Journal of Orthopedics & Bone Disorders最新文献

{"title":"Regeneration of Cartilage Tissue by Comparing the Natural and Synthetic Biomaterials during ADSCs Differentiation","authors":"M. Ghiasi","doi":"10.23880/jobd-16000231","DOIUrl":"https://doi.org/10.23880/jobd-16000231","url":null,"abstract":"Objectives: Human adipose-derived stem cells have shown chondrogenic differentiation for cartilage engineering. In the present study, we evaluated different scaffolds for chondrogenic differentiation of Human adipose-derived stem cells. Methods: cells were cultured and chondrogenic differentiation was investigated in Polycaprolactone, Platelet Rich Plasma, and Fibrin glue scaffolds by MTT, Real time and histology. Results: Cell proliferation and collagen levels in Platelet Rich Plasma scaffolds were significantly higher than other scaffolds. The levels of Sox9 and col II were up regulated in Platelet Rich Plasma. Histological examination revealed that the pores of the scaffolds were filled cells. Conclusion: The results show that 3D Platelet Rich Plasma scaffolds provide a better environment for chondrogenic differentiation than others.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134015469","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":"Low Intensity Pulsed Ultrasound (LIPUS) for Orthopaedic Trauma: A Pilot Study","authors":"Jameel Ss","doi":"10.23880/jobd-16000210","DOIUrl":"https://doi.org/10.23880/jobd-16000210","url":null,"abstract":"Introduction: The incidence of non-union is 5% for all fractures. Non-operative biophysical modes to stimulate osteogenesis and fracture healing have explored electrical, laser and ultrasound modalities to varying degrees of success over the past few decades. Methods: This pilot study was undertaken at a District general hospital (DGH) in a publicly funded healthcare delivery system to assess the benefits and report the healing rate/success with use of Low intensity pulsed ultrasound (LIPUS) ExoGen device in delayed and non-unions of closed appendicular skeletal fractures. A standard device that delivered acoustic radiation at an operating frequency of 1.5 MHz with a temporal average power of 30 mW/cm2 and self-administered by the patient for 20mins/day for 250 sessions was used. Results: 11 adult patients enrolled into the study were followed-up until the end of their treatment and seven of them had clinical plus radiological union with excellent outcomes. The mean age of patients was 54.9years (range: 26 to 71y). The mean follow-up duration was 18.5months (range: 10.0 to 24.5m). The mean duration from sustaining the fracture to application of ExoGen to hasten osteosynthesis was 4.1months (range: 1.0 to 9.0m). Two patients warranted revision surgery to achieve fracture union. Of the remaining two patients, one with fibrous non-union was coping satisfactorily whilst a salvage procedure was proposed for another. Discussion: LIPUS was used as an ‘Alternative’ to surgery (and revision surgery) in all but one patient where it was used as an adjunct with surgery. There were no complications with its use and the healing rate was 63.6% (7/11 patients). There was an estimated cost savings of at least £10,000 in this small cohort of patients. Smoking status, high velocity trauma, advancing age or gender did not influence the outcomes.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134346554","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":"Functional Outcome of Distraction Osteogenesis Using Linear Rail System (LRS) in Adults with Isolated Femoral Bone Gap","authors":"Alabi Ia","doi":"10.23880/jobd-16000211","DOIUrl":"https://doi.org/10.23880/jobd-16000211","url":null,"abstract":"Background: The management of bone gap in the femoral shaft has remained difficult and challenging to the orthopaedic and trauma Surgeons. Distraction osteogenesis using the linear rail system (LRS) may be a useful tool in bridging such defects in our environment. Objective: To study the radiologic bone union, functional outcome and complications of distraction osteogenesis in the management of femoral bone gap using linear rail system (LRS). Methodology: A hospital based prospective interventional study conducted at National Orthopaedic Hospital, Dala and Albarka clinic, Dandishe, Kano, between March 2013 and March 2018. Sixty-eight cases were recruited. Every patient had LRS applied after adequate debridement when needed. Primary or interval corticotomy was done depending on the extent of soft tissue dissection in relation to the corticotomy site. Follow up was done until the regenerate had corticalized and LRS removed. Complications were noted and recorded. Radiologic union and functional outcome were assessed using the RUST and ASAMI outcome scores respectively. Data was analyzed using SPSS version 20. Results: Sixty-eight cases were recruited with M: F ratio of 16: 1. The mean age was 36.7 +/- 10.5years. The age range between 36-45years was more commonly treated representing 34(50.0%). Primary corticotomy was done in 52 (76.5%) while interval corticotomy was done in 16 (23.5%). The mean regenerate length achieved was 9.6 +/- 2.7cm. The mean duration of treatment was 20.3 +/- 6 months. Radiologic union was achieved in 66 (97.1%) patients. Sixty-four (94.1%) had excellent or good ASAMI functional outcome scores. Sixty-six (97.1%) were either very satisfied or satisfied with their treatment while 2 (2.9%) were indifferent. The common complications were intermittent pin tract infections recorded in 28 (41.2%), knee stiffness in 18 (26.5), proximal or distal varus deformity in 10 (14.7%) and non-union in 2 (2.9%) of cases. Conclusion: Distraction osteogenesis using LRS can achieve bone union and excellent outcome in the management of bone gap in the femur. However, intermittent pin tract infection, knee stiffness and varus deformities post significant challenges.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134491041","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":"Stripe Wear - Ceramic on Polyethylene Bearing Surface: A Case Report","authors":"S. Khakharia","doi":"10.23880/jobd-16000238","DOIUrl":"https://doi.org/10.23880/jobd-16000238","url":null,"abstract":"Background: Stripe wear is a well-known phenomenon that might be caused by rim impingement, edge loading, metal particle entrapment, micro-separation, and transient subluxation. Stripe wear is felt to represent metal transfer and has been associated with squeaking in ceramic-on-ceramic bearings. In our paper, we report the presence of stripe wear on a retrieved modular ceramic femoral head from a patient with ceramic-on-polyethylene-bearing total hip arthroplasty. Method: We report a case of a 57-year-old male who originally had metal-on-metal (MOM) THA and underwent debridement and exchange of the bearing surface from MOM to ceramic-on-polyethylene (COP) articulation for pain and metallosis. He subsequently developed sepsis and underwent resection arthroplasty. Result: Intraoperatively, a cross-table lateral radiograph revealed the forward flexion of the acetabular component and femoral neck to posterior acetabular margin impingement. By analyzing the retrieved components macroscopically and microscopically, linear scars were found on the polyethylene liner, femoral neck, and femoral head in a pattern consistent with the X-ray finding. Conclusion: If metallosis is encountered after THA, the source of the metal wear should be identified. Component malposition is a possible cause, and the surgeon should consider revision or repositioning of the components if evidence of impingement is seen, as a simple bearing exchange may not solve the problem. This report indicates that stripe wear is not limited to ceramic on ceramic articulations.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131019906","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 MRI and Laboratory Evidence of Muscle Injury after Intramuscular Injection of Diclofenac 1 mL and 3 mL: Case Study Reports","authors":"D. Balat","doi":"10.23880/jobd-16000212","DOIUrl":"https://doi.org/10.23880/jobd-16000212","url":null,"abstract":"Aim & Objectives: Intramuscular (IM) injections of 1 mL and 3 mL Diclofenac 75 mg are used in the clinic in the management of the pain. The present study was performed with the aim to evaluate muscle injury after IM injection of Diclofenac 75 mg/1 mL (Dynapar AQ ® , Troikaa Pharmaceuticals Limited, India) and Diclofenac injection 75 mg/3 mL (commercially available) in subjects using Magnetic Resonance Imaging (MRI) and laboratory blood tests. Material & Methods: Two separate single arm case studies, (each comprising of a single healthy subject) were carried out after Ethics Committee approvals and CTRI Registration. Two subjects who gave written informed consent received either Diclofenac injection 75 mg/1 mL (Dynapar AQ ® , Troikaa Pharmaceuticals Limited, India) OR Diclofenac injection 75 mg/3 mL (commercially available) and the muscle injury was evaluated at different time points up to 14 days. Results: In both the subjects, the intramuscular injury after the injection was reliably documented by MRI and laboratory tests. For the subject who received Diclofenac injection 75 mg/3 mL, there was significant muscle injury observed (T2- weighted magnetic resonance was increased manifold: the volume of muscle injury was 108 mL at 24 hr after injection; 137 mL at 48 hours, and progressive worsening after 48 hours, rising to 271 mL on Day 7 with subsequent normalization at Day 119). However, in the subject who received Diclofenac injection 75 mg/1 mL, muscle injury was relatively minor and reversed quickly at day 7; (T2-weighted magnetic resonance volume of muscle injury was 66 mL at 24 hr after injection, a flatter peak of 69 mL at 48 hours, declining thereafter). In the subject who received 3 mL injection, the CPK levels (Normal range: serum CPK: 39 – 308 U/L by immune assay) were highly increased (from baseline of 47 U/L to 1975 U/L in 8 hours, 1320 U/L at 48 hours, continued elevation after 48 hours: 420 U/L at 7 Days and 267 U/L on Day 119), with prolonged plateau of elevation and gradual decline over weeks indicating significant muscle injury with Diclofenac injection 75 mg/3 mL whereas, in the subjects who received diclofenac injection 75 mg/ 1 mL, there was only minor increase in CPK (from baseline of 93 U/L to 433 U/L in 24 hours) and was normalized to 95 U/L at day 7. In the subject who received Diclofenac injection 75 mg/3 mL, the IL-6 was within the upper range of normal (Normal Range: IL6 0-50 pg/mL by ELISA), and rose from a baseline of < 2 pg/mL to 37.3 pg/mL, but in the subject who received 1 mL IM Diclofenac, values stayed low throughout (<4 pg/mL). Conclusion: There was higher muscle injury following 3 mL Diclofenac intramuscular injection when compared to 1 mL Diclofenac intramuscular injection. This is the first comparative report confirming radiologic and laboratory evidence of muscle injury produced by a 1 mL and 3 mL Diclofenac injection, and opens the door for further research on muscle injury, and focuses our efforts to prevent","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127776231","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":"Time Frame to Surgery from Presentation of Ankle Fractures and the Impact of the BOAST Standards, do we meet the BOAST Guidelines?","authors":"Ahmed Al Wadiya","doi":"10.23880/jobd-16000227","DOIUrl":"https://doi.org/10.23880/jobd-16000227","url":null,"abstract":"Purpose: The aim of this study was to evaluate the compliance with the BOAST guidelines for early fixation on the day or day after ankle fractures in the age group of 60 years old or less when the ankle mortise is unstable. Method: This retrospective study reviewed all the ankle fractures that were admitted for ankle fixation in 2015-2016, pre- BOAST standard, and following it in 2018- 2019. The inclusion and exclusion criteria used in the standard were then applied. Results: In 2018-19, 44 patients fulfilled the inclusion criteria, 18 males with an average age of 39.3 and 26 females with an average age of 42.2. Twenty-nine ankles (66%) were fixed on the day or day after injury while 5 ankles (11%) had the surgery within 48 hours. In 2015-16, 37 patients fulfilled our inclusion criteria, 21 males with an average age of 37.8 years, 16 females with an average age of 42.1 years. Twenty-one ankles (56.7%) were fixed on the day or day after injury. While 8 ankles (21.6%) had the surgery within 48 hours. Conclusion: Most of the ankle fractures requiring surgery, who presented to our trust, were fixed within 48 hours accounting for 77% of cases in 2018-19 versus 79% in 2015-16 with no statistically significant difference in our practice between pre and post BOAST guidelines publishing. The rest of cases had delayed fixation mainly due to the surrounding soft tissue swelling.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121669445","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":"Systematic Review and Meta-Analysis of Sciatic Nerve Injury in Acetabular Fractures","authors":"Hakeem Nn","doi":"10.23880/jobd-16000229","DOIUrl":"https://doi.org/10.23880/jobd-16000229","url":null,"abstract":"Background: Acetabular fracture is a challenging orthopaedic injury, usually associated with post-traumatic arthritis, deep vein thrombosis, and sciatic nerve injury (SNI). Therefore, we assess the incidence and outcome of SNI associated with acetabular fractures in this study. Methodology: We applied search keywords across PubMed, clinicaltrail.gov, Scopus, and Cochrane library database from 2002 to March 2022 with the studies reporting SNI associated with acetabular fracture. Patient's demographic details, acetabular fracture type, recoveries rate and time, number of patients with acetabular fracture reporting SNI, and follow-up. Methodological Index for Observational Non-Randomized Studies (MINORS) criteria assessed the quality appraisal of each identified study. Results: This study includes twenty-one studies with a total of 682 patients, 19 iatrogenic SNI, and 44 post-traumatic injuries. Overall incidence of post-traumatic and iatrogenic SNI associated with acetabular fractures was 9% [95% CI: 6%-11%] and 5% [95% CI: 3%-7%] respectively. The overall recoveries rate from iatrogenic SNI and post-traumatic SNI associated with acetabular fracture were 55% (95% CI: 22%-83%) and 68% (95% CI: 53% -81%), respectively. The overall quality score of all included studies was 64.28± 7.43% (R: 56.25 % -81.25%), with seven studies below 60%. In most cases, Recoveries of sciatic nerve injury occur within 2-24 months after any open reduction and internal fixation (ORIF). Conclusion: This review estimates SNI incidence with acetabular fracture and recoveries rates. However, this study fails to report the association of SNI with specific acetabular fracture types due to insufficient reported data across eligible studies","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"325 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125786369","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":"Panton-Valentine Leucocidin-Positive Staphylococcus Aureus Gonarthritis in a Healthy Adult Leads To Fulminant Sepsis with Multiple Metastatic Soft Tissue Infection and Necessity of Extracorporeal Membrane Oxygenation","authors":"T. Berk","doi":"10.23880/jobd-16000224","DOIUrl":"https://doi.org/10.23880/jobd-16000224","url":null,"abstract":"Background: Infections with Panton-Valentine leucocidin (PVL) positive Staphylococcus aureus ( S. aureus ) are often complicated by necrotizing pneumonia, myositis and osteomyelitis. Case Description: We describe a 50 years old, previously healthy male which presented a severe infection with PVL-positive, methicillin- susceptible S. aureus (MSSA) in his left knee after returning from China. He developed a fulminant sepsis with necrotizing pneumonia, acute respiratory distress syndrome (ARDS), acute renal failure and multiple soft tissue abscesses. Extra-corporeal membrane oxygenation (ECMO) was needed for five days. The patient recovered after multiple surgical interventions and long-term antibiotic treatment and eventually returned to work five months after initial admission. Conclusion: While most staphylococcal skin and soft tissue infections (SSTI) show a favorable outcome, SSTI caused by PVL- positive bacteria can lead to fulminant and fatal disease manifestations. Immunocompetent individuals are equally affected as immunocompromised ones. Early suspicion, surgical intervention with debridement and drainage of abscess formations are of key importance in concert with appropriate antibiotic therapy without delay. Imaging should be done to identify clinically silent foci.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128466307","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}