The Open Orthopaedics Journal最新文献

{"title":"Muscle Damage in Different Approaches in Total Hip Arthroplasty According to Serum Markers","authors":"Stylianos Tottas, A. Fiska, Ioannis E. Kougioumtzis, A. Ververidis, K. Tilkeridis, G. Drosos","doi":"10.2174/1874325001913010097","DOIUrl":"https://doi.org/10.2174/1874325001913010097","url":null,"abstract":"Total Hip Arthroplasty (THA) is the final treatment of end-stage hip osteoarthritis. Nowadays, THA has become very common, cost- effective and one of the most successful orthopaedic procedures. Recently, surgeons have shifted their interest to approaches according to Minimally Invasive Surgery (MIS). These approaches are either modifications of conventional approaches or they are designed from the beginning as MIS approaches. Muscle damage and soft tissue damage are issues that concern researchers who perform studies on THA.The aim of this study is to review the literature concerning studies by comparing different approaches using serum and inflammatory markers for muscle and soft tissue damage.We searched the PubMed database in the English language systematically for clinical studies or reviews, comparing muscle damage according to serum markers between two or more approaches in primary total arthroplasty.In total, twenty-one studies were included in this review. Although the results are controversial, it seems that MIS approaches in most of the studies were related to lower levels of inflammation markers contrasting with conventional approaches. Nevertheless, this difference in muscle damage is not correlated with a difference in functional scores or other perioperative data and clinical outcomes in all studies.The existing literature does not lead to a safe consensus about the superiority of any approach. Therefore, there is still a need for further research with well-designed studies.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88634913","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":"Injury Patterns of Equine-Related Trauma","authors":"F. Liaw, S. Govilkar, T. Woo, I. Britton, Bishoy Youssef, Justin Lim","doi":"10.2174/1874325001913010130","DOIUrl":"https://doi.org/10.2174/1874325001913010130","url":null,"abstract":"Equestrian sports are popular in the United Kingdom (UK), with approximately 2.7 million people of all ages participating in equine-related sports in 2015. These sports are not without risk; the position of the mounted rider puts them at risk of injuries sustained by fall from a height, compounded by movement at speed. The aim of this study was to characterise demographics and injury patterns of equine-related trauma presentations at a major trauma centre in the UK.From a trauma admissions database and electronic search of radiology requests including keywords “equine”, “equestrian”, “horse”, and “pony” with cross-referencing from ICD-10 coding, 144 patients were identified to have presented to an adult major trauma centre with equine-related injuries from falls while mounted over a 3-year period.Females accounted for 86% of patients (n = 123). The most common presenting age group was age 20-29, but most injuries occurred with patients of ages 50-59. Spinal injuries accounted for 41% (n = 69) of all injuries and occurred in a similar proportion in all age groups. Upper limb injuries accounted for 100% of injuries in those aged 0-9. 39% (n = 56) of patients required operative management for their injuries.We have been able to identify which body zones of injury are more at-risk in equine-related sports following falls from mounted riders, and recognize how certain injury patterns may be more prevalent in particular age groups. Spinal injuries have been demonstrated to be a new leading zone of injury, possibly due to stricter legislation from government and industry leading to the relative reduction of head injuries. Reducing the number and severity of these injuries will not only improve patient outcomes but reduce the burden on the healthcare system.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86108964","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":"Evaluating the Outcome of a New Functional Brace for the Management of Humeral Shaft Fractures","authors":"P. Athreya, V. Abbott, L. Elias, B. Thomas","doi":"10.2174/1874210601913010136","DOIUrl":"https://doi.org/10.2174/1874210601913010136","url":null,"abstract":"\u0000 \u0000 Our practice identified several issues with the commercially available plastic off-the-shelf Sarmiento brace that is used in managing humeral shaft fractures, with regards to comfort, moulding, and ability to hold reduction. A custom-moulded fibreglass brace was developed which was soft padded for comfort, lightweight, and could be adjusted with changes in swelling.\u0000 \u0000 \u0000 \u0000 The aim of this study was to evaluate the use of this new brace.\u0000 \u0000 \u0000 \u0000 16 patients were identified having treatment with the brace from March 2011 to July 2013. Retrospective analysis of medical records and imaging occurred to assess union and angulation. Prospective analysis of patient function was assessed with the CONSTANT, DASH and SPADI Shoulder score.\u0000 \u0000 \u0000 \u0000 Patients were initially managed with a U-Slab for an average of 26 days. Patients were followed up for an average of 70 days post brace application. 5 patients were lost to follow up. The remaining 11 patients had the brace on for an average of 73 days. In the last follow up, 15 patients had an acceptable anterior/posterior angulation of less than 200 (1 patient - 220), varus/valgus angulation less than 200, and less than 3cm of shortening. 12 patients had radiological evidence of union, with the other 4 demonstrating significant callus. 4 patients were recruited for prospective analysis with DASH, SPADI and CONSTANT shoulder scores, and demonstrated minimal loss of function. There were no complications of bracing treatment.\u0000 \u0000 \u0000 \u0000 Our new functional brace led to bony union in most patients, and from a clinical perspective, most patients were pain free and had minimal loss of function.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"81 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89583150","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":"Comparison of G-guide and Image-free Navigation System in Accuracy of Stem Anteversion Assessment During Total Hip Arthroplasty","authors":"Y. Fujihara, S. Fukunishi, Tomokazu Fukui, Shoji Nishio, Y. Takeda, Shohei Okahisa, S. Yoshiya","doi":"10.2174/1874325001913010109","DOIUrl":"https://doi.org/10.2174/1874325001913010109","url":null,"abstract":"\u0000 \u0000 We have developed and utilized the Gravity-guide (G-guide) as a simple manual instrument for intraoperative assessment and adjustment of stem anteversion (AV). Since 2013, we simultaneously measured stem AV using the G-guide and image-free navigation during THA procedure. The purpose of this study was to compare the measurement accuracy of the G-guide and navigation system using the postoperative CT results as a reference.\u0000 \u0000 \u0000 \u0000 In total, 59 hips in 56 patients who underwent primary THA using both the G-guide and image-free navigation system were included in the study. All patients underwent postoperative CT examination, and the femoral stem AV was assessed using a 3D image analysis system (Zed hip, LEXI, Japan). The AV angle derived from the postoperative CT image analysis was used as the reference value to assess the accuracy of the two intraoperative measurement systems.\u0000 \u0000 \u0000 \u0000 The discrepancy between the G-guide and the postoperative CT-measured values averaged 5.0° ± 3.9°, while the corresponding value for the navigation system was 5.2° ± 4.1°. Acceptable accuracy with a measurement error of less than 10° was achieved in 86% and 90% of the cases for the G-guide and navigation measurements respectively.\u0000 \u0000 \u0000 \u0000 Consequently, it was shown that both navigation and G-guide measurements can achieve comparative accuracy and are clinically useful.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77864533","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":"A Clinical and Magnetic Resonance Imaging Assessment of Anterior Cruciate Ligament Reconstruction with Different Fixation Techniques Using Gracilis and Semitendinosus Autograft","authors":"Ioannis D. Apostolopoulos, S. Pneumaticos, D. Korres, K. Markatos, A. Andreakos","doi":"10.2174/1874325001913010144","DOIUrl":"https://doi.org/10.2174/1874325001913010144","url":null,"abstract":"\u0000 \u0000 Hamstring tendons are widely used in anterior cruciate ligament reconstruction. Improvements in fixation materials have increased the success of the reconstruction procedures using this type of graft. The main advantage of the hamstring tendon autograft is the lower donor site morbidity associated with its harvesting. On the other hand, tunnel widening is reported more frequently with the use of hamstring tendon autograft compared to patellar or quadriceps tendons. The objective of the present study was to evaluate three different fixation techniques at a minimum of 2 years after Anterior Cruciate Ligament (ACL) reconstruction using gracilis and semitendinosus autograft.\u0000 \u0000 \u0000 \u0000 Between February 2012 and March 2016, 112 ACL reconstructions using double looped semitendinosus and gracilis graft were performed. Patients were divided into 3 groups in a randomized fashion. 98 patients were followed up for 2 years. In the first group (43 patients), suspensory fixation using Retrobutton (Arthrex, Inc, Naples, Florida) was used. In the second group (30 patients), transcondylar graft fixation Bio-Transfix (Arthrex, Naples, Florida) was performed, and in the third group (25 patients), aperture fixation using AperFix (Cayenne Medical, Scottdale, Arizona, Biomet) was performed. Clinical evaluation was performed using the International Knee Documentation Committee (IKDC) form, Lysholm knee and Tegner activity level scores, as well as arthometer measurements. Tunnel enlargement and graft integrity were evaluated using Magnetic Resonance Imaging (MRI) at 6, 12 and 24 months.\u0000 \u0000 \u0000 \u0000 Ten patients were completely lost to follow up, and four had undergone a revision ACL reconstruction before the two-year follow up period, leaving 98 patients for analysis. No statistically significant differences between the three groups were noted other than that the first group tended to have more tunnel enlargement than the other two groups, especially at the femoral tunnel (p=.026), but not at the tibial tunnel (p>0.408). Our results showed that almost 90% of the patients in the three groups had functionally normal or near normal IKDC, Lysholm and Tegner scores.\u0000 \u0000 \u0000 \u0000 The three different techniques yielded equal results as regards improved patient performance. The functional results as well as knee stability tests were not related with tunnel enlargement, at least in the short term.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82481871","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":"Effectiveness of Surgical versus Conservative Treatment for Distal Femoral Growth Plate Fractures: A Systematic Review","authors":"Nicholas Hayes, K. Umapathysivam, B. Foster","doi":"10.2174/1874325001913010117","DOIUrl":"https://doi.org/10.2174/1874325001913010117","url":null,"abstract":"The objective of this review was to determine whether surgery, in comparison to conservative treatment, is a safe and effective intervention for the management of distal femoral growth plate fractures.A systematic literature review was performed using a three-step search strategy. The PubMed, Embase and Scopus databases were utilized to identify current studies from 1 January 1990 to 8 January 2017. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments. Primary outcomes of interest were rates of growth arrest and angular deformity.Of the 7740 studies identified with the search, 15 case studies with data inclusive of outcomes of interest were selected for inclusion. A total of 466 patients were included.The rate of complication in the surgical population was 37.8%. In the conservative population the rate of complication was 34.0%. Five of the 15 papers showed Salter-Harris (SH) classification to correlate with prognosis, three papers showed the presence of displacement to correlate with prognosis which would have had an influence on the results of these higher graded injuries likely to have been managed operatively. A high rate of position loss and subsequent growth abnormalities was observed when conservative management was instituted.The rate of complication was marginally higher in the surgical population than that in the conservative population. This study also identified that higher severity distal femur physeal fractures, determined by the amount of displacement and Salter Harris grade, may associate a poorer outcome. It appears that managing higher severity distal femoral physeal injuries conservatively would be less likely to achieve and maintain reduction and therefore associate higher risks of malunion with subsequent growth arrest, leg length discrepancy and angular deformity as compared with surgical intervention. Further studies with higher patient numbers and comparable cohorts are needed to compare surgical and conservative interventions for the lower severity distal femoral physeal fractures.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90183686","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":"Subacromial Balloon Interpositional Arthroplasty for the Management of Irreparable Rotator Cuff Tears: Five-year Results","authors":"N. Bakti, M. Bhat, A. Gulihar, V. Prasad, Bijayendra Singh","doi":"10.2174/1874325001913010089","DOIUrl":"https://doi.org/10.2174/1874325001913010089","url":null,"abstract":"\u0000 \u0000 Management of massive irreparable rotator cuff tears can be a source of significant dilemma for the treating surgeon. This is especially true when dealing with patients with poor physiological reserves where options of tendon transfer, superior capsular repair or arthroplasty might be unsuitable. We report the five-year outcomes of 26 patients who underwent balloon interpositional arthoplasty for the management of massive irreparable rotator cuff tears.\u0000 \u0000 \u0000 \u0000 Fifty-four consecutive patients underwent balloon interpositional arthroplasty in our institution. Of these, 26 patients completed at least two postoperative functional outcome measures over a five-year period, which included the Visual Analogue Score (VAS), Oxford Shoulder Score (OSS) and the SF12 score. Outcome scores were obtained prospectively.\u0000 \u0000 \u0000 \u0000 The average age at implantation was 67 years old. Our result shows statistically significant improvement in pain up to five years post-implantation of the device (p = 0.012). Function measured by the OSS and SF12 (PCS) score showed improvement up to two years post-implantation (p = 0.006). Three of the 54 patients in our cohort went on to have arthroplasty surgery for their rotator cuff tears. None of the patients in our cohort suffered from any adverse reactions following implantation.\u0000 \u0000 \u0000 \u0000 Results from our study identify the spacer device as an option in the management of irreparable rotator cuff tears with statistical improvement in pain and function. It may also delay the need for arthoplasty surgery.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85672094","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":"Full Endoscopic Discectomy Using Transforaminal Endoscopic Spine System Technique: A Mini Review of Complications","authors":"S. Kapetanakis, C. Chaniotakis, A. Angoules","doi":"10.2174/1874325001913010076","DOIUrl":"https://doi.org/10.2174/1874325001913010076","url":null,"abstract":"Full Endoscopic Discectomy (FED) is a minimally invasive technique for the treatment of Lumbar Disk Herniation (LDH) with increasing popularity among surgeons in the recent years. This alternative to conventional procedures surgical approach is generally a safe and efficient technique possessing many advantages such as less soft tissue trauma, preservation of dorsal musculature, and reduced perioperative morbidity and rapid recovery. However, FED is associated with a number of complications such as postoperative dysesthesia, nerve root injury, and dural tears.Α search of PubMed, Google Scholar and Scopus electronic databases was used to revised the literature on complications of full endoscopic discectomy using transforaminal endoscopic spine system techniqueIn this review complications associated with FED are analyzed, emphasizing on the potential beneficial role of Transforaminal Endoscopic Spine System (TESSYS) technique in reducing their frequency.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78421532","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":"Recovery of Range of Motion and Decrease in Pain after Progression of Supraspinatus Tendon Tear: A Case Report","authors":"Y. Hagiwara, J. Hamada, Akira Ando, Kenji Kanazawa, Y. Yabe, E. Itoi","doi":"10.2174/1874325001913010084","DOIUrl":"https://doi.org/10.2174/1874325001913010084","url":null,"abstract":"Rotator cuff disease is one of the most prevalent shoulder disabilities especially in the elderly population. Tear progression is significantly greater in the symptomatic patients than in the asymptomatic ones. From these aspects, shoulder surgeons interpret surgical indications and counsel patients regarding the risk of non-operative treatments. However, there were a few reports that pain and duration of symptoms were not strongly associated with severity of rotator cuff tears, and non-operative management with physical therapy was effective. There have remained controversies for the treatment of rotator cuff tears.A 59-year-old man with a sedentary work life experienced right shoulder pain with abduction at night. However, the pain kept worsening after two months, and he finally visited our clinic three months after the onset of pain. Magnetic resonance imaging in the coronal and axial planes showed effusion around the subacromial and subcoracoid bursae and joint-side tear of the supraspinatus tendon. A range of motion in the right shoulder was severely restricted at the initial visit of our clinic. After sufficient rehabilitation, the symptoms were not changed and an arthroscopic rotator cuff repair was scheduled. However, during waiting for surgery, he felt something popped in the right shoulder while wearing a jacket. Immediately after this, pain during motion and at night decreased, and he experienced no difficulty with activities of daily living and the surgery was cancelled. This is the first case with a recovery of range of motion and a decrease in pain after progression of a supraspinatus tendon tear.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81924201","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":"Chondral Injury After Inside-Out Meniscal Suture Repair Using Meniscal Sutures","authors":"T. Mine, Riri Hayashi, K. Ihara, H. Kawamura, Ryutaro Kuriyama, Y. Tominaga","doi":"10.2174/1874325001913010072","DOIUrl":"https://doi.org/10.2174/1874325001913010072","url":null,"abstract":"Chondral injury after arthroscopic meniscal suture repair is rare. We present a case of chondral injury due to the migration of suture after meniscal repair. The aberrant suture that remained temporarily at the medial tibiofemoral joint may have led to the chondral lesion of the femoral medial condyle and the tibial medial plateau at the weight-bearing portion.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77120521","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}