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https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#1
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28614352/a-novel-iterative-mixed-model-to-remap-three-complex-orthopedic-traits-in-dogs
#2
Meng Huang, Jessica J Hayward, Elizabeth Corey, Susan J Garrison, Gabriela R Wagner, Ursula Krotscheck, Kei Hayashi, Peter A Schweitzer, George Lust, Adam R Boyko, Rory J Todhunter
Hip dysplasia (HD), elbow dysplasia (ED), and rupture of the cranial (anterior) cruciate ligament (RCCL) are the most common complex orthopedic traits of dogs and all result in debilitating osteoarthritis. We reanalyzed previously reported data: the Norberg angle (a quantitative measure of HD) in 921 dogs, ED in 113 cases and 633 controls, and RCCL in 271 cases and 399 controls and their genotypes at ~185,000 single nucleotide polymorphisms. A novel fixed and random model with a circulating probability unification (FarmCPU) function, with marker-based principal components and a kinship matrix to correct for population stratification, was used...
2017: PloS One
https://www.readbyqxmd.com/read/28607938/biomechanical-head-to-head-comparison-of-2-sutures-and-the-giftbox-versus-bunnell-techniques-for-midsubstance-achilles-tendon-ruptures
#3
Rufus O Van Dyke, Sejul A Chaudhary, Gregory Gould, Roman Trimba, Richard T Laughlin
BACKGROUND: Acute midsubstance Achilles tendon ruptures are a common orthopaedic problem for which the optimal repair technique and suture type remain controversial. Head-to-head comparisons of current fixation constructs are needed to establish which stitch/suture combination is most biomechanically favorable. HYPOTHESIS: Of the tested fixation constructs, Giftbox repairs with Fiberwire will exhibit superior stiffness and strength during biomechanical testing. STUDY DESIGN: Controlled laboratory study...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28600218/systematic-review-of-patient-specific-surgical-simulation-toward-advancing-medical-education-%C3%A2
#4
Won Hyung A Ryu, Navjit Dharampal, Ahmed E Mostafa, Ehud Sharlin, Gail Kopp, William Bradley Jacobs, Robin John Hurlbert, Sonny Chan, Garnette R Sutherland
OBJECTIVE: Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training...
June 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28588107/staffs-and-managers-perceptions-of-how-and-when-discrete-event-simulation-modelling-can-be-used-as-a-decision-support-in-quality-improvement-a-focus-group-discussion-study-at-two-hospital-settings-in-sweden
#5
Helena Hvitfeldt-Forsberg, Pamela Mazzocato, Daniel Glaser, Christina Keller, Maria Unbeck
OBJECTIVE: To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. DESIGN: Two focus group discussions were performed. SETTING: Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. PARTICIPANTS: Healthcare staff and managers (n=13) from the two settings. INTERVENTIONS: Two workshops were performed, one at each setting...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28573966/learning-navigation-learning-with-navigation-a-review
#6
Jean-Yves Jenny, Frederic Picard
The goal of this review paper is to retrieve from the existing literature relevant information (1) about the learning curve of the currently existing navigation systems and (2) about the use of navigation system for teaching orthopaedic procedures. All studies reporting on the learning curve of navigation systems support the hypothesis that computer-navigated total knee arthroplasty (TKA) involves only a short learning curve and that beginners can obtain good results from the beginning of their experience, as navigation provides continuous feedback during all phases of the knee replacement surgery and allows for correcting any bone cut errors...
2017: SICOT-J
https://www.readbyqxmd.com/read/28552412/connecting-the-wrist-to-the-hand-a-simulation-study-exploring-changes-in-thumb-tip-endpoint-force-following-wrist-surgery
#7
Jennifer A Nichols, Michael S Bednar, Sarah J Wohlman, Wendy M Murray
The wrist is essential for hand function. Yet, due to the complexity of the wrist and hand, studies often examine their biomechanical features in isolation. This approach is insufficient for understanding links between orthopaedic surgery at the wrist and concomitant functional impairments at the hand. We hypothesize that clinical reports of reduced force production by the hand following wrist surgeries can be explained by the surgically-induced, biomechanical changes to the system, even when those changes are isolated to the wrist...
June 14, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28532092/cytocompatibility-studies-of-titania-doped-calcium-borosilicate-bioactive-glasses-in-vitro
#8
Rajkumar Samudrala, Abdul Azeem P, Vasudevarao Penugurti, Bramanandam Manavathi
The present study aims to elucidate the applications of Titania (TiO2) doped calcium borosilicate glass as a biocompatible material in regenerative orthopedic applications. In this context, we have examined the bioactivity of various concentrations of TiO2 doped glasses with the help of simulated body fluid (SBF). Cytocompatibility, cell proliferation, and protein expression studies revealed the potential candidature of TiO2 doped glasses on osteoblast cell lines (MG-63). We hypothesized that TiO2 doped calcium borosilicate glasses are most cytocompatible material for bone implants...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28523072/delayed-endothelial-progenitor-cell-therapy-promotes-bone-defect-repair-in-a-clinically-relevant-rat-model
#9
Brent D Bates, Charles Godbout, David J Ramnaraign, Emil H Schemitsch, Aaron Nauth
The repair of segmental bone defects remains a significant challenge for orthopaedic surgeons. Endothelial progenitor cells (EPCs) have successfully promoted the repair of acute defects in animal models; however, the ability of EPCs to induce the repair of chronic nonhealing defects, such as those often encountered clinically, has not been investigated. Therefore, the purpose of this study was to investigate the ability of EPCs delivered in delayed fashion to induce the repair of nonhealing defects in a clinically relevant model...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28521380/-clinical-practical-examination-in-orthopaedic-teaching-who-is-the-ideal-examiner
#10
Peter Melcher, Andreas Roth, Mohamed Ghanem, Daisy Rotzoll
Background Medical curricula require an increasing amount of integrated clinical practical skills education. German medical faculties are increasingly implementing the OSCE (objective structured clinical examination) to test students' practical as well as communication skills. Teaching and assessment tools for practical skills include simulators and simulated patient scenarios, where peer-assisted teaching (PAT) is applied. Trained student tutors support this process. This study examines for the first time the use of PAT student tutors as examiners in an orthopaedic OSCE unit and the existence of possible differences in rating between faculty and PAT student tutors...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28507421/orthopaedic-tumors-what-problems-are-we-solving-and-are-universities-and-major-medical-centers-doing-enough
#11
Mohamed Mediouni, Daniel R Schlatterer
Little has been published about the complexity of orthopaedic tumors compared to others tumors. The current study in the literature treated this problem in terms of classification, surgical intervention and impact on the patient. In this article, factors risks of tumors will be we identified. A strategy based on three dimensional simulations will be explained in order to improve the clinical trials.
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28504931/robust-real-time-musculoskeletal-modeling-driven-by-electromyograms
#12
Guillaume Durandau, Dario Farina, Massimo Sartori
OBJECTIVE: Current clinical biomechanics involves lengthy data acquisition and time-consuming offline analyses and current biomechanical models cannot be used for real-time control in man-machine interfaces. We developed a method that enables online analysis of neuromusculoskeletal function in vivo in the intact human. METHODS: We used electromyography (EMG)-driven musculoskeletal modeling to simulate all transformations from muscle excitation onset (EMGs) to mechanical moment production around multiple lower-limb degrees of freedom (DOFs)...
May 12, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28503805/development-of-a-siyalon-glaze-for-improved-osteoconductivity-of-implantable-medical-devices
#13
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/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/28497097/a-randomized-controlled-pilot-study-of-educational-techniques-in-teaching-basic-arthroscopic-skills-in-a-low-income-country
#15
Abhiram R Bhashyam, Catherine Logan, Heather J Roberts, Rameez A Qudsi, Jacky Fils, George S M Dyer
BACKGROUND: Little is known about how to introduce complex technologies like arthroscopy into low-income countries. Thus, we compared low- versus high-resource intensive methods of teaching basic arthroscopic skills in a randomized controlled trial in Haiti. METHODS: Forty-eight Haitian orthopaedic surgeons and residents attending an orthopaedic conference in Haiti were block randomized to receive instruction through a composite video (Control) or a composite video plus hands-on teaching with an expert visiting surgeon (Intervention)...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28481956/tibial-revision-knee-arthroplasty-with-metaphyseal-sleeves-the-effect-of-stems-on-implant-fixation-and-bone-flexibility
#16
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/28475021/individualized-3d-printed-model-assisted-posterior-screw-fixation-for-the-treatment-of-craniovertebral-junction-abnormality-a-retrospective-study
#17
Fangyou Gao, Qu Wang, Chuangxi Liu, Bing Xiong, Tao Luo
OBJECTIVE This study was undertaken to evaluate the feasibility and efficacy of individualized 3D printed model-assisted posterior internal fixation in treating craniovertebral junction (CVJ) abnormalities. METHODS Forty-four patients (19 males and 25 females; mean age 36.5 ± 9.2 years, range 11-62 years; symptom duration 1 month-15 years) with a CVJ abnormality who were admitted to the authors' institution between April 2010 and April 2015 were retrospectively studied. The individualized 3D printed model of the CVJ was produced based on the individual CT data by use of 3D printing technology...
May 5, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28474057/-biomechanical-effect-of-2-anchorages-on-maxillary-protraction-with-cleft-lip-and-palate-a-finite-element-analysis
#18
Han Han, Ya-Fen Xu, Yu-Feng Duan, Yong-Hua Lei
PURPOSE: To establish cranio-maxillary complex finite element models (FEMs) in cleft lip and palate (CLP) patients with miniplate and tooth-borne anchorage, and to investigate the biomechanical effects on maxillary protraction. METHODS: The protracting process was simulated on FEMs established from a male patient's cone beam CT (CBCT) data to analyze the displacement and stress from different appliances. RESULTS: Four FEMs of unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) patients' cranio-maxillary complex with MA and TA were established...
February 2017: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/28473955/orthopaedic-education-in-the-era-of-surgical-simulation-still-at-the-crawling-stage
#19
EDITORIAL
Kivanc Atesok, Peter MacDonald, Jeff Leiter, James Dubberley, Richard Satava, Ann VanHeest, Shepard Hurwitz, J Lawrence Marsh
Surgical skills education is in the process of a crucial transformation from a master-apprenticeship model to simulation-based training. Orthopaedic surgery is one of the surgical specialties where simulation-based skills training needs to be integrated into the curriculum efficiently and urgently. The reason for this strong and pressing need is that orthopaedic surgery covers broad human anatomy and pathologies and requires learning enormously diverse surgical procedures including basic and advanced skills...
April 18, 2017: World Journal of Orthopedics
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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