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Orthopaedic implant

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https://www.readbyqxmd.com/read/28549406/supramalleolar-osteotomy-for-tibial-component-malposition-in-total-ankle-replacement
#1
Manja Deforth, Nicola Krähenbühl, Lukas Zwicky, Markus Knupp, Beat Hintermann
BACKGROUND: Persistent pain despite a total ankle replacement is not uncommon. A main source of pain may be an insufficiently balanced ankle. An alternative to the revision of the existing arthroplasty is the use of a corrective osteotomy of the distal tibia, above the stable implant. This strictly extraarticular procedure preserves the integrity of the replaced joint. The aim of this study was to review a series of patients in whom a corrective supramalleolar osteotomy was performed to realign a varus misaligned tibial component in total ankle replacement...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28543599/optimization-of-screw-fixation-in-rat-bone-with-extracorporeal-shock-waves
#2
Marianne K E Koolen, Moyo C Kruyt, Amir A Zadpoor, F C Öner, Harrie Weinans, Olav P van der Jagt
Screw fixation in osteoporotic patients is becoming an increasing problem in orthopaedic surgery as deterioration of cortical and cancellous bone hamper biomechanical stability and screw fixation. This might result in delayed weight-bearing or failure of instrumentation. We hypothesized that local peri-operative shock wave treatment can optimize osseointegration and subsequent screw fixation. In eight female Wistar rats, two cancellous and two cortical bone screws were implanted in both femora and tibiae. Immediately after implantation, 3...
May 24, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28537539/-metal-on-metal-hip-implant-continues-to-be-a-source-of-concern
#3
J A N Verhaar, T Gosens
It has recently been suggested that patients with metal-on-metal (MOM) hip implants have an increased chance of mortality. These observations come from a meta-analysis including many small randomised controlled trials (RCTs) and cohort studies. Because of the high risk of bias there is no reason for great concern. In the Netherlands, the Dutch Orthopaedic Association (NOV) advised against the use of MOM implants in 2012, and that all patients with MOM implants should be followed up every year. There are good arguments to continue this policy because of the high risk of revision associated with MOM implants and the potential toxic effects of metal ions...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28529866/which-orthopaedic-patients-are-infected-with-gram-negative-non-fermenting-rods
#4
Omid Jamei, Shpresa Gjoni, Besa Zenelaj, Benjamin Kressmann, Wilson Belaieff, Didier Hannouche, Ilker Uçkay
Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Results: Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to Pseudomonas aeruginosa...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529865/hyaluronic-acid-and-its-composites-as-a-local-antimicrobial-antiadhesive-barrier
#5
REVIEW
C L Romanò, E De Vecchi, M Bortolin, I Morelli, L Drago
Living in biofilms is probably the most common condition for bacteria and fungi and biofilm-related infections account for the majority of bacterial infectious diseases worldwide. Among others biofilm-related infections, those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma, cardio-surgery and several other surgical disciplines. Given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms, new strategies are needed to protect implants and host tissues, overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28525489/minimum-5-year-follow-up-results-for-occipitocervical-fusion-using-the-screw-rod-system-in-craniocervical-instability
#6
Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Hideki Yagi, Ryuichi Shinjo, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the clinical outcome of patients who had undergone occipitocervical (OC) fusion using pedicle screws and rods over a minimum 5-year follow-up. SUMMARY OF BACKGROUND DATA: Few studies have evaluated occipitocervical (OC) fusion using pedicle screws and rods for long-term follow-up. METHODS: Twenty-seven consecutive patients treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28522447/photofunctionalised-ti6al4v-implants-enhance-early-phase-osseointegration
#7
R Yamauchi, T Itabashi, K Wada, T Tanaka, G Kumagai, Y Ishibashi
OBJECTIVES: Ultraviolet (UV) light-mediated photofunctionalisation is known to improve osseointegration of pure titanium (Ti). However, histological examination of titanium alloy (Ti6Al4V), which is frequently applied in orthopaedic and dental surgery, has not yet been performed. This study examined the osseointegration of photofunctionalised Ti6Al4V implants. METHODS: Ti and Ti6Al4V implants were treated with UV light, and the chemical composition and contact angle on the surfaces were evaluated to confirm photofunctionalisation...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28522446/non-contact-electromagnetic-induction-heating-for-eradicating-bacteria-and-yeasts-on-biomaterials-and-possible-relevance-to-orthopaedic-implant-infections-in-vitro-findings
#8
B G Pijls, I M J G Sanders, E J Kuijper, R G H H Nelissen
OBJECTIVES: Infection of implants is a major problem in elective and trauma surgery. Heating is an effective way to reduce the bacterial load in food preparation, and studies on hyperthermia treatment for cancer have shown that it is possible to heat metal objects with pulsed electromagnetic fields selectively (PEMF), also known as induction heating. We therefore set out to answer the following research question: is non-contact induction heating of metallic implants effective in reducing bacterial load in vitro? METHODS: Titanium alloy cylinders (Ti6Al4V) were exposed to PEMF from an induction heater with maximum 2000 watts at 27 kHz after being contaminated with five different types of micro-organisms: Staphylococcus epidermidis; Staphylococcus aureus; Pseudomonas aeruginosa; spore-forming Bacillus cereus; and yeast Candida albicans...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28522445/evaluation-of-bacterial-adherence-of-clinical-isolates-of-staphylococcus-sp-using-a-competitive-model-an-in-vitro-approach-to-the-race-for-the-surface-theory
#9
M Martinez-Perez, C Perez-Jorge, D Lozano, S Portal-Nuñez, R Perez-Tanoira, A Conde, M A Arenas, J M Hernandez-Lopez, J J de Damborenea, E Gomez-Barrena, P Esbrit, J Esteban
OBJECTIVES: Implant-related infection is one of the most devastating complications in orthopaedic surgery. Many surface and/or material modifications have been developed in order to minimise this problem; however, most of the in vitro studies did not evaluate bacterial adhesion in the presence of eukaryotic cells, as stated by the 'race for the surface' theory. Moreover, the adherence of numerous clinical strains with different initial concentrations has not been studied. METHODS: We describe a method for the study of bacterial adherence in the presence of preosteoblastic cells...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28521381/-time-in-the-or-outcome-and-surgeons-experience-the-use-of-patient-matched-instruments-in-arthroplasty-of-the-knee
#10
Christoph Schulze, Cem Kai Inan, Claudia Hacke, Alexander Kaltenborn, André Gutcke
Background Arthrosis of the knee is a common problem in Germany that is often treated with arthroplasty. To support the orthopaedic surgeon, person-matched instruments (PMI) are available from several providers. In this study we investigated the clinical and radiological outcome of the use of the PMI Visionaire(™) (Smith&Nephew). Furthermore, we investigated the influence of operative experience of the orthopaedic surgeon on the clinical and radiological results. Time in the operating room (OR) was identified as a parameter for cost effectiveness even during training to become an orthopaedic surgeon...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28508765/a-comparison-of-outcomes-of-treatment-with-resection-prosthesis-of-the-hip-in-revision-and-oncological-surgery
#11
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Jerzy Mirosław Jaworski, Bogusław Frańczuk
INTRODUCTION: The introduction of resection prostheses paved the way for the development of limb-sparing surgery in patients with primary or metastatic bone tumours. After some time, the developing possibilities of treatment of extensive bone defects allowed for the use of resection prostheses as an emergency procedure in patients undergoing revision surgery due to hip implant loosening. The aim of this paper is to compare treatment outcomes in patients receiving the Modular Universal Tumour and Revision System (MUTARS) resection prosthesis during arthroplasty performed for different indications: treatment of a tumour metastasis and revision surgery in cases of implant loosening...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28503805/development-of-a-siyalon-glaze-for-improved-osteoconductivity-of-implantable-medical-devices
#12
Ryan M Bock, Elia Marin, Alfredo Rondinella, Francesco Boschetto, Tetsuya Adachi, Bryan J McEntire, B Sonny Bal, Giuseppe Pezzotti
The application of bioactive coatings onto orthopaedic appliances is commonly performed to compensate for the otherwise bioinert nature of medical devices and to improve their osseointegration. Calcium phosphates, hydroxyapatite (HAp), and bioglasses are commercially available for this purpose. Until recently, few other inorganic compounds have been identified with similar biofunctionality. However, silicon nitride (Si3 N4 ) has emerged as a new orthopaedic material whose unique surface chemistry also enhances osteoconductivity...
May 15, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28502707/surgical-innovation-in-sarcoma-surgery
#13
L Jeys, G Morris, S Evans, J Stevenson, M Parry, J Gregory
The field of orthopaedic oncology relies on innovative techniques to resect and reconstruct a bone or soft tissue tumour. This article reviews some of the most recent and important innovations in the field, including biological and implant reconstructions, together with computer-assisted surgery. It also looks at innovations in other fields of oncology to assess the impact and change that has been required by surgeons; topics including surgical margins, preoperative radiotherapy and future advances are discussed...
May 11, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28502388/the-grapefruit-an-alternative-arthroscopic-tool-skill-platform
#14
David A Molho, Stephen M Sylvia, Daniel L Schwartz, Sara L Merwin, I Martin Levy
PURPOSE: To establish the construct validity of an arthroscopic training model that teaches arthroscopic tool skills including triangulation, grasping, precision biting, implant delivery and ambidexterity and uses a whole grapefruit for its training platform. METHODS: For the grapefruit training model (GTM), an arthroscope and arthroscopic instruments were introduced through portals cut in the grapefruit skin of a whole prepared grapefruit. After institutional review board approval, participants performed a set of tasks inside the grapefruit...
May 11, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28500496/patient-specific-instrumentation-improves-alignment-of-lateral-unicompartmental-knee-replacements-by-novice-surgeons
#15
Chin Ting Justin Ng, Simon Newman, Simon Harris, Susannah Clarke, Justin Cobb
PURPOSE: Patient-specific instrumentation (PSI) has the potential to offer numerous benefits-not least of all, improved resection accuracy; but its potential has not been realised in clinical studies. An explanation may be the focus of such studies on the total knee replacement (TKR-a common procedure, with which surgeons are generally very familiar. Consequently, we sought to investigate the potential role of PSI in guiding novice surgeons to perform the more technically demanding and less familiar lateral unicondylar knee replacement (LUKR)...
May 13, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#16
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28483964/towards-elimination-of-pin-tract-infections-novel-antibacterial-coating-on-orthopaedic-wires
#17
Dmitry Gil, Sergey Shuvaev, Anastasia Frank-Kamenetskii, Vladimir Reukov, Christopher Gross, Alexey Vertegel
Novel approaches to prevention of microbial infections after insertion of orthopedic external fixators are in great demand because of extremely high incidence rate of such infections, which can reach up to 100% for longer implant residence times. Monolaurin is an antimicrobial agent with known safety record, broadly used in food and cosmetic industries; however, its use in antimicrobial coatings of medical devices has not been studied in much detail. Here, we report the use of monolaurin as an antibacterial coating on external fixators for the first time...
May 8, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28482501/metallic-powder-bed-based-3d-printing-of-cellular-scaffolds-for-orthopaedic-implants-a-state-of-the-art-review-on-manufacturing-topological-design-mechanical-properties-and-biocompatibility
#18
REVIEW
X P Tan, Y J Tan, C S L Chow, S B Tor, W Y Yeong
Metallic cellular scaffold is one of the best choices for orthopaedic implants as a replacement of human body parts, which could improve life quality and increase longevity for the people needed. Unlike conventional methods of making cellular scaffolds, three-dimensional (3D) printing or additive manufacturing opens up new possibilities to fabricate those customisable intricate designs with highly interconnected pores. In the past decade, metallic powder-bed based 3D printing methods emerged and the techniques are becoming increasingly mature recently, where selective laser melting (SLM) and selective electron beam melting (SEBM) are the two representatives...
July 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28481956/tibial-revision-knee-arthroplasty-with-metaphyseal-sleeves-the-effect-of-stems-on-implant-fixation-and-bone-flexibility
#19
Jan Nadorf, Stefan Kinkel, Simone Gantz, Eike Jakubowitz, J Philippe Kretzer
INTRODUCTION: Revision total knee arthoplasty often requires modular implants to treat bone defects of varying severity. In some cases, it may not be clear which module size and implant combination (e.g. sleeve and stem) should be chosen for a specific defect. When balancing implant stability and osseointegration against stress-shielding, it is important to choose an appropriate implant combination in order to match the given level of bone loss. Therefore, the necessity of stems in less extensive tibial defects and the advantage of different stems (lengths and stiffnesses) in combination with large metaphyseal sleeves on implant fixation and bone flexibility using a modular tibial revision knee system, were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28473698/implantable-strain-sensor-to-monitor-fracture-healing-with-standard-radiography
#20
Hunter Pelham, Donald Benza, Paul W Millhouse, Nathan Carrington, Md Arifuzzaman, Caleb J Behrend, Jeffrey N Anker, John D DesJardins
Current orthopaedic clinical methods do not provide an objective measure of fracture healing or weight bearing for lower extremity fractures. The following report describes a novel approach involving in-situ strain sensors to objectively measure fracture healing. The sensor uses a cantilevered indicator pin that responds to plate bending and an internal scale to demonstrate changes in the pin position on plain film radiographs. The long lever arm amplifies pin movement compared to interfragmentary motion, and the scale enables more accurate measurement of position changes...
May 4, 2017: Scientific Reports
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