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https://www.readbyqxmd.com/read/29314250/inhibition-of-camkk2-enhances-fracture-healing-by-stimulating-indian-hedgehog-signaling-and-accelerating-endochondral-ossification
#1
Justin N Williams, Anuradha Valiya Kambrath, Roshni B Patel, Kyung Shin Kang, Elsa Mével, Yong Li, Ying-Hua Cheng, Austin J Pucylowski, Mariah A Hassert, Michael J Voor, Melissa A Kacena, William R Thompson, Stuart J Warden, David B Burr, Matthew R Allen, Alexander G Robling, Uma Sankar
Approximately ten percent of all bone fractures do not heal, resulting in patient morbidity and healthcare costs. However, no pharmacological treatments are currently available to promote efficient bone healing. Inhibition of Ca2+ /calmodulin (CaM)-dependent protein kinase kinase 2 (CaMKK2) reverses age-associated loss of trabecular and cortical bone volume and strength in mice. In the current study, we investigated the role of CaMKK2 in bone fracture healing and show that its pharmacological inhibition using STO-609 accelerates early cellular and molecular events associated with endochondral ossification, resulting in a more rapid and efficient healing of the fracture...
January 3, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29284442/how-to-avoid-unintended-valgus-alignment-in-distal-femoral-derotational-osteotomy-for-treatment-of-femoral-torsional-malalignment-a-concept-study
#2
Florian B Imhoff, Bastian Scheiderer, Philip Zakko, Elifho Obopilwe, Franz Liska, Andreas B Imhoff, Augustus D Mazzocca, Robert A Arciero, Knut Beitzel
BACKGROUND: Defining the optimal cutting plane for derotational osteotomy at the distal femur for correction of torsion in cases of patellofemoral instability is still challenging. This preliminary study investigates changes of frontal alignment by a simplified trigonometrical model and demonstrates a surgical guidance technique with the use of femur cadavers. The hypothesis was that regardless of midshaft bowing, a cutting plane perpendicular to the virtual anatomic shaft axis avoids unintended valgus malalignment due to derotation...
December 29, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29248806/magnesium-alloy-based-interference-screw-developed-for-acl-reconstruction-attenuates-peri-tunnel-bone-loss-in-rabbits
#3
Jiali Wang, Yuanhao Wu, Huafang Li, Yang Liu, Xueling Bai, Wingho Chau, Yufeng Zheng, Ling Qin
Peri-tunnel bone loss after anterior cruciate ligament (ACL) reconstruction is often observed clinically, which may detrimentally affect tendon graft integration with surrounding bone tissue. Biodegradable magnesium (Mg) based fixators in terms of interference screws may be suitable for fixation of the tendon graft due to their favorable effects on promotion of new bone formation. However, the poor mechanical strength of Mg is still one of the major challenges for its clinical applications. The addition of alloying elements into Mg is one of the strategies to improve their mechanical properties...
December 11, 2017: Biomaterials
https://www.readbyqxmd.com/read/29196774/-suitability-of-computer-assisted-femoral-intramedullary-nailing-for-control-of-torsion-and-length-systematic-review-of-clinical-studies
#4
REVIEW
Emmanouil Liodakis, Christian Krettek, Nael Hawi
BACKGROUND: Despite promising results in experimental studies, computer-assisted femoral intramedullary nailing has not become established in the clinical practice for most orthopedic surgeons. The purpose of this study was to evaluate the advantages and disadvantages of computer-assisted reduction and nailing of femoral fractures as reported in clinical studies. MATERIAL AND METHODS: A systematic analysis of the available literature on the clinical application of computer-assisted femoral intramedullary nailing (Pubmed, Cochrane library and Embase) was carried out...
December 1, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29189535/torsional-growth-modulation-of-long-bones-by-oblique-plating-in-a-rabbit-model
#5
David E Lazarus, Christine L Farnsworth, Megan E Jeffords, Nikolas Marino, Jericho Hallare, Eric W Edmonds
BACKGROUND: There is evidence that oblique tension band plating can affect torsional growth in long bones. This study sought to determine if the torsional growth could be modulated based on the angles of the tension band plating and whether or not oblique plating affected overall longitudinal growth. METHODS: New Zealand White rabbits (10.5 wk old) had one screw placed on the metaphyseal side and one on the epiphyseal side of both medial and lateral sides of the right knee distal femoral physis...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29162229/design-of-experiments-confirms-optimization-of-lithium-administration-parameters-for-enhanced-fracture-healing
#6
Kathak Vachhani, Andrea Pagotto, Yufa Wang, Cari Whyne, Diane Nam
Fracture healing is a lengthy process which fails in 5-10% of cases. Lithium, a low-cost therapeutic used in psychiatric medicine, up-regulates the canonical Wingless pathway crucial for osteoblastic mineralization in fracture healing. A design-of-experiments (DOE) methodology was used to optimize lithium administration parameters (dose, onset time and treatment duration) to enhance healing in a rat femoral fracture model. In the previously completed first stage (screening), onset time was found to significantly impact healing, with later (day 7 vs...
October 28, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29154969/adults-with-cystic-fibrosis-have-deficits-in-bone-structure-and-strength-at-the-distal-tibia-despite-similar-size-and-measuring-standard-and-relative-sites
#7
Kyle K Nishiyama, Sanchita Agarwal, Anna Kepley, Fernando Rosete, Yizhong Hu, X Edward Guo, Claire L Keating, Emily A DiMango, Elizabeth Shane
Individuals with cystic fibrosis (CF) have lower bone mineral density (BMD) by DXA and are at higher risk of fracture than healthy controls. However, the 2-dimensional measurement of areal BMD (aBMD) provided by DXA is influenced by bone size and the true extent of the bone deficit is unclear. Our objective was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) and individual trabecula segmentation (ITS) analysis to compare volumetric BMD (vBMD), microarchitecture and estimated strength at the distal radius and tibia in 26 young adults with CF and 26 controls matched for age, gender, and race...
November 14, 2017: Bone
https://www.readbyqxmd.com/read/29150745/alignment-in-the-transverse-plane-but-not-sagittal-or-coronal-plane-affects-the-risk-of-recurrent-patella-dislocation
#8
Shigeru Takagi, Takashi Sato, Satoshi Watanabe, Osamu Tanifuji, Tomoharu Mochizuki, Go Omori, Naoto Endo
PURPOSE: Abnormalities of lower extremity alignment (LEA) in recurrent patella dislocation (RPD) have been studied mostly by two-dimensional (2D) procedures leaving three-dimensional (3D) factors unknown. This study aimed to three-dimensionally examine risk factors for RPD in lower extremity alignment under the weight-bearing conditions. METHODS: The alignment of 21 limbs in 15 RPD subjects was compared to the alignment of 24 limbs of 12 healthy young control subjects by an our previously reported 2D-3D image-matching technique...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29119287/smoking-and-obesity-influence-the-risk-of-nonunion-in-lateral-opening-wedge-closing-wedge-and-torsional-distal-femoral-osteotomies
#9
Franz Liska, Bernhard Haller, Andreas Voss, Julian Mehl, Florian B Imhoff, Lukas Willinger, Andreas B Imhoff
PURPOSE: Lateral distal femoral osteotomies (DFO) have recently been performed more frequently. In addition to realignment for varus and valgus deformity, the indication was extended with the introduction of torsional osteotomies in patellofemoral instability. The purpose of this study was to assess the general and technical risk factors for nonunion in lateral opening, closing and torsional DFO. METHODS: A total of 150 lateral DFO [98 opening wedge (LOWDFO) and 52 closing wedge (LCWDFO)] were analyzed in regard to potential risk factors for nonunion until plate removal...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29116392/anchoring-and-resulting-primary-stability-of-a-kinked-compared-to-a-straight-uncemented-femoral-stem
#10
Markus Heinecke, Fabian Rathje, Frank Layher, Georg Matziolis
INTRODUCTION: The number of revision hip arthroplasties being performed is growing and implantation of a cementless stem has become established as the gold standard. For producing a primary stability, the press-fit procedure is the method of choice, but also can be achieved by multiple-point impactions. Specific femoral stems should follow the anatomical shape and provide a more extensive anchorage. The objective of this study was to evaluate the type, localization of the impaction and resulting primary stability of two different femoral revision stem designs (kinked vs...
November 7, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29114631/bore-disruption-an-unusual-mechanical-failure-of-two-hip-hemiarthroplasties
#11
Federico Dettoni, Umberto Cottino, Silvia Spriano, Davide Edoardo Bonasia, Roberto Rossi
We report a case of two hemiarthroplasties (HAs) that underwent an unexpected mechanical failure. Two patients affected by femoral fractures were treated with an HA. At 5 and 7 years after surgery, they showed a breakage of the HA at the head-stem junction. We analyzed macroscopically and microscopically (by a scanning electron microscopy) the surfaces of the broken prostheses. In both cases, a fracture was detected starting at the joining point between the femoral head and the slot that receives the taper cone of the stem (the so-called bore), with the typical macroscopic and microscopic pattern of a fatigue fracture...
March 2017: Joints
https://www.readbyqxmd.com/read/29106746/low-dose-lithium-regimen-enhances-endochondral-fracture-healing-in-osteoporotic-rodent-bone
#12
Kathak Vachhani, Cari Whyne, Yufa Wang, David Burns, Diane Nam
Osteoporotic bone fractures are highly prevalent and involve lengthy recovery. Lithium, commonly used in psychiatric medicine, inhibits glycogen synthase kinase-3β in the Wnt/β-catenin pathway, leading to up-regulation of osteogenesis. Our recent preclinical work demonstrated that a 20mg/kg lithium dose administered beginning 7 days post-fracture for 14 days optimally improved femoral fracture healing in healthy rats at 4 weeks post fracture (46% higher torsional strength). In this study, lithium treatment was evaluated for healing of osteoporotic bone fractures...
November 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29079908/patellofemoral-dysbalance-and-genua-valga-outcome-after-femoral-varisation-osteotomies
#13
Jörg Dickschas, Felix Ferner, Christoph Lutter, Kolja Gelse, Jörg Harrer, Wolf Strecker
INTRODUCTION: Patellofemoral dysbalance may be caused by trochlear dysplasia, an elevated TTTG distance, femoral or tibial torsional deformities, patella alta, or a genu valgum. The surgical procedure for the treatment of a genu valgum is varisation osteotomy, usually in the femoral aspect. Several authors believe that a genu valgum is one cause of patellofemoral dysbalance, but studies about the outcome of the treatment with a varisation osteotomy are rare. MATERIALS AND METHODS: Nineteen knees in 18 patients, aged on average 28 (16-52) years were investigated in a retrospective study...
October 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29065654/biomechanical-property-of-a-newly-designed-assembly-locking-compression-plate-three-dimensional-finite-element-analysis
#14
Jiang-Jun Zhou, Min Zhao, Da Liu, Hai-Ying Liu, Cheng-Fei Du
In this study, we developed and validated a refined three-dimensional finite element model of middle femoral comminuted fracture to compare the biomechanical stability after two kinds of plate fixation: a newly designed assembly locking compression plate (NALCP) and a locking compression plate (LCP). CT data of a male volunteer was converted to middle femoral comminuted fracture finite element analysis model. The fracture was fixated by NALCP and LCP. Stress distributions were observed. Under slow walking load and torsion load, the stress distribution tendency of the two plates was roughly uniform...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29020057/high-dose-teriparatide-rpth1-34-therapy-increases-callus-volume-and-enhances-radiographic-healing-at-8-weeks-in-a-massive-canine-femoral-allograft-model
#15
Kohei Nishitani, Zachary Mietus, Christopher A Beck, Hiromu Ito, Shuichi Matsuda, Hani A Awad, Nicole Ehrhart, Edward M Schwarz
Small animal studies have demonstrated significant high-dose recombinant parathyroid hormone1-34 (rPTH1-34) effects on intercalary allograft healing. Towards a human adjuvant therapy to decrease non-unions, we evaluated rPTH1-34 safety and efficacy in a clinically relevant canine femoral allograft model. Adult female mongrel hounds (n = 20) received a 5cm mid-diaphyseal osteotomy reconstructed with a plated allograft, and were randomized to: 1) Placebo (n = 5; daily saline), 2) Continuous rPTH1-34 (n = 7; 5 μg/kg/day s...
2017: PloS One
https://www.readbyqxmd.com/read/28975643/change-in-axial-rotation-of-the-femur-in-the-resting-supine-position-following-total-hip-arthroplasty
#16
Keisuke Uemura, Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
Stem anteversion in the setting of total hip arthroplasty (THA) is usually measured by referencing the posterior condylar line (PCL). However, stem anteversion may not express the functional torsion of the femur if a consistent horizontal tilt in the PCL is observed after THA. Herein, the horizontal tilt of the PCL at the resting neutral position of the hip was retrospectively measured in 53 THA patients from three computed tomography (CT) datasets: (i) preoperative (preop-CT), (ii) 3 weeks after THA (1st postop-CT), and (iii) more than 2 years after THA (2nd postop-CT)...
October 3, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28945686/an-anatomic-study-on-whether-femoral-version-originates-in-the-neck-or-the-shaft
#17
Hunter D Archibald, Kathleen F Petro, Raymond W Liu
BACKGROUND: Femoral anteversion is generally asymptomatic but can result in lower extremity issues like patellofemoral instability and pain. Surgical correction of anteversion can be performed proximal, mid shaft or distal. A better understanding of the specific location of the rotational deformity can help guide the optimal location of the osteotomy. In this study we examine the contribution of the femoral neck and shaft to total femoral version. METHODS: We studied 590 pairs of well-preserved cadaveric femurs...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28942027/tibial-tubercle-torsion-a-new-factor-of-patellar-instability
#18
V Chassaing, J-M Zeitoun, M Camara, J-L Blin, S Marque, M-D Chancelier
INTRODUCTION: External torsion of the anterior tibial tubercle (TT), defined as external rotation around a craniocaudal axis with respect to the posterior femoral condylar plane, may induce patellar instability. To our knowledge no studies have focused on this parameter. The present study aimed to perform an MRI analysis of TT torsion. The study hypothesis was that TT torsion correlates with patellar instability and with 3 of its components: tibial tubercle-trochlear groove (TT-TG) distance, axial engagement index of the patella (AEI), and patellar tilt...
September 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28925669/lower-extremity-abnormalities-in-children
#19
Caitlyn M Rerucha, Caleb Dickison, Drew C Baird
Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing is less common than intoeing and occurs more often in older children. Out-toeing is caused by external tibial torsion and femoral retroversion. Angular problems include genu varum (bowleg) and genu valgum (knock knee). With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28883088/humeral-loads-during-swimming-and-walking-in-turtles-implications-for-morphological-change-during-aquatic-reinvasions
#20
Vanessa K Hilliard Young, Charlotte E Wienands, Brittany P Wilburn, Richard W Blob
During evolutionary reinvasions of water by terrestrial vertebrates, ancestrally tubular limb bones often flatten to form flippers. Differences in skeletal loading between land and water might have facilitated such changes. In turtles, femoral shear strains are significantly lower during swimming than during walking, potentially allowing a release from loads favoring tubular shafts. However, flipper-like morphology in specialized tetrapod swimmers is most accentuated in the forelimbs. To test if the forelimbs of turtles also experience reduced torsional loading in water, we compared strains on the humerus of river cooters (Pseudemys concinna) between swimming and terrestrial walking...
September 7, 2017: Journal of Experimental Biology
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