MOJ orthopedics & rheumatology最新文献_第2页

Failure due to metallosis after cruciate retaining total knee replacement 保留交叉韧带的全膝关节置换术后金属化失败

MOJ orthopedics & rheumatology Pub Date : 2021-08-11 DOI: 10.15406/mojor.2021.13.00552

Ebied Wessam, Maziad Ali, A. Mahmoud

{"title":"Failure due to metallosis after cruciate retaining total knee replacement","authors":"Ebied Wessam, Maziad Ali, A. Mahmoud","doi":"10.15406/mojor.2021.13.00552","DOIUrl":"https://doi.org/10.15406/mojor.2021.13.00552","url":null,"abstract":"Background: Rupture of PCL on cruciate retaining TKA can cause abnormal accelerated wear of polyethylene component which may result in metal/metal articulation and development of massive infiltration of metal debris in the periprosthetic soft tissue (metallosis). Patient and methods: Eight cases (Five females, 3 males, mean age 64.6 years) with failed primary cruciate retaining knee arthroplasty were retrospectively studied. Revisions were performed after a mean of 59.8 months due to pain and instability. All the patients had variable degrees of clinically relevant posterior knee instability. Infection was excluded in all cases through microbiological examination and synovial fluid analysis. Results: Abnormal direct metal-on-metal articulation between the femoral component and the tibial base plate with advanced polyethylene wear were found intraoperatively in all cases in addition to extensive tissues black staining, advanced osteolysis and pseudotumor formation. All cases were managed by single stage revision surgery with implant removal, profound synovectomy and revision using a more constrained modular revision knee system. Conclusion: Metallosis after total knee arthroplasty is a rare situation that should be suspected in total knee arthroplasty cases with radiologically evident advanced polyethylene wear especially in cruciate retaining knee systems. It could lead to significant osteolysis making revision surgery technically challenging.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43704907","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}

引用次数: 0

Bilateral elbow indirect Cubital tunnel syndrome due to mass effect of Gouty tophi 痛风性痛风引起的双侧肘间接肘管综合征

MOJ orthopedics & rheumatology Pub Date : 2021-07-21 DOI: 10.15406/mojor.2021.13.00551

Akshay Lekhi

引用次数: 0

Successful therapeutic response with sequential therapy of rituximab and belimumab in a hispanic patient with refractory lupus nephritis 利妥昔单抗和贝利单抗序贯治疗一例西班牙难治性狼疮肾炎患者的成功疗效

MOJ orthopedics & rheumatology Pub Date : 2021-07-14 DOI: 10.15406/mojor.2021.13.00550

Vinicki Jp, Daza JL,2, Na Ma

{"title":"Successful therapeutic response with sequential therapy of rituximab and belimumab in a hispanic patient with refractory lupus nephritis","authors":"Vinicki Jp, Daza JL,2, Na Ma","doi":"10.15406/mojor.2021.13.00550","DOIUrl":"https://doi.org/10.15406/mojor.2021.13.00550","url":null,"abstract":"Lupus nephritis (LN) is the most common severe organ manifestation of systemic lupus erythematosus (SLE). Life expectancy and renal survival is reduced in these patients. A partial remission in LN is associated with a significantly better patient and renal survival rate compared with no remission. We report the case of a 27-year-old Hispanic patient with diffuse proliferative lupus nephritis (grade IV with high activity index) managed with induction therapy with mycophenolate mophethyl (MMF, 1000 mg daily escalating to 3000 mg daily and prednisone (PDN) 1 mg/kg/day. Progression of proteinuria with preserved renal function and extra-renal activity were observed (alopecia). Re-induction with IV cyclophosphamide (CYC, 1 gr.) and pulse IV methylprednisolone (500 mg for three days) was administered, followed by a lower starting dose of PDN (0.5 mg/kg/day). Treatment failure was observed. A second renal biopsy evidenced renal damage (chronicity index 4/12 and activity index 4/24). The patient also developed non-renal clinical manifestations (malar rash, oral ulcers and arthritis). Treatment with IV rituximab (RTX) 1000 mg X2 associated with MMF 1000 mg per day and IV methylprednisolone 500 mg X3 was initiated, followed by PDN 0.5 mg/kg/day with a dose-tapering scheme similar to CYC re-induction. Treatment continued with IV Belimumab (BLM) 600 mg every month associated with MMF 1000 mg per day. Sequential therapy with RTX + BLM showed a partial renal and complete extra-renal response in a patient with severe lupus despite two 2 immunosuppressive treatment schemes.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42293040","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}

引用次数: 0

Posterior tibial slope measurement among Saudi population 沙特人群胫骨后斜度测量

MOJ orthopedics & rheumatology Pub Date : 2021-06-18 DOI: 10.15406/mojor.2021.13.00549

Mouad Alsowaigh, Mohammad A Arafah, Sultan K Alharbi, Omar Al Sultan, Adel Alshahrani, F. A. Hulaibi

{"title":"Posterior tibial slope measurement among Saudi population","authors":"Mouad Alsowaigh, Mohammad A Arafah, Sultan K Alharbi, Omar Al Sultan, Adel Alshahrani, F. A. Hulaibi","doi":"10.15406/mojor.2021.13.00549","DOIUrl":"https://doi.org/10.15406/mojor.2021.13.00549","url":null,"abstract":"To measure the posterior slope of the tibia among the healthy Saudi population using Magnetic Resonance Imaging (MRI). A retrospective study review of 151 knee MRIs at King Khaled University Hospital, Riyadh, Saudi Arabia. All patients with no previous surgical intervention to their knees and did not suffer any bone injury around the knee were included. Three different orthopedic physicians (two senior residents, one orthopedic fellow) measured the posterior tibial slope (PTS) angle for all patients, and their average was taken for all readings using a sagittal T2 MRI cut. Patients with a history of previous surgical intervention to the knee joint, trauma involving distal femur or proximal tibia, osteoarthritis and inflammatory arthritis, and congenital deformities were excluded from the study. The mean age of patients was 28.15 in a range of 15-50 years. The posterior tibial slope mean and the median and the mode were 8.76, 8.73, 7.53, respectively. In addition, the mean angle (degree) in females was 9.69±4.02 and 8.76±4.15 in males. The Maximum and the minimum posterior slope angle calculated in these patients were respectively 19.73 and 0.3 degrees. Our findings are that the mean posterior tibia slope among the Saudi population is 8.76˚. The results showed the difference of PTS in Saudi people comparing to deferent communities. The association between the numbers of the posterior tibial slope with gender was tested and no significant correlation. In this study, we did not calculate weight and height in the cases as independent factors. Because of that, upcoming studies might consider these factors.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44647379","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}

引用次数: 0

Psychological intervention to enhance the volitional quality of perseverance in athletes with hearing impairment 心理干预提高听力障碍运动员毅力意志品质

MOJ orthopedics & rheumatology Pub Date : 2021-06-11 DOI: 10.15406/mojor.2021.13.00547

Lic. Julio Cesar Cobas Román, Dr C Alina Bestard Revilla

引用次数: 0

Comorbidities and indications for total hip arthroplasty at a tertiary care center in Saudi Arabia 沙特阿拉伯三级医疗中心全髋关节置换术的并发症和适应症

MOJ orthopedics & rheumatology Pub Date : 2021-06-10 DOI: 10.15406/mojor.2020.12.00519

B. Hetaimish, Eyad A Alakkas, K. Alharbi, Abdulrahman M Alradadi, Habib Y Aletani, Abdullah M Baslaim, Ahmed Q Alturkistany

{"title":"Comorbidities and indications for total hip arthroplasty at a tertiary care center in Saudi Arabia","authors":"B. Hetaimish, Eyad A Alakkas, K. Alharbi, Abdulrahman M Alradadi, Habib Y Aletani, Abdullah M Baslaim, Ahmed Q Alturkistany","doi":"10.15406/mojor.2020.12.00519","DOIUrl":"https://doi.org/10.15406/mojor.2020.12.00519","url":null,"abstract":"Objectives: Total hip arthroplasty (THA) is one of the most effective orthopedic interventions for the treatment of patients with advanced‑ stage hip disease. However, reports regarding indications for primary THA in Saudi Arabia are limited. We aimed to evaluate primary indications for THA and identify associated chronic diseases and postoperative complications in THA patients at a tertiary hospital in Saudi Arabia. These are important to provide knowledge on types of hip diseases and variables that may affect the outcome of this intervention in the Saudi population. Methods: This is a retrospective cohort study of THA cases performed between 2010 and 2019 at a tertiary center in Saudi Arabia. Retrieved data include patients’ ages at the time of surgery, chronic diseases, presurgical diagnosis, site and duration of surgery, and postoperative complications. Results: We identified 83 patients who had undergone primary THA; in regard to comorbidities, 32.5% and 30.1% had hypertension and diabetes mellitus, respectively. The most common indication for THA was degenerative hip osteoarthritis (50.6%), followed by post-traumatic arthritis (22.9%) and hip avascular necrosis (20.5%). Conclusion: Despite the high rate of trauma and accidents in Saudi Arabia, degenerative osteoarthritis remains the most common indication for primary THA. Post-traumatic osteoarthritis is identified as the second major indication for THA.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49603566","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}

引用次数: 1

Access to care for workers’ compensation patients in dense and sparse population centers 人口密集和稀疏的中心地区工伤补偿患者的护理可及性

MOJ orthopedics & rheumatology Pub Date : 2021-05-15 DOI: 10.15406/mojor.2020.12.00517

Blair A Skylar M Rhode, Skylar M Rhode Skylar M Rhode

{"title":"Access to care for workers’ compensation patients in dense and sparse population centers","authors":"Blair A Skylar M Rhode, Skylar M Rhode Skylar M Rhode","doi":"10.15406/mojor.2020.12.00517","DOIUrl":"https://doi.org/10.15406/mojor.2020.12.00517","url":null,"abstract":"Background: Workers’ compensation was originated to provide a no-fault, timely access to appropriate medical care. Unfortunately, we have found that the system fails the injured worker in certain environments. By implementing procedural roadblocks in the form of initial claim denial and delay methods, the injured worker finds himself/herself in a battle of attrition. By delaying treatment and compensation benefits, the injured workers are “starved out” of their access to care and often walk away from their claim or accept a payout without treatment. Methods: We performed a randomized, consecutive case-series where 300 hypothetical patients called medical offices to attempt to arrange a physician consultation. We analyzed the ability of a patient to gain access (an appointment) to a primary care (N=100), orthopedic (N=100) and neurology (N=100) physician after stating that they were injured at work. We analyzed two cohorts, one as an injured worker that was given a claim number (N=150) and the other that was injured at work but not yet given a claim number (N=150). Conclusion: This study demonstrates how difficult it is to gain access to care as an injured worker. An injured worker in a low densely populated area without a claim number was unable to gain access to a primary care doctor in our cohort (100% denial rate). Even a patient with an accepted claim number in densely populated Cook County, IL had a 52% chance of being denied access to care with an orthopedic surgeon while a patient without a claim number had an 84% chance of being denied access to orthopedic care.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47550392","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}

引用次数: 0

Nonvascularized autologous fibular strut graft can be an option for treatment of segmental bone loss in comminuted femoral shaft fracture 非血管化自体腓骨支柱移植物可作为治疗粉碎性股骨干骨折节段性骨丢失的一种选择

MOJ orthopedics & rheumatology Pub Date : 2021-05-14 DOI: 10.15406/mojor.2021.13.00545

Chowdhury Foyzur Rob, Md Gulam Mustofa, Lt Col Mohammad Saiful Islam, Md Tabibul Islam, A. Bhuiyan

{"title":"Nonvascularized autologous fibular strut graft can be an option for treatment of segmental bone loss in comminuted femoral shaft fracture","authors":"Chowdhury Foyzur Rob, Md Gulam Mustofa, Lt Col Mohammad Saiful Islam, Md Tabibul Islam, A. Bhuiyan","doi":"10.15406/mojor.2021.13.00545","DOIUrl":"https://doi.org/10.15406/mojor.2021.13.00545","url":null,"abstract":"We present the case of a patient who suffered a comminuted femoral shaft fracture. The patient was a 20 years-old male following a sustained RTA and presented at our hospital after about 6 weeks after the incidence. Initially he was treated with skeletal traction with surgical toileting and debridement; and later on external fixator with dressing several times. Open reduction and internal fixation was performed with the use of a non-vascularized autologous fibular strut graft as an augmentation technique in conjunction with dynamic plating. Bony union occurred at 24 weeks. Clinically patient had stable, painless extremity, and resumed active use of the involved extremity without protective device after 2 year after femur fixation. No pain involving the donor graft site was reported at the time of the most recent follow-up examination. This case study demonstrates the use of free non-vascularized autogenous fibular strut bone graft as an option to bridge segmental bone loss in comminuted femoral shaft fracture. This is a relatively simple, not expensive procedure.","PeriodicalId":91366,"journal":{"name":"MOJ orthopedics & rheumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43932838","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}

引用次数: 0

Artificial intelligence and data processing in injury diagnosis and prevention in competitive sports: A literature review 人工智能与数据处理在竞技体育损伤诊断与预防中的应用——文献综述

MOJ orthopedics & rheumatology Pub Date : 2021-05-14 DOI: 10.15406/mojor.2021.13.00544

P. Poulios, Athanasios Serlis, P. Groumpos, I. Gliatis

引用次数: 1

Post traumatic genu valgum with valgus deformity of left lower femur and upper tibia valgus and procurvatum deformity with 10cm lld and puckering of skin around knee with bad scar 创伤后膝外翻伴左下股骨外翻畸形，胫骨上外翻及膝前凸畸形，宽10cm，膝周围皮肤起皱，瘢痕严重

MOJ orthopedics & rheumatology Pub Date : 2021-05-14 DOI: 10.15406/mojor.2021.13.00546

Bari Mm, Choudhury Quayyum Mki, I. Shahidul, Ashraf Mohammad Shayan, Bari AM Shayan R

引用次数: 0