Introduction: The objective of this work was to evaluate the clinical and radiological results; and the quality of life of patients with THA at final follow-up. Patients and Method: This was a prospective, multicenter, multi-operator study, which was carried out in patients with THA, between January 1, 2014 and December 31, 2022. The clinical evaluation was carried out with the PMA, Devane and WOMAC activity scores. Radiologically, the analysis focused on the inclination of the cup, the peri-prosthetic lines and the bony integration of the implants. Results: 85 patients were re-evaluated out of 145; 60 were lost to follow-up including 16 due to death, the average follow-up was 5.85 years. The average age was 51.81 years (39-85). The functional scores were generally satisfactory at the last follow-up with a mean PMA, Devane and WOMAC score of 15.8 respectively; 2 and 76.54 and a rate of resumption of sexual intercourse after THA of 54.11%. The mechanical complications were: 8 revisions for prosthetic loosening, 4 wear and osteolysis, 02 periprosthetic margins. The patients were much more optimistic than the surgeon: 94.73% of the patients judged their results to be excellent or good while the surgeon only accepted 85.96%. Conclusion: Degenerative hip joint pathologies seem to be increasing due to the incidence of complications of sickle cell disease. The need for joint replacement is growing despite the still expensive cost. At the last follow-up, the overall results are satisfactory and a rate of resumption of sexual intercourse after THA of 54.11%. Chronic pain and muscle atrophy have had a significant impact on quality of life and sexual activity. Our study confirms the medium-term reliability of dual mobility with a survival rate of 90.60%. These results must be tempered because of the occurrence of long-term complications, linked to the risk of dual mobility in young subjects.
{"title":"Operative Treatment of Patients with Fractures During COVID-19","authors":"Kombate Noufanangue Kanfitine","doi":"10.46889/josr.2023.4310","DOIUrl":"https://doi.org/10.46889/josr.2023.4310","url":null,"abstract":"Introduction: The objective of this work was to evaluate the clinical and radiological results; and the quality of life of patients with THA at final follow-up.\u0000\u0000Patients and Method: This was a prospective, multicenter, multi-operator study, which was carried out in patients with THA, between January 1, 2014 and December 31, 2022. The clinical evaluation was carried out with the PMA, Devane and WOMAC activity scores. Radiologically, the analysis focused on the inclination of the cup, the peri-prosthetic lines and the bony integration of the implants.\u0000\u0000Results: 85 patients were re-evaluated out of 145; 60 were lost to follow-up including 16 due to death, the average follow-up was 5.85 years. The average age was 51.81 years (39-85). The functional scores were generally satisfactory at the last follow-up with a mean PMA, Devane and WOMAC score of 15.8 respectively; 2 and 76.54 and a rate of resumption of sexual intercourse after THA of 54.11%. The mechanical complications were: 8 revisions for prosthetic loosening, 4 wear and osteolysis, 02 periprosthetic margins. The patients were much more optimistic than the surgeon: 94.73% of the patients judged their results to be excellent or good while the surgeon only accepted 85.96%.\u0000\u0000Conclusion: Degenerative hip joint pathologies seem to be increasing due to the incidence of complications of sickle cell disease. The need for joint replacement is growing despite the still expensive cost. At the last follow-up, the overall results are satisfactory and a rate of resumption of sexual intercourse after THA of 54.11%. Chronic pain and muscle atrophy have had a significant impact on quality of life and sexual activity. Our study confirms the medium-term reliability of dual mobility with a survival rate of 90.60%. These results must be tempered because of the occurrence of long-term complications, linked to the risk of dual mobility in young subjects.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138943671","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}
Background: Lateral Condyle Fractures are the second most common fracture amongst the pediatric elbow fractures, which is usually neglected commonly due to parents not seeking timely medical help or clinician missing the diagnosis with lack of knowledge or understanding. Case Presentation: A 3-year-old female was presented in the outpatient department with outward bowing of the right elbow following a history of FOOSH injury more than a month back. Clinical examination showed gross valgus deformity with an increased carrying angle with thickened and irregular lateral condyle on examination. Adiograph of the elbow showed nonunion of the lateral humeral condyle with lateral displacement and malrotation of the fracture fragment. The carrying angle of the affected side was 50º and Baumann’s angle on affected side was 40º. A CT scan also showed displaced fracture of lateral epicondyle of right humerus. Patient was treated successfully with Open Reduction and Internal Fixation (ORIF) with Kirschner (k) wires. On follow up, the patient had significant improvement with the correction of valgus deformity and overall improvement in the elbow range of movements.
{"title":"Do not Miss a Pediatric Lateral Condyle Fracture- A Case Based Description of Neglected Case Managed with Good Outcome","authors":"Sharat Agarwal","doi":"10.46889/josr.2023.4308","DOIUrl":"https://doi.org/10.46889/josr.2023.4308","url":null,"abstract":"Background: Lateral Condyle Fractures are the second most common fracture amongst the pediatric elbow fractures, which is usually neglected commonly due to parents not seeking timely medical help or clinician missing the diagnosis with lack of knowledge or understanding.\u0000\u0000Case Presentation: A 3-year-old female was presented in the outpatient department with outward bowing of the right elbow following a history of FOOSH injury more than a month back. Clinical examination showed gross valgus deformity with an increased carrying angle with thickened and irregular lateral condyle on examination. Adiograph of the elbow showed nonunion of the lateral humeral condyle with lateral displacement and malrotation of the fracture fragment. The carrying angle of the affected side was 50º and Baumann’s angle on affected side was 40º. A CT scan also showed displaced fracture of lateral epicondyle of right humerus. Patient was treated successfully with Open Reduction and Internal Fixation (ORIF) with Kirschner (k) wires. On follow up, the patient had significant improvement with the correction of valgus deformity and overall improvement in the elbow range of movements.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963128","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}
Methandrostenolone, commonly known as Dianabol or Dbol, is an anabolic steroid that gained immense popularity in the 20th century due to its potential to promote muscle growth and enhance athletic performance. Originally developed for medicinal purposes, it quickly found its way into the realms of bodybuilding and sports. This research article aims to provide an in-depth review of Methandrostenolone’s pharmacology, mechanisms of action, performance-enhancing effects, potential side effects and overall health implications. We explore the scientific evidence surrounding its use, the risks associated with its misuse and the legal status of Methandrostenolone in various countries.
{"title":"Dianabol Unveiled: A Systematic Review of Methandrostenolone","authors":"Khaled Hamlaoui","doi":"10.46889/josr.2023.4307","DOIUrl":"https://doi.org/10.46889/josr.2023.4307","url":null,"abstract":"Methandrostenolone, commonly known as Dianabol or Dbol, is an anabolic steroid that gained immense popularity in the 20th century due to its potential to promote muscle growth and enhance athletic performance. Originally developed for medicinal purposes, it quickly found its way into the realms of bodybuilding and sports. This research article aims to provide an in-depth review of Methandrostenolone’s pharmacology, mechanisms of action, performance-enhancing effects, potential side effects and overall health implications. We explore the scientific evidence surrounding its use, the risks associated with its misuse and the legal status of Methandrostenolone in various countries.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"124 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138607028","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}
Introduction: Trochanteric fractures are mostly due to RTA and falls. Unstable trochanteric fractures include those with a reverse oblique fracture line, intertrochanteric comminution, big posteromedial fragment, subtrochanteric extension, a broken greater trochanter and lateral cortex breach. As per the AO Classification of intertrochanteric fractures, AO31-2.2, AO31-2.3, AO31-3.1, AO31-3.2 and AO31-3.3 fall under the category of unstable trochanteric fractures. Internal fixation is mandatory to provide early mobilization of patients with partial weight-bearing and prevent further compli&cations. Materials and Methods: 43 patients more than 18 years old with unstable trochanteric fractures, less than 3 weeks old trauma were included in the prospective study for 1 year period (1st June 2020 to 31st May 2021). 22 cases were treated with short Proximal Femoral Nail (PFN) and 21 cases were treated with Proximal Femoral Locking Compression Plate (PFLCP). Results: (P<0.05), mean duration of surgery, blood loss was less in the PFN group (67minutes; 80mL) than PFLCP group (99 minutes; 152 ml). Union and partial weight-bearing was seen earlier in PFN group (14.1weeks; 10.6weeks) than in PFLCP group (18.7 weeks; 15.8weeks) (P<0.05). Good-excellent outcome was seen in 100% cases in PFN group and 85.71% cases in PFLCP group. There were 3 cases of delayed union in PFLCP group and 1 in PFN group. 1 PFLCP case had malunion in varus deformity. Conclusion: Short PFN is the optimum implant in treatment of unstable trochanteric fractures as it is an intramedullary, load sharing device with short lever arm and hastens biological healing with early ambulation and minimal complications.
{"title":"Comparative Outcome of Short Proximal Femoral Nail Versus Proximal Femoral Locking Compression Plate in the Management of Unstable Trochanteric Fractures","authors":"Abhijith N. Das","doi":"10.46889/josr.2023.4209","DOIUrl":"https://doi.org/10.46889/josr.2023.4209","url":null,"abstract":"Introduction: Trochanteric fractures are mostly due to RTA and falls. Unstable trochanteric fractures include those with a reverse oblique fracture line, intertrochanteric comminution, big posteromedial fragment, subtrochanteric extension, a broken greater trochanter and lateral cortex breach. As per the AO Classification of intertrochanteric fractures, AO31-2.2, AO31-2.3, AO31-3.1, AO31-3.2 and AO31-3.3 fall under the category of unstable trochanteric fractures. Internal fixation is mandatory to provide early mobilization of patients with partial weight-bearing and prevent further compli&cations.\u0000\u0000Materials and Methods: 43 patients more than 18 years old with unstable trochanteric fractures, less than 3 weeks old trauma were included in the prospective study for 1 year period (1st June 2020 to 31st May 2021). 22 cases were treated with short Proximal Femoral Nail (PFN) and 21 cases were treated with Proximal Femoral Locking Compression Plate (PFLCP).\u0000\u0000Results: (P<0.05), mean duration of surgery, blood loss was less in the PFN group (67minutes; 80mL) than PFLCP group (99 minutes; 152 ml). Union and partial weight-bearing was seen earlier in PFN group (14.1weeks; 10.6weeks) than in PFLCP group (18.7 weeks; 15.8weeks) (P<0.05). Good-excellent outcome was seen in 100% cases in PFN group and 85.71% cases in PFLCP group. There were 3 cases of delayed union in PFLCP group and 1 in PFN group. 1 PFLCP case had malunion in varus deformity.\u0000\u0000Conclusion: Short PFN is the optimum implant in treatment of unstable trochanteric fractures as it is an intramedullary, load sharing device with short lever arm and hastens biological healing with early ambulation and minimal complications.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130536460","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}
Introduction: Cementless Total Hip Arthroplasty (THA) is generally safe, but intraoperative fractures of the acetabulum and proximal femur can occur and can have significant consequences for the patient. This systematic review aims to synthesize the available literature on intraoperative fractures of the acetabulum and proximal femur during primary uncemented THA and highlight the incidence, risk factors, and potential preventive measures for these fractures, to improve patient outcomes and reduce the incidence of this complication. Methods: We conducted a thorough review in the PUBMED, EMBASE, Cochrane database and Scopus library, and extracted the articles describing the intraoperative acetabulum and femur fractures in primary cementless THA. Results: The initial search carried out produced 1792 results. After exclusion processing, 22 articles were included for the review. Of these, 16 were intraoperative fractures of the femur and 6 were intraoperative fractures of the acetabulum. Incidence of acetabular fractures was 0.49% and 2.7% for femoral fractures with female preponderance in both groups. Time of occurrence and location of the intra-operative fractures can vary widely, with femoral fractures occurring more commonly during broaching and acetabular fractures during cup implantation. Conclusion: A plethora of management options have been utilized according to surgeon preference and the fracture pattern as well as location. Standard principles of fracture fixation and arthroplasty should be followed to achieve stable internal fixation and any unstable fracture site should be bypassed with the utilization of long-stemmed components.
{"title":"Intraoperative Fractures of Acetabulum and Proximal Femur in Cementless Primary Total Hip Arthroplasty: A Systematic Review","authors":"R. Kalia","doi":"10.46889/josr.2023.4208","DOIUrl":"https://doi.org/10.46889/josr.2023.4208","url":null,"abstract":"Introduction: Cementless Total Hip Arthroplasty (THA) is generally safe, but intraoperative fractures of the acetabulum and proximal femur can occur and can have significant consequences for the patient. This systematic review aims to synthesize the available literature on intraoperative fractures of the acetabulum and proximal femur during primary uncemented THA and highlight the incidence, risk factors, and potential preventive measures for these fractures, to improve patient outcomes and reduce the incidence of this complication.\u0000\u0000Methods: We conducted a thorough review in the PUBMED, EMBASE, Cochrane database and Scopus library, and extracted the articles describing the intraoperative acetabulum and femur fractures in primary cementless THA.\u0000\u0000Results: The initial search carried out produced 1792 results. After exclusion processing, 22 articles were included for the review. Of these, 16 were intraoperative fractures of the femur and 6 were intraoperative fractures of the acetabulum. Incidence of acetabular fractures was 0.49% and 2.7% for femoral fractures with female preponderance in both groups. Time of occurrence and location of the intra-operative fractures can vary widely, with femoral fractures occurring more commonly during broaching and acetabular fractures during cup implantation.\u0000\u0000Conclusion: A plethora of management options have been utilized according to surgeon preference and the fracture pattern as well as location. Standard principles of fracture fixation and arthroplasty should be followed to achieve stable internal fixation and any unstable fracture site should be bypassed with the utilization of long-stemmed components.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122787815","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}
Background: Hip joint osteoarthritis remains an incurable disabling health condition. Aim: To examine what trends exist in the realm of Artificial Intelligence [AI] applications to hip osteoarthritis. Methods: An in-depth literature review focusing on hip osteoarthritis and selected artificial intelligence association’s themes was conducted. Results: Artificial intelligence is being widely studied and applied in the realms of hip osteoarthritis diagnoses and surgical factors and approaches, but less so in the clinical, and deterministic spheres. Conclusion: Future expanded research efforts that integrate the features of the whole joint and person-environment factors and their association with favorable and unfavorable hip osteoarthritis outcomes are needed and are likely to prove promising and save immense human and service costs. Keywords: Arthroplasty; Artificial Intelligence; Deep Learning, Diagnosis; Hip Osteoarthritis; Machine Learning; Outcomes; Pathology; Prevention; Surgery
{"title":"Artificial Intelligence and Its Potential Application in Advancing Hip Osteoarthritis Care","authors":"R. Marks","doi":"10.46889/josr.2023.4207","DOIUrl":"https://doi.org/10.46889/josr.2023.4207","url":null,"abstract":"Background: Hip joint osteoarthritis remains an incurable disabling health condition. Aim: To examine what trends exist in the realm of Artificial Intelligence [AI] applications to hip osteoarthritis. Methods: An in-depth literature review focusing on hip osteoarthritis and selected artificial intelligence association’s themes was conducted. Results: Artificial intelligence is being widely studied and applied in the realms of hip osteoarthritis diagnoses and surgical factors and approaches, but less so in the clinical, and deterministic spheres. Conclusion: Future expanded research efforts that integrate the features of the whole joint and person-environment factors and their association with favorable and unfavorable hip osteoarthritis outcomes are needed and are likely to prove promising and save immense human and service costs. Keywords: Arthroplasty; Artificial Intelligence; Deep Learning, Diagnosis; Hip Osteoarthritis; Machine Learning; Outcomes; Pathology; Prevention; Surgery","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129145317","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}
In the pathology of children, from the orthopedic point of view, there commonly occur problems connected with the Syndrome of Contractures and Deformities described by Professor Hans May from Germany. His observations have been made between 1960 and 1980, additionally, in this subject, there are observations from Lublin (Tomasz Karski and Jacek Karski) from 1995-2023. The second group of causes of pathologies in children which if not properly treated, can also occur in adults leading to problems of locomotor system disorders connected with abnormalities of the Central Nervous System – Minimal Brain Dysfunction (MBD). This article is devoted to the MBD problems.
{"title":"Minimal Brain Dysfunctions (MBD): Causes, Clinical Symptoms - Deformity of The Feet, Knees, Hips, Pelvis and Spine Physiotherapy","authors":"T. Karski","doi":"10.46889/josr.2023.4206","DOIUrl":"https://doi.org/10.46889/josr.2023.4206","url":null,"abstract":"In the pathology of children, from the orthopedic point of view, there commonly occur problems connected with the Syndrome of Contractures and Deformities described by Professor Hans May from Germany. His observations have been made between 1960 and 1980, additionally, in this subject, there are observations from Lublin (Tomasz Karski and Jacek Karski) from 1995-2023.\u0000\u0000The second group of causes of pathologies in children which if not properly treated, can also occur in adults leading to problems of locomotor system disorders connected with abnormalities of the Central Nervous System – Minimal Brain Dysfunction (MBD). This article is devoted to the MBD problems.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130644670","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}
Tendinosis with or without tendon tear is a common form of tendon pathology and should be managed differently from inflammatory tendinitis although both are termed tendinopathy. The current tendinopathy management involves rest, icing, a brace, oral anti-inflammatory medicine, and physiotherapy. Should that fail a trial of Corticosteroid (CS) injection allow surgery as a last resort. This article presents a middle-aged male, a human resources manager who suffered two occasions of tendinopathy with the first one being a gradual development of symptomatic right common flexor origin calcific tendinosis (golfer’s elbow) on ultrasound (USS) secondary to competitive squash that failed conservative management and USS-guided CS injection. He had a long-term symptomatic recovery after six weeks following a single autologous platelet-rich plasma (PRP) therapy. Three years later he injured his right hip following a twisting injury to the right hip/gluteal area resulted in debilitating symptoms, USS scan revealed gluteus minimus/ medius calcific tendinosis, a partial split tear of the gluteus minimus, and trochanteric bursitis. He failed physiotherapy and anti-inflammatory medicine. He elected PRP therapy over CS injection, he became symptoms free six weeks after the injection. Teen weeks post-injection USS revealed a complete resolution of gluteus minimus tendon tear and no trochanteric bursitis, no clear tendinosis features but calcifications present. This case demonstrates the use of relatively safe affordable clinic-based PRP therapy for long-term symptomatic control of tendinopathy with/without a tear. This is superior to oral anti-inflammatory and CS injections. Additionally, the healing of the tendon tear could save people from avoiding invasive surgery with its complications and long recovery time. Thanks to the regenerative healing power of the growth factors and signaling proteins in platelets that stimulate the internal mesenchymal stem cells. We recommend a large-scale randomized control trial to confirm those findings and standardization of the PRP technique, hoping regenerative medicine to become the mainstream therapy in several musculoskeletal pathologies, particularly in resistant injuries.
{"title":"Gluteal Tendon Tear Healing on Ultrasound 10 Weeks Following a Single Platelet-Rich Plasma Injection: A Case Report","authors":"H. Mubark","doi":"10.46889/josr.2023.4205","DOIUrl":"https://doi.org/10.46889/josr.2023.4205","url":null,"abstract":"Tendinosis with or without tendon tear is a common form of tendon pathology and should be managed differently from inflammatory tendinitis although both are termed tendinopathy.\u0000\u0000The current tendinopathy management involves rest, icing, a brace, oral anti-inflammatory medicine, and physiotherapy. Should that fail a trial of Corticosteroid (CS) injection allow surgery as a last resort.\u0000\u0000This article presents a middle-aged male, a human resources manager who suffered two occasions of tendinopathy with the first one being a gradual development of symptomatic right common flexor origin calcific tendinosis (golfer’s elbow) on ultrasound (USS) secondary to competitive squash that failed conservative management and USS-guided CS injection. He had a long-term symptomatic recovery after six weeks following a single autologous platelet-rich plasma (PRP) therapy. Three years later he injured his right hip following a twisting injury to the right hip/gluteal area resulted in debilitating symptoms, USS scan revealed gluteus minimus/ medius calcific tendinosis, a partial split tear of the gluteus minimus, and trochanteric bursitis. He failed physiotherapy and anti-inflammatory medicine. He elected PRP therapy over CS injection, he became symptoms free six weeks after the injection. Teen weeks post-injection USS revealed a complete resolution of gluteus minimus tendon tear and no trochanteric bursitis, no clear tendinosis features but calcifications present.\u0000\u0000This case demonstrates the use of relatively safe affordable clinic-based PRP therapy for long-term symptomatic control of tendinopathy with/without a tear. This is superior to oral anti-inflammatory and CS injections. Additionally, the healing of the tendon tear could save people from avoiding invasive surgery with its complications and long recovery time.\u0000\u0000Thanks to the regenerative healing power of the growth factors and signaling proteins in platelets that stimulate the internal mesenchymal stem cells. We recommend a large-scale randomized control trial to confirm those findings and standardization of the PRP technique, hoping regenerative medicine to become the mainstream therapy in several musculoskeletal pathologies, particularly in resistant injuries.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115602508","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}
Background: Hexapod devices, colloquially referred to as frames, are powerful tools to correct lower extremity deformity. However, patients who undergo treatment with frames are followed closely to ensure that clinical and radiographic correction are satisfactory. Depending on the size of the state and the number of surgeons that offer frame treatment, patients may need to travel a long distance and frequently, to obtain care. We sought to characterize the number of clinical and surgical encounters, as well as the cumulative driving distance, for frame patients treated at a single academic health center. Methods: All patients treated with a hexapod frame for any etiology by three pediatric orthopaedic surgeons at a single children’s hospital over an 8-year period were investigated. Patients were queried for demographic data, number of non-surgical and surgical clinical encounters and number of days in the frame. Driving distance was calculated from the patients address to the academic health system address. Results: Thirteen patients qualified for inclusion (10 male, 3 female). Mean age at frame application was 14.6 years (range 4-31). Mean time in the frame was 150.5 days (range 90-207). Throughout the course of their frame treatment, patients had a mean of 16 non-surgical (range 5-26) encounters and a mean of 3 (range 2-6) surgical encounters. Mean one-way driving distance between the treating institution and the patient’s home was 77 miles (range 20-212 miles). When two way driving distance was multiplied by the total number of encounters for each patient, the mean distance driven was 2616 miles (range 862-7632 miles). Conclusion: In this cohort of patients with a lower extremity frame, there were on mean 16 non-surgical and 3 surgical encounters, with a mean driving distance during the treatment program of 2600 miles. When agreeing to undertake a hexapod-assisted program for lower extremity pathology, patients should be counseled about the temporal and financial nature of this strategy, so they are aware of the large commitment needed.
{"title":"Time and Travel Burden Associated with Hexapod-Assisted Correction of Lower Extremity Deformity","authors":"R. Murphy","doi":"10.46889/josr.2023.4204","DOIUrl":"https://doi.org/10.46889/josr.2023.4204","url":null,"abstract":"Background: Hexapod devices, colloquially referred to as frames, are powerful tools to correct lower extremity deformity. However, patients who undergo treatment with frames are followed closely to ensure that clinical and radiographic correction are satisfactory. Depending on the size of the state and the number of surgeons that offer frame treatment, patients may need to travel a long distance and frequently, to obtain care. We sought to characterize the number of clinical and surgical encounters, as well as the cumulative driving distance, for frame patients treated at a single academic health center.\u0000\u0000Methods: All patients treated with a hexapod frame for any etiology by three pediatric orthopaedic surgeons at a single children’s hospital over an 8-year period were investigated. Patients were queried for demographic data, number of non-surgical and surgical clinical encounters and number of days in the frame. Driving distance was calculated from the patients address to the academic health system\u0000\u0000address.\u0000\u0000Results: Thirteen patients qualified for inclusion (10 male, 3 female). Mean age at frame application was 14.6 years (range 4-31). Mean time in the frame was 150.5 days (range 90-207). Throughout the course of their frame treatment, patients had a mean of 16 non-surgical (range 5-26) encounters and a mean of 3 (range 2-6) surgical encounters. Mean one-way driving distance between the treating institution and the patient’s home was 77 miles (range 20-212 miles). When two way driving distance was multiplied by the total number of encounters for each patient, the mean distance driven was 2616 miles (range 862-7632 miles).\u0000\u0000Conclusion: In this cohort of patients with a lower extremity frame, there were on mean 16 non-surgical and 3 surgical encounters, with a mean driving distance during the treatment program of 2600 miles. When agreeing to undertake a hexapod-assisted program for lower extremity pathology, patients should be counseled about the temporal and financial nature of this strategy, so they are aware of the large commitment needed.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122368941","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}
Background: The term idiopathic is a non-specific disease label, which fails account for proper etiological understanding. The frequent usage of the term idiopathic may indicate clinical incompetence. We describe a number of patients from our practice with a history of complex bone disorders who were falsely given the term idiopathic by other Institutes. The sole tool used by other Institutes to conclude osteoporosis as a diagnosis is the bone mineral density. Material and Methods: Two Austrian families and one unrelated adult female patient (total number of 12 subjects) have been referred to our department with referral letters confirming the diagnosis of idiopathic osteoporosis. All patients manifested a diverse constellation of skeletal deformities. In all these patients, regular courses of anti-resorptive treatment plus calcium and vitamin D supplements. These have been excessively prescribed. Results: Our diagnostic process which is based heavily on detailed clinical and radiological phenotypic characterizations, we refuted the diagnosis of idiopathic osteoporosis for all patients because of the clear-cut clinical features. For the first family, we suggested the diagnosis of a novel type of mucopolysaccharidosis (the genetic results confirmed the diagnosis of a novel subtype of mucopolysaccharidosis (through the identification of arylsulfatase K ARSK). For the second family which has been subjected to a lengthy useless investigation for almost more than a decade, we refuted the diagnosis of idiopathic osteoporosis and the whole exome sequencing was consistent with the phenotypic diagnosis Nasu-Hakola disease (heterozygous missense mutations in TYROBP gene). The other unrelated 42-year-old- female patient was correctly diagnosed with Nasu-Hakola disease. Conclusion: The objective of this study is to minimize and suppress the usage of the term idiopathic. It has been imperative to understand the sequence of pathological events that occurred in these families. The core for diagnosis is the etiological understanding, which stemmed from professional conscientiousness. Patients underwent misdiagnosis of idiopathic osteoporosis and were treated extensively with anti-resorptive agents, calcium supplements and vitamin D. Strikingly, these medications resulted in a combination of serious cranial and cerebral lesions because of massive pathological calcifications. Imaging analysis via conventional radiographs, MRI and CT scan showed massive calcifications of the cranial sutures, inter-clinoid ligaments and hyper-calcification of the skull base. Sadly speaking, early onset dementia emerged in connection with sclerosing leukoencephalopathy. We believe that the exogenous toxic effects of the huge amounts of bone supplements consumed by these patients enhanced the pre-existing metabolic bone and cerebral disorders. Our findings can ameliorate the etiological understanding of early onset dementia and other correlated cranial and skeletal lesions.
{"title":"Etiology Understanding Is the Core of Skeletal Diagnosis","authors":"A. Kaissi","doi":"10.46889/josr.2023.4203","DOIUrl":"https://doi.org/10.46889/josr.2023.4203","url":null,"abstract":"Background: The term idiopathic is a non-specific disease label, which fails account for proper etiological understanding. The frequent usage of the term idiopathic may indicate clinical incompetence. We describe a number of patients from our practice with a history of complex bone disorders who were falsely given the term idiopathic by other Institutes. The sole tool used by other Institutes to conclude osteoporosis as a diagnosis is the bone mineral density.\u0000\u0000Material and Methods: Two Austrian families and one unrelated adult female patient (total number of 12 subjects) have been referred to our department with referral letters confirming the diagnosis of idiopathic osteoporosis. All patients manifested a diverse constellation of skeletal deformities. In all these patients, regular courses of anti-resorptive treatment plus calcium and vitamin D supplements. These have been excessively prescribed. \u0000\u0000Results: Our diagnostic process which is based heavily on detailed clinical and radiological phenotypic characterizations, we refuted the diagnosis of idiopathic osteoporosis for all patients because of the clear-cut clinical features. For the first family, we suggested the diagnosis of a novel type of mucopolysaccharidosis (the genetic results confirmed the diagnosis of a novel subtype of mucopolysaccharidosis (through the identification of arylsulfatase K ARSK). For the second family which has been subjected to a lengthy useless investigation for almost more than a decade, we refuted the diagnosis of idiopathic osteoporosis and the whole exome sequencing was consistent with the phenotypic diagnosis Nasu-Hakola disease (heterozygous missense mutations in TYROBP gene). The other unrelated 42-year-old- female patient was correctly diagnosed with Nasu-Hakola disease.\u0000\u0000Conclusion: The objective of this study is to minimize and suppress the usage of the term idiopathic. It has been imperative to understand the sequence of pathological events that occurred in these families. The core for diagnosis is the etiological understanding, which stemmed from professional conscientiousness. Patients underwent misdiagnosis of idiopathic osteoporosis and were treated extensively with anti-resorptive agents, calcium supplements and vitamin D. Strikingly, these medications resulted in a combination of serious cranial and cerebral lesions because of massive pathological calcifications. Imaging analysis via conventional radiographs, MRI and CT scan showed massive calcifications of the cranial sutures, inter-clinoid ligaments and hyper-calcification of the skull base. Sadly speaking, early onset dementia emerged in connection with sclerosing leukoencephalopathy. We believe that the exogenous toxic effects of the huge amounts of bone supplements consumed by these patients enhanced the pre-existing metabolic bone and cerebral disorders. Our findings can ameliorate the etiological understanding of early onset dementia and other correlated cranial and skeletal lesions.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132269311","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}
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