Browse
You are looking at 51 - 60 of 761 items
Search for other papers by Thorsten Gehrke in
Google Scholar
PubMed
Search for other papers by Mustafa Citak in
Google Scholar
PubMed
Search for other papers by Mustafa Akkaya in
Google Scholar
PubMed
-
Acetabular revision arthroplasty, a demanding field of reconstructive hip surgery, calls for innovative strategies to deal with challenging bone defects and implant failure seen in revision cases.
-
Conventional implant solutions might fall short of adequately addressing severe bone loss and ensuring stable fixation, highlighting the necessity of customized strategies.
-
Personalized megaimplants, distinguished by their tailor-made design and large-scale construction, present a viable option to overcome these challenges.
-
The present article provides an elaborate analysis of custom-made megaimplants in acetabular revision arthroplasty, shedding light on the underlying principles, design complexities, manufacturing methods, applications in the clinical setting, and outcome assessment.
-
The aim of this review is to present a comprehensive insight into personalized megaimplants and their contribution to the advancement of orthopedic surgery.
Search for other papers by Andrea Pratobevera in
Google Scholar
PubMed
Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg
Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg-Clinique d’Eich, Luxembourg, Luxembourg
Search for other papers by Romain Seil in
Google Scholar
PubMed
Orthopaedic Surgery Service, University Hospital of Geneva, Geneva, Switzerland
Search for other papers by Jacques Menetrey in
Google Scholar
PubMed
-
This review explores the intricate relationship between knee osteotomy and frontal plane joint line orientation, emphasizing the dynamic nature of the joint line’s influence on knee forces and kinematics.
-
Consideration of coronal alignments, knee phenotypes, and associated angles (medial proximal tibial angle (MTPA), lateral distal femoral angle (LDFA), joint line convergence angle (JLCA)) becomes crucial in surgical planning to avoid joint line deformities.
-
The double-level osteotomy is to be considered a valid option, especially for severe deformities; however, the target patient cannot be selected solely based on high predicted postoperative joint line obliquity (JLO) and MPTA.
Search for other papers by Enrique Gómez-Barrena in
Google Scholar
PubMed
Search for other papers by Christian Ehrnthaller in
Google Scholar
PubMed
-
Long bone non-unions represent a serious clinical and socioeconomical problem due to the prolonged episodes, frequent sequelae, and variable treatment effectiveness.
-
Bone grafts, classically involving the autologous iliac crest graft as the ‘gold standard’ bone graft, enhance bone regeneration and fracture healing incorporating osteoconductive and/or osteoinductive/osteogenic capacity to the non-union under treatment.
-
Structural alternatives to autologous bone grafts include allografts and bone substitutes, expanding the available stock but loosing biological properties associated with cells in the graft.
-
Biological alternatives to autologous bone grafts include bone marrow concentration from iliac crest aspiration, bone marrow aspiration from reaming of the diaphyseal medullary canal in the long bones, and isolated, expanded mesenchymal stem cells under investigation.
-
When the combination with natural and synthetic bone substitutes allows for larger volumes of structural grafts, the enhancement of the biological regenerative properties through the incorporation of cells and their secretoma permits to foresee new bone grafting solutions and techniques.
Search for other papers by Elisa Pala in
Google Scholar
PubMed
Search for other papers by Giulia Trovarelli in
Google Scholar
PubMed
Search for other papers by Andrea Angelini in
Google Scholar
PubMed
Search for other papers by Maria Chiara Cerchiaro in
Google Scholar
PubMed
Search for other papers by Pietro Ruggieri in
Google Scholar
PubMed
-
The best treatment of unicameral bone cyst and aneurismatic bone cyst (ABC) is debated in the literature.
-
For simple bone cysts, multiple treatments were proposed from observation only to open curettage. The historical treatment with intraosseous injection of methylprednisolone acetate into the bone cysts nowadays is reduced due to the morbidity of multiple injections and the risk of multiple pathologic fractures until the healing.
-
Different types of treatments for ABC are reported, including surgery, percutaneous treatments, and medical treatments; however, there is currently no consensus on the best approach. The association of curettage, bone graft, and elastic stable intramedullary nail (ESIN) had a success rate of over 85%. Decompressing the cyst wall is more critical for increasing the healing rate than the type of graft used to fill the cavity.
-
In ABC, sclerotherapy offers the advantages of lower invasiveness and morbidity, associated with better functional scores and faster return to full weight-bearing. Moreover, they can be used in challenging locations.
-
Selective arterial embolization is a complex procedure and often requires association with other treatments. Further studies are needed to confirm the effectiveness of denosumab and its side effects on skeletally immature patients. Curettage with adjuvants and autogenous bone grafting still shows promising results and can be used in larger, aggressive defects or superficial lesions.
-
For simple bone cysts, the combination of curettage, bone graft, and ESIN showed the best results. Sclerotherapy for ABC also shows promising results.
Search for other papers by Ilse Degreef in
Google Scholar
PubMed
Search for other papers by Donald H Lalonde in
Google Scholar
PubMed
-
Wide-awake local anesthesia no tourniquet is named the WALANT technique.
-
WALANT has had a major positive impact on cost, convenience, ecology, patient satisfaction, access to surgical care, and outcomes in hand surgery in the last 20 years.
-
Safe and efficient application of the technique is based on two principles.
-
The first principle is the tumescent injection of a large volume low concentration 0.25–1% lidocaine, with 1:100 000–1:400 000 epinephrine.
-
The second principle of WALANT is that the proper injection should be almost painless, with the patient only feeling the first needle poke of a tiny 30G needle.
-
This wide awake patient approach reduces pain, neuropraxia, and systemic side effects of sedation with preservation of motor control, thereby aiding balanced reconstruction in hand surgery.
Search for other papers by Anna E van der Windt in
Google Scholar
PubMed
Search for other papers by Lisette C Langenberg in
Google Scholar
PubMed
Search for other papers by Joost W Colaris in
Google Scholar
PubMed
Search for other papers by Denise Eygendaal in
Google Scholar
PubMed
-
Despite the common occurrence of radial head fractures, there is still a lack of consensus on which radial head fractures should be treated surgically.
-
The radial head is an important secondary stabilizer in almost all directions. An insufficient radial head can lead to increased instability in varus–valgus and posterolateral rotatory directions, especially in a ligament-deficient elbow.
-
The decision to perform surgery is often not dictated by the fracture pattern alone but also by the presence of associated injury. Comminution of the radial head and complete loss of cortical contact of at least one fracture fragment are associated with a high occurrence of associated injuries.
-
Nondisplaced and minimally displaced radial head fractures can be treated non-operatively with early mobilization. Displacement (>2 mm) of fragments in radial head fractures without a mechanical block to pronation/supination is not a clear indication for surgery.
-
Mechanical block to pronation/supination and comminution of the fracture are indications for surgery.
-
The following paper reviews the current literature and provides state-of-the-art guidance on which radial head fractures should be treated surgically.
Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Murcia, Spain
Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Search for other papers by Guillermo Droppelmann in
Google Scholar
PubMed
Search for other papers by Constanza Rodríguez in
Google Scholar
PubMed
Search for other papers by Carlos Jorquera in
Google Scholar
PubMed
Search for other papers by Felipe Feijoo in
Google Scholar
PubMed
Purpose
-
The integration of artificial intelligence (AI) in radiology has revolutionized diagnostics, optimizing precision and decision-making. Specifically in musculoskeletal imaging, AI tools can improve accuracy for upper extremity pathologies. This study aimed to assess the diagnostic performance of AI models in detecting musculoskeletal pathologies of the upper extremity using different imaging modalities.
Methods
-
A meta-analysis was conducted, involving searches on MEDLINE/PubMed, SCOPUS, Cochrane Library, Lilacs, and SciELO. The quality of the studies was assessed using the QUADAS-2 tool. Diagnostic accuracy measures including sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR, NLR), area under the curve (AUC), and summary receiver operating characteristic were pooled using a random-effects model. Heterogeneity and subgroup analyses were also included. All statistical analyses and plots were performed using the R software package.
Results
-
Thirteen models from ten articles were analyzed. The sensitivity and specificity of the AI models to detect musculoskeletal conditions in the upper extremity were 0.926 (95% CI: 0.900; 0.945) and 0.908 (95% CI: 0.810; 0.958). The PLR, NLR, lnDOR, and the AUC estimates were found to be 19.18 (95% CI: 8.90; 29.34), 0.11 (95% CI: 0.18; 0.46), 4.62 (95% CI: 4.02; 5.22) with a (P < 0.001), and 95%, respectively.
Conclusion
-
The AI models exhibited strong univariate and bivariate performance in detecting both positive and negative cases within the analyzed dataset of musculoskeletal pathologies in the upper extremity.
Hospital Base de Valdivia, Valdivia, Chile
AO Foundation, LEGEC Expert Group, Davos, Switzerland
Search for other papers by Matías Sepulveda in
Google Scholar
PubMed
Hospital Base de Valdivia, Valdivia, Chile
Search for other papers by Gabriel Orellana in
Google Scholar
PubMed
Clínica Puerto Montt, Puerto Montt, Chile
Search for other papers by Francisco Sanchez in
Google Scholar
PubMed
Hospital Base de Valdivia, Valdivia, Chile
Search for other papers by Estefania Birrer in
Google Scholar
PubMed
-
Brachymetatarsia involves a reduction in length of one or more metatarsals.
-
The affected metatarsal is shortened by 5 mm or more, altering the normal metatarsal parabola.
-
In addition to being an aesthetic deformity, it can present with pain due to transfer metatarsalgia.
-
A possible association with genetic disorders needs to be investigated during clinical evaluation.
-
Surgical treatment may involve a one-stage lengthening procedure or progressive distraction, each having its advantages and limitations.
West Hertfordshire Hospitals NHS Trust, London, United Kingdom
Search for other papers by Andrew Kailin Zhou in
Google Scholar
PubMed
Search for other papers by Eric Jou in
Google Scholar
PubMed
James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, Norfolk, United Kingdom
Search for other papers by Victor Lu in
Google Scholar
PubMed
Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, Essex, United Kingdom
Search for other papers by James Zhang in
Google Scholar
PubMed
School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
Search for other papers by Shirom Chabra in
Google Scholar
PubMed
Search for other papers by Matija Krkovic in
Google Scholar
PubMed
-
Compared to other techniques, poller screws with intramedullary nailing are technically simple, practical, and reproducible for the fixation of metaphyseal fractures.
-
In addition, poller screws do not require special instruments or hardware and are minimally invasive. This review takes a historical perspective to evaluate poller screws holistically.
-
A non-systematic search on PubMed was performed using ‘Poller screw’ or ‘Blocking screw’ to find early use of poller blocking screws. Relevant references from these primary studies were then followed up.
-
In 1999, Krettek et al. first coined the term poller screws after the small metal bollards that block and direct traffic.
-
Poller screws were introduced as an adjunct to aid the union of metaphyseal long bone fractures during intramedullary nailing.
-
However, as more evidence was published, the true effectiveness of poller screws was not appreciated, leading to split opinions.
-
Through our research, we have built upon our understanding of poller screws, and we present a novel classification of poller screws over the years while exploring our novel technique and what we believe to be the fourth generation of poller screws.
-
Currently, there is a paucity of research focussing on poller screws.
-
However, studying the original evidence regarding poller screws through the most recent articles has demonstrated a confusion of research in this field. Therefore, we suggest a more organised approach to classify the use of poller screws.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Search for other papers by Hongfu Jin in
Google Scholar
PubMed
Search for other papers by Shide Jiang in
Google Scholar
PubMed
Search for other papers by Volotovski Pavel in
Google Scholar
PubMed
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Search for other papers by Djandan Tadum Arthur Vithran in
Google Scholar
PubMed
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Search for other papers by Wenfeng Xiao in
Google Scholar
PubMed
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Search for other papers by Yusheng Li in
Google Scholar
PubMed
-
Reverse total shoulder arthroplasty (rTSA) has been demonstrated to be an effective intervention for various shoulder disorders. The number of rTSA-related studies performed has increased annually over the past three decades.
-
The Journal of Shoulder and Elbow Surgery had the highest number of publications and citations in the rTSA-related research domain and is therefore considered to be the most influential journal in this field.
-
The USA published the most publications and established a high degree of cooperation with many countries worldwide. The University of Florida, the Hospital for Special Surgery, and Rush University, Mayo Clinic were representative and active institutions in this field.
-
It is anticipated that advancements in prosthesis design, specifically with regards to lateralized design concepts, expanding indications for rTSA, a trend toward younger patient populations, and the management of postoperative complications will emerge as research hotspots in the following years.
-
The most valuable publications, influential journals, major researchers, and leading countries were analyzed. The findings of our study will help researchers gain insights into current research hotspots and frontiers and shape their research focus in the field of rTSA.
