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Simulation AND Orthop*

Augusta Whitney Kluk, Tina Zhang, Joseph P Russell, Hyunchul Kim, Adam H Hsieh, Robert V O'Toole
Orthopedic dogma states that external fixator stiffness is improved by placing 1 pin close to the fracture and 1 as distant as possible ("near-far"). This fixator construct is thought to be less expensive than placing pins a shorter distance apart and using "pin-bar" clamps that attach pins to outriggers. The authors therefore hypothesized that the near-far construct is stiffer and less expensive. They compared mechanical stiffness and costs of near-far and pin-bar constructs commonly used for temporary external fixation of femoral shaft fractures...
October 13, 2016: Orthopedics
Piya-On Numpaisal, Benjamin B Rothrauff, Riccardo Gottardi, Chung-Liang Chien, Rocky S Tuan
PURPOSE: Treatment of meniscus tears is a persistent challenge in orthopaedics. Although cell therapies have shown promise in promoting fibrocartilage formation in in vitro and preclinical studies, clinical application has been limited by the paucity of autologous tissue and the need for ex vivo cell expansion. Rapid dissociation of the free edges of the anterior and posterior meniscus with subsequent implantation in a meniscus lesion may overcome these limitations. The purpose of this study was to explore the effect of rapidly dissociated meniscus tissue in enhancing neotissue formation in a radial meniscus tear, as simulated in an in vitro explant model...
October 11, 2016: Connective Tissue Research
Baoqing Pei, Gang Zhu, Yu Wang, Huiting Qiao, Xiangqian Chen, Binbin Wang, Xiaoyun Li, Weijun Zhang, Wenyong Liu, Yubo Fan
BACKGROUND: Spatial positioning is the key function of a surgical navigation robot system, and accuracy is the most important performance index of such a system. METHODS: The kinematic parameters of a six degrees of freedom (DOF) robot arm were used to form the transformation from intraoperative fluoroscopy images to a robot's coordinate system without C-arm calibration and to solve the redundant DOF problem. The influences of three typical error sources and their combination on the final navigation error were investigated through Monte Carlo simulation...
October 9, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Henry B Colaco, Katie Hughes, Eyiyemi Pearse, Magnus Arnander, Duncan Tennent
OBJECTIVE: We have developed a low-cost, portable shoulder simulator designed to train basic arthroscopic skills. This study aimed to establish the construct validity of the simulator by determining which parameters discriminated between experience levels and to assess the experience of using the simulator. DESIGN: Participants were given an introductory presentation and an untimed practice run of a 6-step triangulation task using hooks and rubber bands. A total of 6 consecutive attempts at the task were timed, and the number of times the participant looked at their hands during the task was recorded...
October 5, 2016: Journal of Surgical Education
Jing-Xin Zhao, Xiu-Yun Su, Ruo-Xiu Xiao, Zhe Zhao, Li-Hai Zhang, Li-Cheng Zhang, Pei-Fu Tang
We established a mathematical method to precisely calculate the radiographic anteversion (RA) and radiographic inclination (RI) angles of the acetabular cup based on anterior-posterior (AP) pelvic radiographs after total hip arthroplasty. Using Mathematica software, a mathematical model for an oblique cone was established to simulate how AP pelvic radiographs are obtained and to address the relationship between the two-dimensional and three-dimensional geometry of the opening circle of the cup. In this model, the vertex was the X-ray beam source, and the generatrix was the ellipse in radiographs projected from the opening circle of the acetabular cup...
October 5, 2016: Medical Engineering & Physics
Hesameddin Mahjoubi, Emily Buck, Praveena Manimunda, Reza Farivar, Richard Chromik, Monzur Murshed, Marta Cerruti
: Polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical resistance and radiolucency, making it suitable for use as orthopedic implants. However, its surface is hydrophobic and bioinert, and surface modification is required to improve its bioactivity. In this work, we showed that grafting phosphonate groups via diazonium chemistry enhances the bioactivity of PEEK. Decreased contact angle indicated reduced hydrophobicity as a result of the treatment and X-ray photoelectron spectroscopy (XPS) confirmed the attachment of phosphonate groups to the surface...
October 4, 2016: Acta Biomaterialia
Elham Babaie, Boren Lin, Vijay K Goel, Sarit B Bhaduri
This paper reports for the first time the development of a biodegradable, non-exothermic, self-setting orthopedic cement composition based on amorphous magnesium phosphate (AMP). The occurrence of undesirable exothermic reactions was avoided through using AMP as the solid precursor. The phenomenon of self-setting with optimum rheology is achieved by incorporating a water soluble biocompatible/biodegradable polymer, polyvinyl alcohol (PVA). Additionally, PVA enables a controlled growth of the final phase via a biomimetic process...
October 7, 2016: Biomedical Materials
Adam O'Reilly, Daniel John Kelly
Developing successful tissue engineering strategies requires an understanding of how cells within an implanted scaffold interacts with the host environment. The objective of this study was to use a computational mechanobiological model to explore how the design of a cell laden scaffold influences the spatial formation of cartilage and bone within an osteochondral defect. Tissue differentiation was predicted using a previously developed model in which cell fate depends on the local oxygen tension and the mechanical environment within a damaged joint...
October 6, 2016: Tissue Engineering. Part A
Lane Koenig, Qian Zhang, Matthew S Austin, Berna Demiralp, Thomas K Fehring, Chaoling Feng, Richard C Mather, Jennifer T Nguyen, Asha Saavoss, Bryan D Springer, Adolph J Yates
BACKGROUND: Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery. QUESTIONS/PURPOSES: We asked: (1) What is the expected effect of THA on patients' employment and earnings? (2) How does accounting for these effects influence the cost-effectiveness of THA relative to nonsurgical treatment? METHODS: Taking a societal perspective, we used a Markov model to assess the overall cost-effectiveness of THA compared with nonsurgical treatment...
October 3, 2016: Clinical Orthopaedics and related Research
Ryan Siskey, Lauren Ciccarelli, Melissa K C Lui, Steven M Kurtz
BACKGROUND: Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-on-PEEK bearings) have been previously investigated, but little is known about PEEK-on-ceramic bearings for TDR. QUESTIONS/PURPOSES: (1) What is the tribologic behavior of a PEEK-on-ceramic bearing for cervical TDR under idealized, clean wear test conditions? (2) How does the PEEK-on-ceramic design perform under impingement conditions? (3) How is the PEEK-on-ceramic bearing affected by abrasive wear? (4) Is the particle morphology from PEEK-on-ceramic bearings for TDRs affected by adverse wear scenarios? METHODS: PEEK-on-ceramic cervical TDR bearings were subjected to a 10 million cycle ideal wear test based on ASTM F2423 and ISO 181912-1 using a six-station spine wear simulator (MTS, Eden Prairie, MN, USA) with 5 g/L bovine serum concentration at 23° ± 2° C (ambient temperature)...
November 2016: Clinical Orthopaedics and related Research
Stefanie A Pawelek, Jennifer D Illes, John A Taylor
OBJECTIVE: The purpose of this case report is to describe a case where calcium pyrophosphate dehydrate crystal deposition disease (CPPD) simulated osteoarthritis of the knee. CLINICAL FEATURES: A 78-year-old woman had a 2-week history of severe right knee pain accompanied by mild swelling. The onset was sudden and did not involve a history of trauma or previous injury to the right knee. Inspection and palpation revealed pain along the medial joint line and marked difficulty ambulating...
September 2016: Journal of Chiropractic Medicine
Yaser Shanjani, Yunqing Kang, Livia Zarnescu, Audrey K Ellerbee Bowden, Jeong-Tae Koh, Dai Fei Elmer Ker, Yunzhi Yang
Vascularization of tissue engineering constructs (TECs) in vitro is of critical importance for ensuring effective and satisfactory clinical outcomes upon implantation of TECs. Biomechanical properties of TECs have remarkable influence on the in vitro vascularization of TECs. This work utilized in vitro experiments and finite element analysis to investigate endothelial patterns in hybrid constructs of soft collagen gels and rigid macroporous poly(ε-caprolactone)-β-tricalcium phosphate (PCL-β-TCP) scaffold seeded/embedded with human umbilical vein endothelial cells (HUVECs) for bone tissue engineering applications...
September 4, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Paul J Switaj, Daniel Fuchs, Mohammed Alshouli, Avinash G Patwardhan, Leonard I Voronov, Muturi Muriuki, Robert M Havey, Anish R Kadakia
BACKGROUND: A lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to plating is an intramedullary implant, which allows maintenance of length, alignment, and rotation and which allows for decreased soft tissue dissection. While there has been clinical data suggesting favorable short-term outcomes with these implants, there is no current biomechanical literature investigating this technology in this particular fracture pattern...
2016: Journal of Orthopaedic Surgery and Research
Samuel R Heaton, Zoe Little, Kash Akhtar, Manoj Ramachandran, Joshua Lee
AIM: To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. METHODS: A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients...
August 18, 2016: World Journal of Orthopedics
S Shahbazi, F Moztarzadeh, G Mir Mohamad Sadeghi, Y Jafari
A novel poly propylene fumarate (PPF)-based glue which is reinforced by nanobioactive glass (NBG) particles and promoted by hydroxyethyl methacrylate (HEMA) as crosslinker agent, was developed and investigated for bone-to-bone bonding applications. In-vitro bioactivity, biodegradability, biocompatibility, and bone adhesion were tested and the results have verified that it can be used as bone glue. In an in-vitro condition, the prepared nanocomposite (PPF/HEMA/NBG) showed improved adhesion to wet bone surfaces...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
Chunling Qin, Qingfeng Hu, Yongyan Li, Zhifeng Wang, Weimin Zhao, Dmitri V Louzguine-Luzgin, Akihisa Inoue
We demonstrate, for the first time, that the (Fe0.75B0.15Si0.1)100-xNbx (x=0, 1 and 3at.%) metallic glasses without toxic and allergic elements exhibit excellent apatite-forming ability in simulated body fluids (SBF), which is expected to be a new generation of biomaterials in stents and orthopedic implants. For the alloys without any surface treatment, spherical particles corresponding to octacalcium phosphate are spontaneously nucleated and precipitated throughout the alloy surface after immersion only for 1day, indicating that the present alloys possess an unusual high bioactivity...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
Yan Ma, Haitao Chu, Madhu Mazumdar
The conventional random effects model for meta-analysis of proportions approximates within-study variation using a normal distribution. Due to potential approximation bias, particularly for the estimation of rare events such as some adverse drug reactions, the conventional method is considered inferior to the exact methods based on binomial distributions. In this paper, we compare two existing exact approaches-beta binomial (B-B) and normal-binomial (N-B)-through an extensive simulation study with focus on the case of rare events that are commonly encountered in medical research...
2016: Communications in Statistics: Simulation and Computation
Paul C Ivancic
Synopsis Head and spinal injuries commonly occur during motor vehicle crashes (MVCs). The goal of this clinical commentary is to discuss real-life versus simulated MVCs and to present clinical, biomechanical, and epidemiological evidence of MVC-related injury mechanisms. It will also address how this knowledge may guide and inform the design of injury mitigation devices and assist in clinical decision making. Evidence indicates that there exists no universal injury tolerance applicable to the entire population of the occupants of MVCs...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Ziqiu Wang, Zhijun Xu, Weilong Zhao, Wei Chen, Toshikazu Miyoshi, Nita Sahai
The superior biomechanical properties of bone and dentin are dictated, in part, by the unique plate-like morphology of hydroxyapatite (HAP) nanocrysals within a hierarchically assembled collagen matrix. Understanding the mechanism of crystal growth and thus morphology is important to the rational design of bioinspired apatite nanocrystals for orthopedic and dental applications. Citrate has long been proposed to modulate apatite crystal growth, but major questions exist regarding the HAP-bound citrate conformations and the identities of the interacting functional groups and HAP surface sites...
October 5, 2016: ACS Applied Materials & Interfaces
Meng-Tzu Hu, Ar-Tyan Hsu, Fong-Chin Su
OBJECTIVE: Thumb problems are common in some health professionals such as physical therapists. The purpose of this case-control study is to investigate the influence of clinical experience and different mobilization techniques on the kinematics of the thumb. METHODS: Twenty-three participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopedic experience (the Experienced Group) participated...
2016: PloS One
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