Journal of Orthopaedic Reports最新文献

{"title":"Is the regular use of iliac crest cancellous bone in foot and ankle arthrodesis versus correction justifiable? A comparison study of fusion rate and complications","authors":"","doi":"10.1016/j.jorep.2024.100433","DOIUrl":"10.1016/j.jorep.2024.100433","url":null,"abstract":"<div><h3>Background and aim</h3><p>Pseudarthrosis is a major consequence of foot and ankle surgery, frequently necessitating extra treatment and imposing significant patient and economic issues. Bone defects and quality both have an impact on bone healing. Grafts are commonly utilized to bridge defects or rectify axis, and both autologous and allogeneic materials are accessible. Because of its high complication rate and patient burden, autologous bone transplantation from the iliac crest is being questioned. This retrospective study seeks to determine if these drawbacks exceed the benefits of osteoconductive and osteoinductive effects.</p></div><div><h3>Materials and methods</h3><p>A retrospective study analyzed patients who underwent foot and ankle surgery and were treated with a tricortical iliac crest chip. The study included patients with a follow-up period of at least six months and analyzed X-ray images. The surgical procedure for removing the chip was standardized, with the iliac crest marked, skin incisions made, wound preparation, and muscle parts exposed. A hemostyptic was inserted, and the wound closed in layers. A subcutaneous drain was inserted, and a pain catheter was inserted percutaneously. All patients were treated as inpatients, with mobilization depending on the surgical treatment.</p></div><div><h3>Results</h3><p>The study examined autologous bone grafting from the iliac crest for a variety of diagnoses, including calcaneal lengthening osteotomy (22 %), arthrodesis of the tarsometatarsal (TMT) II and III joints (14 %), and revision surgery following pseudarthrosis with interposition (11 %). Nicotine use was reported in 18.45 % of patients, with rheumatoid arthritis in 14 %. Bony consolidation was 97 %, including three incidences of pseudarthrosis. The local complication rate at the iliac crest was 3 %, with three occurrences of seroma, sutured drain, and prolonged hypesthesia. No operational revisions were made.</p></div><div><h3>Conclusion</h3><p>Our study proposes autologous bone chip removal from the anterior iliac crest as a therapeutic alternative because of its robust mesenchymal cells and diverse chip structure.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100433"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001280/pdfft?md5=d2b413a513a9022180f15d8ef8cee145&pid=1-s2.0-S2773157X24001280-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing anthropometric measurements to forecast hamstring autograft dimensions among adolescents","authors":"","doi":"10.1016/j.jorep.2024.100432","DOIUrl":"10.1016/j.jorep.2024.100432","url":null,"abstract":"<div><h3>Purpose</h3><p>This investigation aimed to assess the predictive capability of pre-operative anthropometric data in determining the diameter of hamstring autografts among adolescents undergoing anterior cruciate ligament reconstruction (ACLR).</p></div><div><h3>Materials and methods</h3><p>This retrospective analysis included 68 adolescent patients aged 13 to 17 who underwent single-bundle ACLR with a 4-stranded hamstring autograft (Gracilis and Semi-Tendinosus) from 2008 to 2012. Pre-operative anthropometric data, including bone age, gender, height, weight, body mass index (BMI), and body surface area (BSA), were documented. Correlation between anthropometric data and the intra-operative diameter of the 4-strand hamstring autograft was assessed using multiple regression analysis.</p></div><div><h3>Results</h3><p>This study comprised 68 participants (36 males and 32 females), with females having a mean bone age of 14.9 years (±1.1) and males 15.2 years (±0.9). Males exhibited a significantly larger graft size than females (p &lt; 0.05). Graft diameter showed a moderate correlation with weight in both males (r = 0.40, p &lt; 0.05) and females (r = 0.35, p &lt; 0.05). Height displayed a moderate correlation in females only (r = 0.49, p &lt; 0.05). BMI did not correlate with graft diameter in females but had a moderate correlation in males (r = 0.38, p &lt; 0.05). BSA moderately correlated with graft diameter in both females (r = 0.40, p &lt; 0.05) and males (r = 0.39, p &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>Anthropometric measurements reveal a direct correlation with hamstring graft diameter among adolescents, empowering surgeons to improve preoperative strategizing and offer more comprehensive patient guidance ahead of ACL reconstruction.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100432"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001279/pdfft?md5=e3d0084e987cc0dbec3e08832b7d442a&pid=1-s2.0-S2773157X24001279-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low pre-operative vitamin D associated with lower baseline PROMs but greater improvement following total joint arthroplasty","authors":"","doi":"10.1016/j.jorep.2024.100430","DOIUrl":"10.1016/j.jorep.2024.100430","url":null,"abstract":"<div><h3>Aims and objectives</h3><p>This study investigated whether low pre-operative 25-OH-vitamin-D (25(OH)D) is associated with worse patient-reported outcome measures (PROMs) and higher odds of post-operative complications following TJA in a diverse population.</p></div><div><h3>Materials &amp; methods</h3><p>This was a retrospective study of patients undergoing total hip (THA) or knee arthroplasty (TKA) at an urban tertiary care center between 2020 and 2023. A total of 488 patients were included, representing 538 surgeries. Patients identified as 25(OH)D deficient (&lt;12 nmol/L) or insufficient (12–30 nmol/L) were prescribed supplementation before or at the time of surgery per institution protocol. We analyzed the relationship between 25(OH)D level and Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) or Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) pre-operatively, at 6 weeks, and at 90-days post-surgery, as well as 90-day complications.</p></div><div><h3>Results</h3><p>Low pre-operative 25(OH)D was observed in 46.5% of surgeries and was associated with lower pre-operative HOOS, JR score (<em>P</em> = 0.002). Improvement in HOOS, JR score at 90-days post-operatively was significantly greater in the 25(OH)D deficient group (<em>P</em> = 0.043). No statistical difference was found among KOOS, JR scores. Low pre-operative 25(OH)D did not increase odds of re-operation (<em>P</em> = 0.484), readmission (<em>P</em> = 0.385), wound complications (<em>P</em> = 0.595), or overall complications (<em>P</em> = 0.656).</p></div><div><h3>Conclusion</h3><p>Our results suggest that low 25(OH)D is associated with lower pre-operative HOOS, JR score and greater improvement in HOOS, JR score following THA; similar trends were appreciated in TKA but were not significant. TJA coupled with 25(OH)D supplementation in patients who have low 25(OH)D may result in similar post-operative outcomes as those with normal pre-operative 25(OH)D.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001255/pdfft?md5=63549d1df447d0c103a66fd9b729b1b1&pid=1-s2.0-S2773157X24001255-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcaneal lipofibromatosis reconstructed with reverse sural artery flap: A case report","authors":"","doi":"10.1016/j.jorep.2024.100401","DOIUrl":"10.1016/j.jorep.2024.100401","url":null,"abstract":"<div><h3>Background</h3><p>Lipofibromatosis is a very rare benign soft tissue tumor, almost exclusive to the pediatric population and which is most commonly found in the distal limbs. They are typically treated with a wide local excision and simple closure.</p></div><div><h3>Case report</h3><p>We present an unusual case where a large lipofibromatosis (5.5cm x 5cm) in a 4-month-old infant necessitated tissue reconstruction. Furthermore, the less common site of the lipofibromatosis over the calcaneum presented additional considerations pertaining to weight-bearing. We performed a reverse sural artery flap for the patient with favorable outcomes.</p></div><div><h3>Conclusion</h3><p>The reverse sural artery flap is an effective and efficient option for reconstruction following large lipofibromatosis excision in the heel and foot.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24000961/pdfft?md5=b8a36a6730523c873a7bad14081e2921&pid=1-s2.0-S2773157X24000961-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of mild and advanced cases of Elbow OA with Arthroscopic Debridement and Intra-Articular Hyaluronic Acid","authors":"","doi":"10.1016/j.jorep.2024.100425","DOIUrl":"10.1016/j.jorep.2024.100425","url":null,"abstract":"<div><h3>Background</h3><p>Intra-articular hyaluronic acid (HA) injections have demonstrated efficacy for osteoarthritis in joints such as the hip, knee, and ankle. As few published studies exist on the subject, HA injections for elbow OA have not been proven to be effective. This study investigates the efficacy of arthroscopic debridement with/without intra-articular hyaluronic acid (HA) injections with respect to pain relief, arc of movement, and functional improvement in 24 elbows with osteoarthritis.</p></div><div><h3>Material and methods</h3><p>24 elbows were treated for posttraumatic (n = 11) or primary degenerative (n = 13) osteoarthritis of the elbow by arthroscopic debridement. HA (Synvisc) injection protocol was either preoperative (n = 5), postoperative (n = 5), combined pre- and post-operative (n = 5), or without HA injections (n = 9). A clinical examination and Mayo elbow performance score was conducted at an average of 15 months (range 12–18 months) post-operation. The results were statistically analysed with the Mann-Whitney, Wilcoxon, and ANOVA tests.</p></div><div><h3>Results</h3><p>Intra-articular cartilage changes were observed to be mild fraying (n = 5), significant fraying/fibrilliation (n = 6), and significant fibrillation with areas of bare bone (n = 13). HA injections were associated with worse outcomes in patients with severe cartilage changes and exposed bone. A non-statistically significant trend toward improved outcomes in patients without exposed bone was seen when treated with HA injection.</p></div><div><h3>Discussion and conclusions</h3><p>These results support the use of <span>HA</span> in combination with elbow debridement in earlier stages of osteoarthritis with intact / frayed cartilage layer, but not in advanced cases with bone in communication with the synovial cavity. There is a symptomatic benefit in earlier stages (0–2) and a symptomatic detriment associated with HA in osteoarthritic joints with later stages (3–4), in the short term. Longer term studies are required to better understand the longevity of these results.</p></div><div><h3>Level of evidence</h3><p>II.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100425"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001206/pdfft?md5=651801b9b128343e2149b693c42afc74&pid=1-s2.0-S2773157X24001206-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of artificial intelligence (AI) in paediatric orthopaedic surgery","authors":"","doi":"10.1016/j.jorep.2024.100416","DOIUrl":"10.1016/j.jorep.2024.100416","url":null,"abstract":"<div><p>Artificial Intelligence (AI) technologies are gradually becoming widespread in pediatric orthopedic surgery and contribute to diagnostic and surgical processes, planning, execution, and treatment. This review focuses on new AI technologies that enhance bone age determinations and identification of early musculoskeletal abnormalities. AI contributes to better preoperative planning and helps while performing operations by augmented reality and robotic systems, so operation becomes safer and more accurate. In postoperative care, AI is able to track a patient's progress, modify treatment regimens and oversee chronic illnesses, thus enabling individualized patient attention. This paper aims to review existing usage, future prospects, and the implications of AI in treating children with orthopedic disorders in order to highlight the effectiveness of the tool in enhancing the health of children and the development of pediatric orthopedics as a specialty.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100416"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001115/pdfft?md5=7953992532aa74d331d4c5e063358add&pid=1-s2.0-S2773157X24001115-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141390967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of vitamin D deficiency following corrective spinal surgery in adolescent idiopathic scoliosis: A narrative review","authors":"","doi":"10.1016/j.jorep.2024.100428","DOIUrl":"10.1016/j.jorep.2024.100428","url":null,"abstract":"<div><p>Adolescent idiopathic scoliosis (AIS) is a common rigid structural spinal deformity with unknown etiology. It has been associated with low bone mineral density and osteopenia. Vitamin D has an essential role in bone health and mineralization. So it is assumed that vitamin D deficiency (VDD) is associated with the onset and development of AIS. Risk factors of VDD in general population had been introduced and discussed widely but those involved in patients after corrective spinal surgery are debated. Here we review the most dominant risk factors associated with VDD in AIS patients following corrective spinal surgery. Preoperative VDD is probably the main risk factor of postoperative VDD. Female gender, eating disorders, dressing habits, physical inactivity, and increased bone turnover are the most important contributors of preoperative VDD. ICU admission, pain, medications, surgical complications, delirium, stress response, and bracing are probably the main risk factors of VDD postoperatively. The risk factor modifications and nutritional supplementation could profoundly impact surgical outcomes in this high-risk group of patients.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001231/pdfft?md5=0ce620f12b3f5624e4153aa83f31bdf1&pid=1-s2.0-S2773157X24001231-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Camurati-Engelmann disease – A case report of a rare diaphyseal dysplasia","authors":"","doi":"10.1016/j.jorep.2024.100423","DOIUrl":"10.1016/j.jorep.2024.100423","url":null,"abstract":"<div><h3>Background</h3><p>Camurati Engelmann disease is an uncommon genetic disorder affecting mainly the diaphysis of long bones. The rarity of this disease and the reduced availability of literature often creates a diagnostic confusion among the treating physicians. Here, we present a case report of this rare dysplastic bone disorder, and outline the treatment and follow up of the patient.</p></div><div><h3>Case report</h3><p>A 24-year-old Asian male with chronic pain over bilateral lower limbs and frequent headaches for a period of 3 years and 1 year respectively, presented with a new onset pain over small joints of the hand. He had marfanoid habitus, with tenderness over upper limb joints. Investigations were suggestive of a sclerotic bone disease with enhanced tracer uptake along the cortical borders of long bones on spect CT bone scan.</p></div><div><h3>Conclusion</h3><p>The rarity of genetic disorders of bone can be diagnostically challenging. CED should be suspected in subjects with multiple long bone pain with proximal muscle weakness, supported by radiological evidence of cortical hyperostosis of long bones. Treatment with zoledronic acid improves the pain and standard of living in such patients.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 3","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001188/pdfft?md5=9f060d13c23d5d637a5c5ef827123d35&pid=1-s2.0-S2773157X24001188-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of Larsen syndrome – A rare genetic disorder affecting the musculoskeletal system","authors":"","doi":"10.1016/j.jorep.2024.100421","DOIUrl":"10.1016/j.jorep.2024.100421","url":null,"abstract":"<div><h3>Background</h3><p>Larsen syndrome is an extremely rare genetic disorder with craniofacial abnormalities, and multiple dislocations of large joints. It can also involve various other systems causing hearing loss, cardio-respiratory and visual problems. Here, we illustrate a case report of this genetic syndrome while also outlining the treatment and follow up.</p></div><div><h3>Case report</h3><p>A 26-year-old female, with history of congenital bilateral hip dislocation, difficulty in walking and abnormal craniofacial features was brought to us with persistent lower back pain for a duration of 12 years. She had a low birth weight, facial dysmorphism, hypotonia and was put on plaster casts for congenital bilateral hip dislocations. She had recurrent ear and respiratory infections in childhood. Her intelligence was normal and the family history was negative for genetic and bone diseases. She was evaluated, and treated conservatively based on the assessment of benefits outweighing the risks by a multidisciplinary approach.</p></div><div><h3>Conclusion</h3><p>The diagnosis of Larsen syndrome can be a challenging one because of limited availability of literature. Understanding the need and interest of the patient is of utmost important. The multidisciplinary approach is the key to patient satisfaction. It is imperative that more literature evidences should be gathered on this topic on specific management of spinal deformities and their complications.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001164/pdfft?md5=7fe4ca1f51114de703595c1d1583eb0b&pid=1-s2.0-S2773157X24001164-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic bilateral Gluteal Muscle Contracture: Case report of two patients","authors":"","doi":"10.1016/j.jorep.2024.100424","DOIUrl":"10.1016/j.jorep.2024.100424","url":null,"abstract":"<div><h3>Introduction</h3><p>Gluteus Muscle Contractures in children are uncommon in India, and only a few case reports have been published from India. Such patients present to the clinician with difficulty squatting and sitting cross-legged.</p></div><div><h3>Case reports</h3><p>Gluteus muscle contracture is a condition which is difficult to diagnose in routine outpatient clinics as the patient might have normal hip joints clinically and radiologically, but still have difficulty squatting and sitting cross-legged. In this case report, we describe two idiopathic bilateral Gluteus Muscle Contracture patients who are otherwise healthy and who were managed successfully with open release after a precise diagnosis.</p></div><div><h3>Conclusion</h3><p>Diagnosing this condition in a busy outpatient department is the key to the successful management of this condition and prompt intervention can give the patient a reasonable functional outcome.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100424"},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X2400119X/pdfft?md5=d5aa0a1731ec046678b41939a8b7ad89&pid=1-s2.0-S2773157X2400119X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}