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Maria C Cusimano, Rachel Walker, Marcus Q Bernardini, Geneviève Bouchard-Fortier, Stephane Laframboise, Taymaa May, Joan Murphy, Barry Rosen, Al Covens, Blaise Clarke, Patricia Shaw, Marjan Rouzbahman, Ravi Mohan, Sarah E Ferguson
OBJECTIVE: Sentinel lymph node (SLN) biopsy is becoming a reasonable alternative to pelvic lymphadenectomy in early-stage cervical cancer. It is therefore imperative that centres without prior experience are able to successfully implement the procedure. The objectives of the current study were to (1) describe the process of implementing an SLN biopsy program with a novel peer mentorship component and (2) assess post-program quality improvement metrics, including SLN detection rate (DR) and diagnostic parameters...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Lani K Clinton, Jordan Kondo, Michael E Carney, Pamela Tauchi-Nishi, Keith Terada, David Shimizu
OBJECTIVE: The aim of this study was to determine the histopathologic characteristics of patients with endometrial carcinoma with low-volume metastases (micrometastases and isolated tumor cells) compared with macrometastases. METHODS: We performed a retrospective review of patients with endometrial carcinoma. RESULTS: Among 350 robotic-assisted hysterectomies for endometrial cancer, 187 (53%) underwent attempted sentinel lymph node (SLN) biopsy...
July 2017: International Journal of Gynecological Cancer
Matthew S Manganaro, Yoav Morag, William J Weadock, Corrie M Yablon, Kara Gaetke-Udager, Erica B Stein
Acetabular fractures are frequently encountered in some clinical practices, and the precise classification of these fractures greatly influences treatments and outcomes. The authors identified the need for an educational aid when teaching acetabular fracture classifications, given the complex spatial anatomy and the nonintuitive classification system that is commonly used. Three-dimensional ( 3D three-dimensional ) printing is an evolving technique that has applications as an educational aid, providing the student with a tangible object to interact with and learn from...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Mohamed Kenawey
INTRODUCTION: The operative treatment of unstable pelvic injuries in paediatrics is not frequently indicated. The detailed modes of pelvic ring failure, surgical techniques, fixation choices, and peri-operative difficulties are not well reported. METHODS: From September 2010 to March 2016, 62 paediatric patients were admitted to an academic level I trauma center with the diagnosis of pelvic ring injury. Of them, 29 (17 males and 12 females) had operative fixation of unstable pelvic injuries...
April 13, 2017: International Orthopaedics
P Upex, P Jouffroy, G Riouallon
Acetabular fractures can be challenging to treat, in part because the shape of the fixation plates needs to be adjusted during the surgical procedure. One possibility is to generate a model of the uninjured half of a fractured pelvis with 3D printing, and then pre-contour the fixation plates preoperatively on this model. The purpose of this technical note is to describe how we used 3D printing as an aid to treat acetabular fractures. The quality of the fracture reduction, fracture fixation and time savings were evaluated...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Corinne A Zurmühle, Helen Anwander, Christoph E Albers, Markus S Hanke, Simon D Steppacher, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d'Aubigné scores in a midterm followup compared with rim trimming...
April 2017: Clinical Orthopaedics and related Research
Jessica O Leasure, Jeffrey N Peck, Armando Villamil, Kara L Fiore, Cheryl A Tano
OBJECTIVE: To evaluate the inter- and intra-observer variability in measurement of the angle of lateral opening (ALO) and version angle measurement using digital radiography and computed tomography (CT). METHODS: Each hemipelvis was implanted with a cementless acetabular cup. Ventrodorsal and mediolateral radiographs were made of each pelvis, followed by CT imaging. After removal of the first cup, the pelves were implanted with an acetabular cup in the contralateral acetabulum and imaging was repeated...
November 23, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Nicholas Quercetti, Brandon Horne, Zac DiPaolo, Michael J Prayson
BACKGROUND: Traditionally, operative fixation of pelvic and acetabular injuries involves complex approaches and significant complications. Accelerated rehabilitation, decreased soft tissue stripping and decreased wound complications are several benefits driving a recent interest in percutaneous fixation. We describe a new fluoroscopic view to guide the placement of screws within the anterior pelvic ring. METHODS: Twenty retrograde anterior pelvic ring screws were percutaneously placed in ten cadaveric specimens...
October 7, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Dermot O'Rourke, Saulo Martelli, Murk Bottema, Mark Taylor
Understanding the sensitivity of FE models to assumptions and uncertainties in geometric parameters and material properties is a fundamental step in understanding the reliability of model predictions. The computational cost of individual simulations and the large number of required models limits comprehensive quantification of model sensitivity. To quickly assess the sensitivity of a FE model, we built linear and Kriging surrogate models of a FE model of the intact hemipelvis. The percentage of the total sum of squares (%TSS) was used to determine the most influential input parameters and their possible interactions on the median, 95th percentile and maximum equivalent strains...
September 29, 2016: Journal of Biomechanical Engineering
Arun Sasikumar, Ajith Joy, Raviteja Nanabala, M R A Pillai, Hari T A
65-year-old man with left-sided pelvic pain on evaluation was found to have features suggestive of either Paget disease or prostatic bone metastasis of the left hemipelvis based on Tc-MDP bone scan and MRI. Ga-PSMA PET/CT to assess the possibility of primary prostate cancer and if present to stage it helped to rule out prostate cancer because of absence of focal abnormal increased tracer uptake in the prostate gland. However, false-positive tracer uptake was noted in the left hemipelvis, which was subject to biopsy and histopathologically proven to be Paget disease involvement...
October 2016: Clinical Nuclear Medicine
Adnan Yousaf, Mushtaq Ahmed, Mahmud Aurangzeb
This case report describes a young man who presented with 9-day history of sudden-onset epigastric and right-sided lower abdominal pain. He was tachycardiac with temperature of 102°F. Tenderness was present in the peri-umbilical area and right iliac fossa. Investigations revealed a raised total leucocyte count (predominantly neutrophilic). Triphasic CTscan abdomen found thrombosis of right portal vein and its hepatic tributaries alongwith superior mesenteric vein (SMV) and its tributaries. Co-existent fluid in right hemipelvis abutting the cecum and appendiceal tip was suggestive of acute appendicitis...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Frank R Avilucea, Paul S Whiting, Hassan Mir
BACKGROUND: Biomechanical studies suggest that augmenting anterior fixation of the pelvic ring with posterior fixation increases stability. Prior clinical studies have assessed radiographic outcomes following plate fixation of the symphysis. However, to our knowledge, none have directly compared the radiographic and clinical outcomes of anterior plate fixation alone with the outcomes of such plate fixation with the addition of posterior percutaneous screw fixation in the treatment of a partially disrupted hemipelvis...
June 1, 2016: Journal of Bone and Joint Surgery. American Volume
Matthew Swann, Daniel J Sucato, Jose Romero, David A Podeszwa
INTRODUCTION: The Ganz periacetabular osteotomy (PAO) is a well-accepted surgical intervention for hip dysplasia. In the adolescent population it is performed in patients who are skeletally mature with symptoms related to acetabular dysplasia. Redistribution of stresses through the hemipelvis after PAO can lead to a fracture at the ischio-pubic junction (IPJ). METHODS: This is an IRB-approved, retrospective analysis of adolescent patients treated with a PAO for acetabular dysplasia from 1999 to 2012 at a single institution...
March 2017: Journal of Pediatric Orthopedics
Rosyane Rena de Freitas, André Luiz Soares Crivellaro, Glauco José Pauka Mello, Múrio Armani Neto, Geraldo de Freitas Filho, Letícia Viani da Silva
OBJECTIVE: To show the experience of the Erasto Gaertner Hospital with hemipelvectomy surgery over a 10-year period. METHODS: This was a retrospective study on 32 patients who underwent hemipelvectomy at Erasto Gaertner Hospital between 1998 and 2008, assessing clinical and surgical characteristics. RESULTS: Among the 32 patients, 15 were female and 17 were male. The mean age was 37.94 years. Eight cases showed involvement of the neurovascular bundle: three were located in the iliac and extended to the thigh, two were in the acetabulum and extended to the thigh and three were in the acetabulum and pubis...
July 2010: Revista Brasileira de Ortopedia
Juan Gómez-Hoyos, Ricardo Schröder, Ian J Palmer, Manoj Reddy, Anthony Khoury, Hal David Martin
The objective of this study was to describe the footprint location of the iliopsoas tendon on the lesser trochanter to clarify the surgical implications of the lesser trochanterplasty for treating ischiofemoral impingement. Ten non-matched, fresh-frozen, cadaveric hemipelvis specimens (average age, 62.4 years; range, 48-84 years; 7 male and 3 female) were included. Registered measures included bony parameters of the lesser trochanter (lesser trochanteric area, distances from the tip to the base in a coordinate system, height and area) and tendinous iliopsoas footprint descriptions (areas and detailed location)...
December 2015: Journal of Hip Preservation Surgery
Bartosz Musielak, Marek Jóźwiak, Michał Rychlik, Brian Po-Jung Chen, Maciej Idzior, Andrzej Grzegorzewski
BACKGROUND: Although acetabulum orientation is well established anatomically and radiographically, its relation to the innominate bone has rarely been addressed. If explored, it could open the discussion on patomechanisms of such complex disorders as femoroacetabular impingement (FAI). We therefore evaluated the influence of pelvic bone position and structure on acetabular spatial orientation. We describe this relation and its clinical implications. METHODS: This retrospective study was based on computed tomography scanning of three-dimensional models of 31 consecutive male pelvises (62 acetabulums)...
March 16, 2016: BMC Musculoskeletal Disorders
J D Bastian, M Savic, J L Cullmann, W D Zech, V Djonov, M J Keel
BACKGROUND: As an alternative to the modified Stoppa approach, the Pararectus approach is used clinically for treatment of acetabular fractures involving the anterior column. The current study assessed the surgical exposure and the options for instrumentation using both of these approaches. METHODS: Surgical dissections were conducted on five human cadavers (all male, mean age 88 years (82-97)) using the modified Stoppa and the Pararectus approach, with the same skin incision length (10cm)...
March 2016: Injury
Mitchel R Obey, Stephen M Broski, Robert J Spinner, Mark S Collins, Aaron J Krych
BACKGROUND: The adductor magnus (AM) has historically been a potential source of confusion in patients with suspected proximal hamstring avulsion injuries. PURPOSE: To investigate the anatomic characteristics of the AM, including its osseous origin, anatomic dimensions, and relationship to the proximal hamstring tendons. STUDY DESIGN: Descriptive laboratory study. METHODS: Dissection of the AM origin was performed in 11 (8 cadavers) fresh-frozen hip-to-foot cadaveric hemipelvis specimens...
January 2016: Orthopaedic Journal of Sports Medicine
J Ryan Martin, Ian J Barrett, Rafael J Sierra, David G Lewallen, Daniel J Berry
BACKGROUND: Pelvic discontinuity (PD) is a rare but devastating mechanism of failure in total hip arthroplasty. Radiographic findings have been described for the identification of PD. However, no study has specifically examined radiographic parameters and the utility of specific views in the preoperative identification of PD. METHODS: We performed a retrospective review of 133 patients who underwent acetabular revision for PD. Preoperative radiographic studies were reviewed including anteroposterior pelvis (AP; n = 133), true lateral hip (n = 132), Judet (n = 47), false profile (n = 4), and computed tomography scans (n = 14)...
2016: Journal of Arthroplasty
Yan Zhuang, Shenglu Cao, Yanbin Lin, Renbin Li, Gang Wang, Yiran Wang
PURPOSE: To investigate the treatment of acetabular anterior column fractures using a two-incision minimally invasive (TIMI) approach and minimally invasive plate osteosynthesis (MIPO) technique using a preshaped 3D plate. METHODS: A group of 12 consecutive cases of acetabular fractures from March 2013 to July 2014 were treated with the TIMI approach. 3D mirror models of the uninjured side of the hemipelvis were printed preoperatively; the plates used in surgery were preshaped according to these models...
January 15, 2016: International Orthopaedics
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