Journal of Bone and Joint Surgery-british Volume最新文献

{"title":"Elbow Arthroplasty Using Inter-Positional JK Membrane in the Era of Biologics: A Report of Two Cases","authors":"C. Weijia, R. Nagamine","doi":"10.11551/JSJD.31.487","DOIUrl":"https://doi.org/10.11551/JSJD.31.487","url":null,"abstract":"Objective: Total elbow joint arthroplasty has limited longevity and is therefore not appropriate for younger rheumatoid arthritis patients. Arthroplasty using an inter-positional membrane may be another surgical option for this population. However, clinical results for joint arthroplasty using the inter-positional membrane have not traditionally been favorable because rheumatoid activity could not be controlled. Today, rheumatoid activity can be controlled with biologics; therefore, the utility of the inter-positional membrane procedure was re-evaluated. Methods: An 8×6 cm sheet of fascia was detached from the patient9s tensor fascia lata muscle to produce a JK membrane. The fascia was stretched on a frame and kept in a 2% chromic acid potassium solution for 24 hours. Then, the fascia was exposed to direct sunlight in order to reduce the dichromic acid. The fascia was washed out in running water for 24 hours and was then stored in phenol with the addition of 70% alcohol. Elbow arthroplasties were performed on three elbow joints in two young female patients. The first case had a significantly damaged right elbow joint with severe joint dysfunction. A JK membrane arthroplasty was done for the first case in 2003, when this patient was 34 years old. Biologics were administered with methotrexate after the surgery. The second case demonstrated bilateral ankylosed elbows due to idiopathic juvenile arthritis. Bilateral JK membrane arthroplasties were performed in 2010, when this patient was 32 years old. Several operative and manual manipulations were necessary in order to increase the range of motion following surgery. Biologics were administered with cyclosporine. Results: Joint function was significantly improved in all three joints without pain after the JK membrane elbow arthroplasties. In case one, the JOA (Japan Orthopaedic Association) elbow score improved from 21 points before surgery to 85 points after surgery and active elbow flexion improved to 110 degrees following surgery. In case two, the JOA elbow score was 55 and 82 points in the right elbow and 52 and 83 points in left elbow before and after surgery, respectively. In case two, active flexion improved to 120 degrees for the right elbow and 110 degrees for the left elbow following surgery. RA was well controlled in both patients. Conclusion: Elbow arthroplasty using an inter-positional membrane appears to be useful in young patients when RA activity is controlled with biologics.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"8 1","pages":"581-581"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82836275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Reduction by Fenestration to the Ilium for Central Acetabular Depression Fracture: A Case Report and Operative Technique","authors":"M. Maruyama, Kazushige Yoshida, K. Kitagawa","doi":"10.4236/OJO.2016.68029","DOIUrl":"https://doi.org/10.4236/OJO.2016.68029","url":null,"abstract":"We reported a case of the acetabular depression fracture in conjunction with a central fracture dislocation of the hip that was treated with a unique surgical technique. CASE REPORT: A 76-year-old man suffered a left acetabular fracture with severe left hip joint pain and walking disability. Acetabular fracture was not apparent on the initial radiographs including anteroposterior and oblique views of the pelvis. However, computed tomography (CT) scanning showed displaced acetabular depression fracture (a third fracture fragment) in the center of the weight-bearing area with fracture of the ilium and spontaneous reposition of central dislocation of the hip (Fig. 1, 2). It seemed that this fracture fragment created incongruity of the acetabular articular surface and the potential for hip joint instability. Therefore, the patient was treated with open reduction and internal fixation. SURGICAL TECHNIQUE: To perform the procedure, the patient was placed in the lateral decubitus position. A direct lateral approach to the hip was used for exposure. The vastus lateralis was released 1 cm distal from its origin, trochanteric osteotomy was done by the Gigli saw. To observe the hip articular surface and to identify the fracture fragment, the femoral head was posterior dislocated with excision of teres ligamentum after T-shaped capsulotomy. The depressed fragment in the acetabulum was identified under direct vision but could not be reduced. Therefore, the outer cortex of the ilium was fenestrated in a size of 2 × 2 cm so that a 1-cm-wide levator was inserted to the depressed fragment at 2 cm proximal from the hip articular surface through the fenestrated window (Fig. 3). Subsequently, the displaced bone fragment was pushed down by using the levator to the adequate articular joint level. The fragment was stabilized with packed cancellous bone graft harvested from the osteotomized greater trochanter. The removed outer cortex of the ilium from fenestrated site was repositioned and fixed by a reconstruction plate and screws. The osteotomized greater trochanter was reattached and fixed with two cannulated cancellous hip screws. RESULTS: At 9-month follow-up, he was pain-free and continued to function well without the use of external supports. The acetabular depression fracture was completely reduced and healed in the CT scanning evaluation. The patient had no signs of posttraumatic osteoarthritis in radiographs. DISCUSSION and CONCLUSION: In acetabular fracture dislocations of the hip joint, the precise pathological anatomy is not easily demonstrated by routine radiographs with classification of acetabular fractures. In our case, however, details of acetabular fracture were not well visible on conventional radiographs. It has been shown that computed tomography is useful method in precise evaluation of the fracture type with bone damage and integrity of joint configuration. Concerning approach to the fracture fragment which existed in the center of the weight bea","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"57 1","pages":"599-599"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74872845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"John Mark Hamilton Paterson (1954 to 2013)","authors":"Joint Surgery","doi":"10.1302/0301-620X.95B12.33421","DOIUrl":"https://doi.org/10.1302/0301-620X.95B12.33421","url":null,"abstract":"![][1] \u0000\u0000Mark Paterson was a key figure in developing Children’s Orthopaedic services in East London. He was born in Hong Kong to a family with a history of missionary service. His father Edward Hamilton Paterson was a surgeon with an interest in the correction of cleft palate, who","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"464 1","pages":"1726-1726"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83911673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BIOMECHANICAL TESTING OF A SPINAL ALIGNMENT CUSHION (‘ROPHI™’ CUSHION) IN ADULTS WITH LOWER BACK PAIN","authors":"Ambreen Chohan, Katherine Payne, J. Selfe, J. Richards","doi":"10.1016/J.GAITPOST.2013.07.211","DOIUrl":"https://doi.org/10.1016/J.GAITPOST.2013.07.211","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"3 1","pages":"12-12"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74396263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam Corner – October 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B10.33053","DOIUrl":"https://doi.org/10.1302/0301-620X.95B10.33053","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"57 Suppl 1","pages":"1439-1440"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87649980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Caucasian and Chinese Femur Shapes for Evidence-Based Implant Design","authors":"Mike Lawrenchuk, L. Vigneron, Sebastian DeBoodt","doi":"10.1115/FMD2013-16151","DOIUrl":"https://doi.org/10.1115/FMD2013-16151","url":null,"abstract":"With the increasing use of 3D medical imaging, it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This is applied to the development of ‘standard implants’ targeted to specific population groups. INTRODUCTION Human beings are diverse in their physical makeup while implants are often designed based on some key measurements taken from the literature or a limited sampling of patient data. The different implant sizes are often scaled versions of the ‘average’ implant, although in reality, the shape of anatomy changes as a function of the size of patient. The implant designs are often developed based on a certain demographic and ethnicity and then, simply applied to others, which can result in poor design fitment [1]. Today, with the increasing use of 3D medical imaging (e.g. CT or MRI), it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This can be applied to the development of new ‘standard implants’ targeted to a specific population group [2]. PATIENTS & METHODS Our population analysis was performed by creating a Statistical Shape Model (SSM) [3] of the dataset. In this study, 40 full Chinese cadaver femurs and 100 full Caucasian cadaver femurs were segmented from CT scans using Mimics®. Two different SSMs, specific to each population, were built using in-house software tools. These SSMs were validated using leave-one-out experiments, and then analyzed and compared in order to enhance the two population shape differences. RESULTS An SSM is typically represented by an average model and a few independent modes of variation that capture most of the inherent variations in the data. Based on these main modes of variations, the shape features, e.g. length, thickness, curvature neck angle and femoral version, presenting largest variations were determined, and correlations between these features were calculated. Figure 1 represents the Caucasian and Chinese average models, and shows that while the length of these two models was significantly different, the AP and ML dimensions were similar, indicating a difference of morphology (other than a scaling) between the two populations. Figure 2 represents the first mode of variation that illustrates the variation of Chinese femur shape with size. As an example, the neck angle increases of 26° with an increase of 139 mm in femur length, indicative of the effect of changes in loading conditions on geometry as a function of size. CONCLUSION The advantage of using more advanced statistical analyses is that the 3D data are probed in an unbiased fashion, allowing the most important parameters of variation to be determined. These analyses are thus particularly effective to compare different populations, to evaluate how well existing implant designs fit specific populations, and to highlight the design parameters that need to be adapted for good fitment of specific populations.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"6 1","pages":"116-116"},"PeriodicalIF":0.0,"publicationDate":"2013-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87559956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam Corner – September 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B9.32854","DOIUrl":"https://doi.org/10.1302/0301-620X.95B9.32854","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"40 1","pages":"1295-1296"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78742818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOOL BRACING FOR PERFORMANCE IMPROVEMENT IN SIMULATED FEMORAL HEAD-NECK OSTEOCHONDROPLASTY","authors":"J. Kooyman, A. Hodgson","doi":"10.14288/1.0074229","DOIUrl":"https://doi.org/10.14288/1.0074229","url":null,"abstract":"Introduction Bracing, a strategy employed by humans and robotic devices, can be generally described as a parallel mechanical link between the actor, the environment, and/or the workpiece that alters the mechanical impedance between the tool and workpiece in order to improve task performance. In this study we investigated the potential value of bracing in the context of bone milling to treat cam-type femoroacetabular impingement (FAI) lesions. The goal of this study was to evaluate whether a proposed bracing technique could enable a user to perform a cam resection more accurately and quickly than a currently employed arthroscopic technique. Materials/Methods Test samples consisted of white urethane plastic reproductions of a commercially available adult proximal femur, which were laser scanned to obtain ground-truth surface information. A black cam lesion was then cast onto the surface of the femur in the anterosuperior region of the femoral neck, creating a clear visual resection boundary for the simulated osteochondroplasty. Test subjects were 4 adult males (25 +/− 3 years) with no surgical experience. Test conditions included two binary factors: (1) Braced vs. Unbraced – The braced case introduced a spherical bearing tool support mounted in the approximate anterolateral arthroscopic portal position. (2) Speed vs. Accuracy – The subject was instructed to perform the resection as quickly as possible or as accurately as possible with a moderate regard for time. Following the removal of the lesion, femurs were laser scanned to acquire the post-resection surface geometry, with accuracy being reported as RMS deviation between the pre- and post-resection scans over the anterosuperior neck region. Results In both accuracy and speed cases, bracing tended to reduce errors (on the order of 7–14%) and task duration (on the order of 32–52%), although given the small number of subjects in this pilot study, these differences were not statistically significant. Conclusion These results provide some encouragement that our hypothesis that bracing can improve both speed and accuracy of cam lesion resection by untrained subjects may be true. The standard deviations between subjects are high and are likely due to both the difficulty of the task and differences in experience using handheld power tools, so additional subjects would be needed to verify the trends identified here.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"1 1","pages":"11-11"},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89592449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism","authors":"J. Bilezikian, Roger Bouillon, Thomas L. Clemens, J. Compston, D. C. Bauer, Peter R. Ebeling, Klaus Engelke, David Goltzman, Theresa A. Guise, S. J. Beur, H. Jüppner, Karen Lyons, Laurie K. McCauley, Michael R Mcclung, Paul D. Miller, S. Papapoulos, G. David Roodman, Clifford J. Rosen, Ego Seeman, Rajesh V. Thakker, Michael P. Whyte, Mone Zaidi","doi":"10.1002/9781119266594","DOIUrl":"https://doi.org/10.1002/9781119266594","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"51 1","pages":"1087-1087"},"PeriodicalIF":0.0,"publicationDate":"2013-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86637327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam Corner – July 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B7.32457","DOIUrl":"https://doi.org/10.1302/0301-620X.95B7.32457","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"18 1","pages":"1007-1008"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85177669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}