Ludwig Maximilians University Munich, Department of Orthopaedic and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany
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Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK
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Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
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Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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The objectives of the 1st EFORT European Consensus on ‘Medical and Scientific Research Requirements for the Clinical Introduction of Artificial Joint Arthroplasty Devices’ were foremost to focus on patient safety by establishing performance requirements for medical devices.
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The 1st EFORT European Consensus applied an a priori-defined, modified Delphi methodology to produce unbiased, high-quality recommendation statements, confirmed by consensus voting of a European expert panel.
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Intended key outcomes are practical guidelines justified by the current stage of knowledge and based on a broad European Expert Consensus, to maintain innovation and optimisation of orthopaedic devices within the boundaries of MDR 2017/745.
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Twenty-one main research areas of relevance were defined relying on input from the EFORT IPSI WG1 ‘Introduction of Innovation’ recommendations and a related survey.
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A modified Delphi approach with a preparatory literature review and work in small groups were used to prepare answers to the research questions in the form of 32 draft Consensus statements.
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A Consensus Conference in a hybrid format, on-site in the Carl Gustav Carus University of Dresden was organised to further refine the draft statements and define consensus within the complete group of participants by final voting, intended to further quantify expert opinion knowledge.
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The modified Delphi approach provides practical guidelines for hands-on orientation for orthopaedic surgeons, research institutes and laboratories, orthopaedic device manufacturers, patient representatives, Notified Bodies, National Institutes and authorities.
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For the first time, initiated by the EFORT IPSI (WG1 ‘Introduction of Innovation’), knowledge of all related stakeholders was combined in the 1st EFORT European Consensus to develop guidelines and result in a comprehensive set of recommendations.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
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Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Objective
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The aim of the study was to evaluate the efficacy and safety of teriparatide compared to other treatments for postmenopausal osteoporosis.
Methods
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A review of studies from 2000 to January 2023 analyzed randomized controlled trials on postmenopausal women treated with teriparatide (PTH 1–34), comparing it to placebo or other osteoporosis treatments. The analysis focused on bone mineral density (BMD), bone turnover markers, and clinical outcomes, employing Review Manager 5.4.1 and the RoB 2 tool for bias assessment.
Results
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Our analysis of 23 randomized controlled trials (RCTs) found that PTH (134) treatment significantly increased lumbar spine BMD (mean difference (MD) = 0.02, 95% CI: 0.01–0.03) and femoral neck BMD (MD = 0.01, 95% CI: 0.00–0.01). However, there were no significant changes in total hip and radial bone BMD among the 3536 and 2046 participants, respectively. We also found that PTH (1–34) increased P1NP in a larger cohort (n = 1415) when compared to osteocalcin (n = 206). Although the risk of adverse events increased (relative risk (RR) = 1.65, 95% CI: 1.32–2.07), the incidence of fractures decreased significantly (RR = 0.57, 95% CI: 0.45–0.072), with no significant difference observed in mortality rates between treatment and control groups.
Conclusion
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Teriparatide improves lumbar spine and femoral neck BMD in postmenopausal women. Particularly notable is the novel finding regarding its effect on radius BMD, an area less explored in previous research. Despite an uptick in adverse events, the marked decrease in fracture incidence confirms its clinical utility for high-risk osteoporosis patients, highlighting the necessity for ongoing investigations into its full skeletal effects.
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Objective
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Through meta-analysis, this study aims to comprehensively evaluate the efficacy of single-plating and double-plating in the treatment of comminuted fractures of the distal femur.
Methods
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Computer searches of PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang digital journals were performed, and the timeframe for the searches was from the establishment of each database to July 2023 for each of the databases. Meta-analysis was performed using RevMan 5.4 software provided by the Cochrane Library, and the review process was registered in the PROSPERO database.
Results
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A total of ten studies were included for statistical analysis. One randomised controlled study and nine retrospective cohort studies with a total of 563 patients were included. The double-plate group was superior to the single-plate group in terms of knee mobility at 6 months postoperatively, overall postoperative complications, and the rate of healing of knee deformity. However, it increased the operation time and intraoperative bleeding, and the difference between the two groups was statistically significant (P < 0.05). There was no significant difference between the two groups in terms of excellent knee function rate, fracture healing time, plate fracture, postoperative infection, delayed fracture healing, and non-union (P ≥ 0.05).
Conclusion
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Double plate fixation for comminuted fractures of the distal femur can improve knee mobility at 6 months postoperatively, reduce overall postoperative complications, and decrease the incidence of malunion healing. However, it increases operative time and bleeding. Randomised studies are needed to provide strong evidence in the future.
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used to template total hip replacements: Two-dimensional (2D) acetate templating, which overlays acetate templates on printed radiographs. 2D digital templating, which uses computer software to template implant size and position on digital
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injury to digital nerves and arteries in primary cases and possibly even more in recurrent disease due to excessive scar tissue formation ( 13 , 14 ). Rationale for microsurgery in Dupuytren’s fasciectomy Risk for complications Possible
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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LLD in DAA patients. On the other hand, several methods have been proposed to ease preoperative and intraoperative measurement of LLD in DAA: preoperative planning with manual or digital systems, the use of navigation systems and robot
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followed to avoid potential complications such as compression neuropathies or muscular contractures. 42 Pseudoaneurysms and true aneurysms Palmar digital artery aneurysms, like all other aneurysms, are classified into two broad categories, true
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany
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Institute for Hand- and Plastic Surgery, Oldenburg, Germany
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-joint[Title/Abstract]) OR (finger[Title/Abstract]) OR (digital[Title/Abstract]) OR (pipj[Title/Abstract]) OR (proximal interphalangeal[Title/Abstract])) AND ((arthrodesis[Title/Abstract]) OR (fusion[Title/Abstract]))) NOT equine[Title/Abstract] Embase (‘proximal
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palmar fascial complex is composed by the radial, ulnar and central aponeurosis and the palmodigital and digital fasciae. All these structures might be involved in the pathology. 29 The palmar fascia consists of a deep and a superficial layer. Only
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essence indelible and the traces persist as long as the written word itself. One finds it in antiquity and Roman law acknowledges plagiarism as a crime. In our times, plagiarism remains an offence that cannot be erased from the records. The digital word is
