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https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#1
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#2
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/28713704/the-anterior-interosseus-artery-perforator-flap-anatomical-dissections-and-clinical-study
#3
Nikhil S Panse, Sheetal B Joshi, Parag B Sahasrabudhe, B Bahetee, Pradnya Gurude, Ajay Chandanwale
BACKGROUND: Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28713612/in-vivo-magnetic-resonance-imaging-morphometry-of-the-patella-bone-in-south-indian-population
#4
Reshma Muhamed, Vasudha V Saralaya, B V Murlimanju, Ganesh Kumar Chettiar
Racial differences exist in the dimensions of structures and the commercially available prostheses are designed based on the Caucasians. In this context, the goal of the present investigation was to determine the gender wise measurements of patella bone in South Indians. The present study included axial magnetic resonance images of the knee joint from 140 South Indian adults (70 males, 70 females; aged between 20-70 years). The angle, width, thickness, lateral facet width, facet thickness, ratio of the lateral facet, the relative thickness and ratio of facet thickness were measured in the patella by using the digital ruler...
June 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/28711342/birmingham-hip-resurfacing-vs-total-hip-arthroplasty-a-matched-pair-comparison-of-clinical-outcomes
#5
Victor R Ortiz-Declet, David A Iacobelli, Leslie C Yuen, Itay Perets, Austin W Chen, Benjamin G Domb
BACKGROUND: Birmingham hip resurfacing (BHR) has proven to be a good alternative for younger patients with osteoarthritis. Some have asserted that BHR may yield outcomes which are superior to total hip arthroplasty (THA), and that some studies which failed to show a difference were plagued by ceiling effects and lack of sensitivity of outcome measures. The purpose of this study is to compare outcomes of BHR and THA using the "Forgotten Joint" Score-12 (FJS), a more sensitive score with lesser vulnerability to the ceiling effect...
June 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28706814/tibial-allograft-transfer-for-medial-tibial-plateau-resurfacing
#6
Jonathan A Godin, Salvatore Frangiamore, Jorge Chahla, Mark E Cinque, Nicholas N DePhillipo, Robert F LaPrade
A large cartilage lesion of the tibial plateau with a deficient meniscus in a young patient is a challenging pathology for the orthopaedic surgeon due to the limited options available. While hemiarthroplasty procedures can be an option, the risk of revision in a young patient is high, and therefore a reconstructive procedure is advocated. The purpose of this Technical Note is to describe our technique for tibial plateau resurfacing, including the preparation and implantation of a medial tibial plateau and medial meniscal allograft, in a patient with a post-traumatic KD-4 knee dislocation with a medial tibial plateau rim fracture, medial meniscus deficiency, and medial tibiofemoral joint subluxation...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28703030/cartilage-health-in-knees-treated-with-metal-resurfacing-implants-or-untreated-focal-cartilage-lesions-a-preclinical-study-in-sheep
#7
Nicolas Martinez-Carranza, Kjell Hultenby, Anne Sofie Lagerstedt, Peter Schupbach, Hans E Berg
Background Full-depth cartilage lesions do not heal and the long-term clinical outcome is uncertain. In the symptomatic middle-aged (35-60 years) patient, treatment with metal implants has been proposed. However, the cartilage health surrounding these implants has not been thoroughly studied. Our objective was to evaluate the health of cartilage opposing and adjacent to metal resurfacing implants. Methods The medial femoral condyle was operated in 9 sheep bilaterally. A metallic resurfacing metallic implant was immediately inserted into an artificially created 7...
July 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28697226/randomized-split-face-d%C3%A3-collet%C3%A3-comparative-trial-of-procedure-enhancement-system-for-fractional-non-ablative-laser-resurfacing-treatment
#8
Deanne Mraz Robinson, Ashton P Frulla
<p>INTRODUCTION: A topical proprietary procedural enhancement system (PES) containing a combination of active ingredients including a tripeptide and hexapeptide (TriHex Technology™, Alastin Procedure Enhancement Invasive System, ALASTIN Skincare™, Inc., Carlsbad, CA) has been used successfully to aid in healing and improve symptomatology following resurfacing procedures.</p> <p>METHODS: PES (Gentle Cleanser, Regenerating Skin Nectar with TriHex Technology™, Ultra Nourishing Moisturizer with TriHex Technology™, Soothe + Protect Recovery Balm, Broad Spectrum 30+ Sunscreen) was compared to a basic regimen (Aquaphor™, Cerave™ cleanser, Vanicream™, Alastin Broad Spectrum 30+ Sunscreen) in a split face/ décolleté trial following fractional non-ablative thulium-doped resurfacing treatment to the face or décolleté...
July 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28688007/how-is-patella-height-modified-after-total-knee-arthroplasty
#9
Jean Louis Prudhon, Jacques H Caton, Thierry Aslanian, Régis Verdier
INTRODUCTION: Since the first measurement method of patella height in 1929 (Janssen), more than 16 methods have been described. Most of these measures are not suitable to measure patella height after total knee arthroplasty (TKA). One of us (JC) modified the original Caton Deschamps (oCD), index with a new relative index called modified Caton Deschamps (mCD) index, by using new landmarks. The purpose of this study was to determine how patella height is modified after TKA. MATERIAL AND METHOD: Sixty primary TKAs were consecutively prospectively enrolled...
July 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28678126/the-effect-on-long-term-survivorship-of-surgeon-preference-for-posterior-stabilized-or-minimally-stabilized-total-knee-replacement-an-analysis-of-63-416-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#10
Christopher J Vertullo, Peter L Lewis, Michelle Lorimer, Stephen E Graves
BACKGROUND: Controversy still exists as to the optimum management of the posterior cruciate ligament (PCL) in total knee arthroplasty. Surgeons can choose to kinematically substitute the PCL with a posterior-stabilized total knee replacement or alternatively to utilize a cruciate-retaining, also known as minimally stabilized, total knee replacement. Proponents of posterior-stabilized total knee replacement propose that the reported lower survivorship in registries when directly compared with minimally stabilized total knee replacement is due to confounders such as selection bias because of the preferential usage of posterior-stabilized total knee replacement in more complex or severe cases...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28676162/skin-and-composite-grafting-techniques-in-facial-reconstruction-for-skin-cancer
#11
REVIEW
Michael J Brenner, Jeffrey S Moyer
Skin and composite grafting provide effective resurfacing and reconstruction for cutaneous defects after excision of the malignancy. The goal is to restore a natural appearance and function while preventing distortion of the eyelid, nose, or lips. With careful planning and attention to aesthetic subunits, the surgeon can camouflage incisions and avoid blunting aesthetically sensitive sulci. The surgical plan is also informed by the pathology, as basal or squamous cell carcinomas removed by Mohs micrographic excision have different prognostic and logistical considerations from melanoma...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28672782/vitamin-e-and-alzheimer-s-disease-is-it-time-for-personalized-medicine
#12
REVIEW
Breana Cervantes, Lynn M Ulatowski
For the last two decades, it has been hotly debated whether vitamin E-the major lipid-soluble antioxidant, which functions to maintain neurological integrity-is efficacious as a therapy for Alzheimer's disease. Several factors key to the debate, include (1) which of the eight naturally-occurring vitamin E forms should be used; (2) how combination treatments affect vitamin E efficacy; and (3) safety concerns that most-recently resurfaced after the results of the Selenium and vitamin E Cancer prevention trial SELECT prostate cancer trial...
June 24, 2017: Antioxidants (Basel, Switzerland)
https://www.readbyqxmd.com/read/28670152/deep-learning-in-medical-imaging-general-overview
#13
REVIEW
June-Goo Lee, Sanghoon Jun, Young-Won Cho, Hyunna Lee, Guk Bae Kim, Joon Beom Seo, Namkug Kim
The artificial neural network (ANN)-a machine learning technique inspired by the human neuronal synapse system-was introduced in the 1950s. However, the ANN was previously limited in its ability to solve actual problems, due to the vanishing gradient and overfitting problems with training of deep architecture, lack of computing power, and primarily the absence of sufficient data to train the computer system. Interest in this concept has lately resurfaced, due to the availability of big data, enhanced computing power with the current graphics processing units, and novel algorithms to train the deep neural network...
July 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28668181/arthroscopic-joint-preservation-in-severe-glenohumeral-arthritis-using-interpositional-human-dermal-allograft
#14
Robert U Hartzler, Sabelo Melapi, Joe F de Beer, Stephen S Burkhart
PURPOSE: To investigate the outcomes of arthroscopic glenoid resurfacing (AGR) for severe glenohumeral arthritis at short- to medium-term follow-up. METHODS: We performed a multicenter retrospective review of consecutive patients undergoing AGR (2005-2013) with a minimum of 2 years' follow-up or until revision. Patients lost to follow-up and those included in a prior study were excluded. The indications for AGR were severe primary shoulder osteoarthritis without significant bone loss in younger, higher-demand patients...
June 28, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28663390/risk-factors-for-wear-related-failures-after-hip-resurfacing-in-patients-with-a-low-contact-patch-to-rim-distance
#15
H C Amstutz, M J Le Duff, S K Bhaurla
AIMS: A contact patch to rim (CPR) distance of < 10 mm has been associated with edge-loading and excessive wear. However, not all arthroplasties with a low CPR distance show problems with wear. Therefore, CPR distance may not be the only variable affecting the post-operative metal ion concentrations. PATIENTS AND METHODS: We used multiple logistic regression to determine what variables differed between the patients who had high and low cobalt (CoS) and chromium (CrS) serum ion concentrations within a cohort of patients with low (< 10 mm) CPR distances...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28662866/refining-the-extended-circumflex-scapular-flap-for-neck-burn-reconstruction-a-30-year-experience
#16
Claudio Angrigiani, Guillermo Artero, Carlos Sereday, Roger K Khouri, Zachary P French
INTRODUCTION: Neck burn sequelae remain a major challenge for the reconstructive surgeon. To achieve satisfactory functional and aesthetic results, the anterior neck aesthetic unit must be covered as a single unit. In cases where free flaps are required, harvesting a flap of sufficient size can cause major donor site morbidity. In 1994, we published our favorable 6-year experience of reconstructing neck burn sequelae with an extended circumflex scapular flap (ECSF). Since then, we have made several modifications to the technique, resulting in improved long-term functional and aesthetic results...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28662692/comparison-of-fixed-and-mobile-bearing-total-knee-arthroplasty-in-terms-of-patellofemoral-pain-and-function-a-prospective-randomised-controlled-trial
#17
P Z Feczko, L M Jutten, M J van Steyn, P Deckers, P J Emans, J J Arts
BACKGROUND: Despite growing evidence in the literature, there is still a lack of consensus regarding the use of the mobile-bearing (MB) design total knee arthroplasty (TKA). METHODS: In a prospective, comparative, randomised, single centre trial, 106 patients with end-stage osteoarthritis of the knee were randomised to either an MB or fixed-bearing (FB) group to receive posterior stabilised (PS)-TKA using a standard medial parapatellar approach and patellar resurfacing with follow-up (FU) for 5 years...
June 29, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28662298/advanced-film-forming-gel-formula-vs-spring-thermal-water-and-white-petrolatum-as-primary-dressings-after-full-face-ablative-fractional-co2-laser-resurfacing-a-comparative-split-face-pilot-study
#18
Leonardo Marini
BACKGROUND: Aesthetically pleasing results and fast, uneventful recovery are highly desirable after rejuvenating ablative laser procedures. Wound dressings following ablative laser procedures should ideally improve and optimize the wound healing environment. OBJECTIVE: The purpose of this comparative split face, single blinded, prospective observational study was to assess the efficacy and acceptability of two primary wound dressings immediately after a full face fractional CO2 laser resurfacing procedure...
June 29, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28660477/correlation-of-serum-metal-ion-levels-with-pathological-changes-of-armd-in-failed-metal-on-metal-hip-resurfacing-arthroplasties
#19
George Grammatopoulos, Mitsuru Munemoto, Athanasios Pollalis, Nicholas A Athanasou
BACKGROUND: Metal-on-metal-hip-resurfacing arthroplasties (MoMHRAs) have been associated with an increased failure rates due to an adverse-response-to-metal-debris (ARMD) associated with a spectrum of pathological features. Serum levels of cobalt (Co) and chromium (Cr) are used to assess MoMHRAs, with regard to ARMD, but it is not certain whether ion levels correlate with pathological changes in periprosthetic tissues. METHODS: Serum Co and Cr levels were correlated with histological findings in 38 revised MoMHRAs (29 pseudotumour cases and 9 non-pseudotumour cases revised for pain)...
June 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28660436/adventure-sports-and-sexual-freedom-hip-replacement-the-tripolar-hip
#20
James W Pritchett
Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations...
June 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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