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Chelsea N Koch, Laura Serrano Mateo, Stephen Kayiaros, Kevin A Cassidy, Seth A Jerabek, Alejandro Gonzalez Della Valle
BACKGROUND: Femoral stem fracture following total hip arthroplasty is an uncommon event that requires immediate revision surgery. QUESTIONS/PURPOSES: We report on four patients who experienced stem fractures of one design and a review of the US Food and Drug Administration adverse event reports on this design. METHODS: Fracture surfaces of four EMPERION™ (Smith & Nephew, Memphis, TN) femoral stems were analyzed under optical and scanning electron microscopy...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Manuel Held, Anne-Sophie Engelke, Dascha Sophie Tolzmann, Afshin Rahmanian-Schwarz, Hans-Eberhard Schaller, Jens Rothenberger
INTRODUCTION: There is a high prevalence of superficial wounds such as partial-thickness burns. Treatment of these wounds frequently includes temporary application of wound dressings. The aim of this study was to compare a newly developed collagen matrix with commonly used temporary skin dressings for treatment of partial-thickness skin defects. MATERIALS AND METHODS: Through a skin dermatome, 42 standardized superficial skin defects were generated on the back of 28 adult male Lewis rats...
September 2016: Wounds: a Compendium of Clinical Research and Practice
Christopher Hein, Serkan Inceoglu, David Juma, Lee Zuckerman
OBJECTIVES: Cortical bone drilling for preparation of screw placement is common in multiple surgical fields. The heat generated while drilling may reach thresholds high enough to cause osteonecrosis. This can compromise implant stability. Orthopedic drill bits are several orders more expensive than their similarly sized, publicly available industrial counterparts. We hypothesize an industrial bit will generate less heat during drilling, and the bits will not generate more heat after multiple cortical passes...
September 24, 2016: Journal of Orthopaedic Trauma
Dong Ren, Yueju Liu, Ming Li, Zhaohui Song, Shuangquan Yao, Pengcheng Wang
BACKGROUND: Cephalomedullary Nail (CMN) is seen as the mainstay of internal fixation in femoral fractures. The purpose of the study was to present an accurate calculation method by simulating diverse anterior bow femoral models with finite element software. We hypothesized that anterior cortical penetration in distal femur would occur in patients whose femoral anterior bow was identified as too large for nailing by preoperative measurement of contralateral X-ray. METHODS: A 31-year healthy male was selected for building 3D bone model through computed tomography (CT) scan of right femoral femur...
September 26, 2016: BMC Surgery
Lisa Renner, Tom Schmidt-Braekling, Martin Faschingbauer, Friedrich Boettner
INTRODUCTION: Serum metal ions are part of the regular follow-up routine of patients with metal-on-metal total hip arthroplasties (MoM-THA). Increased cobalt levels have been suggested to indicate implant failure and corrosion. QUESTIONS: (1) Is there a correlation between the size of the osteolysis measured on a CT scan and metal ion levels? (2) Can metal ion levels predict the presence of osteolysis in MoM-THA? (3) Are cobalt and chromium serum levels or the cobalt-chromium-ratio diagnostic for osteolysis? MATERIALS AND METHODS: CT scans of patients (n = 75) with a unilateral MoM-THA (Birmingham Hip System, Smith & Nephew, TN, USA) implanted by a single surgeon were reviewed to determine the presence of osteolysis...
September 15, 2016: Archives of Orthopaedic and Trauma Surgery
N Kaku, T Tabata, H Tsumura
PURPOSE: To compare the past and present bipolar hip arthroplasty (BHA) models in terms of balance between pull-out strength and oscillation angle (OA). METHODS: The pull-out strength and OA of 8 BHA models were compared: UPF-II, IBC, and Tandem XLPE (Smith & Nephew); Ringloc x (Biomet); J-FX (DePuy); Bipolar (Nakashima Medical); Multipolar (Zimmer); and Centrax (Stryker). RESULTS: Respectively for the UPF-II, IBC, Tandem, Ringloc, J-FX, Nakashima Bipolar, Multipolar, and Centrax, the mean pull-out strength was 2219 N, 3303 N, 1503 N, 951 N, 1453 N, 1856 N, 1536 N, and 753 N, whereas the mean OA was 54...
August 2016: Journal of Orthopaedic Surgery
John Loveluck, Tom Copeland, Jason Hill, Allan Hunt, Robin Martin
OBJECTIVES: The use of negative pressure wound therapy (NPWT) on closed surgical incisions is an emerging technology that may reduce the incidence of complications such as surgical site infections. One of the mechanisms through which incisional NPWT is thought to operate is the reduction of lateral tension across the wound. METHODS: Finite element analysis computer modeling and biomechanical testing with Syndaver SynTissue™ synthetic skin were used to explore the biomechanical forces in the presence of the PICO(⋄) (Smith & Nephew Ltd, Hull, United Kingdom) negative pressure wound therapy system on a sutured incision...
2016: Eplasty
David E Hartigan, Matthew C Beran, James E Fleischli, Donald F D'Alessandro, Naiquan Nigel Zheng
The percutaneous intra-articular transtendon (PITT) technique has recently been shown to have results comparable to those of more accepted techniques. Its mode of failure was secondary to the suture pulling through the tendon substance. A modification was made whereby the tendon is locked within the suture configuration in an attempt to avoid pullout. We compared this new technique with a well-accepted technique of all-arthroscopic interference screw. In each of 8 pairs of cadaveric shoulders (mean age, 55 years; range, 51-59 years), one shoulder was randomized to be treated with either modified PITT or interference screw (Biceptor; Smith & Nephew) biceps tenodesis, and the other shoulder was treated with the other technique...
July 2016: American Journal of Orthopedics
Onur Hapa, Ahmet Karakaşlı, Onur Başçı, Hakan Cici, Berivan Çeçen, Hasan Havitçioğlu
OBJECTIVES: The aims of this study was first to investigate whether the bite size or the bite distance from the tear edge is of primary importance in mattress suture configuration for rotator cuff repair. Secondly, whether the use of a 450 left side bent Arthro-Pierce™ (Smith & Nephew, Andover, USA) during suture passage can be more effective on the strength of the configuration compared to a straight Arthro-Pierce™. MATERIALS AND METHODS: Twenty-eight bovine infraspinatus muscle tendons were randomized into four groups...
August 2016: Acta Orthopaedica et Traumatologica Turcica
Allison K Royer, Mark C Royer
Posterior epistaxis is a serious condition that can be difficult to treat in a wilderness setting. The initial standard of care involves packing the affected nostril with a 7 to 9 cm nasal pack to tamponade the bleed. These packs are often unavailable outside of the emergency or operating room. This study set out to determine whether a posterior nasal pack could be constructed from the supplies present in a basic first aid kit in order to control massive nasal hemorrhage in a wilderness setting. A basic first aid kit was utilized to construct a posterior nasal pack that was inserted into an anatomical model and visibly compared with the Rapid Rhino (Posterior, 7...
September 2016: Wilderness & Environmental Medicine
William W Schairer, Benedict U Nwachukwu, David M Dare, Mark C Drakos
Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2...
April 2016: Arthroscopy Techniques
Phillip Penny, Michael Swords, Jason Heisler, Adam Cien, Andrew Sands, Peter Cole
OBJECTIVES: The purpose of this study was to examine the screw trajectory of ten commercially available distal tibia plates and compare them to common fracture patterns seen in OTA C type pilon fractures to determine their ability to stabilize the three most common fracture fragments while buttressing anterolateral zones of comminution. HYPOTHESIS: We hypothesized that a single plate for the distal tibia would fail to adequately stabilize all three main fracture fragments and zones of comminution in complex pilon fractures...
August 2016: Injury
Iris Lin, Jennifer Sung, Robert J Sanchez, Usha G Mallya, Mark Friedman, Mary Panaccio, Andrew Koren, Peter Neumann, Joseph Menzin
BACKGROUND: Widespread use of statins has improved hypercholesterolemia management, yet a significant proportion of patients remain at risk for cardiovascular (CV) events. Analyses of treatment patterns reveal inadequate intensity and duration of statin therapy among patients with hypercholesterolemia, and little is known about real-world statin use, specifically in subgroups of patients at high risk for CV events. OBJECTIVE: To examine patterns of statin use and outcomes among patients with high-risk features who newly initiated statin monotherapy...
June 2016: Journal of Managed Care & Specialty Pharmacy
K Dreyer, M C I Lier, M H Emanuel, J W R Twisk, B W J Mol, R Schats, P G A Hompes, V Mijatovic
STUDY QUESTION: Does hysteroscopic proximal tubal occlusion by intratubal devices as a treatment for hydrosalpinges result in comparable ongoing pregnancy rates following IVF/ICSI when compared with laparoscopic salpingectomy? SUMMARY ANSWER: Hysteroscopic proximal tubal occlusion by intratubal devices is inferior to laparoscopic salpingectomy in the treatment of hydrosalpinges in women undergoing IVF/ICSI with respect to ongoing pregnancy rates. WHAT IS KNOWN ALREADY: It is known that women with hydrosalpinges undergoing IVF have poorer pregnancy outcomes compared with women with other forms of tubal infertility...
September 2016: Human Reproduction
Per-Erik Johanson, Martin Antonsson, Bita Shareghi, Johan Kärrholm
BACKGROUND: Radiostereometry (RSA) measurements of early micromotion can predict later failure in hip and knee prostheses. In hip implants, RSA has been particularly helpful in the evaluation of composite-beam stem designs. The Spectron EF Primary stem (Smith & Nephew, London, UK) has shown inferior performance compared with its predecessors in both clinical studies and registry reports. Early RSA studies have shown somewhat greater subsidence for the Spectron EF Primary stem compared with the earlier Spectron EF, but still within boundaries considered to be safe...
October 2016: Clinical Orthopaedics and related Research
Ethan J Fraser, Ian Savage-Elliott, Youichi Yasui, Jakob Ackermann, Geoffrey Watson, Keir A Ross, Timothy Deyer, John G Kennedy
BACKGROUND: Autologous osteochondral transplantation (AOT) has an inherent risk of donor site morbidity (DSM). The reported rates of DSM vary from 0% to 50%, with few studies reporting clinical or imaging outcomes at the donor site as a primary outcome and even fewer report these outcomes when a biosynthetic plug backfill is employed. Although TruFit (Smith & Nephew, Andover, MA) plugs have been removed from the market for regulatory purposes, biphasic plugs (including TruFit plugs) have been used for several years and the evaluation of these is therefore pertinent...
September 2016: Foot & Ankle International
Josephine Berger-Groch, Martin Rupprecht, Steffen Schoepper, Malte Schroeder, Johannes Maria Rueger, Michael Hoffmann
OBJECTIVES: To compare the radiological and functional outcome after fixation of intertrochanteric fractures (IF) using either an integrated 2-screw cephalomedullary nail [InterTan (IT); Smith & Nephew] or a single-screw device [Gamma3 (G3); Stryker] with a 5-year follow-up. DESIGN: Prospective, randomized. SETTINGS: A single-center study. PATIENTS: One hundred four patients with a mean age of 81.2 ± 9.2 years were included, 33 patients were available for the final 5-year follow-up, 63 patients died, and 8 patients were lost for follow-up...
September 2016: Journal of Orthopaedic Trauma
Lisa Renner, Martin Faschingbauer, Tom Schmidt-Braekling, Friedrich Boettner
INTRODUCTION: Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) and resurfacings (HR). QUESTIONS: (1) Is there a difference in metal ion concentrations between HR and MoM-THR using the same bearing design (Birmingham Hip Resurfacing System, Smith & Nephew, Inc...
May 2016: Archives of Orthopaedic and Trauma Surgery
Shannon W Hill, Christopher R Chapman, Samer Adeeb, Kajsa Duke, Lauren Beaupre, Martin J Bouliane
BACKGROUND: The Nice knot is a bulky double-stranded knot. Biomechanical data supporting its use as well as the number of half hitches required to ensure knot security is lacking. MATERIALS AND METHODS: Nice knots with, one, two, or three half-hitches were compared with the surgeon's and Tennessee slider knots with three half hitches. Each knot was tied 10 times around a fixed diameter using four different sutures: FiberWire (Arthrex, Naples, FL), Ultrabraid (Smith and Nephew, Andover, MA), Hi-Fi (ConMed Linvatec, Largo, FL) and Force Fiber (Teleflex Medical OEM, Gurnee, IL)...
January 2016: International Journal of Shoulder Surgery
İsmail Levent Eralp, Mehmet Kocaoğlu, Göksel Dikmen, Mohsin E Azam, Halil İbrahim Balcı, F Erkal Bilen
OBJECTIVE: The purpose of this study was to summarize our clinical results with distraction osteogenesis for the treatment of infected tibial nonunion around the ankle joint. METHODS: Between 1994 and 2009, 13 patients with a mean age of 50 years (range: 27-79 years) underwent tibial reconstruction for the treatment of infected nonunion of the distal tibia, with a mean bone loss of 4.8 cm (range: 1-7 cm). Lengthening over an intramedullary nail as a second procedure was used in 2 patients, bifocal compression and distraction technique in 5 cases, compression with Ilizarov external fixator in 5 cases, and Taylor Spatial Frame (TSF, Smith Nephew, Memphis, TN, USA) in 1 case...
2016: Acta Orthopaedica et Traumatologica Turcica
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