The aim of this study was to analyze the effect of a lateral rim mesh on the survival of primary total hip arthroplasty (THA) in young patients, aged 50 years or younger. We compared a study group of 235 patients (257 hips) who received a primary THA with the use of impaction bone grafting (IBG) with an additional lateral rim mesh with a group of 306 patients (343 hips) who received IBG in the absence of a lateral rim mesh during the same period from 1988 to 2015. In the mesh group, there were 74 male and 183 female patients, with a mean age of 35 years (13 to 50). In the no-mesh group, there were 173 male and 170 female patients, with a mean age of 38 years (12.6 to 50). Cox regression analyses were performed to study the effect of a lateral rim mesh on acetabular component survival. Kaplan–Meier analyses with 95% confidence intervals (CIs) were performed to estimate the survival of the acetabular implant.Aims
Patients and Methods
To assess the effect of physical exercise (PE) on the histological and transcriptional characteristics of proteoglycan-induced arthritis (PGIA) in BALB/c mice. Following PGIA, mice were subjected to treadmill PE for ten weeks. The tarsal joints were used for histological and genetic analysis through microarray technology. The genes differentially expressed by PE in the arthritic mice were obtained from the microarray experiments. Bioinformatic analysis in the DAVID, STRING, and Cytoscape bioinformatic resources allowed the association of these genes in biological processes and signalling pathways.Aims
Methods
Ceramic bearings have several desirable properties, such as resistance to wear, hardness, and biocompatibility, that favour it as an articulating surface in hip arthroplasty. However, ceramic fracture remains a concern. We have reviewed the contemporary literature, addressing the factors that can influence the incidence of ceramic bearing surface fracture. Cite this article:
The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated allograft bone in acetabular reconstruction. Between 1990 and 2000, 123 hips in 110 patients underwent acetabular reconstruction for aseptic loosening, using impaction bone grafting with frozen, irradiated, and morsellized femoral heads and a cemented acetabular component. A total of 55 men and 55 women with a mean age of 64.3 years (26 to 97) at the time of revision surgery are included in this study.Aims
Patients and Methods
The aim of this study was to evaluate the clinical and radiological
outcome of using an anatomical short-stem shoulder prosthesis to
treat primary osteoarthritis of the glenohumeral joint. A total of 66 patients (67 shoulders) with a mean age of 76 years
(63 to 92) were available for clinical and radiological follow-up
at two different timepoints (T1, mean 2.6 years, Aims
Patients and Methods
This study reviews the use of a titanium mesh cage (TMC) as an
adjunct to intramedullary nail or plate reconstruction of an extra-articular
segmental long bone defect. A total of 17 patients (aged 17 to 61 years) treated for a segmental
long bone defect by nail or plate fixation and an adjunctive TMC
were included. The bone defects treated were in the tibia (nine),
femur (six), radius (one), and humerus (one). The mean length of
the segmental bone defect was 8.4 cm (2.2 to 13); the mean length
of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and
radiological records of the patients were analyzed retrospectively.Aims
Patients and Methods
The aim of this systematic literature review was to assess the clinical level of evidence of commercially available demineralised bone matrix (DBM) products for their use in trauma and orthopaedic related surgery. A total of 17 DBM products were used as search terms in two available databases: Embase and PubMed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. All articles that reported the clinical use of a DBM-product in trauma and orthopaedic related surgery were included.Objectives
Methods
Aims
Patients and Methods
Ubiquitin E3 ligase-mediated protein degradation regulates osteoblast function. Itch, an E3 ligase, affects numerous cell functions by regulating ubiquitination and proteasomal degradation of related proteins. However, the Itch-related cellular and molecular mechanisms by which osteoblast differentiation and function are elevated during bone fracture repair are as yet unknown. We examined the expression levels of E3 ligases and NF-κB members in callus samples during bone fracture repair by quantitative polymerase chain reaction (qPCR) and the total amount of ubiquitinated proteins by Western blot analysis in wild-type (WT) mice. The expression levels of osteoblast-associated genes in fracture callus from Itch knockout (KO) mice and their WT littermates were examined by qPCR. The effect of NF-κB on Itch expression in C2C12 osteoblast cells was determined by a chromatin immunoprecipitation (ChIP) assay.Objectives
Methods
The purpose of this retrospective study was to differentiate
between the MRI features of normal post-operative change and those
of residual or recurrent disease after intralesional treatment of
an atypical cartilage tumour (ACT)/grade I chondrosarcoma. We reviewed the case notes, radiology and histology of 75 patients,
who had been treated for an ACT/grade I chondrosarcoma by curettage,
phenolisation and bone allografting between 1994 and 2005. The first
post-operative Gd-enhanced MRI scan was carried out within one year
of surgery. Patients had a minimum of two scans and a mean follow-up
of 72 months (13 to 169). Further surgery was undertaken in cases
of suspected recurrence.Aims
Patients and Methods
The aim of this study was to examine the results of the acetabular
distraction technique in achieving implantation of a stable construct,
obtaining biological fixation, and producing healing of chronic
pelvic discontinuity at revision total hip arthroplasty. We identified 32 patients treated between 2006 and 2013 who underwent
acetabular revision for a chronic pelvic discontinuity using acetabular
distraction, and who were radiographically evaluated at a mean of
62 months (25 to 160). Of these patients, 28 (87.5%) were female.
The mean age at the time of revision was 67 years (44 to 86). The patients
represented a continuous series drawn from two institutions that
adhered to an identical operative technique.Aims
Patients and Methods
Many Specific keywords were used to search electronic databases (EMBASE, PubMed, and Web of Science) for English-language literature published between 1995 and 2017.Objectives
Methods
Non-traumatic osteonecrosis of the femoral head
is a potentially devastating condition, the prevalence of which
is increasing. Many joint-preserving forms of treatment, both medical
and surgical, have been developed in an attempt to slow or reverse
its progression, as it usually affects young patients. However, it is important to evaluate the best evidence that is
available for the many forms of treatment considering the variation
in the demographics of the patients, the methodology and the outcomes
in the studies that have been published, so that it can be used
effectively. The purpose of this review, therefore, was to provide an up-to-date,
evidence-based guide to the management, both non-operative and operative,
of non-traumatic osteonecrosis of the femoral head. Cite this article:
This review summarises the technique of impaction
grafting with mesh augmentation for the treatment of uncontained
acetabular defects in revision hip arthroplasty. The ideal acetabular revision should restore bone stock, use
a small socket in the near-anatomic position, and provide durable
fixation. Impaction bone grafting, which has been in use for over
40 years, offers the ability to achieve these goals in uncontained
defects. The precepts of modern, revision impaction grafting are
that the segmental or cavitary defects must be supported with a
mesh; the contained cavity is filled with vigorously impacted morselised
fresh-frozen allograft; and finally, acrylic cement is used to stabilise
the graft and provide rigid, long-lasting fixation of the revised
acetabular component. Favourable results have been published with this technique. While
having its limitations, it is a viable option to address large acetabular
defects in revision arthroplasty. Cite this article:
Diabetes mellitus (DM) is known to impair fracture healing. Increasing evidence suggests that some microRNA (miRNA) is involved in the pathophysiology of diabetes and its complications. We hypothesized that the functions of miRNA and changes to their patterns of expression may be implicated in the pathogenesis of impaired fracture healing in DM. Closed transverse fractures were created in the femurs of 116 rats, with half assigned to the DM group and half assigned to the control group. Rats with DM were induced by a single intraperitoneal injection of streptozotocin. At post-fracture days five, seven, 11, 14, 21, and 28, miRNA was extracted from the newly generated tissue at the fracture site. Microarray analysis was performed with miRNA samples from each group on post-fracture days five and 11. For further analysis, real-time polymerase chain reaction (PCR) analysis was performed at each timepoint.Objectives
Methods
‘Big data’ is a term for data sets that are so
large or complex that traditional data processing applications are
inadequate. Billions of dollars have been spent on attempts to build predictive
tools from large sets of poorly controlled healthcare metadata.
Companies often sell reports at a physician or facility level based
on various flawed data sources, and comparative websites of ‘publicly
reported data’ purport to educate the public. Physicians should
be aware of concerns and pitfalls seen in such data definitions,
data clarity, data relevance, data sources and data cleaning when
evaluating analytic reports from metadata in health care. Cite this article:
A common situation presenting to the orthopaedic
surgeon today is a worn acetabular liner with substantial acetabular
and pelvic osteolysis. The surgeon has many options for dealing
with osteolytic defects. These include allograft, calcium based
substitutes, demineralised bone matrix, or combinations of these
options with or without addition of platelet rich plasma. To date
there are no clinical studies to determine the efficacy of using
bone-stimulating materials in osteolytic defects at the time of
revision surgery and there are surprisingly few studies demonstrating
the clinical efficacy of these treatment options. Even when radiographs
appear to demonstrate incorporation of graft material CT studies
have shown that incorporation is incomplete. The surgeon, in choosing
a graft material for a surgical procedure must take into account
the efficacy, safety, cost and convenience of that material. Cite this article:
We performed a systematic review of the literature to determine the safety and efficacy of bone morphogenetic protein (BMP) compared with bone graft when used specifically for revision spinal fusion surgery secondary to pseudarthrosis. The MEDLINE, EMBASE and Cochrane Library databases were searched using defined search terms. The primary outcome measure was spinal fusion, assessed as success or failure in accordance with radiograph, MRI or CT scan review at 24-month follow-up. The secondary outcome measure was time to fusion.Objectives
Methods
