Journal of Orthopaedics & Bone Disorders最新文献

{"title":"Allied Disorders and Complications of Rheumatoid Arthritis - A Statistical Comorbidity Study of 234 Autopsy Patients","authors":"M. Bély","doi":"10.23880/jobd-16000174","DOIUrl":"https://doi.org/10.23880/jobd-16000174","url":null,"abstract":"Objective : The incidence of co - morbidities is higher in rheumatoid arthritis (RA) than in the general population. Associated diseases accompanying RA may modify the clinical course and symptoms of RA and may influence the prevalence and mortality of complications related to the basic diseases and vica versa. The aim of this study was t o determine statistically the possible effect of certain allied disorders: type 2 diabetes mellitus (DM), atherosclerosis (Ath) , hypertension (HT), tuberculosis (Tb) with miliary dissemination (mTb), and malignant tumours (mTu) on the prevalence and mortal ity of RA related complications: systemic autoimmune vasculitis (AV), AA amyloidosis (AAa), lethal cardiac insufficiency (CI) caused by endo - , myo - or pancarditis, with or without interstitial pneumonitis, furthermore lethal septic infection (SI) combined with septic vasculitis (SV) or purulent arthritis (PA) Patients a nd Methods : Twohundred thirty four (234) non - selected autopsy patients with RA were studied. RA was confirmed clinically according to the criteria of the American College of Rheumatology (A CR). The presence of DM, Ath, HT, Tb, mTb, or mTu was determined and analyzed retrospectively, reviewing the clinical and pathological reports. The prevalence and mortality of AV, AAa, CI, SI, SV and PA was determined at autopsy and confirmed by a detailed review of extensive histological material. Demographics of different patient cohorts were compared with the Student (Welch) t - probe. The link between Ath, HT, DM, Tb, mTb, or mTu and AV, AAa, CI, SI, SV or PA was analyzed by Pearson's chi - squared (χ2) tes t. Results : RA associated with DM in 41 (17.52%), with severe Ath in 107 (45.72%), with HT in 41 (17.52%), with with Tb in 28 (11.96%), including active disseminated mTb in 9 (3.85%), and with mTu in 27 (11.54%) of 234 patients. RA was complicated by AV in 43 (18.38 %), by AAa in 48 (20.51%), by CI in 15 (6.41%), and by lethal SI in 33 (14.10%) of 234 patients. SI was combined with PA in 15 (6.41% of 234; 45.45% of 33) or with SV in 7 (2.99% of 234; 21.21% of 33) patients; PA or SV did not occur without gen eralized SI. The relationship between Ath and AV, AV (lethal), AAa, AAa (lethal), CI, SI, PA or SV was consequently inverse and mostly significant. There was a positive and significant correlation between Tb or mTb and AV, furthermore between mTb and mortality of AV. Discussion and Conclusions : The consequently inverse and (in most cases) significant correlation between atherosclerosis and autoimmune vasculitis, amyloidosis or sepsis shows that the prevalence or mortality of AV, AAa and SI wa s not influenced by Ath. RA patients with Ath may represent a special group, characterized by lower incidence of SV, AAa, SI, CI, and carry a better prognosis. Ath is basically an age - dependent phenomenon, characteristically present in RA patients with adv anced age, while AV, AAa (with or without lethal outcome) and SI are complications of RA, and ","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"302 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":"121465122","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":"A. Abolaji","doi":"10.23880/jobd-16000208","DOIUrl":"https://doi.org/10.23880/jobd-16000208","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":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"15 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":"125609086","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":"Postural Control at Hospital Discharge after Spine Surgery–The Influence of the Type of Surgery, Pain Level, Radiculopathy and Stance Parameters","authors":"Henrique Relvas","doi":"10.23880/jobd-16000197","DOIUrl":"https://doi.org/10.23880/jobd-16000197","url":null,"abstract":"Information on postural control has gained recognition as an objective outcome measure after spine surgery. Insights on the patterns of posture and movement exhibited by patients using nonlinear tools can provide useful information on the structure of sway variability, adding value to the traditional quantification of its magnitude. The results should guide efficient therapeutic strategies to promote early recovery. To date, no clinical trial used this protocol at the time of hospital discharge. This study aims to analyse postural control under the acute effect of spine surgery. Thirty-seven patients submitted to decompressive or fusion spine surgery to treat degenerative pathologies or correct severe deformities were recruited (21 male, 16 female; mean age: 53,4 ± 18,1 y, range 14-80). Thirty-seven matching healthy volunteers included the control group. All participants performed a standard stabilometric test on a force platform for 180 seconds, patients being tested at the hospital on discharge day. Six more trials were randomly performed in different stance conditions: 1) eyes closed; 2) feet together; 3) performing a mental task; 4) on a high-density foam; 5) on a low-density foam; 6) holding a box. Values of sway range, mean velocity, elliptic area, and sample entropy, were extracted from centre-of-pressure displacement time-series and analysed using parametric statistical methods. Comparisons were made between control values and the effects of surgery, type of surgical procedure, level of back or leg pain, and residual radiculopathy. During the baseline task (eyes open) patients increased their total area of oscillation (p=0,016), mainly its range in the anteroposterior (AP) direction (p=0,010); the structure of that variability has less complexity and more regularity compared to control participants, showing lower sample entropy values (p=0,031 / AP direction). Differences were not significant in the mediolateral (ML) direction, and the mean velocity did not discriminate participants. Eyes closed condition, being on a high- density foam, or holding a box, exhibited the most robust cumulative significance. Interactions between all the parameters (the type of surgery, level of pain, presence of radiculopathy) may reveal more significant determinants to the postural patterns adopted. However, present data should be interpreted cautiously, being necessary broader samples for each sub-group in future studies, the replication of these measures in later follow-ups, and consider the effects of rehabilitation programs tailored in concordance to the main findings. At hospital discharge, patients having surgery for spine conditions show a significant increase in the magnitude of body sway and a postural pattern markedly regular with low complexity. Stabilometric trials performed with eyes closed, on high-density foam, or holding a box, demonstrate superior ability to discriminate patients from controls and should be used preferentially in future tria","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"10 2 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":"131514407","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":"Bisphosphonates in Postmenopausal Women with Osteoporosis to Prevent Future Fractures","authors":"Bashir I","doi":"10.23880/jobd-16000179","DOIUrl":"https://doi.org/10.23880/jobd-16000179","url":null,"abstract":"Postmenopausal women who have osteoporosis are at increased risk of future fractures. Bisphosphonates are drugs that are used to treat osteoporosis by acting on the osteoclasts to inhibit bone resorption. Several studies have shown that bisphosphonate s can maintain or even increase bone mineral density in osteoporosis patients. This review study analyzed the literature on clinical experiments with bisphosphonate therapy in postmenopausal women to determine if these drugs are efficacious in preventing f uture fractures. Four out of five studies found that women treated with bisphosphonates were at decreased risk of future fractures, and six of six studies found that bisphosphonate therapy increases bone mineral density relative to placebo control. Althoug h further work is warranted to understand the level of bone mineral density increase that is associated with fracture prevention, this study implies that bisphosphonate therapy can be used to help prevent future fractures in postmenopausal osteoporotic wom en. The study is significant in that it helps to underscore the efficacy of bisphosphonate therapy in postmenopausal women, and it may be generalizable to other populations with osteopo s rosis who are at increased risk of fractures.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"15 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":"122235516","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":"Rheumatic Fever Arthritis","authors":"Hasina C","doi":"10.23880/jobd-16000169","DOIUrl":"https://doi.org/10.23880/jobd-16000169","url":null,"abstract":"","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & 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":"131120514","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":"The Effect of Infrapatellar Fat Pad Resection in Total Knee Replacement on Patella Tendon Length and Functional Outcomes after Five Years","authors":"S. M.","doi":"10.23880/jobd-16000187","DOIUrl":"https://doi.org/10.23880/jobd-16000187","url":null,"abstract":"Background : It remains unclear whether infrapatellar fat pad (IPFP) excision leads to patella tendon shortening. Shortening of the tendon alters the biomechanics of the knee and can be problematic however current literature is divided regarding the effect of IPFP resect ion on patella length and functional outcomes following total knee replacement. Methods : Our aim was to identify any functional and radiographic differences incurred with IPFP resection. We conducted a retrospective study comparing resection and preservation of the infrapatellar fat pad between 2007 - 2009 using the Stryker Triathlon or Duracon implants between two independent consultant surgeons. 168 consecutive patients were recruited. Baseline demographics were similar between resection and preservation groups with a mean age of 68.5 (70 vs 67, p=0.17), BMI 31.71 (31.02 vs 32.4, p=0.84) and pa tella resurfacing 23.5 (24 vs 23, p=0.29). Results : Comparisons between the resection and preservation groups for the Insall - Salvati, Modified Insall - Salvati, Caton - deschamps and Blackburne - peel ratios preoperatively, at one year and five years postoperat ively did not demonstrate any statistically significant differences. Knee society scores (KSS) preoperatively (45.36 vs 40.5, p=0.31) and at five years postoperatively (90.49 vs 85.31, p=0.2) were not statistically different. Similarly anterior knee pain s cores (AKPS) demonstrated no statistical significance between groups preoperatively (50.6 vs 42.8, p=0.3) and at five years post operatively (69.4 vs 62.0, p=0.88). Conclusion : There is no statistical difference in radiological measures or functional score s (AKPS &KSS) at one or five years post - operatively between resection or preservation of the infrapatellar fat pad following total knee arthroplasty for primary osteoarthritis.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"15 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":"127973159","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":"Kahler's Disease Revealed by a Fracture of the Humeral Diaphysis","authors":"Dehayni B","doi":"10.23880/jobd-16000181","DOIUrl":"https://doi.org/10.23880/jobd-16000181","url":null,"abstract":"Kahler's disease or multiple myeloma is a malignant hematological pathology, characterized by the malignant proliferation of plasma cells. Reportin g a case of a humeral shaft fracture in a non - traumatic context that revealed Kahler's disease during paraclinical investigations. Management involves histological confirmation of the pathology, osteosynthesis of the fracture by static centromedullary nail ing, with medical treatment made of biphosphonate combined with a chemotherapy protocol targeting the disease. The management of a pathological fracture is a diagnostic emergency, but never an operating emergency. A diagnosis of certainty must be made befo re any intervention.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"28 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114047764","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":"Bilateral Anterior Fracture - Dislocation of Shoulder Following Electrocution: About a Rare Case and Review of the Literature","authors":"Dehayni Badreddine","doi":"10.23880/jobd-16000173","DOIUrl":"https://doi.org/10.23880/jobd-16000173","url":null,"abstract":"Bilateral anterior dislocation of the shoulders associated with a bilateral fracture of the greater tuberosity is an extremel y rare lesion. We reported a case of bilateral dislocation of the shoulder following an electrocution received and operated on in t he Traumatology Orthopaedics I department of the Mohamed V Military Training Hospital in Rabat. The diagnosis was clinical as confirmed by radiological investigations; the patient received surgical treatment after failure of orthopaedic treatment, a bloody reduction in dislocation and osteosynthesis of the greater tuberosity of both shoulders. An evolution was marked by a satisfactory functional recovery of both shoulders. Even clinical examination can help to suspect dislocation, but x - rays are mandatory f or an accurate and early diagnosis. Surgery is recommended for unreduced dislocations or displaced fractures; orthopaedic treatment is indicated in non - displaced fractures subsequent functional rehabilitation allows results after surgical and non - surgical treatment.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"89 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":"115170647","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":"Limited Effect of Generalized Systematic Lockdown on Urgent Orthopedic and Limb Trauma Surgery in a Geographical Area Mildly Affected by the First of SARS-CoV-2 Pandemic: A Multicentric Study (Limited Effect of Lockdown in an Area Mildly affected by the Pandemic)","authors":"G. Villatte","doi":"10.23880/jobd-16000206","DOIUrl":"https://doi.org/10.23880/jobd-16000206","url":null,"abstract":"Purpose: The SARS-CoV-2 pandemic led to a systematic lockdown of populations in many countries along with the reorganization of care systems to respond to this unprecedented health crisis. This study determined (i) the number of urgent surgical operations carried out during the lockdown in a region of France mildly affected by the SARS-CoV-2 pandemic, and (ii) the types of surgery concerned (main characteristics). Methods: A retrospective, comparative, observational, multicentric study of urgent orthopedic and limb trauma surgery during lockdown was conducted. It included three reference care centers of which two were teaching hospitals. A comparison was made with data for the same period in 2019. For each patient, the following data were collected: date of surgery, age, sex, place of residence, and standardized descriptors used to classify the injury anatomically, context in which the injury occurred, and SARS-CoV-2 PCR status. Results: 1098 patients underwent surgery against 1266 over the same period in 2019, a non-significant difference of −13.3% (p = 0.11) [−39.2% in Week 13 (p = 0.02), +7.6% in Week 19 (p = 0.16)]. Except for bone injuries of the hand and wrist (+13.4%, p = 0.07), a decrease in activity was observed for all anatomic locations, and especially for the distal radius (−55.8%, p = 0.001), ankle (−40.5%, p = 0,01). The context in which the injury occurred changed, with in particular a significant decrease in the number of sport accidents (−80.0%, p < 0.001) and road traffic accidents (−41.8%, p = 0.04), and an increase in DIY and gardening accidents (+62.7%, p < 0.001). Conclusion: The decrease in emergency surgery was much less marked in this geographical area mildly affected by the pandemic. Health policy that sets ways to ensure continuity in the care needed by the population must be adapted locally when a global health crisis strikes. Level of proof: 4 – Descriptive epidemiological study.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"58 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":"125715076","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":"Increasing posterior condyle cut for high-flex knee prosthesis may injure popliteus tendon origin: a cadaveric study","authors":"O. Phruetthiphat","doi":"10.23880/jobd-16000193","DOIUrl":"https://doi.org/10.23880/jobd-16000193","url":null,"abstract":"Background: High-flex total knee prosthesis designs were proposed to improve flexion in total knee replacement (TKA). One of high-flex features is increasing posterior condyle cut which put popliteal tendon in higher risk of injury and may result in gap changes. Methods: Thirty-six popliteal origin sites from eighteen fresh cadavers were measured distances between the posterior rim of popliteal tendon origin and posterior border of the lateral femoral condyle (distance A) using digital “Vernier caliper”. The mean distances were compared to posterior condyle thickness of different prosthesis designs. Results: The mean of distance A on the right knee was 9.59 ±1.66 mm (6.03-12.70) while the mean of distance A on the left knee was 9.13 ± 1.78 mm (5.80-11.07). Posterior condyle thickness of the femoral prostheses varies upon their design and size from 7.4 to 10 mm for standard model and from 8.2 to 12.5 mm for high-flex design. Possibilities of popliteal tendon injury during posterior condyle bone cut were 16.7% to 66.7% for standard model and 27.8% to 97.2% for the high-flex design. Conclusion: High-flex TKA prosthesis with thicker posterior condyle relates to higher possibility of popliteal tendon origin injury compared to standard one.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"19 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":"134092537","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}