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https://www.readbyqxmd.com/read/28645423/a-technique-for-extraction-of-the-distal-segment-of-a-broken-femoral-nail-using-a-flexible-reamer
#1
C Zhao, G J R Slater
INTRODUCTION: Extraction of broken femoral nails in peri-implant fractures is becoming an increasingly common problem faced by orthopaedic surgeons. Different closed and open techniques for removal of broken nails have been previously described but due to variations in equipment and fracture configurations these methods are not always easily reproducible. We describe an open surgical technique using simple equipment that can be utilised when other methods of extraction have failed. CASE PRESENTATION AND SURGICAL TECHNIQUE: We present a case of a peri-implant fracture secondary to non-union involving a short cephalomedullary nail where the broken distal segment of nail was significantly more distal to the femoral fracture site...
June 16, 2017: Injury
https://www.readbyqxmd.com/read/28639846/antibiotic-prophylaxis-is-not-indicated-prior-to-dental-procedures-for-prevention-of-periprosthetic-joint-infections
#2
Willem M H Rademacher, Geert H I M Walenkamp, Dirk Jan F Moojen, Johannes G E Hendriks, Theo A Goedendorp, Frederik R Rozema
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28633770/a-24-month-follow-up-of-a-custom-made-suture-button-assembly-for-syndesmotic-injuries-of-the-ankle
#3
Mohamed A Imam, Ahmed Matthana, Ji Wan Kim, Mohamed Nabil
In the present retrospective analysis, we introduce a custom suture-button fixation device for acute ankle syndesmotic injuries that allows for early weightbearing without another planned operation for hardware removal. We evaluated 87 consecutive ankles in 87 patients (49 males [56.32%] and 38 females [43.68%]). Of the 87 patients, 15 (17.24%) withdrew or were lost to follow-up, leaving 72 patients (82.76%) in the present study. Their mean age was 35.2 (range 17 to 67) years. Nineteen patients (26.39%) presented with a pure syndesmotic disruption, and 53 (73...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#4
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632455/joint-preservation-techniques-in-orthopaedic-surgery
#5
Philip J York, Frank B Wydra, Matthew E Belton, Armando F Vidal
CONTEXT: With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis. Treatment in the past was limited, however, and surgical treatment options continue to evolve that may allow restoration of the natural biology of the articular cartilage...
June 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28630851/vacuum-assisted-closure-in-patients-with-post-operative-infections-after-instrumented-spine-surgery-a-series-of-12-cases
#6
Maya Kale, Pravin Padalkar, Varshil Mehta
INTRODUCTION: Post-operative wound infections after spinal surgery is a very serious problem, leading to a risk of significant morbidity which may even lead to prolonged hospitalization. Various treatment protocols have been recommended for debridement, antibiotic, and soft-tissue management, but with mixed results. However, the risk of morbidity is still high with these treatment options. Vacuum-assisted closure (VAC) system has been gaining popularity recently in the management of subacute, acute, and chronic wounds...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630749/imaging-in-peri-prosthetic-assessment-an-orthopaedic-perspective
#7
Christoph H Lohmann, Sanjiv Rampal, Martin Lohrengel, Gurpal Singh
As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28626592/diffuse-b-cell-non-hodgkin-s-lymphoma-presenting-atypically-as-periprosthetic-joint-infection-in-a-total-hip-replacement
#8
Aysha Rajeev, Angela Ralte, Nameer Choudhry, Faizan Jabbar, Paul Banaszkiewicz
The occurrence of extranodal primary B cell non-Hodgkin's lymphoma is rare. Total hip replacement is one of the most common orthopaedic procedures performed. There has been an increased incidence of primary lymphomas involving periprosthetic sites. Chronic inflammation due to metal debris arising from the prosthetic implants has been evidenced as one of the causes for the development of soft tissue lymphomas albeit rarely. We describe a case report of a 77-year-old patient who had underwent a cemented total hip replacement in the past who further developed large B cell primary non-Hodgkin's lymphoma...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28624853/biophysical-stimulation-improves-clinical-results-of-matrix-assisted-autologous-chondrocyte-implantation-in-the-treatment-of-chondral-lesions-of-the-knee
#9
Marco Collarile, Andrea Sambri, Giada Lullini, Matteo Cadossi, Claudio Zorzi
PURPOSE: The purpose of the present study was to evaluate the effects of pulsed electromagnetic fields (PEMFs) on clinical outcome in patients who underwent arthroscopic matrix-assisted autologous chondrocyte implantation (MACI) for chondral lesions of the knee. METHODS: Thirty patients affected by grade III and IV International Cartilage Repair Society chondral lesions of the knee underwent MACI. After surgery, patients were randomly assigned to either experimental group (PEMFs 4 h per day for 60 days) or control group ...
June 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28623650/the-incidence-of-dissociated-liners-in-4-751-consecutive-total-hip-arthroplasties-using-pinnacle-polyethylene-acetabular-liners
#10
Richard J Napier, Owen Diamond, Chris K J O'Neill, Seamus O'Brien, David E Beverland
INTRODUCTION: Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). METHODS: The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners)...
June 14, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28621834/from-intricate-to-integrated-biofabrication-of-articulating-joints
#11
Wilhelmina Margaretha Groen, Paweena Diloksumpan, Paul René van Weeren, Riccardo Levato, Jos Malda
Articulating joints owe their function to the specialized architecture and the complex interplay between multiple tissues including cartilage, bone and synovium. Especially the cartilage component has limited self-healing capacity and damage often leads to the onset of osteoarthritis, eventually resulting in failure of the joint as an organ. Although in its infancy, biofabrication has emerged as a promising technology to reproduce the intricate organization of the joint, thus enabling the introduction of novel surgical treatments, regenerative therapies, and new sets of tools to enhance our understanding of joint physiology and pathology...
June 16, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28619648/biophysical-characterization-of-nanostructured-tio2-as-a-good-substrate-for-hbm-msc-adhesion-growth-and-differentiation
#12
L Petecchia, C Usai, M Vassalli, P Gavazzo
Mesenchymal stem cells from human bone marrow (hBM-MSC) are widely utilized for clinical applications involving bone healing. In this context, their use has been often optimized in association to variously designed titanium substrates, being this material of great use in orthopaedic implants. According to recent findings, the ability of hBM-MSC to differentiate towards a specific lineage is not only driven by biochemical signals, but physical stimuli, such as rigidity or roughness of the substrate, can also support a commitment towards osteogenic differentiation...
June 12, 2017: Experimental Cell Research
https://www.readbyqxmd.com/read/28615491/enhanced-osteointegration-of-poly-methylmethacrylate-bone-cements-by-incorporating-strontium-containing-borate-bioactive-glass
#13
Xu Cui, Chengcheng Huang, Meng Zhang, Changshun Ruan, Songlin Peng, Li Li, Wenlong Liu, Ting Wang, Bing Li, Wenhai Huang, Mohamed N Rahaman, William W Lu, Haobo Pan
Although poly(methylmethacrylate) (PMMA) cements are widely used in orthopaedics, they have numerous drawbacks. This study aimed to improve their bioactivity and osseointegration by incorporating strontium-containing borate bioactive glass (SrBG) as the reinforcement phase and bioactive filler of PMMA cement. The prepared SrBG/PMMA composite cements showed significantly decreased polymerization temperature when compared with PMMA and retained properties of appropriate setting time and high mechanical strength...
June 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28610471/mechanically-loading-cell-hydrogel-constructs-with-low-intensity-pulsed-ultrasound-for-bone-repair
#14
James A Veronick, Fayekah Assanah, Nicole J Piscopo, Yasemin Kutes, Varun Vyas, Bryan D Huey, Yusuf Khan
Low-intensity pulsed ultrasound (LIPUS) has been shown to be effective for orthopaedic fracture repair and non-union defects but the specific mechanism behind its efficacy is still unknown. Previously we have shown a measurable acoustic radiation force at LIPUS intensities traditionally used for clinical treatment and have applied this force to osteoblastic cells encapsulated in type I collagen hydrogels. Our goal here is to provide insight and inform the appropriate design of a cell therapy approach to bone repair in which osteoblasts are embedded in collagen hydrogels, implanted into a bony defect, and then transdermally stimulated using LIPUS-derived acoustic radiation force to enhance bone formation at the earliest time points after bone defect repair...
June 13, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28608421/polydopamine-mediated-assembly-of-hydroxyapatite-nanoparticles-and-bone-morphogenetic-protein-2-on-magnesium-alloys-for-enhanced-corrosion-resistance-and-bone-regeneration
#15
Yanan Jiang, Bi Wang, Zhanrong Jia, Xiong Lu, Liming Fang, Kefeng Wang, Fuzeng Ren
Magnesium alloys have the great potential to be used as orthopaedic implants due to their biodegradability and mechanical resemblance to human cortical bone. However, the rapid degradation in physiological environment with the evolution of hydrogen gas release hinders their clinical applications. In this study, we developed a novel functional and biocompatible coating strategy through polydopamine mediated assembly of hydroxyapatite nanoparticles and growth factor, bone morphogenetic protein-2 (BMP-2), onto the surface of AZ31 Mg alloys...
June 12, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28601703/controlled-and-sustained-delivery-of-sirna-nps-from-hydrogels-expedites-bone-fracture-healing
#16
Yuchen Wang, Dominic W Malcolm, Danielle S W Benoit
Despite great potential, delivery remains as the most significant barrier to the widespread use of siRNA therapeutics. siRNA has delivery limitations due to susceptibility to RNase degradation, low cellular uptake, and poor tissue-specific localization. Here, we report the development of a hybrid nanoparticle (NP)/hydrogel system that overcomes these challenges. Hydrogels provide localized and sustained delivery via controlled release of entrapped siRNA/NP complexes while NPs protect and enable efficient cytosolic accumulation of siRNA...
September 2017: Biomaterials
https://www.readbyqxmd.com/read/28599578/antimicrobial-and-bone-forming-activity-of-a-copper-coated-implant-in-a-rabbit-model
#17
Cornelia Prinz, Mohamed Elhensheri, Joachim Rychly, Hans-Georg Neumann
Current strategies in implant technology are directed to generate bioactive implants that are capable to activate the regenerative potential of the surrounding tissue. On the other hand, implant-related infections are a common problem in orthopaedic trauma patients. To meet both challenges, i.e. to generate a bone implant with regenerative and antimicrobial characteristics, we tested the use of copper coated nails for surgical fixation in a rabbit model. Copper acetate was galvanically deposited with a copper load of 1 µg/mm(2) onto a porous oxide layer of Ti6Al4V nails, which were used for the fixation of a tibia fracture, inoculated with bacteria...
January 1, 2017: Journal of Biomaterials Applications
https://www.readbyqxmd.com/read/28594487/current-management-of-talar-fractures
#18
Matthew P Sullivan, Reza Firoozabadi
Talar fractures are some of the most challenging injuries that orthopaedic traumatologists manage. The current knowledge of functional alterations with regard to malreduction of talar fractures is well established. Decision making with regard to timing, approach, and implant selection as well as strategies to help achieve accurate restoration of talar anatomy substantially affect outcomes and must be carefully considered. Perfect anatomic talar reconstruction should always be attempted, and orthopaedic surgeons should have a strong working knowledge of the vascular, three-dimensional, and radiographic anatomy of the talus before performing talar surgery...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28592078/-treatment-of-single-one-stage-posterior-atlantoaxial-fixation-in-chiari-malformation
#19
L N Lu, R Zong, X B Xu, X G Yu, G Y Qiao
Objective: To explore the effects of surgical technique of single one-stage posterior C(1-2) screw rod fixation of Chiari malformation (CM) associated with occipitalization and without atlantoaxial dislocation. Methods: A total of 23 patients with CM treated between January 2014 and October 2015 in Department of Neurosurgery of Chinese People's Liberation Army General Hospital were retrospective reviewed. All of them were diagnosis with CM associated with occipitalization and without atlantoaxial dislocation, including 8 males and 15 females, aging from 11 to 57 years (mean (35...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28592075/-influence-of-tibial-component-slope-on-short-term-clinical-outcome-for-oxford-unicompartmental-knee-arthroplasty
#20
L Y Ma, W S Guo, Q D Zhang
Objective: To investigate the effects of tibial component slope change after microplasty (MP) Oxford unicompartmental knee arthroplasty (UKA) on short-term clinical outcome. Methods: A total of 116 patients(128 UKAs)underwent UKA in Department of Orthopaedic Surgery of China-Japan Friendship Hospital between January 2014 and December 2015 were retrospectively reviewed. Totally 100 patients (108 UKAs) were finally included in the study. There were 31 males and 69 females, aging from 47 to 90 years (mean 67.2 years)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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