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Current view of bone regeneration using mesenchymal stem cells 间充质干细胞骨再生的现状
Pub Date : 2016-01-01 DOI: 10.4103/2319-2585.180677
O. Al-Mohrej, Noura K Al-Ayedh, Abdullah Y Al-Awlah, Nader S. Al-Kenani
Bone regeneration, reparative and restorative techniques of bone length discrepancies, correction of posttraumatic and congenital defects and deformities can be induced mesenchymal stem cells (MSCs) which is taken from the bone marrow. In this review article, we aimed to have a look at MSCs for bone and tissue regeneration. MEDLINE ® , Embase™, the Science Citation Index, and Google™ Scholar were used to look for relevant articles which published in English since January 2000. Studies on bone regeneration using MSCs in the field of clinical orthopedics were retrieved. The bone graft can create a self-reliant mechanism to induce bone cellular environment that adapts to the whole skeletal nature. There are several factors contributory to deciding which approach to take. These include the type of bone deformities, defects, the biological setting of the patient, the nature of the reparative process desired, and surgical or orthopedic possibility of conducting all these processes. All these factors and several others should be taken into consideration and careful medical consultation. Orthopedics along with osteology made much headway in restoring bone and tissue in uniquely medical approach that is MSCs through the autologous cancellous bone taken from the bone marrow.
骨髓间充质干细胞(MSCs)可用于骨再生、骨长度差异的修复和修复技术、创伤后和先天性缺陷和畸形的矫正。在这篇综述文章中,我们旨在探讨骨髓间充质干细胞在骨和组织再生中的作用。使用MEDLINE®、Embase™、科学引文索引和谷歌™Scholar检索自2000年1月以来发表的相关英文文章。本文综述了临床骨科领域利用间充质干细胞进行骨再生的研究。骨移植可以创造一种自我依赖的机制,诱导适应整个骨骼性质的骨细胞环境。有几个因素有助于决定采取哪种方法。这些因素包括骨畸形、缺陷的类型、患者的生理环境、所需修复过程的性质以及进行所有这些过程的外科或骨科可能性。所有这些因素和其他几个因素都应该考虑和仔细的医疗咨询。骨科和骨学在修复骨和组织方面取得了很大进展,这是一种独特的医学方法,即通过取自骨髓的自体松质骨来修复MSCs。
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引用次数: 3
Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment 半职业足球运动员长内收肌完全撕脱:非手术治疗下快速恢复比赛
Pub Date : 2016-01-01 DOI: 10.4103/2319-2585.180693
Vince W. Lands, D. Avery, Steven Puccio
The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.
长内收肌被认为是内侧筋室中最常见的受伤肌肉之一。急性完全破裂损伤发生在近端肌肉是不常见的。关于运动员恢复比赛和功能所需的损伤管理的数据有限。现有数据有利于手术管理;然而,非手术治疗可能是一个可行的选择。近端长内收肌腱撕脱伤的非手术治疗可以证明与手术修复在恢复运动和功能方面的效果相同。一名半职业足球运动员在参加比赛时左腹股沟受伤。由于持续的疼痛、肿胀和怀疑受伤,我们进行了磁共振成像诊断为长内收肌腱近端完全撕裂。记录体格检查、力量和活动范围,直到患者能够正常活动,没有力量缺陷、活动范围丧失和速度恢复。这名球员接受了非手术治疗,最终被允许重返赛场。恢复比赛时间为6周。力量不足或运动能力丧失不受重视,运动员能够恢复到基线功能。非手术治疗近端长内收肌腱完全性撕脱伤,即使存在明显的内收,也比手术治疗能更快地恢复比赛。
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引用次数: 0
Carpal tunnel syndrome: Ultrasonographic evaluation of median nerve diameter 腕管综合征:正中神经直径的超声评价
Pub Date : 2016-01-01 DOI: 10.4103/2319-2585.180690
J. Kamath, Babul Reddy, Umapathy Sivam, A. Venugopal, N. Jayasheelan
Background: Carpal tunnel syndrome is the most frequently encountered peripheral compression neuropathy. Diagnosis of carpal tunnel syndrome involves physical examination, nerve conduction studies and electromyography. Ultrasonography (USG) examination of median nerve in carpal tunnel has been proposed as a useful alternative in diagnosing carpal tunnel syndrome. Materials and Methods: Patients were selected from those undergoing diagnostic workup for carpal tunnel syndrome in pre-treatment period. USG was performed using 11 MHz linear array transducer. Cross-sectional area at each level, major and minor axes were measured. Results: In our study, the mean median nerve cross sectional area at proximal part of carpal tunnel by direct method was 12.33 mm 2 in patients and 7.33 mm 2 in controls. By indirect method it was 12.01 mm 2 and 6.633 mm 2 in cases and controls respectively. In this study we found significant difference in flattening ratio between cases and controls. The mean flattening ratio in distal part of tunnel (at the level of hook of hamate) was 2.97 and 2.38 in cases and controls respectively. The sensitivity and specificity for cut-off value ≥2.5 was 76% and 63% respectively. Conclusion: We found that best discriminatory criterion for diagnosis of carpal tunnel syndrome are median nerve cross sectional area in the proximal part of carpal tunnel ≥9 mm 2 (Direct method) and ≥8.5 mm 2 (Indirect method). With our experience, we found it easier to evaluate the median nerve in the carpal tunnel in the disto proximal sequence by identifying the flexor pollicislongus (FPL) first with dynamic evaluation. As the percentage of space occupying lesions causing symptoms in unilateral (atypical) carpal tunnel syndrome is 35%, we highly recommend this pre-operative investigation in all carpal tunnel syndrome patients.
背景:腕管综合征是最常见的周围压迫性神经病变。腕管综合征的诊断包括体格检查、神经传导检查和肌电图。超声检查腕管正中神经是诊断腕管综合征的一种有效方法。材料与方法:选取治疗前接受腕管综合征诊断检查的患者。USG使用11 MHz线性阵列传感器进行。测量了各水平、长、小轴的横截面积。结果:本组直接法腕管近端正中神经平均截面积为12.33 mm 2,对照组为7.33 mm 2。间接法测得病例为12.01 mm 2,对照组为6.633 mm 2。在本研究中,我们发现病例与对照组之间的扁平化率有显著差异。隧道远端(钩骨水平)平均压扁率分别为2.97和2.38。临界值≥2.5的敏感性为76%,特异性为63%。结论:腕管综合征的最佳鉴别标准是腕管近端正中神经截面积≥9mm2(直接法)和≥8.5 mm2(间接法)。根据我们的经验,我们发现通过动态评估先识别掌长屈肌(FPL)可以更容易地评估腕管远端至近端序列的正中神经。由于单侧(非典型)腕管综合征中占位性病变引起症状的比例为35%,我们强烈建议所有腕管综合征患者术前进行这项检查。
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引用次数: 1
Percutaneous autologous stem cell enriched marrow concentrate injection for treatment of cases of impaired fracture healing with implant in situ: A cost-effective approach in present Indian scenario 经皮自体干细胞富集骨髓浓缩液注射治疗原位植入骨折愈合受损病例:目前印度的一种经济有效的方法
Pub Date : 2016-01-01 DOI: 10.4103/2319-2585.172721
Sachin Upadhyay, H. Varma, V. Yadav
Background: The objective of present study is to investigate the feasibility of proposed methodology in present Indian scenario, to enhance fracture repair in cases of impaired healing with the implant in situ using autologous bone marrow concentrate. During critical analysis, the existing study also aimed to assess the outcome (both objective and subjective) as well as to document complications specific to the proposed therapy if any. Materials and Methods: First the marrow is aspirated from posterior iliac crests. After that Ficoll-Paque technique of density gradient separation for the isolation of mononuclear cell populations enriched with stem cells is employed. Later, the concentrate is injected into critical-sized defects of eight patients with stable fracture delayed/nonunion via fluoroscopic guidance. New bone formation was evaluated by X-rays in two standard planes (anteroposterior (AP)/lateral). Level of statistical significance was set at a P < 0.05. Result: The critical osseous defect reached radiographic observable union by a mean of 12.28 ± 1.38 weeks. A distance of 5 mm or less between the fractures′ ends resulted in healing in seven cases (87.5%). The results of the Likert four-point scale showed that majority were very satisfied with the outcome of the procedure (Cronbach′s alpha coefficient (follow-up): 0.93 (6 week); 1.0 (1 year)). There were no adverse events reported during the procedure. Conclusion: Our preliminary results indicate that the approach proposed is feasible and effective in the management of stable (implant in situ) fracture with impaired healing. In context of its cost-effectiveness, we recommend to follow proposed methodology in present Indian scenario.
背景:本研究的目的是探讨在目前印度的情况下提出的方法的可行性,以加强骨折愈合受损的情况下使用自体骨髓浓缩液原位植入物的修复。在关键分析过程中,现有研究还旨在评估结果(客观和主观),并记录拟议治疗的并发症(如果有的话)。材料和方法:首先从髂后嵴抽取骨髓。然后采用密度梯度分离的Ficoll-Paque技术分离富集干细胞的单核细胞群。随后,通过透视引导将浓缩物注射到8例稳定骨折延迟/不愈合患者的临界尺寸缺陷中。新骨形成通过x线在两个标准平面(正位/侧位)评估。P < 0.05为差异有统计学意义的水平。结果:严重骨缺损平均12.28±1.38周达到x线可观察愈合。7例(87.5%)骨折端间距小于5mm愈合。李克特四分量表结果显示,大多数患者对手术结果非常满意(Cronbach 's alpha系数(随访):0.93(6周);1.0(1年))。手术过程中无不良事件报告。结论:我们的初步结果表明,所提出的方法是可行和有效的治疗稳定性(原位种植体)骨折愈合受损。考虑到其成本效益,我们建议在印度目前的情况下遵循拟议的方法。
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引用次数: 1
Simultaneous bilateral Mason type IIb radial head fractures in a young female: Was an increased carrying angle the cause? 年轻女性双侧Mason型IIb型桡骨头同时骨折:是搬运角度增加的原因吗?
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.167980
Pradyumna Raval, C. Fhoghlu, A. Mahapatra
Radial head fracture is the most common type of elbow fracture in adults. It results from a fall on an outstretched hand. However, simultaneous bilateral radial head fractures are extremely rare. We report a case of simultaneous bilateral mason type IIb radial head fractures in a young female, which was treated nonoperatively with excellent results.
桡骨头骨折是成人最常见的肘部骨折类型。它是由伸出的手摔倒造成的。然而,同时发生双侧桡骨头骨折极为罕见。我们报告一例年轻女性同时双侧mason型IIb桡骨头骨折,非手术治疗效果良好。
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引用次数: 1
Anatomical reconstruction of unstable trochanteric fractures through posterior approach 后入路不稳定转子骨折的解剖重建
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.158516
P. Saha, S. Ayan, Utpal Bandyopadhyay, A. Mukhopadhyay, Gautam Bhattyacharyya, K. Mukhopadhyay
Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS) or dynamic condylar screw (DCS) for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks). Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.
目的不稳定转子间骨折由于其术后功能限制一直是骨科医生面临的难题。通过常规的外侧入路,后内侧碎片的解剖重建变得困难,导致骨折过度塌陷和跛行。材料和方法:前瞻性、非随机研究共纳入40例患者。手术采用俯卧位,经后路入路。松质螺钉或ss -钢丝用于固定大或小转子碎片,动力髋螺钉(DHS)或动力髁螺钉(DCS)用于固定主要的两个碎片。骨移植物用于填充后转子区空腔。结果:与常规外侧入路相比,大多数病例骨折愈合较早,且无过度骨折塌陷(平均愈合时间为13.8周;范围:10-18周)。在24周时,75%的Harris髋关节评分为“良好”或“优秀”,功能恢复良好。结论:不稳定粗隆骨折经后路入路解剖重建容易,功能恢复早,效果好。
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引用次数: 4
High signal intervertebral disc in T1-weighted magnetic resonance imaging 高信号椎间盘t1加权磁共振成像
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.158519
A. Agrawal, Kishor V. Hegde, Umamaheswara V Reddy, Satish Kumar, Malleswara G. Rao
{"title":"High signal intervertebral disc in T1-weighted magnetic resonance imaging","authors":"A. Agrawal, Kishor V. Hegde, Umamaheswara V Reddy, Satish Kumar, Malleswara G. Rao","doi":"10.4103/2319-2585.158519","DOIUrl":"https://doi.org/10.4103/2319-2585.158519","url":null,"abstract":"","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70434932","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
Unusual presentation of osteochondroma (Trevor's disease) 异常表现的骨软骨瘤(特雷弗病)
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.167975
Digvijay Agarwal, R. Maheshwari, A. Agrawal
Osteochondromas are common benign tumors. They probably are developmental malformation rather than true neoplasm and are thought to originate within the periosteum and small cartilage nodule. They rarely develop in the joint. Trevor disease or dysplasia epiphysealis hemimelica (DEH) refers to intraarticular epiphyseal osteochondroma. DEH has an incidence of 1 in 1 million and is characterized by asymmetric overgrowth of cartilage. Though many cases of DEH are asymptomatic, but they may be troublesome when they cause mechanical and pressure symptoms depending on the size and location. We report a case of Trevor's disease of the knee in a 21-year-old male with mechanical obstruction.
骨软骨瘤是常见的良性肿瘤。它们可能是发育畸形而不是真正的肿瘤,被认为起源于骨膜和小软骨结节。它们很少发生在关节。特雷弗病或半骨骺发育不良(DEH)是指关节内骨骺骨软骨瘤。DEH的发病率为百万分之一,其特征是软骨不对称过度生长。虽然许多DEH病例是无症状的,但当它们根据大小和位置引起机械和压力症状时,可能会很麻烦。我们报告一例膝关节特雷弗病在一个21岁的男性机械阻塞。
{"title":"Unusual presentation of osteochondroma (Trevor's disease)","authors":"Digvijay Agarwal, R. Maheshwari, A. Agrawal","doi":"10.4103/2319-2585.167975","DOIUrl":"https://doi.org/10.4103/2319-2585.167975","url":null,"abstract":"Osteochondromas are common benign tumors. They probably are developmental malformation rather than true neoplasm and are thought to originate within the periosteum and small cartilage nodule. They rarely develop in the joint. Trevor disease or dysplasia epiphysealis hemimelica (DEH) refers to intraarticular epiphyseal osteochondroma. DEH has an incidence of 1 in 1 million and is characterized by asymmetric overgrowth of cartilage. Though many cases of DEH are asymptomatic, but they may be troublesome when they cause mechanical and pressure symptoms depending on the size and location. We report a case of Trevor's disease of the knee in a 21-year-old male with mechanical obstruction.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70434982","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
Effects of platelet-rich plasma in supraspinatus tendinopathy 富血小板血浆在冈上肌腱病中的作用
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.167981
P. Singh, N. Saxena, Sohael M. Khan
{"title":"Effects of platelet-rich plasma in supraspinatus tendinopathy","authors":"P. Singh, N. Saxena, Sohael M. Khan","doi":"10.4103/2319-2585.167981","DOIUrl":"https://doi.org/10.4103/2319-2585.167981","url":null,"abstract":"","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70435262","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: 2
Primary intraosseus meningioma of the calvarium presenting as solitary osteolytic lesion 颅骨原发性骨内脑膜瘤表现为孤立性溶骨损伤
Pub Date : 2015-07-01 DOI: 10.4103/2319-2585.167977
Kanika Mehta, V. Mohan, A. Munshi, R. Sehrawat
A rare case of primary intraosseous meningioma of the calvarial bones presenting as solitary osteolytic lesion on the skull radiograph and correctly diagnosed pre-operatively on computed tomography (CT) and magnetic resonance imaging (MRI) by correlating the clinical and imaging findings is reported in this communication. The clinical, radiographic, CT and MR imaging features of the case and the difficulties in making a correct clinico –radiological diagnosis are highlighted in this communication.
本文报道一例罕见的颅骨原发性骨内脑膜瘤,在颅骨x线片上表现为孤立性溶骨性病变,并在术前通过计算机断层扫描(CT)和磁共振成像(MRI)将临床和影像学结果相结合,正确诊断。该病例的临床、放射学、CT和MR成像特征以及做出正确的临床放射学诊断的困难在本交流中被强调。
{"title":"Primary intraosseus meningioma of the calvarium presenting as solitary osteolytic lesion","authors":"Kanika Mehta, V. Mohan, A. Munshi, R. Sehrawat","doi":"10.4103/2319-2585.167977","DOIUrl":"https://doi.org/10.4103/2319-2585.167977","url":null,"abstract":"A rare case of primary intraosseous meningioma of the calvarial bones presenting as solitary osteolytic lesion on the skull radiograph and correctly diagnosed pre-operatively on computed tomography (CT) and magnetic resonance imaging (MRI) by correlating the clinical and imaging findings is reported in this communication. The clinical, radiographic, CT and MR imaging features of the case and the difficulties in making a correct clinico –radiological diagnosis are highlighted in this communication.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70435096","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
期刊
Journal of Orthopaedics and Allied Sciences
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