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https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#1
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28074257/outcomes-of-dual-mobility-cups-in-a-young-middle-eastern-population-and-its-influence-on-life-style
#2
Chahine Assi, Elie El-Najjar, Camille Samaha, Kaissar Yammine
Dual mobility cups (DMC) in total hip arthroplasty (THA) are becoming popular among orthopaedic surgeons. Substantial benefit of their use has been reported among high risk patients, particularly in reducing post-operative hip instability (dislocation). Many reports stated some concern when implanted in young and active people where complications such as polyethylene wear and mechanical loosening could potentially be higher. This Middle Eastern study analyses a retrospective series of THA for any aetiology other than infection, using DMC for the acetabular component in 75 patients (85 implants) less than 70 years old...
January 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28072649/is-early-definitive-fixation-of-bicondylar-tibial-plateau-fractures-safe-an-observational-cohort-study
#3
Florence Unno, Kelly A Lefaivre, Georg Osterhoff, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Peter O'Brien
OBJECTIVES: The optimal treatment protocol for bicondylar plateau fractures remains controversial. Contrary to popular practice which favors a staged protocol in many high-energy fracture patterns, we have used early single-stage open reduction and internal fixation (ORIF) to treat these injuries whenever possible. The purpose of this study was to determine the complication rate as well as the functional and radiographic outcomes of this strategy. DESIGN: Retrospective Cohort study and prospective data collection...
December 28, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#4
Samo K Fokter, Andrej Moličnik, Rajko Kavalar, Primož Pelicon, Rebeka Rudolf, Nenad Gubeljak
BACKGROUND: Increased modularity in total hip arthroplasty (THA) through extra junction between the neck and the femoral stem is gaining popularity among orthopaedic community. However, the advantage of the additional junction is shadowed by an increased risk of mechanical failure. The aim of this study was to describe the exact mechanism of fracture of the modular femoral neck in an uncemented stem. METHODS: Clinical, metallurgical, and mechanical analysis including finite-element modelling and elemental-sensitive tissue analysis with the micro-PIXE method was performed on two patients treated with fully modular primary THA made from Titanium alloy of the same oval taper-cone design...
December 27, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28050814/what-orthopaedic-operating-room-surfaces-are-contaminated-with-bioburden-a-study-using-the-atp-bioluminescence-assay
#5
Raveesh Daniel Richard, Thomas R Bowen
BACKGROUND: Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050809/the-treatment-of-olecranon-fractures-in-adults
#6
REVIEW
A J Powell, O M Farhan-Alanie, J K Bryceland, T Nunn
Olecranon fractures are common. They are usually managed surgically with open reduction and either tension band wiring or plate fixation. Currently, there are few studies comparing fracture treatments. We aim to review the available literature to guide the orthopaedic surgeon on the management of these fractures. A literature review of peer-reviewed publications in international orthopaedic journals detailing olecranon fracture treatment was conducted. An additional focus was placed on the evidence base for and surgical outcomes of tension band wiring for common two-part fractures...
January 3, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28050640/is-the-humeral-stem-useful-in-anatomic-total-shoulder-arthroplasty
#7
Philippe Collin, Tetsu Matsukawa, Pascal Boileau, Ulrich Brunner, Gilles Walch
PURPOSE: Traditionally and since Neer, the humeral side of shoulder arthroplasty consisted of a stemmed component but the real need for stem fixation in total shoulder arthroplasty (TSA) has barely been investigated. The current study evaluated the clinical and radiological outcomes with a stemless TSA. METHODS: Forty-seven patients, 20 female and 27 male patients with an average age of 63, were selected in four orthopaedic centres during a four year period, and implanted with a humeral head prosthesis with a three-fin design and titanium coating...
January 3, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28050455/outcomes-of-short-segment-posterior-instrumentation-in-unstable-thoracolumbar-fractures
#8
Sharvil H Gajjar, Hari J Menon, Nitin Chaudhari, Vipul Chaudhari
INTRODUCTION: The spinal traumas are common and leading problem in orthopaedics practice. The individuals are at a risk of high energy trauma in modern era. Unstable thoracolumbar burst fractures are serious injuries of concern, if left untreated may result in marked morbidity and disability to the patient. Thoracolumbar is the second most common segment involved in the spinal cord following spinal injuries followed by cervical segment. The goal of treatment of any spinal injury is restoration of the patient to maximum possible function with disability free life...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043850/allergies-in-orthopaedic-and-trauma-surgery
#9
REVIEW
C H Lohmann, R Hameister, G Singh
Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28042119/periprosthetic-femoral-fractures-and-trying-to-avoid-them-what-is-the-contribution-of-femoral-component-design-to-the-increased-risk-of-periprosthetic-femoral-fracture
#10
A V Carli, J J Negus, F S Haddad
AIMS: Periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) are devastating complications that are associated with functional limitations and increased overall mortality. Although cementless implants have been associated with an increased risk of PFF, the precise contribution of implant geometry and design on the risk of both intra-operative and post-operative PFF remains poorly investigated. A systematic review was performed to aggregate all of the PFF literature with specific attention to the femoral implant used...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28042111/joint-registries-what-can-we-learn-in-2016
#11
D J Berry
AIMS: To demonstrate, with concrete examples, the value of in-depth exploration and comparison of data published in National Joint Arthroplasty registry reports. PATIENTS AND METHODS: The author reviewed published current reports of National Joint Arthroplasty registries for findings of current significance to current orthopaedic practice. RESULTS: A total of six observations that demonstrate actionable or unexpected findings from joint registries are described...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#12
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28032697/patient-specific-orthopaedic-implants
#13
REVIEW
Jack M Haglin, Adam E M Eltorai, Joseph A Gil, Stephen E Marcaccio, Juliana Botero-Hincapie, Alan H Daniels
Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28032030/lessons-learned-from-study-of-congenital-hip-disease-in-adults
#14
REVIEW
George Hartofilakidis, Kalliopi Lampropoulou-Adamidou
Orthopaedic surgeons specialising in adult hip reconstruction surgery often face the problem of osteoarthritis secondary to congenital hip disease (CHD). To achieve better communication among physicians, better treatment planning and evaluation of the results of various treatment options, an agreed terminology is needed to describe the entire pathology. Furthermore, a generally accepted classification of the deformities is necessary. Herein, the authors propose the use of the term "congenital hip disease" and its classification as dysplasia, low dislocation and high dislocation...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28028406/midshaft-clavicular-fractures-osteosynthesis-with-minimally-invasive-technique
#15
Tabet A Al-Sadek, Desislav Niklev, Ahmed Al-Sadek
BACKGROUND: Fractures of the clavicle are one of the most common fractures in modern orthopaedics and traumatology practice. Knowing the mechanism of trauma, and it's pathophysiological elements, it's clear distinction and it's individual features are essential to the development of more new and effective methods for their treatment, and the minimising of postoperative complications. AIM: The aim of this paper was to present the results of our patients treated with minimally invasive plate osteosynthesis (MIPO)...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28012049/complications-during-removal-of-conventional-versus-locked-compression-plates-is-there-a-difference
#16
Hanjo Neumann, Anne Stadler, Hinrich Heuer, Marc Auerswald, Justus Gille, Arndt Peter Schulz, Benjamin Kienast
BACKGROUND: Osteosynthesis plate removal is one of the most commonly performed procedures in orthopaedic surgery. Due to technological advances and the quality of increasing osteosynthesis material, more and more locked plates have been implanted over the last 20 years. The aim of this study was to determine whether the complication rate during plate removal differs between conventional and locked plates. MATERIAL AND METHODS: In this retrospective cohort study, 620 patients were included and divided into two groups based on the type of plate (locked and conventional)...
December 24, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/28007224/efficacy-of-surgical-safety-checklist-assessing-orthopaedic-surgical-implant-readiness
#17
Benjamin G Thomasson, David Fuller, John Mansour, Robert Marburger, Erin Pukenas
INTRODUCTION: Our institution employs a Surgical Universal Protocol Preoperative Checklist in accordance with World Health Organization guidelines to promote patient safety. It is used in part to evaluate orthopaedic surgical equipment and implant readiness prior to the initiation of each surgical case. Our goal is to measure the preoperative checklist's efficacy in assessing orthopaedic equipment readiness preoperatively and its ability to prevent orthopaedic equipment failures (OEF)...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28005292/early-results-using-a-biodegradable-magnesium-screw-for-modified-chevron-osteotomies
#18
Christian Plaass, Sarah Ettinger, Lena Sonnow, Soeren Koenneker, Yvonne Noll, Andreas Weizbauer, Janin Reifenrath, Leif Claassen, Kiriakos Daniilidis, Christina Stukenborg-Colsman, Henning Windhagen
This is the first larger study analyzing the use of magnesium-based screws for fixation of modified Chevron osteotomies in hallux valgus surgery. Forty-four patients (45 feet) were included in this prospective study. A modified Chevron osteotomy was performed on every patient and a magnesium screw used for fixation. The mean clinical follow up was 21.4 weeks. The mean age of the patients was 45.5 years. Forty patients could be provided with the implant, in four patients the surgeon decided to change to a standard metallic implant...
December 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28001358/additively-manufactured-and-surface-biofunctionalized-porous-nitinol
#19
Z Gorgin Karaji, M Speirs, S Dadbakhsh, J-P Kruth, H Weinans, A A Zadpoor, S Amin Yavari
Enhanced bone tissue regeneration and improved osseointegration are among the most important goals in design of multifunctional orthopedic biomaterials. In this study, we used additive manufacturing (selective laser melting) to develop multifunctional porous nitinol that combines superelasticity with a rationally designed microarchitecture and biofunctionalized surface. The rational design based on triply periodic minimal surfaces aimed to properly adjust the pore size, increase the surface area (thereby amplifying the effects of surface biofunctionalization), and resemble the curvature characteristics of trabecular bone...
January 5, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28000413/bacteriostatic-behavior-of-surface-modulated-silicon-nitride-in-comparison-to-polyetheretherketone-and-titanium
#20
Ryan M Bock, Erin N Jones, Darin A Ray, B Sonny Bal, Giuseppe Pezzotti, Bryan J McEntire
Perioperative and latent infections are leading causes of revision surgery for orthopaedic devices resulting in significant increased patient care, comorbidities, and attendant costs. Identifying biomaterial surfaces that inherently resist biofilm adhesion and bacterial expression is an important emerging strategy in addressing implant-related infections. This in vitro study was designed to compare biofilm formation on three biomaterials commonly employed in spinal fusion surgery - silicon nitride (Si3 N4 ), polyetheretherketone (PEEK), and a titanium alloy (Ti6Al4V-ELI) - using one gram-positive and one gram-negative bacterial species...
December 21, 2016: Journal of Biomedical Materials Research. Part A
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