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Treatment of femoral bone loss in revision total hip arthroplasty: a clinical practice review 翻修全髋关节置换术中股骨头缺损的治疗:临床实践综述
IF 0.4 4区 医学 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.21037/aoj-23-31
Erden Ali, L. Howard, M. Neufeld, Bassam A. Masri
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引用次数: 0
Connexin 43 in the function and homeostasis of osteocytes: a narrative review 连接蛋白 43 在骨细胞功能和稳态中的作用:综述
IF 0.4 4区 医学 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.21037/aoj-23-65
Liang Ma, Wenzhao Wang, Guixuan Xu, Hao Li, Fei Liu, H. Shao, Xiuhua Zhang, Yuxia Ma, Gang Li, Hui Li, Shuzhong Gao, Peixue Ling
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引用次数: 0
Trabecular titanium cups in hip revision surgery: a systematic review of the literature 骨小梁钛杯在髋关节翻修手术中的应用:文献系统综述
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-28
Giorgio Cacciola, Fortunato Giustra, Francesco Bosco, Federico De Meo, Antongiulio Bruschetta, Ivan De Martino, Salvatore Risitano, Luigi Sabatini, Alessandro Massè, Pietro Cavaliere
Background: Hip revision surgery in extensive acetabular bone defects represents a complex challenge for hip surgeons. The primary goal is to obtain a stable acetabular component and restore the hip biomechanics. Through the years, different prosthetic implants have been developed to perform acetabular revision depending on bone loss location and extension. This systematic review aims to summarize the clinical outcomes and complications reported with trabecular titanium (TT) cups in hip revision surgery.
背景:广泛髋臼骨缺损的髋关节翻修手术对髋关节外科医生来说是一个复杂的挑战。主要目标是获得稳定的髋臼部件并恢复髋关节生物力学。多年来,不同的假体植入物被开发出来,根据骨丢失的位置和延伸进行髋臼翻修。本系统综述旨在总结骨小梁钛(TT)杯在髋关节翻修手术中的临床结果和并发症。
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引用次数: 0
Massive rotator cuff tears: algorithmic approach to surgical treatment 大规模肩袖撕裂:手术治疗的算法方法
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-7
Kaitlyn Guadagno, Uma Srikumaran, Eric G. Huish Jr, Matthew J. Best
: The management of massive rotator cuff tears (MRCT) presents a unique challenge to many orthopedic specialists. Unlike tears that are predicted to do well with primary, complete repair, MRCT are affected by tissue retraction, in-elasticity, bursal scarring, muscle atrophy, and fatty degeneration; operative repair thus portends worse healing rates than smaller tears and is associated with recurrent tear rates of up to 91% based on ultrasonography and magnetic resonance imaging (MRI). Rotator cuff tears are a common condition in patients over the age of 50. Thus, multiple advances in treatment strategies have been made to combat the limited efficacy of complete or partial rotator cuff repair in the setting of a massive or irreparable rotator cuff tears. It is of utmost importance that the operating orthopedic surgeon be familiar with these various treatment modalities to best serve the patient and that they harbor these skills within their armamentarium. This article details a review of the current literature including nonoperative and operative treatments for the management of massive and irreparable rotator cuff tears. The primary objective is to propose a literature-based algorithm for the treatment of massive and often irreparable rotator cuff tears to allow for informed ease in the decision-making process.
大量肩袖撕裂(MRCT)的管理提出了一个独特的挑战,许多骨科专家。与预测的通过初级、完全修复可以很好地修复撕裂不同,MRCT会受到组织缩回、无弹性、法囊瘢痕、肌肉萎缩和脂肪变性的影响;因此,手术修复预示着比小撕裂更差的愈合率,并且根据超声检查和磁共振成像(MRI),复发撕裂率高达91%。肩袖撕裂是50岁以上患者的常见病。因此,在治疗大面积或不可修复的肩袖撕裂时,已经取得了多种治疗策略的进展,以克服完全或部分修复肩袖的有限疗效。最重要的是,整形外科医生熟悉这些不同的治疗方式,以最好地为患者服务,并在他们的设备中拥有这些技能。这篇文章详细回顾了目前的文献,包括非手术和手术治疗大量和不可修复的肩袖撕裂。主要目的是提出一种基于文献的算法,用于治疗大量且通常不可修复的肩袖撕裂,以便在决策过程中方便知情。
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引用次数: 0
Should megaprosthesis implants be a viable option in elderly patients after distal femur and periprosthetic distal femur fractures?—a retrospective cohort study 对于股骨远端骨折和股骨远端假体周围骨折后的老年患者,大型假体植入是否是可行的选择?-回顾性队列研究
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-21
Salvatore Risitano, Davide D’Antonio, Francesco Bosco, Fortunato Giustra, Fabio Rocca, Marcello Capella, Luigi Sabatini, Alessandro Massè
Background: Distal femur fractures (DFF) and periprosthetic distal femur fractures (PDFF) in elderly patients are challenging to manage, often requiring the use of distal femur replacement (DFR) implants to manage severe bone loss and comminution. The study’s main purpose was to analyze outcomes and complications of DFR implant after DFF or PDFF at our institution to understand the feasibility and reliability of this treatment considering a review of the current literature.
背景:老年患者股骨远端骨折(DFF)和假体周围股骨远端骨折(PDFF)的治疗具有挑战性,通常需要使用股骨远端置换(DFR)植入物来治疗严重的骨丢失和粉碎。本研究的主要目的是通过对现有文献的回顾,分析我院DFF或PDFF术后DFR种植体的结局和并发症,了解这种治疗方法的可行性和可靠性。
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引用次数: 0
Current development in surgical techniques, graft selection and additional procedures for anterior cruciate ligament injury: a path towards anatomic restoration and improved clinical outcomes—a narrative review 前交叉韧带损伤的外科技术、移植物选择和其他手术的最新进展:解剖修复和改善临床结果的途径
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-39
Koji Nukuto, Yuichi Hoshino, Kiminari Kataoka, Ryosuke Kuroda
Current development in surgical techniques, graft selection and additional procedures for anterior cruciate ligament injury: a path towards anatomic restoration and improved clinical outcomes—a narrative review
前交叉韧带损伤的外科技术、移植物选择和其他手术的最新进展:解剖修复和改善临床结果的途径
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引用次数: 0
Isolated posterolateral corner knee injuries: high incidence in Jiu-Jitsu athletes and with anterolateral ligament injuries 孤立性膝后外侧角损伤:柔术运动员高发,伴前外侧韧带损伤
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-42
Nicholas N. DePhillipo, Zachary S. Aman, Travis J. Dekker
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引用次数: 0
Conservative treatment of spinal tuberculosis in a retrospective cohort study over 20-year period: high eradication rate and successful health status can be expected 20年回顾性队列研究中脊柱结核的保守治疗:高根除率和成功的健康状况是可以预期的
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-22-54
Alessandro Rava, Michele Mercurio, Giosuè Gargiulo, Federico Fusini, Gabriele Boasso, Olimpio Galasso, Giorgio Gasparini, Alessandro Massè, Massimo Girardo
Background: Tuberculosis (TB) which mainly cause lung primarily TB, can also affect the musculoskeletal system. Spine involvement occurs in 50% of the cases and neurologic deficit and kyphotic deformity may occur. The choice of conservative or surgical management of spinal TB in the absence of neurologic deficits remains controversial. The aim of the present study was to investigate the outcome and the success rate of conservative treatment and to provide evidence for the timing of treatment for spinal TB in adult patients.
背景:结核(TB)主要引起肺部结核,也可影响肌肉骨骼系统。50%的病例发生脊柱受累,可能发生神经功能缺损和后凸畸形。在没有神经功能缺陷的情况下,选择保守或手术治疗脊柱结核仍然存在争议。本研究的目的是调查保守治疗的结果和成功率,并为成人脊柱结核患者的治疗时机提供证据。
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引用次数: 0
Preoperative planning in reverse shoulder arthroplasty: plain radiographs vs. computed tomography scan vs. navigation vs. augmented reality 肩关节置换术的术前计划:x线平片vs.计算机断层扫描vs.导航vs.增强现实
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-20
Jorge Rojas Lievano, Andrés Mauricio Jiménez, Helberth Augusto González-Rico, Mercedes Salas, Guido Fierro, Juan Carlos González
: Reverse shoulder arthroplasty (RSA) has become a highly successful treatment option for various shoulder conditions, leading to a significant increase in its utilization since its approval in 2003. However, postoperative complications, including scapular notching, prosthetic instability, and component loosening, remain a concern. These complications can often be attributed to technical errors during component implantation, emphasizing the importance of proper preoperative planning and accurate positioning of prosthetic components. Improper baseplate and glenosphere positioning in RSA have been linked to impingement, reduced range of motion, and increased scapular notching. Additionally, the relationship between component positioning and intrinsic stability of RSA has been established, with glenoid component retroversion exceeding 10° posing a risk to implant stability. Adequate initial glenoid baseplate fixation, achieved through optimal seating and the use of appropriate screws, is crucial for long-term success and prevention of early failure. Factors such as lateralization and distalization also influence outcomes and complications in RSA, yet standardized guidelines for preoperative planning in these parameters are still lacking. Despite the impact of component position on outcomes, glenoid component implantation remains challenging, with position errors being common even among experienced surgeons. Challenges arise due to factors such as deformity, bone defects, limited exposure, and the absence of reliable bony landmarks intraoperatively. With the evolving understanding of RSA biomechanics and the significance of implant configuration and positioning, advancements in preoperative planning and surgical aids have emerged. This review article explores the current evidence on preoperative planning techniques in RSA, including plain radiographs, three-dimensional imaging, computer planning software, intraoperative navigation, and augmented reality (AR), highlighting their potential benefits and advancements in improving implant position accuracy.
自2003年获得批准以来,反向肩关节置换术(RSA)已成为治疗各种肩关节疾病的一种非常成功的治疗选择,导致其使用率显著增加。然而,术后并发症,包括肩胛骨的切口,假体不稳定,和组件松动,仍然是一个问题。这些并发症通常可以归因于技术错误组件注入期间,强调正确的术前计划的重要性和假体组件的精确定位。RSA中不正确的底板和关节盂定位与撞击、活动范围减小和肩胛骨切迹增加有关。另外,组件定位和RSA的内在稳定性之间的关系已经建立,与关节窝的组件向后弯曲超过10°植入构成风险的稳定性。足够的初始关节窝的底板固定,通过最佳的座位和使用合适的螺丝,是至关重要的长期成功和预防早期的失败。侧位和远端等因素也会影响RSA的预后和并发症,但这些参数的术前规划标准化指南仍然缺乏。尽管关节假体的位置对结果有影响,但关节盂假体植入仍然具有挑战性,即使在经验丰富的外科医生中,位置错误也很常见。由于诸如畸形、骨缺损、暴露有限以及术中缺乏可靠的骨标记等因素,出现了挑战。随着对RSA生物力学的不断了解以及植入物配置和定位的重要性,在术前计划和手术辅助方面取得了进展。这个评论文章探讨了现有的证据在RSA术前规划技术,包括平片、三维成像、计算机规划软件,术中导航,和增强现实(AR),突出其潜在的利益和进步在改善植入位置准确性。
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引用次数: 0
Usefulness of modular neck adapter in partial hip revision 模块化颈部接头在部分髋关节翻修中的应用
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/aoj-23-22
Andrea Pautasso, Giuseppe Bardellini, Placido Stissi, Fabio D’Angelo
Background and Objective: Modular neck adapters allow different length and offset changes to reach a stable total hip arthroplasty (THA) and permit a quick partial hip revision procedure without removing the existing components. The literature is poor on this matter and about the long-term related outcomes. This narrative review summarizes the most recent literature about these devices as an option of surgical treatment in partial total hip arthroplasty revision (THAr) focusing on indications, clinical and radiological outcomes, and related complications.
背景和目的:模块化颈部适配器允许不同长度和偏移量的变化,以达到稳定的全髋关节置换术(THA),并允许快速部分髋关节翻修手术,而无需移除现有组件。关于这个问题和长期相关结果的文献很少。这篇叙述性综述总结了关于这些装置作为部分全髋关节置换术翻修(THAr)手术治疗的一种选择的最新文献,重点是指征、临床和放射学结果以及相关并发症。
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Annals of Joint
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