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Direct Anterior Approach

Eiichi Murakami, Daisuke Kurosawa, Toshimi Aizawa
OBJECTIVE The authors evaluated the outcomes of sacroiliac joint (SIJ) arthrodesis via an original anterior approach to the upper anterior surface of the SIJ in patients with a minimum of 5 years' follow-up. METHODS The authors performed anterior SIJ arthrodesis in 45 patients between 2001 and 2015. Of these patients, 27 (11 men and 16 women; mean age at surgery 49 [24-86] years) were followed up for a minimum of 5 years (average 113 months, range 61-157 months). In the 14 patients in the earlier period of this study, the authors used an anterior approach to expose the SIJ by separating the iliac muscle from the iliac bone and performed internal fixation...
June 22, 2018: Journal of Neurosurgery. Spine
C Zhu, X F Shang, R Kong, K R Wu, Y M Wang, R X Ma, M Chen, Z L Luo
Objective: To analyze the feasibility, perioperative complications and early outcomes of minimally invasive small incision in direct anterior approach total hip arthroplasty in lateral decubitus position. Methods: From January 2015 to January 2017, 212 patients (228 hips) received minimally invasive small incision (approximately 8 cm in length) direct anterior approach total hip arthroplasty in modified lateral decubitus position and approach. Sixteen cases underwent bilateral hip arthroplasty separately. All procedures were performed by the same surgeon in the Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital...
June 5, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Chao-Qun Yan, Cun-Zhi Liu, Xu Wang, Jian-Wei Huo, Ping Zhou, Shuai Zhang, Qing-Nan Fu, Jie Zhang, Zhong-Yan Wang, Qing-Quan Liu
Background: Recently, there have been many reports about abnormalities regarding structural and functional brain connectivity of the patients with primary insomnia. However, the alterations in functional interaction between the left and right cerebral hemispheres have not been well understood. The resting-state fMRI approach, which reveals spontaneous neural fluctuations in blood-oxygen-level-dependent signals, offers a method to quantify functional interactions between the hemispheres directly. Methods: We compared interhemispheric functional connectivity (FC) between 26 patients with primary insomnia (48...
2018: Frontiers in Aging Neuroscience
Alli Gokeler, Romain Seil, Gino Kerkhoffs, Evert Verhagen
Efficacy studies have demonstrated decreased anterior cruciate ligament (ACL) injury rates for athletes participating in injury prevention programs. Typically, ACL injury prevention programs entail a combination of plyometrics, strength training, agility and balance exercises. Unfortunately, improvements of movement patterns are not sustained over time. The reason may be related to the type of instructions given during training. Encouraging athletes to consciously control knee movements during exercises may not be optimal for the acquisition of complex motor skills as needed in complex sports environments...
June 18, 2018: Journal of Experimental Orthopaedics
Grace E Rice, Paul Hoffman, Richard J Binney, Matthew A Lambon Ralph
The anterior temporal lobes (ATLs) play a key role in conceptual knowledge representation. The hub-and-spoke theory suggests that the contribution of the ATLs to semantic representation is (a) transmodal, i.e. integrating information from multiple sensorimotor and verbal modalities, and (b) pan-categorical, representing concepts from all categories. Another literature, however, suggests that this region's responses are modality- and category-selective; prominent examples include category selectivity for socially relevant concepts and face recognition...
August 5, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Brian P Gladnick, John L Masonis
Release of the conjoined tendon has been reported to facilitate femoral exposure during a direct anterior hip approach. However, the authors are not familiar with any description of an anterior approach repair technique for this important structure. Conjoined tendon repair is commonly performed in the posterior approach to help preserve hip biomechanics and restore anatomic tissue planes. The authors describe their algorithm for sequential soft tissue releases to facilitate femoral exposure and a technique for repairing the insertion of the conjoined tendon after it has been released for exposure during the direct anterior approach...
June 18, 2018: Orthopedics
Marcello Costantini, Vincenzo Carbone, Lorenzo Costantini
The atrioventricular (AV) node is an anatomically well-defined structure, conveniently housed in the triangle of Koch. There are two distinct atrial impulse approaches to the AV node, one of which (in the anterior portion of triangle of Koch) has a faster conduction, while the other one (in the posterior portion) has a slower conduction. However, it is not said that such a conductive duality translates into any arrhythmic phenomena. Actually, these arrhythmias are due to an imbalance of the two pathways electrophysiological properties, which does not always exist...
April 2018: Giornale Italiano di Cardiologia
Zhe Zhao, Haitao Wu
Electrical high-frequency stimulation (HFS), using implanted electrodes targeting various brain regions, has been proven as an effective treatment for various neurological and psychiatric disorders. HFS in the deep region of the brain, also named deep-brain stimulation (DBS), is becoming increasingly important in clinical trials. Recent progress in the field of high-frequency DBS (HF-DBS) surgery has begun to spread the possibility of utilizing this invasive technique to other situations, such as treatment for major depression disorder (MDD), obsessive-compulsive disorder (OCD), and so on...
June 2, 2018: Journal of Visualized Experiments: JoVE
Orlando M Diaz, Maria M Toledo, John O F Roehm, Richard P Klucznik, Ponraj Chinnadurai, Gloria Viviana Lopez, Gavin W Britz
PURPOSE: To report percutaneous transcranial puncture, embolisation and occlusion of a very symptomatic hypoglossal canal/anterior condylar vein dural arteriovenous fistula (DAVF) using syngo iGuide navigational software in a patient in whom transarterial and transvenous embolisation and surgery had failed. METHODS: After unsuccessful arterial and venous embolisation and surgical treatment of a symptomatic hypoglossal canal DAVF, a 47-year-old man was transferred for further management...
June 16, 2018: Journal of Neurointerventional Surgery
Richard C Cook, Anthony Y Fung, Edward D Percy, John R Mayo
OBJECTIVE: Robotically assisted minimally invasive direct coronary artery bypass is an alternative to sternotomy-based surgery in properly selected patients. Identifying the left anterior descending artery when it is deep in the epicardial fat can be particularly challenging through a 5- to 6-cm mini-thoracotomy incision. The objective of this study was to evaluate a technique for predicting conversion to sternotomy or complicated left anterior descending artery anastomosis using preoperative cardiac-gated computed tomography angiograms...
June 14, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Bruno Gonçalves Schröder E Souza, Ranieri Monteiro Cardoso, Rodrigo Silva Loque, Luiz Fernando Ribeiro Monte, José Paulo Sabino, Valdeci Manoel de Oliveira
To describe the arthroscopic surgical technique for subspine impingement (SSI) of the anterior inferior iliac spine (AIIS) associated with mixed type femoroacetabular impingement (FAI), through two standard arthroscopic portals (anterolateral and distal mid-anterior) in two patients with trifocal impingement. The authors report the cases of two young male patients, aged 32 and 36 years old, with trifocal femoropelvic impingement (TFPI). The technique consists of segmental capsulectomy, arthroscopic dissection of the AIIS, partial release of the direct head of the rectus femoris, resection of the AIIS projection with a burr and with fluoroscopic aid, correction of the pincer deformity, repair of the labrum with bioabsorbable anchors, and femoral osteoplasty...
May 2018: Revista Brasileira de Ortopedia
Eugene S Jang, James D Lin, Roshan P Shah, Jeffrey A Geller, H John Cooper
Intraoperative fluoroscopy can improve the precision of acetabular component positioning during direct anterior hip arthroplasty. However, changes in pelvic tilt with c-arm positioning may compromise accuracy. A geometric model of an acetabular component's projection onto fluoroscopy images was created and manipulated to simulate c-arm tilt. An apparently ideally-placed cup will have its effective anteversion changed by 7.5° with just 10° of caudal/cephalad tilt of the c-arm. This effect is greater in cups that are more horizontally placed or less anteverted...
June 2018: Journal of Orthopaedics
Takahito Yuasa, Katsuhiko Maezawa, Hironobu Sato, Yuichiro Maruyama, Kazuo Kaneko
Purpose: We compare the complication rate in transition to direct anterior (DAA) from posterior approach (PA) for total hip arthroplasty (THA). Methods: This is a retrospective cohort single-surgeon study of consecutive primary THAs over a transition period from PA to DAA. Results: There were no significant differences in dislocation rate, femoral fracture, lateral femoral cutaneous nerve injury or success rate in cup inclination and anteversion angle between two groups...
June 2018: Journal of Orthopaedics
Ronen Debi, Evyatar Slamowicz, Ornit Cohen, Avi Elbaz, Omri Lubovsky, Dror Lakstein, Zachary Tan, Ehud Atoun
BACKGROUND: Total hip arthroplasty (THA) is considered a successful surgical procedure. It can be performed by several surgical approaches. Although the posterior and anterolateral approaches are the most common, there has been increased interest in the direct anterior approach. The goal of the present study is to compare postoperative leg length discrepancy and acetabular cup orientation among patients who underwent total hip arthroplasty through a direct anterior (DAA) and anterolateral (ALA) approaches...
June 8, 2018: BMC Musculoskeletal Disorders
Christine Böhmer, Eli Amson, Patrick Arnold, Anneke H van Heteren, John A Nyakatura
BACKGROUND: Sloths are one of only two exceptions to the mammalian 'rule of seven' vertebrae in the neck. As a striking case of breaking the evolutionary constraint, the explanation for the exceptional number of cervical vertebrae in sloths is still under debate. Two diverging hypotheses, both ultimately linked to the low metabolic rate of sloths, have been proposed: hypothesis 1 involves morphological transformation of vertebrae due to changes in the Hox gene expression pattern and hypothesis 2 assumes that the Hox gene expression pattern is not altered and the identity of the vertebrae is not changed...
June 7, 2018: BMC Evolutionary Biology
Aaron Jamison, Larry Benjamin, David Lockington
INTRODUCTION: Surgical adjuncts in cataract surgery are often perceived as sometimes necessary, always expensive, particularly in the "lean" cost-saving era. However, prevention of a surgical complication, rather than subsequent management, should always be the preferred strategy. We wished to model real-world costs associated with surgical adjuncts use and test the maxim for cataract surgery-"if you think of it, use it". METHODS: We compared UK list prices for equipment and related costs of preventing vitreous loss (VL) via use of surgical adjuncts vs its subsequent management in a hypothetical cataract surgery scenario of a white swollen cataract with a moderately dilated pupil...
June 6, 2018: Eye
Kerstin Pannek, Jurgen Fripp, Joanne M George, Simona Fiori, Paul B Colditz, Roslyn N Boyd, Stephen E Rose
Preterm birth causes significant disruption in ongoing brain development, frequently resulting in adverse neurodevelopmental outcomes. Brain imaging using diffusion MRI may provide valuable insight into microstructural properties of the developing brain. The aim of this study was to establish whether the recently introduced fixel-based analysis method, with its associated measures of fibre density (FD), fibre bundle cross-section (FC), and fibre density and bundle cross-section (FDC), is suitable for the investigation of the preterm infant brain at term equivalent age...
2018: NeuroImage: Clinical
Damien C M Yeo, Aaron Nagiel, Unikora Yang, Thomas C Lee, Sui Chien Wong
Endoscopic vitrectomy is a useful and unique adjunct to microincision vitreoretinal surgery. The optical properties of endoscopy allow for some clinically advantageous approaches that are not possible with regular microscope viewing systems, namely, the ability to both bypass optically signficant anterior segment opacities and directly visualize dificult-to-access retroirideal, retrolental, and anterior retinal structures in their natural anatomical configuration. The surgical benefits include improved surgical access to the pars plana, pars plicata, ciliary sulcus, ciliary body, and peripheral lens, along with unique access to anterior traction in complex pediatric anterior detachments, particularly in retinopathy of prematurity...
May 30, 2018: Asia-Pacific Journal of Ophthalmology
Nami Saito, Daniela Schmitt, Mark Bangert
PURPOSE: To retrospectively analyze and estimate the dosimetric benefit of online and offline motion mitigation strategies for prostate IMRT. METHODS: Intrafractional motion data of 21 prostate patients receiving intensity-modulated radiotherapy was acquired with an electromagnetic tracking system. Target trajectories of 734 fractions were analyzed per delivered multileaf-collimator segment in five motion metrics: three-dimensional displacement, distance from beam axis (DistToBeam), and three orthogonal components...
June 3, 2018: Journal of Applied Clinical Medical Physics
Joo Hyun Kwon, Sungbin Im, Minho Chang, Jong-Eun Kim, June-Sung Shim
PURPOSE: This technical procedure describes a method for tracking mandibular movement using a three-dimensional (3D) optical scanner and target tracking system to digitally portray the motion of the mandible and temporomandibular joints by merging cone beam computed tomography (CBCT) data. METHODS: Four nonreflective targets were attached to the labial surface of the incisors in a noncolinear arrangement. Mandibular movement was tracked directly using a 3D facial scanner and target tracking software after merging facial scanning data, digital data obtained from a diagnostic cast, and CBCT scan data based on several landmarks of the anterior teeth...
May 30, 2018: Journal of Prosthodontic Research
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