Background: Cement Penetration Depth (CPD) into bone is an important factor for successful Total Knee Arthroplasties (TKA). Our study investigated the effect of Systolic Blood Pressure (SBP) on average tibial, femoral and total CPD in primary TKA. Methods and Findings: In this retrospective cohort study, patients who had a primary TKA between November 2018 and February 2020 at four, academic medical centers were included. CPD was evaluated according to the Knee Society Radiographic Evaluation System on radiographs one month post-operatively. Two independent evaluators measured four zones of tibial penetration and three zones of femoral penetration and averaged their results. The measurements were combined to create an average tibial, average femoral and average total CPD. SBP was collected at the 3/4 time of surgery length- the estimated time of cementation. 1221 primary TKA cases were included in the study – 1128 in the tourniquet group and 93 in the tourniquet-less group. There were no significant differences between the age, sex, BMI, or LOS between the two cohorts. A multiple, multivariate analysis was performed. In the tourniquet-less group, SBP did not significantly affect average tibial CPD (p=0.98), average femoral CPD (p=0.45), or average total CPD (p=0.23). However, tourniquet use was found to significantly increase average femoral (p<0.001) and total penetration (p=0.001). Conclusion: SBP did not significantly affect tibial, femoral, or total CPD in patients undergoing tourniquet-less, primary TKA. However, the use of a tourniquet significantly aids in average femoral and total CPD. The clinical significance of this difference needs further investigation.
{"title":"The Effect of Systolic Blood Pressure on Cement Penetration Depth in Primary Total Knee Arthroplasty","authors":"M. Shen","doi":"10.46889/josr.2022.3308","DOIUrl":"https://doi.org/10.46889/josr.2022.3308","url":null,"abstract":"Background: Cement Penetration Depth (CPD) into bone is an important factor for successful Total Knee Arthroplasties (TKA). Our study investigated the effect of Systolic Blood Pressure (SBP) on average tibial, femoral and total CPD in primary TKA.\u0000\u0000Methods and Findings: In this retrospective cohort study, patients who had a primary TKA between November 2018 and February 2020 at four, academic medical centers were included. CPD was evaluated according to the Knee Society Radiographic Evaluation System on radiographs one month post-operatively. Two independent evaluators measured four zones of tibial penetration and three zones of femoral penetration and averaged their results. The measurements were combined to create an average tibial, average femoral and average total CPD. SBP was collected at the 3/4 time of surgery length- the estimated time of cementation.\u0000\u00001221 primary TKA cases were included in the study – 1128 in the tourniquet group and 93 in the tourniquet-less group. There were no significant differences between the age, sex, BMI, or LOS between the two cohorts. A multiple, multivariate analysis was performed. In the tourniquet-less group, SBP did not significantly affect average tibial CPD (p=0.98), average femoral CPD (p=0.45), or average total CPD (p=0.23). However, tourniquet use was found to significantly increase average femoral (p<0.001) and total penetration (p=0.001). \u0000\u0000Conclusion: SBP did not significantly affect tibial, femoral, or total CPD in patients undergoing tourniquet-less, primary TKA. However, the use of a tourniquet significantly aids in average femoral and total CPD. The clinical significance of this difference needs further investigation.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126231584","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: Knee joint osteoarthritis is a highly disabling disease with no distinct cause that persists unabated despite decades of research. Among the various possible causes and factors that influence the progression of the disease other than age and trauma may be various forms of muscle dysfunction, especially among the key knee extensor muscle group known as the quadriceps femoris. Aim: This narrative review strove to examine some pertinent past and recent 2022 research highlights in this respect and to offer possible research recommendations in this regard. Methods: To achieve the review aims, the PUBMED data base and others housing reports aligned with this topic was searched using the key words knee osteoarthritis and quadriceps/knee extensor muscles. Pertinent 2022 and related data were carefully examined and the study researchers’ approaches, conclusions, and recommendations were duly recorded. Results: Many diverse studies within the desired topical theme prevail, rendering it challenging to discern or extract any meaningful trend or conceptuality sound deterministic theory of causation or pathogenic osteoarthritis insights. Even in the realm where multiple publications are available on a single theme, conclusions and design approaches remain inconsistent and of possible moderate quality at best. Conclusion: Efforts to examine and intervene to avert one or more manifestations of quadriceps muscle dysfunction may prove to be highly important in the realm of favorably influencing or minimizing excess osteoarthritis knee joint dysfunction, regardless of whether knee extensor muscle dysfunction is a reactive, rather than a causative factor, but requires a more profound evidence base.
{"title":"Quadriceps Muscle Mechanics and Knee Osteoarthritis - A 2022 Update","authors":"R. Marks","doi":"10.46889/josr.2022.3307","DOIUrl":"https://doi.org/10.46889/josr.2022.3307","url":null,"abstract":"Background: Knee joint osteoarthritis is a highly disabling disease with no distinct cause that persists unabated despite decades of research. Among the various possible causes and factors that influence the progression of the disease other than age and trauma may be various forms of muscle dysfunction, especially among the key knee extensor muscle group known as the quadriceps femoris.\u0000\u0000Aim: This narrative review strove to examine some pertinent past and recent 2022 research highlights in this respect and to offer possible research recommendations in this regard.\u0000\u0000Methods: To achieve the review aims, the PUBMED data base and others housing reports aligned with this topic was searched using the key words knee osteoarthritis and quadriceps/knee extensor muscles. Pertinent 2022 and related data were carefully examined and the study researchers’ approaches, conclusions, and recommendations were duly recorded.\u0000\u0000Results: Many diverse studies within the desired topical theme prevail, rendering it challenging to discern or extract any meaningful trend or conceptuality sound deterministic theory of causation or pathogenic osteoarthritis insights. Even in the realm where multiple publications are available on a single theme, conclusions and design approaches remain inconsistent and of possible moderate quality at best.\u0000\u0000Conclusion: Efforts to examine and intervene to avert one or more manifestations of quadriceps muscle dysfunction may prove to be highly important in the realm of favorably influencing or minimizing excess osteoarthritis knee joint dysfunction, regardless of whether knee extensor muscle dysfunction is a reactive, rather than a causative factor, but requires a more profound evidence base.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129159321","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: A group of children presented with diverse forms of spine and joint pathologies in correlation with heritable bone disorders. Patients and Methods: Five children aged from 9 -13 years, presented with a constellation of growth retardation, craniofacial dysmorphic features, axial (scoliotic short and barrel chested with marked diminution of spine biomechanics) and painful enlarged joints and sometimes with the propensity to develop mal-alignment (knock knees). We included a 38-years-old-lady, a mother of an affected boy because of her long term history of joint pain and intractable tinnitus. Clinical and radiographic phenotypic characterizations were the first line tools applied. Results: The clinical and radiographic phenotypes of all five children were consistent with the diagnosis of Kniest dysplasia. Strikingly, the reason behind the tinnitus in the short statured 38-years-old- lady was due to congenital hypoplasia of the posterior arch of the atlas (the hypoplastic posterior arch of the atlas was in connection with the developmental failure of chondrogenesis). Two children underwent the genetic testing and showed a genetic defect of encoding type II collagen (COL2A1). Conclusion: Sadly speaking, soon after birth the vast majority of children born with skeletal dysplasia received the misdiagnosis of achondroplasia by their pediatricians and geneticists. In practice, a misdiagnosis can lead to hazardous repercussions for the affected children and their families. Correctly interpreting the clinical and the radiological phenotypes and relating them to etiologies is an essential basis for the proper management. In the field of hereditary bone disorders, the existence of mild and moderate forms of the same disease within other family subjects is a well-known fact (as seen in a 38-years-old- short statured- lady, a mother of an affected boy with Kniest dysplsia). To counter the overlooked maldevelopment of the atlanto-axial effectively, we need to delineate the disrupted anatomical structures of the craniocervical junction as early as possible. It is important to understand that many of these diseases are so mysterious and daunting that they frighten even some practitioners. Therefore, educating physicians is a priority.
{"title":"Distinctive Skeletal Phenotype in Patients with Kniest Dysplasia","authors":"A. Kaissi","doi":"10.46889/josr.2022.3306","DOIUrl":"https://doi.org/10.46889/josr.2022.3306","url":null,"abstract":"Background: A group of children presented with diverse forms of spine and joint pathologies in correlation with heritable bone disorders.\u0000\u0000Patients and Methods: Five children aged from 9 -13 years, presented with a constellation of growth retardation, craniofacial dysmorphic features, axial (scoliotic short and barrel chested with marked diminution of spine biomechanics) and painful enlarged joints and sometimes with the propensity to develop mal-alignment (knock knees). We included a 38-years-old-lady, a mother of an affected boy because of her long term history of joint pain and intractable tinnitus. Clinical and radiographic phenotypic characterizations were the first line tools applied. \u0000\u0000Results: The clinical and radiographic phenotypes of all five children were consistent with the diagnosis of Kniest dysplasia. Strikingly, the reason behind the tinnitus in the short statured 38-years-old- lady was due to congenital hypoplasia of the posterior arch of the atlas (the hypoplastic posterior arch of the atlas was in connection with the developmental failure of chondrogenesis). Two children underwent the genetic testing and showed a genetic defect of encoding type II collagen (COL2A1).\u0000\u0000Conclusion: Sadly speaking, soon after birth the vast majority of children born with skeletal dysplasia received the misdiagnosis of achondroplasia by their pediatricians and geneticists. In practice, a misdiagnosis can lead to hazardous repercussions for the affected children and their families. Correctly interpreting the clinical and the radiological phenotypes and relating them to etiologies is an essential basis for the proper management. In the field of hereditary bone disorders, the existence of mild and moderate forms of the same disease within other family subjects is a well-known fact (as seen in a 38-years-old- short statured- lady, a mother of an affected boy with Kniest dysplsia). To counter the overlooked maldevelopment of the atlanto-axial effectively, we need to delineate the disrupted anatomical structures of the craniocervical junction as early as possible. It is important to understand that many of these diseases are so mysterious and daunting that they frighten even some practitioners. Therefore, educating physicians is a priority.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130464362","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: Adipose tissue has achieved a great relevance as possible fount of mesenchymal stem cells for the healing of different articular pathologies including Knee Osteoarthritis (KOA). Stem cells derived from the Adipose Tissue (ADSCs) have a possibility to differentiate into chondrocyte, can reduce the immune response and can stimulate a local tissue repair, improving also the intra-articular Methods and Findings: Intra-articular injections of ADSCs with other conservative or surgical treatments can lead to an improving of all clinical and functional postoperative outcomes evaluated in middle-aged patients with KOA or chondral lesions. Moreover, some scores based on Magnetic Resonance Imaging (MRI) demonstrated an incremented quality of repaired cartilage in comparison with the pre-treatment. We observed no serious advent events. Conclusion: The use of ADSCs appeared to be out of danger, effective and it can be supposed an alternative procedure for the healing of chondral lesions and degenerative OA suitable for middle-aged athlete but no specific studies have been focus on this population and no long term follow-up data are available.
{"title":"A Solution for Knee Osteoarthritis with Adipose-Derived Autologous Stem Cells in Middle-Aged People","authors":"L. Milani","doi":"10.46889/josr.2022.3305","DOIUrl":"https://doi.org/10.46889/josr.2022.3305","url":null,"abstract":"Background: Adipose tissue has achieved a great relevance as possible fount of mesenchymal stem cells for the healing of different articular pathologies including Knee Osteoarthritis (KOA). Stem cells derived from the Adipose Tissue (ADSCs) have a possibility to differentiate into chondrocyte, can reduce the immune response and can stimulate a local tissue repair, improving also the intra-articular\u0000\u0000Methods and Findings: Intra-articular injections of ADSCs with other conservative or surgical treatments can lead to an improving of all clinical and functional postoperative outcomes evaluated in middle-aged patients with KOA or chondral lesions. Moreover, some scores based on Magnetic Resonance Imaging (MRI) demonstrated an incremented quality of repaired cartilage in comparison with the pre-treatment. We observed no serious advent events.\u0000\u0000Conclusion: The use of ADSCs appeared to be out of danger, effective and it can be supposed an alternative procedure for the healing of chondral lesions and degenerative OA suitable for middle-aged athlete but no specific studies have been focus on this population and no long term follow-up data are available.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"360 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124534067","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: Plantar fasciitis- and tendinopathy-related foot pain are common cause of functional disability. Low-Dose Radiation Therapy (LDRT) has proven to be effective in the symptomatic relief of these disorders. Material and methods: Between February 2016 and December 2021, 31 patients were included in this prospective register. Seventeen patients suffered from calcaneodynia, 11 from tendonitis and 3 from osteoarthritis. 6 Gy (1 Gy/fraction) or 3 Gy (0,5 Gy/fraction) were delivered and repeated after 12 weeks if no adequate relief. Response was evaluated at the end of the planned courses, after 3 months and subsequently every 6 months using Visual Analogic Score (VAS), the Von Pannewitz Score (VPS) and daily analgesic drug needs. Results: Overall, 87% of the patients experienced pain relief. Patients with a VAS score above 5 dropped from 35.5% at the end of LDRT to 32%, 13% and 6% after 3, 6 and 12 months, respectively. According to the VPS, 74% showed improvement and 26% remained stable. Lastly, 39% of patients stopped or reduced analgesic intake. Nine patients have been followed up for more than 12 months. The median pre-treatment VAS score in this group was 9 (range 7-10), whereas median VAS scores after 3, 6 and 12 months stood at 5 (range 1-7), 3 (range 0-6) and 1 (range 0-6), respectively (Fig. 2). An improvement in functionality was reported by 7 out of 9 individuals (77.7%). No acute or late complications were observed. Conclusion: LDRT appears to be useful for symptomatic treatment of inflammatory and degenerative disorders of the foot.
{"title":"Feet Don’t Fail Me Anymore! Single-Centre Results Using Low-Dose Radiation Therapy for Feet Inflammatory Disorders and Review of Current Evidence","authors":"Á. Montero","doi":"10.46889/josr.2022.3304","DOIUrl":"https://doi.org/10.46889/josr.2022.3304","url":null,"abstract":"Background: Plantar fasciitis- and tendinopathy-related foot pain are common cause of functional disability. Low-Dose Radiation Therapy (LDRT) has proven to be effective in the symptomatic relief of these disorders.\u0000\u0000Material and methods: Between February 2016 and December 2021, 31 patients were included in this prospective register. Seventeen patients suffered from calcaneodynia, 11 from tendonitis and 3 from osteoarthritis. 6 Gy (1 Gy/fraction) or 3 Gy (0,5 Gy/fraction) were delivered and repeated after 12 weeks if no adequate relief. Response was evaluated at the end of the planned courses, after 3 months and subsequently every 6 months using Visual Analogic Score (VAS), the Von Pannewitz Score (VPS) and daily analgesic drug needs.\u0000\u0000Results: Overall, 87% of the patients experienced pain relief. Patients with a VAS score above 5 dropped from 35.5% at the end of LDRT to 32%, 13% and 6% after 3, 6 and 12 months, respectively. According to the VPS, 74% showed improvement and 26% remained stable. Lastly, 39% of patients stopped or reduced analgesic intake. Nine patients have been followed up for more than 12 months. The median pre-treatment VAS score in this group was 9 (range 7-10), whereas median VAS scores after 3, 6 and 12 months stood at 5 (range 1-7), 3 (range 0-6) and 1 (range 0-6), respectively (Fig. 2). An improvement in functionality was reported by 7 out of 9 individuals (77.7%). No acute or late complications were observed.\u0000\u0000Conclusion: LDRT appears to be useful for symptomatic treatment of inflammatory and degenerative disorders of the foot.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123795241","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}
Objective: In order to determine the functional outcome of surgically treated tibia plateau fractures using routine and early CPM physiotherapy following operative treatment a descriptive prospective study was carried out. Methods: 120 patients with tibia plateau fractures were initially included in this study. 18 patients were excluded from the study according to the exclusion criteria and the remaining 102 patients were followed for 1 year. There were 76 men and 26 women in this investigation. The mean age was 39 years old. Fractures were classified according to Schatzker classification algorithm. A 1-year follow-up was done on these 102 patients. Functional outcome of the patients was graded with HSS and SF-36 functional scores. Statistical analysis was performed by means of SPSS analysis software version 22. Results: The average time to union was 13 weeks. A mean ROM of 125 degrees for routine physiotherapy and 140 degrees for early CPM physiotherapy treated patients one year after injury. Functional results showed a mean HSS score of 80 points (Range: 19-100). Schatzker type I, II, III and IV fractures showed statistically significant better results compared to Schatzker type V and VI fractures. With regard to SF-36 score, 1 year after injury of eight SF-36 subscales, the results were better in the patients in 6 subscales in early CPM physiotherapy treated patients compared with routine physiotherapy group. The majority of the patients were able to perform most of the pre-injury daily activities after 1 year. The most important independent factors influencing functional results in this study were doing early rehabilitation procedures, age of the patients and fracture type. Conclusion: Functional results after open reduction and internal fixation of tibia plateau fractures seem to be excellent according to HSS score. However, the overall patient function is more satisfactory in early CPM physiotherapy treated patients’ in comparison with routine physiotherapy group.
{"title":"Comparison of Functional Outcome between Early and Usual CPM Physiotherapy in Healing Tibia Plateau Fracture","authors":"Mohammadhoseini Payam","doi":"10.46889/josr.2022.3303","DOIUrl":"https://doi.org/10.46889/josr.2022.3303","url":null,"abstract":"Objective: In order to determine the functional outcome of surgically treated tibia plateau fractures using routine and early CPM physiotherapy following operative treatment a descriptive prospective study was carried out.\u0000\u0000Methods: 120 patients with tibia plateau fractures were initially included in this study. 18 patients were excluded from the study according to the exclusion criteria and the remaining 102 patients were followed for 1 year. There were 76 men and 26 women in this investigation. The mean age was 39 years old. Fractures were classified according to Schatzker classification algorithm. A 1-year follow-up was done on these 102 patients. Functional outcome of the patients was graded with HSS and SF-36 functional scores. Statistical analysis was performed by means of SPSS analysis software version 22.\u0000\u0000Results: The average time to union was 13 weeks. A mean ROM of 125 degrees for routine physiotherapy and 140 degrees for early CPM physiotherapy treated patients one year after injury. Functional results showed a mean HSS score of 80 points (Range: 19-100). Schatzker type I, II, III and IV fractures showed statistically significant better results compared to Schatzker type V and VI fractures. With regard to SF-36 score, 1 year after injury of eight SF-36 subscales, the results were better in the patients in 6 subscales in early CPM physiotherapy treated patients compared with routine physiotherapy group. The majority of the patients were able to perform most of the pre-injury daily activities after 1 year. The most important independent factors influencing functional results in this study were doing early rehabilitation procedures, age of the patients and fracture type.\u0000\u0000Conclusion: Functional results after open reduction and internal fixation of tibia plateau fractures seem to be excellent according to HSS score. However, the overall patient function is more satisfactory in early CPM physiotherapy treated patients’ in comparison with routine physiotherapy group.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125055155","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}
Acetabular fractures are associated with various complications such as neurovascular injuries, post-traumatic arthritis, osteonecrosis of the femoral head, difficulty in arthroplasty, etc. Total Hip Arthroplasty (THA) is one of the most successful surgeries done for post-traumatic arthritis of hip joint. THA itself is associated with numerous complications such as intraoperative haemorrhage, infection, deep vein thrombosis, malpositioning of implants, instability, dislocation, and aseptic loosening. We herein report a case of post-traumatic arthritis of hip following acetabular fracture ten years back, who was operated on with total hip arthroplasty. Various complications were encountered during the management of the patient. The patient developed prosthetic joint infection and was operated with implant removal and antibiotics cement spacer application followed by revision arthroplasty with mega prosthesis, which dislocated following a dashboard injury and had undergone open reduction.
{"title":"An Acetabular Fracture with a Series of Complications and Their Solutions: A Notable Case Report","authors":"Shubham Sharma","doi":"10.46889/josr.2022.3302","DOIUrl":"https://doi.org/10.46889/josr.2022.3302","url":null,"abstract":"Acetabular fractures are associated with various complications such as neurovascular injuries, post-traumatic arthritis, osteonecrosis of the femoral head, difficulty in arthroplasty, etc. Total Hip Arthroplasty (THA) is one of the most successful surgeries done for post-traumatic arthritis of hip joint. THA itself is associated with numerous complications such as intraoperative haemorrhage, infection, deep vein thrombosis, malpositioning of implants, instability, dislocation, and aseptic loosening. We herein report a case of post-traumatic arthritis of hip following acetabular fracture ten years\u0000back, who was operated on with total hip arthroplasty. Various complications were encountered during the management of the patient. The patient developed prosthetic joint infection and was operated with implant removal and antibiotics cement spacer application followed by revision arthroplasty with mega prosthesis, which dislocated following a dashboard injury and had undergone open reduction.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127847439","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}
This editorial addresses the efficacy of single or repeated fat-derived autologous expanded Mesenchymal Stem Cell (MSC) therapy for orthopaedic conditions, specifically degenerative and injury-related joint and soft tissue disorders.
{"title":"Efficacy and Safety of Fat-Derived Autologous Expanded Mesenchymal Stem Cell Therapy for the Management of Musculoskeletal Conditions: A 5-Year Experience","authors":"H. Mubark","doi":"10.46889/josr.2022.3301","DOIUrl":"https://doi.org/10.46889/josr.2022.3301","url":null,"abstract":"This editorial addresses the efficacy of single or repeated fat-derived autologous expanded Mesenchymal Stem Cell (MSC) therapy for orthopaedic conditions, specifically degenerative and injury-related joint and soft tissue disorders.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115608579","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}
Neurofibroma is common benign peripheral nerve sheath tumor. It may occur anywhere in the body. Including skin and soft tissue, nervous system muscle and skeleton and visceral organ. Solitary neurofibroma is rare in the giant type. We are presenting a rare case of solitary giant gluteal neurofibroma, which was first confirmed with true cut biopsy which was completely excised afterwards and histopathological confirmation was performed. This case had no generalised neurofibromatosis. Presentation, diagnostic features, imaging and treatment are represented here.
{"title":"A Rare Presentation of Solitary Giant Neurofibroma","authors":"R. Ranjan","doi":"10.46889/josr.2022.3215","DOIUrl":"https://doi.org/10.46889/josr.2022.3215","url":null,"abstract":"Neurofibroma is common benign peripheral nerve sheath tumor. It may occur anywhere in the body. Including skin and soft tissue, nervous system muscle and skeleton and visceral organ. Solitary neurofibroma is rare in the giant type. We are presenting a rare case of solitary giant gluteal neurofibroma, which was first confirmed with true cut biopsy which was completely excised afterwards and histopathological confirmation was performed. This case had no generalised neurofibromatosis. Presentation, diagnostic features, imaging and treatment are represented here.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123741274","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}
Periprosthetic knee fracture occur most frequently around the distal femur and are frequently complicated due to poor bone quality and comorbidities. Surgical treatment is typically necessary and requires varied techniques of open fixation, intramedullary fixation, or revision arthroplasty, due to fracture classification. The aim of the study is to report the results obtained in the treatment of periprosthetic knee fractures, comparing the results of two surgical techniques, retrograde intramedullary nail and ORIF with plate and screws. At our institute, a sample of 23 patients with periprosthetic knee fracture were surgically treated. In detail, our patient cohort consisted of 13 women (56.52%) and 10 men (43.48%) with a mean age of 71.91 years (SD ± 12.05) whose mean follow-up was 19.14 months (SD ± 9.90). In terms of treatment, 7 of 23 patients (30.43%) were treated with retrograde Intramedullary Nail (IMN), 2 patients (8.70%) underwent to revision of the prosthesis and 14 patients (60.87%) were treated with plate and screws (ORIF). The clinical evaluation was performed using two different clinical scores as reference, the Lysholm score and the Sanders score. The goal of treatment of periprosthetic knee fractures should be an early mobilization of the patient, in order to reduce the risk of prolonged immobilization, limiting surgical risks. Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction of the fracture and it is not always possible to achieve, due to the conformation of the prosthetic box. The mean results obtained from the evaluation by Lysholm Score was 58.75 ± 10.46 in group treated with IMN and 63.60 ± 6,82 in the group treated with ORIF. Sanders Functional Evaluation Score was 63.60 ± 6,82 in group treated with IMN and 28.26 ± 6.01 in the groups treated with ORIF. The results obtained are similar to the literature. Student’s t-test showed no statistical significance (p-value >0.05). Fractures healed on average at 4 months. We observed a case of mobilization of the nail. Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction and it is not always possible to achieve, due to the conformation of the prosthetic box. The ORIF with plate and screws allows an anatomical reduction of the fracture, but involves in greater risks. It appears, therefore, more suitable in relatively young subjects. The reduction and synthesis with MIPO technique appears a good compromise. However, it is not very effective in comminuted and multi-fragmentary fractures.
{"title":"Treatment of Periprosthetic Knee Fractures with Plate and Screws and With Retrograde Intramedullary Nail: Indications, Limits and Medium-Term Follow-Up","authors":"L. Gurrieri","doi":"10.46889/josr.2022.3214","DOIUrl":"https://doi.org/10.46889/josr.2022.3214","url":null,"abstract":"Periprosthetic knee fracture occur most frequently around the distal femur and are frequently complicated due to poor bone quality and comorbidities. Surgical treatment is typically necessary and requires varied techniques of open fixation, intramedullary fixation, or revision arthroplasty, due to fracture classification. The aim of the study is to report the results obtained in the treatment of periprosthetic knee fractures, comparing the results of two surgical techniques, retrograde intramedullary nail and ORIF with plate and screws.\u0000\u0000At our institute, a sample of 23 patients with periprosthetic knee fracture were surgically treated.\u0000\u0000In detail, our patient cohort consisted of 13 women (56.52%) and 10 men (43.48%) with a mean age of 71.91 years (SD ± 12.05) whose mean follow-up was 19.14 months (SD ± 9.90). In terms of treatment, 7 of 23 patients (30.43%) were treated with retrograde Intramedullary Nail (IMN), 2 patients (8.70%) underwent to revision of the prosthesis and 14 patients (60.87%) were treated with plate and screws (ORIF). The clinical evaluation was performed using two different clinical scores as reference, the Lysholm score and the Sanders score.\u0000\u0000The goal of treatment of periprosthetic knee fractures should be an early mobilization of the patient, in order to reduce the risk of prolonged immobilization, limiting surgical risks.\u0000\u0000Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction of the fracture and it is not always possible to achieve, due to the conformation of the prosthetic box. The mean results obtained from the evaluation by Lysholm Score was 58.75 ± 10.46 in group treated with IMN and 63.60 ± 6,82 in the group treated with ORIF. Sanders Functional Evaluation Score was 63.60 ± 6,82 in group treated with IMN and 28.26 ± 6.01 in the groups treated with ORIF. The results obtained are similar to the literature. Student’s t-test showed no statistical significance (p-value >0.05). Fractures healed on average at 4 months. We observed a case of mobilization of the nail. Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction and it is not always possible to achieve, due to the conformation of the prosthetic box.\u0000\u0000The ORIF with plate and screws allows an anatomical reduction of the fracture, but involves in greater risks. It appears, therefore, more suitable in relatively young subjects. The reduction and synthesis with MIPO technique appears a good compromise. However, it is not very effective in comminuted and multi-fragmentary fractures.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125935387","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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