty-good-for-congenital-cervical-stenosis
#14
Peng-Yuan Chang, Hsuan-Kan Chang, Jau-Ching Wu, Wen-Cheng Huang, Li-Yu Fay, Tsung-Hsi Tu, Ching-Lan Wu, Henrich Cheng
OBJECTIVE Cervical disc arthroplasty (CDA) has been demonstrated to be as safe and effective as anterior cervical discectomy and fusion (ACDF) in the management of 1- and 2-level degenerative disc disease (DDD). However, there has been a lack of data to address the fundamental discrepancy between the two surgeries (CDA vs ACDF), and preservation versus elimination of motion, in the management of cervical myelopathy associated with congenital cervical stenosis (CCS). Although younger patients tend to benefit more from motion preservation, it is uncertain if CCS caused by multilevel DDD can be treated safely with CDA...
March 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28286783/decreasing-incidence-of-cutaneous-chemical-burns-in-a-resource-limited-burn-centre-is-this-a-positive-effect-of-modernization
#15
R E E Nnabuko, C P Okoye, I S Ogbonnaya, Egi Isiwele
BACKGROUND: Burns present a devastating injury to patients. Burns caused by chemical agents, present a worse scenario. In a resource limited country like Nigeria, readily available sources of these corrosive agents are mainly from lead-acid battery vendors and to some extent local small scale soap manufacturers who use caustic soda. We hypothesized that with the reduction in small scale soap manufacturing and increasing trend towards modernization in the use of dry cell batteries, chemical burns may be on the decline, and we sought to investigate this...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28285481/the-highest-impact-combat-orthopedic-and-extremity-injury-articles-in-the-past-70-years-a-citation-analysis
#16
Jason Nam, Woo S Do, Daniel J Stinner, Joseph C Wenke, Jean A Orman, John F Kragh
The objective of this study was to identify the most-cited peer-reviewed combat orthopedic and extremity injury articles published during the past 70 years. Orthopedic trauma presents ongoing challenges to both US civilian and military healthcare personnel. Improvements in combat trauma and extremity injury survival and quality of life are the result of advances in orthopedic trauma research. The Web of Science (including Science Citation Index) was searched for the most cited articles related to combat orthopedic trauma, published from 1940 to 2013...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28284492/posterior-arthroscopic-subtalar-arthrodesis-clinical-and-radiologic-review-of-19-cases
#17
Xavier Martín Oliva, Pedro Falcão, Raul Fernandes Cerqueira, Ricardo Rodrigues-Pinto
Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or post-traumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated...
March 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28284470/virtual-fracture-clinic-management-of-fifth-metatarsal-including-jones-fractures-is-safe-and-cost-effective
#18
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
https://www.readbyqxmd.com/read/28282214/clinical-and-radiographic-outcomes-of-meniscus-surgery-and-future-targets-for-biologic-intervention-a-review-of-data-from-the-moon-group
#19
Robert W Westermann, Morgan Jones, David Wasserstein, Kurt P Spindler
Meniscus injury and treatment occurred with the majority of anterior cruciate ligament reconstructions (ACLR) in the multicenter orthopaedic outcomes (MOON) cohort. We describe the patient reported outcomes, radiographic outcomes and predictors of pain from meniscus injuries and treatment in the setting of ACLR. Patient reported outcomes improve significantly following meniscus repair with ACLR, but differences exist based on the meniscus injury laterally (medial or lateral). Patients undergoing medial meniscus repair have worse patient-reported outcomes and more pain compared to those with uninjured menisci...
March 10, 2017: Connective Tissue Research
https://www.readbyqxmd.com/read/28281315/silicates-in-orthopaedics-and-bone-tissue-engineering-materials
#20
REVIEW
Xianfeng Zhou, Nianli Zhang, Steven Mankoci, Nita Sahai
Following the success of silicate-based glasses as bioactive materials, silicates are believed to play important roles in promoting bone formation and have therefore been considered to provide a hydroxyapatite surface layer capable of binding to bone as well as potentially being a pro-osteoinductive factor. Natural silicate minerals and silicate-substituted hydroxyapatites are also being actively investigated as orthopaedic bone and dental biomaterials for application in tissue engineering. However, the mechanisms for the proposed roles of silicate in these materials have not been fully understood and are controversial...
March 9, 2017: Journal of Biomedical Materials Research. Part A
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