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https://www.readbyqxmd.com/read/29887631/management-options-in-avascular-necrosis-of-talus
#1
Mandeep S Dhillon, Balvinder Rana, Inayat Panda, Sandeep Patel, Prasoon Kumar
Avascular necrosis (AVN) of the talus can be a cause of significant disability and is a difficult problem to treat. The most common cause is a fracture of the talus. We have done a systematic review of the literature with the following aims: (1) identify and summarize the available evidence in literature for the treatment of talar AVN, (2) define the usefulness of radiological Hawkins sign and magnetic resonance imaging in early diagnosis, and (3) provide patient management guidelines. We searched MEDLINE and PUBMED using keywords and MESH terminology...
May 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29775801/narrative-review-on-the-effect-of-shockwave-treatment-for-management-of-upper-and-lower-extremity-musculoskeletal-conditions
#2
REVIEW
Julia M Reilly, Eric Bluman, Adam S Tenforde
Extracorporeal shockwave therapy (ESWT) is a technology that was first introduced into clinical practice in 1982 for urological conditions. Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of non-union fractures, and joint disease including avascular necrosis (AVN). The aim of this review is to summarize the current understanding of treatment of musculoskeletal conditions with ESWT, accounting for differences in treatment protocol and energy levels...
May 15, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29752504/duration-of-immobilization-after-developmental-dysplasia-of-the-hip-and-open-reduction-surgery
#3
Khaled Emara, Mohamed Ahmed Al Kersh, Fahad Abdulazeez Hayyawi
BACKGROUND: There is no consensus about the duration of post-operative immobilization in the treatment of DDH (developmental dysplasia of hip). Our aim in this study is to compare between two post-operative immobilization protocols for patients undergoing open reduction. MATERIALS AND METHODS: Thirty-eight hips in 32 patients assigned to group A were immobilized in hip spica for four weeks followed by abduction brace application which was gradually weaned through the periods of several months and 29 hips in 24 patients assigned to group B immobilized in hip spica for 12 weeks without further bracing...
May 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29715363/hip-joint-contact-pressure-distribution-during-pavlik-harness-treatment-of-an-infant-hip-a-patient-specific-finite-element-model
#4
Behzad Vafaeian, Samer Adeeb, Marwan El-Rich, Dornoosh Zonoobi, Abhilash R Hareendranathan, Jacob L Jaremko
Developmental dysplasia of the hip (DDH) in infants under 6 months of age is typically treated by the Pavlik harness (PH). During successful PH treatment, a subluxed/dislocated hip is spontaneously reduced into the acetabulum, and DDH undergoes self-correction. PH treatment may fail due to avascular necrosis (AVN) of the femoral head. An improved understanding of mechanical factors accounting for the success/failure of PH treatment may arise from investigating articular cartilage contact pressure (CCP) within a hip during treatment...
July 1, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29687316/bernese-type-triple-pelvic-osteotomy-through-a-single-incision-in-children-over-five-years-a-retrospective-study-of-twenty-eight-cases
#5
YiQiang Li, HongWen Xu, Theddy Slongo, QingHe Zhou, Yuanzhong Liu, WeiDong Chen, JingChun Li, Federico Canavese
INTRODUCTION: Bernese-type triple pelvic osteotomy (BTPO) combines periacetabular and triple innominate osteotomy techniques. However, studies that evaluate the clinical and radiographic outcomes of BTPO are scarce. The aim of this study is to report on the clinical and radiographic outcomes of ambulatory children with developmental dysplasia of the hip (DDH) or Legg-Calvé-Perthes disease (LCPD) managed with BTPO that were older than five years of age at the time of surgery. MATERIALS AND METHODS: We retrospectively reviewed the records of 27 consecutive patients with DDH or LCPD (mean age 7...
April 23, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29570157/femoral-head-wedge-resection-for-the-treatment-of-avascular-necrosis-of-the-femoral-head-after-pediatric-femoral-neck-fracture-a-case-report
#6
Ha Yong Kim, Yong Han Cha, Won Sik Choy, Sang Wook Jeung, Yeon Seung Min
This research focuses on femoral head wedge resection for the treatment of avascular necrosis (AVN) of the femoral head. A 9-year-old girl presented to the emergency room complaining of right hip pain that occurred after a pedestrian car accident. After 8 months of internal fixation using cannulated screws for Delbet-type 2 fracture of the femoral neck, AVN of the femoral head developed in the patient. Even though valgus-derotation-extension intertrochanteric osteotomy was performed for the treatment of AVN, it progressed further and femoral head wedge resection was performed to recover the femoral head sphericity...
May 2018: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/29541270/early-results-of-the-a-l-p-s-proximal-humerus-locking-plate
#7
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29537314/custom-3d-printed-total-talar-prostheses-restore-normal-joint-anatomy-throughout-the-hindfoot
#8
Joseph Tracey, Danny Arora, Christopher E Gross, Selene G Parekh
BACKGROUND: Third generation total talar prostheses (TTPs) are viable options for talar avascular necrosis (AVN) in the absence of neighboring joint pathology. The use of modern three-dimensional (3D) printing allows the production of custom implants that exactly mimic the patient's anatomy. The aim of this study is to determine the accuracy of 3D printing in reproducing a synthetic talus and, in doing so, restoring more normal anatomical relationships. We hypothesize that this mode of replication will restore and maintain normal radiographic alignment of the ankle, subtalar, and forefoot joints in the setting of talar AVN...
March 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29451057/comparison-between-modified-dunn-procedure-and-in-situ-fixation-for-severe-stable-slipped-capital-femoral-epiphysis
#9
Giovanni Trisolino, Stefano Stilli, Giovanni Gallone, Pedro Santos Leite, Giovanni Pignatti
Background and purpose - The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. Patients and methods - We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed...
April 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29423066/interferon-%C3%AE-protects-against-avascular-osteonecrosis-through-interleukin-6-inhibition-and-silent-information-regulator-transcript-1-upregulation
#10
Kyoung Min Kim, Sajeev Wagle, Young Jae Moon, Sung Il Wang, Byung-Hyun Park, Kyu Yun Jang, Jung Ryul Kim
Synovitis of the affected joint is a common in avascular osteonecrosis (AVN). Increased levels of pro-inflammatory cytokine interleukin-6 (IL-6) have been reported in AVN, but the mechanism of this increase remains unclear. Silent information regulator transcript-1 (SIRT1), an NAD-dependent deacetylase, inhibits the release of inflammatory cytokines. Interferon β (IFN-β) has clear anti-inflammatory properties. We sought to investigate the effects of IFN-β treatment on AVN and to evaluate the specific signal pathway relating to IL-6 and SIRT1 affected during AVN...
January 9, 2018: Oncotarget
https://www.readbyqxmd.com/read/29411077/regenerative-therapies-increase-survivorship-of-avascular-necrosis-of-the-femoral-head-a-systematic-review-and-meta-analysis
#11
REVIEW
Luca Andriolo, Giulia Merli, Carlos Tobar, Sante Alessandro Altamura, Elizaveta Kon, Giuseppe Filardo
PURPOSE: The aim of this study was to document the available evidence on the use of regenerative techniques for the treatment of femoral head osteonecrosis (or avascular necrosis of femoral head, AVN) and to understand their benefit compared to core decompression (CD) alone in avoiding failure and the need for total hip replacement (THR). METHODS: The search was conducted on three medical electronic databases according to PRISMA guidelines. The studies reporting number and timing of failures were included in a meta-analysis calculating cumulative survivorship with a Kaplan-Mayer curve...
February 6, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29389704/versatility-of-the-medial-femoral-condyle-flap-for-extremity-reconstruction-and-identification-of-risk-factors-for-nonunion-delayed-time-to-union-and-complications
#12
Nikolas H Kazmers, Stephanie Thibaudeau, Patrick Gerety, Alex G Lambi, Lawrence Scott Levin
BACKGROUND: The medial femoral condyle (MFC) flap has become a popular choice for treatment of small bony defects. We aim to describe outcomes after MFC flap treatment of upper and lower extremity osseous defects and test the null hypothesis that no factors influence risks for nonunion, increased time to union, and complications. METHODS: A retrospective chart review was performed on all patients undergoing MFC free vascularized bone flaps by the senior author between May 2010 and March 2016...
April 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29382681/evaluating-the-role-of-prereduction-hip-traction-in-the-management-of-infants-and-children-with-developmental-dysplasia-of-the-hip-ddh-protocol-for-a-systematic-review-and-planned-meta-analysis
#13
Sarah Walton, Emily Schaeffer, Kishore Mulpuri, Peter Cundy, Nicole Williams
INTRODUCTION: Developmental dysplasia of the hip (DDH) affects 4-6 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction...
January 29, 2018: BMJ Open
https://www.readbyqxmd.com/read/29379808/outcome-after-surgical-management-of-acetabular-fractures-a-7-year-experience
#14
Seyed Amir Reza Mesbahi, Ali Ghaemmaghami, Sara Ghaemmaghami, Pouya Farhadi
Objective: To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures. Methods: This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016...
January 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29371164/anti-inflammatory-effect-of-avenanthramides-via-nf-%C3%AE%C2%BAb-pathways-in-c2c12-skeletal-muscle-cells
#15
Chounghun Kang, Woo Shik Shin, Dongwook Yeo, Wonchung Lim, Tianou Zhang, Li Li Ji
Avenanthramides (Avns), the polyphenol compounds found only in oats, have been shown to exhibit anti-inflammatory effects mainly by inhibiting nuclear factor (NF)-κB activation in select cell lines. However, the molecular mechanism by which Avns regulate the NF-κB pathway is still unclear. The purpose of this study was to investigate (1) the molecular mechanism by which three main fractions of Avns (AvnA, AvnB and AvnC) interact with IκB Kinase β (IKKβ); and (2) whether this interaction results in reduced inflammatory responses in skeletal muscle cells...
March 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29361376/diagnosis-and-treatment-of-slipped-capital-femoral-epiphysis-recent-trends-to-note
#16
Takuya Otani, Yasuhiko Kawaguchi, Keishi Marumo
Slipped capital femoral epiphysis (SCFE) is not frequently encountered during routine practice and diagnosis and treatment are often delayed. It is important to understand symptoms and imaging features to avoid delayed diagnosis. After the diagnosis is made correct classification of the disease is required. The classification should be based on the physeal stability in order to choose safe and effective treatment. However, surgeons should bear in mind that the assessment is challenging and actual physeal stability is not always consistent with the stability predicted by a clinical classification method...
March 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29182116/surgical-treatment-for-developmental-dysplasia-of-the-hip-a-single-surgeon-series-of-47-hips-with-a-7-year-mean-follow-up
#17
J Mcfarlane, J H Kuiper, N Kiely
The treatment of developmental dysplasia of the hip (DDH) in children remains controversial. We describe the clinical and radiological outcomes of  47 hips in 43 children treated with open surgery by one surgeon between 2004 and 2008 for DDH. The mean age at operation was 25 months (5 to 113) with a mean follow up of  89 months  (22 to 169). At the latest follow up 40 of the 45 hips where Severin grades were recordable (89%) were graded as excellent or good, Severin class I or II. Clinically significant AVN (grade II to III  according to the Kalamchi and MacEwen classification) was seen in 6  (13%) of the hips...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29181188/intra-articular-osteochondroma-of-the-posteroinferior-femoral-neck-associated-with-hip-joint-osteochondromatosis-a-case-report
#18
Sung Il Wang, Eun Hae Park, Sun Jung Yoon, Jung Ryul Kim
Osteochondromas are usually extra-articular lesions originating from the metaphysis of long bones. Intra-articular osteochondromas may also occur, causing pain and discomfort and restricting the range of motion. Osteochondromas of the femoral neck are intra-articular lesions that are difficult to access for surgical resection, particularly when located posteriorly. We herein present a rare case of an intra-articular osteochondroma involving the posteroinferior aspect of the femoral neck associated with secondary synovial osteochondromatosis (SOC) of the hip joint in a 25-year-old woman...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29130113/long-term-results-of-closed-reduction-for-developmental-dislocation-of-the-hip-in-children-of-walking-age-under-eighteen-months-old
#19
Soo Min Cha, Hyun Dae Shin, Byung Kon Shin
BACKGROUND: Developmental dysplasia of the hip (DDH) diagnosed in older postnatal children can be effectively treated by closed reduction (CR) alone. However, no prospective or comparative trial to explore the differential effectiveness of CR between non-walking and walking postnatal children has yet been reported. This study investigated the clinical and radiologic outcomes of CR in the age range of interest (12-18 months old) via a prospective trial and compared these results with those of a younger age group who also underwent CR...
January 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29125919/autologous-chondrocyte-implantation-sandwich-technique-compared-with-autologous-bone-grafting-for-deep-osteochondral-lesions-in-the-knee
#20
Tom Minas, Takahiro Ogura, Jeff Headrick, Tim Bryant
BACKGROUND: Treating symptomatic osteochondral defects is challenging, especially in young adults with deep (>8-10 mm) empty defects after osteochondritis dissecans (OCD) or collapsed condyles secondary to avascular necrosis (AVN). For this population, osteoarthritis (OA) is inevitable if articular congruence is not restored. PURPOSE: To describe the autologous chondrocyte implantation (ACI) "sandwich" technique with autologous bone grafting (ABG) and compare it with ABG alone for restoration of the osteochondral unit...
February 2018: American Journal of Sports Medicine
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