• Title/Summary/Keyword: Orthopaedics

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Anterior Cervical Discectomy and Fusion YouTube Videos as a Source of Patient Education

  • Ovenden, Christopher Dillon;Brooks, Francis Michael
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.987-991
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    • 2018
  • Study Design: Cross sectional study. Purpose: To assess the quality of anterior cervical discectomy and fusion (ACDF) videos available on YouTube and identify factors associated with video quality. Overview of Literature: Patients commonly use the internet as a source of information regarding their surgeries. However, there is currently limited information regarding the quality of online videos about ACDF. Methods: A search was performed on YouTube using the phrase 'anterior cervical discectomy and fusion.' The Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems were used to rate the first 50 videos obtained. Information about each video was collected, including number of views, duration since the video was posted, percentage positivity (defined as number of likes the video received, divided by the total number of likes or dislikes of that video), number of comments, and the author of the video. Relationships between video quality and these factors were investigated. Results: The average number of views for each video was 96,239. The most common videos were those published by surgeons and those containing patient testimonies. Overall, the video quality was poor, with mean scores of 1.78/5 using the DISCERN criteria, 1.63/4 using the JAMA criteria, and 1.96/8 using the HON criteria. Surgeon authors' videos scored higher than patient testimony videos when reviewed using the HON or JAMA systems. However, no other factors were found to be associated with video quality. Conclusions: The quality of ACDF videos on YouTube is low, with the majority of videos produced by unreliable sources. Therefore, these YouTube videos should not be recommended as patient education tools for ACDF.

Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

  • Sundararajan, Silvampatti Ramasamy;Sambandam, Balaji;Singh, Ajay;Rajagopalakrishnan, Ramakanth;Rajasekaran, Shanmuganathan
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.341-347
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    • 2018
  • Purpose: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening. Materials and Methods: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up. Results: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups. Conclusions: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices. Level of Evidence: Level 3, Retrospective Cohort.

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

  • Paul, Sam;Choudhury, Rupshikha;Kumari, Nandini;Rastogi, Sanjay;Sharma, Ashish;Singh, Vikas;Laskar, Shyamalendu;Dubey, Tushar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.76-82
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    • 2019
  • Objectives: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. Materials and Methods: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. Results: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). Conclusion: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

Specific urinary metabolites in canine mammary gland tumors

  • Valko-Rokytovska, Marcela;Ocenas, Peter;Salayova, Aneta;Titkova, Radka;Kostecka, Zuzana
    • Journal of Veterinary Science
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    • v.21 no.2
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    • pp.23.1-23.10
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    • 2020
  • The identification of biomarkers that distinguish diseased from healthy individuals is of great interest in human and veterinary fields. In this research area, a metabolomic approach and its related statistical analyses can be useful for biomarker determination and allow non-invasive discrimination of healthy volunteers from breast cancer patients. In this study, we focused on the most common canine neoplasm, mammary gland tumor, and herein, we describe a simple method using ultra-high-performance liquid chromatography to determine the levels of tyrosine and its metabolites (epinephrine, 3,4-dihydroxy-L-phenylalanine, 3,4-dihydroxyphenylacetic acid, and vanillylmandelic acid), tryptophan and its metabolites (5-hydroxyindolacetic acid, indoxyl sulfate, serotonin, and kynurenic acid) in canine mammary cancer urine samples. Our results indicated significantly increased concentrations of three tryptophan metabolites, 5-hydroxyindolacetic acid (p < 0.001), serotonin, indoxyl sulfate (p < 0.01), and kynurenic acid (p < 0.05), and 2 tyrosine metabolites, 3,4-dihydroxy-L-phenylalanine (p < 0.001), and epinephrine (p < 0.05) in urine samples from the mammary gland tumor group compared to concentrations in urine samples from the healthy group. The results indicate that select urinary tyrosine and tryptophan metabolites may be useful as non-invasive diagnostic markers as well as in developing a therapeutic strategy for canine mammary gland tumors.

Clinical and radiologic study of total knee replacement arthroplasty using Doujet GF bone cement (liquid-powder bone cement containing gentamicin) (Doujet GF 골 시멘트를 사용한 인공 슬관절치환술의 임상적, 방사선적 고찰)

  • Sungwook Choi;Seong-meen Yoon;Joseph Y. Rho;In-seok Son
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.60-66
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    • 2023
  • Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

Overviews on the Clinical Use of Stem Cells in Orthopaedics (근골격계에서 줄기세포를 이용한 재생치료의 개관)

  • Im, Gun-Il
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.475-477
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    • 2019
  • Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and the relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. On the other hand, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system, few reliable clinical studies have been published. Stem cell therapy can be applied locally for bone, cartilage, and tendon regeneration. The candidate disease modalities in bone regeneration include large bone defects, nonunion of fractures, and osteonecrosis. Focal osteochondral defect and osteoarthritis are the current targets for cartilage regeneration. For tendon regeneration, bone-tendon junction problems, such as rotator cuff tears are hot topics in clinical research. To date, the literature supporting stem cell-based therapies comprises mostly case reports or case series.

Ten technical aspects of baseplate fixation in reverse total shoulder arthroplasty for patients without glenoid bone loss: a systematic review

  • Reinier W.A. Spek;Lotje A. Hoogervorst;Rob C. Brink;Jan W. Schoones;Derek F.P. van Deurzen;Michel P.J. van den Bekerom
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.88-107
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    • 2024
  • The aim of this systematic review was to collect evidence on the following 10 technical aspects of glenoid baseplate fixation in reverse total shoulder arthroplasty (rTSA): screw insertion angles; screw orientation; screw quantity; screw length; screw type; baseplate tilt; baseplate position; baseplate version and rotation; baseplate design; and anatomical safe zones. Five literature libraries were searched for eligible clinical, cadaver, biomechanical, virtual planning, and finite element analysis studies. Studies including patients >16 years old in which at least one of the ten abovementioned technical aspects was assessed were suitable for analysis. We excluded studies of patients with: glenoid bone loss; bony increased offset-reversed shoulder arthroplasty; rTSA with bone grafts; and augmented baseplates. Quality assessment was performed for each included study. Sixty-two studies were included, of which 41 were experimental studies (13 cadaver, 10 virtual planning, 11 biomechanical, and 7 finite element studies) and 21 were clinical studies (12 retrospective cohorts and 9 case-control studies). Overall, the quality of included studies was moderate or high. The majority of studies agreed upon the use of a divergent screw fixation pattern, fixation with four screws (to reduce micromotions), and inferior positioning in neutral or anteversion. A general consensus was not reached on the other technical aspects. Most surgical aspects of baseplate fixation can be decided without affecting fixation strength. There is not a single strategy that provides the best outcome. Therefore, guidelines should cover multiple surgical options that can achieve adequate baseplate fixation.

Management of gunshot wounds near the elbow: experiences at a high-volume level I trauma center

  • Umar Ghilzai;Abdullah Ghali;Aaron Singh;Thomas Wesley Mitchell;Scott A. Mitchell
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.3-10
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    • 2024
  • Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

Ginsenoside Rb1 and Rb2 upregulate Akt/mTOR signaling-mediated muscular hypertrophy and myoblast differentiation

  • Go, Ga-Yeon;Jo, Ayoung;Seo, Dong-Wan;Kim, Woo-Young;Kim, Yong Kee;So, Eui-Young;Chen, Qian;Kang, Jong-Sun;Bae, Gyu-Un;Lee, Sang-Jin
    • Journal of Ginseng Research
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    • v.44 no.3
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    • pp.435-441
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    • 2020
  • Background: As a process of aging, skeletal muscle mass and function gradually decrease. It is reported that ginsenoside Rb1 and Rb2 play a role as AMP-activated protein kinase activator, resulting in regulating glucose homeostasis, and Rb1 reduces oxidative stress in aged skeletal muscles through activating the phosphatidylinositol 3-kinase/Akt/Nrf2 pathway. We examined the effects of Rb1 and Rb2 on differentiation of the muscle stem cells and myotube formation. Methods: C2C12 myoblasts treated with Rb1 and/or Rb2 were differentiated and induced to myotube formation, followed by immunoblotting for myogenic marker proteins, such as myosin heavy chain, MyoD, and myogenin, or immunostaining for myosin heavy chain or immunoprecipitation analysis for heterodimerization of MyoD/E-proteins. Results: Rb1 and Rb2 enhanced myoblast differentiation through accelerating MyoD/E-protein heterodimerization and increased myotube hypertrophy, accompanied by activation of Akt/mammalian target of rapamycin signaling. In addition, Rb1 and Rb2 induced the MyoD-mediated transdifferentiation of the rhabdomyosarcoma cells into myoblasts. Furthermore, co-treatment with Rb1 and Rb2 had synergistically enhanced myoblast differentiation through Akt activation. Conclusion: Rb1 and Rb2 upregulate myotube growth and myogenic differentiation through activating Akt/mammalian target of rapamycin signaling and inducing myogenic conversion of fibroblasts. Thus, our first finding indicates that Rb1 and Rb2 have strong potential as a helpful remedy to prevent and treat muscle atrophy, such as age-related muscular dystrophy.

Biodegradable Inorganic-Organic Composite Artificial Bone Substitute -in vitro biocompatibility evaluation by cell culture- (유기질과 무기질 복합체를 이용한 체내흡수형 인공골재료에 관한 연구 -세포배양에 의한 생체적합성 평가-)

  • Ahn, Sue-Jin;Kim, Yo-Sook;Lee, Choon-Ki;Suh, Hwal
    • Journal of Biomedical Engineering Research
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    • v.16 no.3
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    • pp.331-336
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    • 1995
  • A composite material was produced as an artificial bone substitute which is gradually degrAded and replaced by the regenerated natural bones after implantation. To detect the effect of the material on the cell's activity, the composite specimens were placed in MEMs and incubated at $37^{\circ}C$ for one week. Human uterus cervical cancer origin HeLa 3 cells and mouse subcutaneous origin L929 cells were cul- tured in the specimen dissolved MEMs for 5 days to investigate cytotoxicity via cell growth rates. ${Na_2}^{51}CrO_4$ solution was added to the media, to label the HeLa 53 cells, and the released amount of $^{51}Cr$ was measured by a $\gamma$-counter. On the cell growth investigation, no significant cytotoxic phenomena were revealed in both HeLa S3 and L929 cell cultures. On the released 51CR from the incubated HeLa 53 cells, no significant cell degeneration was observed from the composite embedded MEMs.

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