Orthopaedic 3D is driving major innovations in many areas, such as manufacturing, engineering, art, education and medicine (1). Especially, the orthopaedic field is greatly becoming interested in this technology with the ability to create solutions specific tailored to the patient. From the creation of 3D models that help surgeons plan operations to the fabrication of patient-specific titanium implants, 3D printing is already changing traditional musculoskeletal industry (2).
{"title":"3D and 4D based applications in orthopaedics has not been pioneered","authors":"Y. Moon","doi":"10.21037/AOJ.2019.03.03","DOIUrl":"https://doi.org/10.21037/AOJ.2019.03.03","url":null,"abstract":"Orthopaedic 3D is driving major innovations in many areas, such as manufacturing, engineering, art, education and medicine (1). Especially, the orthopaedic field is greatly becoming interested in this technology with the ability to create solutions specific tailored to the patient. From the creation of 3D models that help surgeons plan operations to the fabrication of patient-specific titanium implants, 3D printing is already changing traditional musculoskeletal industry (2).","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48309590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The demands of the modern patient, both in terms of what a hip replacement will allow them to do as well as for how long it will last, mean that pre-market testing and close surveillance should be robust to avoid the problems of previous implants. Implants that fail in the short-term are relatively easy to detect. Implants that fail in the medium to long-term, but sooner or in more damaging modes than their peers, are much more difficult to identify. What would be the optimal strategy to evaluate a new implant prior to release if time and resource was unlimited? Would the new implant only be released to all surgeons after careful introduction in a small cohort with detailed assessment and extended follow-up? How long is sufficient follow-up?
{"title":"How best to regulate new implants in the market—is radiostereometric analysis enough?","authors":"B. Kendrick, A. Palmer, A. Taylor","doi":"10.21037/aoj.2019.11.01","DOIUrl":"https://doi.org/10.21037/aoj.2019.11.01","url":null,"abstract":"The demands of the modern patient, both in terms of what a hip replacement will allow them to do as well as for how long it will last, mean that pre-market testing and close surveillance should be robust to avoid the problems of previous implants. Implants that fail in the short-term are relatively easy to detect. Implants that fail in the medium to long-term, but sooner or in more damaging modes than their peers, are much more difficult to identify. What would be the optimal strategy to evaluate a new implant prior to release if time and resource was unlimited? Would the new implant only be released to all surgeons after careful introduction in a small cohort with detailed assessment and extended follow-up? How long is sufficient follow-up?","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41785931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linsen T Samuel, Jacob M. Rabin, Alexander H. Jinnah, S. Rosas, Linda H. Chao, R. Sullivan, Chukwuweike U. Gwam
Multi-ligamentous knee injury (MLKI) can be a devastating injury, resulting in long-term knee instability and loss of function. For patients with MLKI, areas of controversy persist on how to best optimize outcomes. These areas of contention are often centered operative timing and technique with the aims of restoring patient function, knee range of motion, and stability. Currently, a paucity of studies exists that can be used to direct orthopedists on how to manage MLKI patients. This review critically analyzes literature in attempts to equip readers with best options for managing patients with MLKI.
{"title":"Management of the multi-ligamentous injured knee: an evidence-based review","authors":"Linsen T Samuel, Jacob M. Rabin, Alexander H. Jinnah, S. Rosas, Linda H. Chao, R. Sullivan, Chukwuweike U. Gwam","doi":"10.21037/AOJ.2019.02.06","DOIUrl":"https://doi.org/10.21037/AOJ.2019.02.06","url":null,"abstract":"Multi-ligamentous knee injury (MLKI) can be a devastating injury, resulting in long-term knee instability and loss of function. For patients with MLKI, areas of controversy persist on how to best optimize outcomes. These areas of contention are often centered operative timing and technique with the aims of restoring patient function, knee range of motion, and stability. Currently, a paucity of studies exists that can be used to direct orthopedists on how to manage MLKI patients. This review critically analyzes literature in attempts to equip readers with best options for managing patients with MLKI.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.02.06","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43167363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On Feb 28, 2019, Antonia F. Chen from Brigham and Women’s Hospital came to Nanjing to have a brief academic exchange with domestic peers on the prevention, diagnosis and treatment of periprosthetic joint infection (PJI) ( Figure 1 ). We were honored to invite Prof. Chen, who is currently the Director of Research, Arthroplasty Service at Brigham and Women’s Hospital at Harvard Medical School, to have an interview with us, sharing her experience in the field of orthopaedic infection.
{"title":"Interview with Prof. Antonia F. Chen: please never give up as long as you love what you are doing","authors":"Crystal M. Yan","doi":"10.21037/AOJ.2019.03.01","DOIUrl":"https://doi.org/10.21037/AOJ.2019.03.01","url":null,"abstract":"On Feb 28, 2019, Antonia F. Chen from Brigham and Women’s Hospital came to Nanjing to have a brief academic exchange with domestic peers on the prevention, diagnosis and treatment of periprosthetic joint infection (PJI) ( Figure 1 ). We were honored to invite Prof. Chen, who is currently the Director of Research, Arthroplasty Service at Brigham and Women’s Hospital at Harvard Medical School, to have an interview with us, sharing her experience in the field of orthopaedic infection.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44485951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Conventional bone replacement surgeries have always been associated with different critical drawbacks. Deviation of the implant from its original position is one of the most important problems associated with surgery. The emergence of computer-aided design/computer-aided manufacturing technology opened a new opportunity for the solution of this problem by the use of patient-specific surgical guides. These 3D-printed surgical guides provide a specific cut and therefore reduces the drawbacks associated with surgical techniques including the fixation difficulties. In this review, 3D-printed guides for knee arthroplasty, pedicle screw placement and mandibular reconstruction will be discussed covering both the progress and the drawbacks.
{"title":"3D-printed surgical guides","authors":"Alperen Yilmaz, Adel Badria, P. Huri, G. Huri","doi":"10.21037/AOJ.2019.02.04","DOIUrl":"https://doi.org/10.21037/AOJ.2019.02.04","url":null,"abstract":"Conventional bone replacement surgeries have always been associated with different critical drawbacks. Deviation of the implant from its original position is one of the most important problems associated with surgery. The emergence of computer-aided design/computer-aided manufacturing technology opened a new opportunity for the solution of this problem by the use of patient-specific surgical guides. These 3D-printed surgical guides provide a specific cut and therefore reduces the drawbacks associated with surgical techniques including the fixation difficulties. In this review, 3D-printed guides for knee arthroplasty, pedicle screw placement and mandibular reconstruction will be discussed covering both the progress and the drawbacks.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.02.04","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41681374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anatomic intra-articular anterior cruciate ligament reconstruction (ACLR) techniques have been shown to reliably correct anteroposterior (translational) stability; however, they have failed to restore normal tibial rotational kinematics. Re-establishing rotational stability correlates with return to sport, functional scores, overall knee function and patient satisfaction. Several structures in addition to the ACL have been identified as important contributors to rotational knee stability. Recent interest in the anatomical and biomechanical properties of the anterolateral soft tissue structures has led to a resurgence in surgical techniques, specifically anterolateral ligament (ALL) reconstruction and lateral extra-articular tenodesis (LET), to address rotational stability at the time of ACL reconstruction. In the accompanying review we outline the relevant anatomy, biomechanics and clinical results for lateral augmentation procedures; discuss the indications and describe our preferred LET technique for lateral augmentation.
{"title":"Consideration of lateral augmentation in anatomic anterior cruciate ligament reconstruction","authors":"S. Tulloch, A. Getgood","doi":"10.21037/AOJ.2019.02.01","DOIUrl":"https://doi.org/10.21037/AOJ.2019.02.01","url":null,"abstract":"Anatomic intra-articular anterior cruciate ligament reconstruction (ACLR) techniques have been shown to reliably correct anteroposterior (translational) stability; however, they have failed to restore normal tibial rotational kinematics. Re-establishing rotational stability correlates with return to sport, functional scores, overall knee function and patient satisfaction. Several structures in addition to the ACL have been identified as important contributors to rotational knee stability. Recent interest in the anatomical and biomechanical properties of the anterolateral soft tissue structures has led to a resurgence in surgical techniques, specifically anterolateral ligament (ALL) reconstruction and lateral extra-articular tenodesis (LET), to address rotational stability at the time of ACL reconstruction. In the accompanying review we outline the relevant anatomy, biomechanics and clinical results for lateral augmentation procedures; discuss the indications and describe our preferred LET technique for lateral augmentation.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.02.01","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48334065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Jofré, Omar Toro Sepúlveda, D. Gómez, L. R. Gómez
This article talks about the difficulties of the inclusion of 3D technology in the world of health. From the point of view of a traumatologist who decided to support a group of engineers who started a foundation that manufactures and donates 3D prosthetics to people with disabilities. Highlighting the work done and the challenges of both the medical community and society.
{"title":"Social 3D printing in Chile—experience and vision","authors":"C. Jofré, Omar Toro Sepúlveda, D. Gómez, L. R. Gómez","doi":"10.21037/aoj.2019.01.05","DOIUrl":"https://doi.org/10.21037/aoj.2019.01.05","url":null,"abstract":"This article talks about the difficulties of the inclusion of 3D technology in the world of health. From the point of view of a traumatologist who decided to support a group of engineers who started a foundation that manufactures and donates 3D prosthetics to people with disabilities. Highlighting the work done and the challenges of both the medical community and society.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/aoj.2019.01.05","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47477845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Shino, T. Mae, R. Uchida, Hiroyuki Yokoi, T. Ohori, Yuta Tachibana
The anatomical rectangular tunnel (ART) ACL reconstruction (ART ACLR) with a single bone-patellar tendon-bone (BTB) graft was developed under the concept of closely replicating the normal ACL. This technique makes it possible (I) to mimic internal fiber orientation inside the ACL, (II) to maximize the graft-tunnel wall contact. Our follow-up study showed that 95% of the patients restored satisfactory stability of the knee with normal motion maintained without extra-articular tenodesis or reconstruction of the anterolateral structures. ART ACLR with a BTB graft can stabilize the knee without loss of motion by closely mimicking the native ACL.
{"title":"Anatomical rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: its concept, indication and efficacy","authors":"K. Shino, T. Mae, R. Uchida, Hiroyuki Yokoi, T. Ohori, Yuta Tachibana","doi":"10.21037/AOJ.2019.01.04","DOIUrl":"https://doi.org/10.21037/AOJ.2019.01.04","url":null,"abstract":"The anatomical rectangular tunnel (ART) ACL reconstruction (ART ACLR) with a single bone-patellar tendon-bone (BTB) graft was developed under the concept of closely replicating the normal ACL. This technique makes it possible (I) to mimic internal fiber orientation inside the ACL, (II) to maximize the graft-tunnel wall contact. Our follow-up study showed that 95% of the patients restored satisfactory stability of the knee with normal motion maintained without extra-articular tenodesis or reconstruction of the anterolateral structures. ART ACLR with a BTB graft can stabilize the knee without loss of motion by closely mimicking the native ACL.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.01.04","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45097345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Seil, D. Cucchi, C. Ninulescu, J. Dor, C. Mouton
Pediatric anterior cruciate ligament reconstruction (ACLR) can be considered a safe procedure with low complication rates, provided that surgery is performed correctly. Correct timing and indication for surgery are of capital importance and should take into consideration the child’s maturation process and his/her individual needs and desires. In recent years, particular attention has been given to the role of conservative treatment and follow-up visits with clinical investigation, magnetic resonance and laxity testing. This appears of special importance, since the young ACL-deficient knee can evolve with patient’s growth. This article provides a synthetic overview on the state of the art of pediatric ACL tears epidemiology, diagnosis, conservative treatment and surgical approaches.
{"title":"Anatomic anterior cruciate ligament reconstruction for adolescent patients with open physis","authors":"R. Seil, D. Cucchi, C. Ninulescu, J. Dor, C. Mouton","doi":"10.21037/AOJ.2019.06.02","DOIUrl":"https://doi.org/10.21037/AOJ.2019.06.02","url":null,"abstract":"Pediatric anterior cruciate ligament reconstruction (ACLR) can be considered a safe procedure with low complication rates, provided that surgery is performed correctly. Correct timing and indication for surgery are of capital importance and should take into consideration the child’s maturation process and his/her individual needs and desires. In recent years, particular attention has been given to the role of conservative treatment and follow-up visits with clinical investigation, magnetic resonance and laxity testing. This appears of special importance, since the young ACL-deficient knee can evolve with patient’s growth. This article provides a synthetic overview on the state of the art of pediatric ACL tears epidemiology, diagnosis, conservative treatment and surgical approaches.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.06.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46186841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reverse shoulder arthroplasty (RSA) has experienced a rebirth in popularity as a surgical procedure starting with the Grammont design. The biomechanics of RSA continues to be studied and better understood, however at the same time there has been rapid development of different prostheses that have taken the geometry of the reverse and made substantial changes, impacting the mechanics of these devices in many ways. Classifying the different styles of design helps surgeons form a working nomenclature to discuss these design parameters and the potential biomechanical consequences of implant selection for patients. This chapter breaks down the RSA into glenoid sided, humeral sided, rotator cuff related and bone quality related components as they relate to biomechanics.
{"title":"The biomechanics of current reverse shoulder replacement options","authors":"M. Hansen, H. Routman","doi":"10.21037/AOJ.2019.01.06","DOIUrl":"https://doi.org/10.21037/AOJ.2019.01.06","url":null,"abstract":"Reverse shoulder arthroplasty (RSA) has experienced a rebirth in popularity as a surgical procedure starting with the Grammont design. The biomechanics of RSA continues to be studied and better understood, however at the same time there has been rapid development of different prostheses that have taken the geometry of the reverse and made substantial changes, impacting the mechanics of these devices in many ways. Classifying the different styles of design helps surgeons form a working nomenclature to discuss these design parameters and the potential biomechanical consequences of implant selection for patients. This chapter breaks down the RSA into glenoid sided, humeral sided, rotator cuff related and bone quality related components as they relate to biomechanics.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/AOJ.2019.01.06","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45865351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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