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debate orthopedics

S E Puchner, R Varga, G M Hobusch, M Kasparek, J Panotopoulos, S Lang, R Windhager, P T Funovics
INTRODUCTION: Adamantinoma (AD) is an ultimately rare, low-grade malignant bone tumor. In most cases it occurs in the tibia of young adults. Osteofibrous dysplasia (OFD) is a rare, benign, lesion that is typically seen in children. Histopathology, ultrastructure, and cytogenetics indicate that these lesions are closely related. Yet, etiology remains a matter of debate. Local recurrence rates are high for both entities as published in literature and long-term outcomes are scarce, due to the rarity of the disease...
October 10, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Luis Gerardo Natera Cisneros, Juan Sarasquete Reiriz
INTRODUCTION: Surgical indication for acromioclavicular joint (ACJ) injuries still represents a reason for shoulder and trauma debate. In high-grade injuries, surgery is advocated because some of the non-operatively managed patients may have persistent shoulder pain that could make them unable to return to their previous activity. It has been shown that many of the patients with high-grade ACJ injuries that are managed non-operatively involve the development of scapular dyskinesis, situation that may result in loss of strength and weakness...
October 12, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Raffaela Pero, Lorena Coretti, Francesca Lembo
Rapid growth of the overweight population and the number of obese individuals in recent decades suggests that current strategies based on diet, exercise, and pharmacological knowledge are not sufficient to address this epidemic. Obesity is the result of a high caloric intake and energy storage, not counterbalanced by an equally important energy expense. Botulinum toxin type A (BoNT-A) use is rapidly expanding to include treatment of a variety of ophthalmological, gastrointestinal, urological, orthopedic, dermatological, secretory, painful, and cosmetic disorders...
2016: Toxins
Elena Chiappini, Maria Vincenza Mastrolia, Luisa Galli, Maurizio De Martino, Simone Lazzeri
Septic arthritis (SA) is an orthopedic emergency in childhood. It is uncommon in high resource settings. However, an incidence of 5-20 per 100,000 children has been reported in low-income countries. Area covered: The predictive value of serum markers is still under debate and the proposed diagnostic algorithms for SA are not sufficiently validated in children. Recent data suggest that short-course intravenous treatment, followed by oral therapy, is as effective as traditional long-term treatment. Results from three randomized controlled trials suggest that the addition of systemic steroids may accelerate clinical improvement...
November 2016: Expert Review of Anti-infective Therapy
Stefano A Bini, John Mahajan
BACKGROUND: Little is known about the implementation rate of clinical practice guidelines (CPGs). Our purpose was to report on the adoption rate of CPGs created and implemented by a large orthopedic group using the Delphi consensus method. METHODS: The draft CPGs were created before the group's annual meeting by 5 teams each assigned a subset of topics. The draft guidelines included a statement and a summary of the available evidence. Each guideline was debated in both small-group and plenary sessions...
November 2016: Journal of Arthroplasty
Mohsen Mardani-Kivi, Ali Karimi, Sohrab Keyhani, Keyvan Hashemi-Motlagh, Khashayar Saheb-Ekhtiari
OBJECTIVES: Acromioplasty has been one of the most common techniques amongst orthopedic surgeries in the past decade. However, its efficacy in arthroscopic surgeries of rotator cuff repair is still debatable. The purpose of this study is to compare the arthroscopic rotator cuff repair with or without acromioplasty in patients with complete rotator cuff tear. METHODS: In this prospective cohort study, patients with complete rotator cuff tear (acromion type II or III Bigliani) and a history of failure to the conservative treatment for at least 6 months were evaluated for eligibility...
September 2016: Physician and Sportsmedicine
Soo Eon Lee, Tae-Ahn Jahng, Hyun-Jib Kim
Surgical treatment is indicated in patients with moderate to severe myelopathy from cervical ossification of the posterior longitudinal ligaments (OPLL), but undertaking prophylactic surgery for asymptomatic or mildly symptomatic patients with a severely compressed spinal cord is debatable. Patients with <8mm space available in the spinal canal on CT scan, were divided into groups I (mild symptoms, Japanese Orthopedic Association (JOA) score range 15-16) and II (moderate to severe symptoms, JOA score <14)...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Beth Linker
Just as the prevalence of scoliosis began to decline precipitously after World War II, American orthopedic surgeon Dr. Paul R. Harrington devised a new, invasive surgical system whereby implantable prosthetic metal rods and hooks were used to straighten curved backs. By the 1970s, "Harrington rods" had become the gold standard of surgical scoliosis care in the United States, replacing more conventional methods of exercise, bracing, and casting. This article situates the success of Harrington rods within a much larger and historically longer debate about why, when compared to those in other nations, American surgeons appear to be "more aggressive" and "knife-happy...
2016: Bulletin of the History of Medicine
Dong-Mei Sun, Shi-Nong Pan, En-Bo Wang, Li-Qiang Zheng, Wen-Li Guo, Xi-Hu Fu
BACKGROUND: The accurate measurement of the femoral anteversion (FA) angle is always a topic of much debate in the orthopedic surgery and radiology research. We aimed to explore a new FA measurement method to acquire accurate results without radiation damage using piglet model. METHODS: A total of thirty piglets were assigned to two groups based on the age. Bilateral femora were imaged with 3.0-T magnetic resonance (MR) and 64-slice computed tomography (CT) examinations on all piglets...
July 5, 2016: Chinese Medical Journal
Tomi Simons, Tuomas Brinck, Lauri Handolin
Timing of the treatment of orthopaedic injuries in multiply injured patients has undergone changes. The timing of definitive fracture management has varied from several weeks to within hours of injury. In many studies a clear benefit has been identified from early definitive care of long bone fractures: early total care (ETC). The most seriously injured patients benefit from damage control orthopaedics, an approach employing primary external fixator stabilization followed by secondary intramedullary nailing...
2016: Duodecim; Lääketieteellinen Aikakauskirja
Ilija Ban, Jan Nowak, Kaisa Virtanen, Anders Troelsen
Background and purpose - The best treatment for displaced clavicle fractures has been debated for decades. Operative treatment has become more common. However, several randomized trials comparing non-operative and operative treatment have not shown any compelling evidence in favor of surgery. We identified the preferred treatment of displaced midshaft clavicle fractures at public hospitals in 3 countries in Scandinavia. Patients and methods - A purpose-made multiple-choice questionnaire in English was sent to all public hospitals in Denmark, Sweden, and Finland...
May 26, 2016: Acta Orthopaedica
D Stengel, K Dreinhöfer, T Kostuj
Registries are a topic of lively debate amongst all stakeholders in healthcare, politics and economics. In general, registries are national or international (prospective) databases documenting the current state of diagnostic, therapeutic and long-term outcome variables of subjects with a distinct condition or health problem. The access to and handling of registry information is subject to strict legal, methodological and ethical principles and regulations before these data can be scientifically utilized and reentered into the routine daily practice...
June 2016: Der Unfallchirurg
Carlos Cruz
The Latham appliance is an active presurgical orthopedic device used for cleft defects. Its long-term effects are debated. It was introduced to help surgeons achieve a more predictable surgical outcome; hence, it should be evaluated for its presurgical benefits. The device has been successful in expanding and aligning the maxillary segments; retruding protruded premaxillae; aligning bilateral alveolar ridges; placing less tension on surgical closures; and reducing fistulation rates. However, it has not been shown to have either a positive or negative long-term effect on maxillary development or occlusion...
May 2016: Oral and Maxillofacial Surgery Clinics of North America
O Alsowayan, A Alzahrani, J-P Farmer, J-P Capolicchio, R Jednak, M El-Sherbiny
INTRODUCTION: Primary tethered spinal cord (TSC) refers to a group of abnormalities associated with a posterior bony spinal defect that develops beneath an intact dermis and epidermis. There is relative agreement that patients with symptomatic TSC will require surgical intervention. However, it is still debatable as to how to approach asymptomatic patients with primary TSC. OBJECTIVE: To study the clinical and urodynamic (UDS) outcomes of patients with primary TSC after spinal cord untethering (SCU)...
March 15, 2016: Journal of Pediatric Urology
Joey P Johnson, Dale B Cassidy, Josef N Tofte, Jason T Bariteau, Alan H Daniels
Student loan debt has become a topic of discussion and debate among physicians and legislators. This study seeks to assess the level of debt of orthopedic surgery residents and to determine whether debt burden affects the career choice of orthopedic trainees. A 26-question, anonymous survey was distributed via email to resident trainees enrolled in different medical and surgical specialty training programs across the United States. Orthopedic trainees were compared with trainees in other specialties using comparative statistics...
May 1, 2016: Orthopedics
Gabor Erdoes, Clemens Kietaibl, Stefan Boehme, Roman Ullrich, Klaus Markstaller, Balthasar Eberle, Klaus U Klein
BACKGROUND: Continuous venovenous hemodialysis (CVVHD) may generate microemboli that cross the pulmonary circulation and reach the brain. The aim of the present study was to quantify (load per time interval) and qualify (gaseous vs. solid) cerebral microemboli (CME), detected as high-intensity transient signals, using transcranial Doppler ultrasound. MATERIALS AND METHODS: Twenty intensive care unit (ICU group) patients requiring CVVHD were examined. CME were recorded in both middle cerebral arteries for 30 minutes during CVVHD and a CVVHD-free interval...
March 18, 2016: Journal of Neurosurgical Anesthesiology
Stefan W Kreuzer, Amir Pourmoghaddam, Kevin J Leffers, Clint W Johnson, Marius Dettmer
Rotation of the femoral component is an important aspect of knee arthroplasty, due to its effects on postsurgery knee kinematics and associated functional outcomes. It is still debated which method for establishing rotational alignment is preferable in orthopedic surgery. We compared force sensing based femoral component rotation with traditional anatomic landmark methods to investigate which method is more accurate in terms of alignment to the true transepicondylar axis. Thirty-one patients underwent computer-navigated total knee arthroplasty for osteoarthritis with femoral rotation established via a force sensor...
2016: Advances in Orthopedics
Daniel M Vasconcelos, Susana G Santos, Meriem Lamghari, Mário A Barbosa
The paradigm of metallic ions as exclusive toxic agents is changing. During the last 60 years, knowledge about toxicological and immunological reactions to metal particles and ions has advanced considerably. Hip prostheses, namely metal-on-metal bearings, have prompted studies about excessive and prolonged exposure to prosthetic debris. In that context, the interactions of metal particles and ions with cells and tissues are mostly harmful, inducing immune responses that lead to osteolysis and implant failure...
April 2016: Biomaterials
Robert Ohsfeldt, Pengxiang Li, John Schneider
BACKGROUND: Despite ongoing policy debate, little is known about the growth in orthopedic surgery practices with onsite magnetic resonance imaging (MRI) capacity, or practice characteristics associated with the acquisition of in-office MRI equipment. METHODS: In July 2012, American Academy of Orthopaedic Surgeons (AAOS) member practices received a web-based survey requesting general information about their practice, such as number practice providers authorized to order MRIs, the type of onsite MRI capacity present (if any), and the date of acquisition for the MRI equipment...
January 2015: International Journal of Technology Assessment in Health Care
Sharad M Hardikar, Sreenivas Prakash, Madan S Hardikar, Rohit Kumar
BACKGROUND: The management of distal radius fractures raises considerable debate among orthopedic surgeons. The amount of axial shortening of the radius correlates with the functional disability after the fracture. Furthermore, articular incongruity has been correlated with the development of arthritis at the radiocarpal joint. We used two peg volar spade plate to provide a fixed angle subchondral support in comminuted distal radius fractures with early mobilization of the joint. MATERIALS AND METHODS: Forty patients (26 males and 14 females) from a period between January 2009 and December 2011 were treated with two peg volar spade plate fixation for distal radius fracture after obtaining reduction using a mini external fixator...
September 2015: Indian Journal of Orthopaedics
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