14201
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Mailey B, Hosseini A, Baker J, Young A, Alfonso Z, Hicok K, Wallace AM, Cohen SR. Adipose-derived stem cells: methods for isolation and applications for clinical use. Methods Mol Biol 2014; 1210:161-181. [PMID: 25173168 DOI: 10.1007/978-1-4939-1435-7_13] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Adipose tissue sciences have rapidly expanded since the identification of regenerative cells contained within the stromal vascular fraction (SVF) of fat. Isolation of the SVF, containing adipose-derived stem cells (ADSC), can be accomplished efficiently in the operating room or in the laboratory through enzymatic digestion of the adipose tissue and concentration of SVF. Cells can be directly re-injected as a mesotherapeutic agent, recombined with a tissue scaffold (e.g., cell-enriched fat grafts) or expanded in culture for tissue-engineered cell therapeutics. The potential for cell therapy is under current investigation by researchers around the world. This chapter reviews laboratory methods for isolating ADSCs and the ongoing clinical trials evaluating cell therapeutic efficacy across many specialties, including cardiology, neurology, immunology, tissue engineering, sports medicine, and plastic and reconstructive surgery.
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Affiliation(s)
- Brian Mailey
- Department of Surgery, University of California San Diego, San Diego, CA, USA,
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14202
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Herrera A, Rebollo S, Ibarz E, Mateo J, Gabarre S, Gracia L. Mid-term study of bone remodeling after femoral cemented stem implantation: comparison between DXA and finite element simulation. J Arthroplasty 2014; 29:90-100. [PMID: 23725926 DOI: 10.1016/j.arth.2013.03.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 03/21/2013] [Accepted: 03/23/2013] [Indexed: 02/01/2023] Open
Abstract
This five-year prospective study was designed to investigate periprosthetic bone remodeling associated with two cemented stem models, ABG-II (Stryker) and VerSys (Zimmer), randomly implanted in patients older than 75 years. The sample consisted of 64 cases (32, ABG-II; 32, VerSys). Inclusion criterion was diagnosis of osteoarthritis recommended for cemented total hip arthroplasty. Besides clinical study, Finite Element (FE) simulation was used to analyze biomechanical changes caused by hip arthroplasty. Bone Mineral Density (BMD) measurements showed a progressive increase in bone mass throughout the entire follow-up period for both stems, well correlated with FE results except in Gruen zones 4, 5, 6 for ABG-II and in zones 4, 5 for VerSys, denoting that remodeling in those zones does not depend on mechanical factors but rather on biological or physiological ones.
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Affiliation(s)
- Antonio Herrera
- Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Medicine School, University of Zaragoza, Zaragoza, Spain; Orthopaedic Surgery, Miguel Servet University Hospital, Zaragoza, Spain
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14203
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Wan H, Zhang L, Li D, Hao S, Feng J, Oudinet JP, Schumacher M, Liu S. Hypoglossal-facial nerve “side”-to-side neurorrhaphy for persistent incomplete facial palsy. J Neurosurg 2014; 120:263-72. [PMID: 24205907 DOI: 10.3171/2013.9.jns13664] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Hypoglossal-facial nerve neurorrhaphy is a widely used method for treating complete facial palsy. However, the classic surgical procedure using a “side”-to-end neurorrhaphy is not suitable for incomplete facial palsy (IFP), because sectioning of the facial nerve for neurorrhaphy compromises remnant axons and potential spontaneous reinnervation. For the treatment of persistent IFP, the authors investigated in rats a modified method using hypoglossal-facial nerve “side”-to-side neurorrhaphy.
Methods
An IFP model was created by crushing the facial nerve and then ligating the injury site to limit axonal regeneration. After 9 weeks, rats with IFP were submitted to hypoglossal-facial nerve “side”-to-side neurorrhaphy: The gap between the 2 nerves was bridged with a predegenerated peroneal nerve graft, which was sutured to only one-half of the hypoglossal nerve and to the remnant facial nerve through a small window created by removing the epineurium, thus preserving regenerating facial axons.
Results
Four months after repair surgery, double innervation of the target whisker pad by hypoglossal and facial motor neurons was supported by the recording of muscle action potentials and their retrograde labeling. Regenerated hypoglossal and facial motor neurons effectively participated in the reinnervation of the whisker pad, significantly improving facial symmetry without evident synkinesis, compared with rats that underwent IFP without hypoglossal-facial nerve neurorrhaphy.
Conclusions
This study demonstrates that hypoglossal-facial nerve “side”-to-side neurorrhaphy with a predegenerated nerve graft can lead to rapid functional benefits for persistent IFP without compromising the remnants of facial axons, thus providing a proof-of-feasibility for further studies in humans.
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Affiliation(s)
- Hong Wan
- 1Beijing Neurosurgical Institute
| | - Liwei Zhang
- 2Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China; and
| | - Dezhi Li
- 2Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China; and
| | - Shuyu Hao
- 2Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China; and
| | - Jie Feng
- 1Beijing Neurosurgical Institute
| | - Jean Paul Oudinet
- 3UMR 788, INSERM et Université Paris-Sud, Le Kremlin-Bicêtre, France
| | | | - Song Liu
- 1Beijing Neurosurgical Institute
- 2Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China; and
- 3UMR 788, INSERM et Université Paris-Sud, Le Kremlin-Bicêtre, France
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14204
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Wirbel R, Ruppert M, Schwarz E, Zapp B. Simple self-reduction method for anterior shoulder dislocation. Journal of Acute Disease 2014; 3:207-10. [DOI: 10.1016/s2221-6189(14)60045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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14205
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Abstract
BACKGROUND Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS THE FUTURE OF WILDERNESS MEDICINE IS UNFOLDING ON MULTIPLE FRONTS: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes.
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Affiliation(s)
- Douglas G. Sward
- Department of Emergency Medicine, University of Maryland School of Medicine, Hyperbaric Medicine, Shock Trauma Center, Baltimore, Maryland, USA
| | - Brad L. Bennett
- Military & Emergency Medicine Department, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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14206
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Rafiei S, Komarova SV. Molecular signaling pathways mediating osteoclastogenesis induced by prostate cancer cells. BMC Cancer 2013; 13:605. [PMID: 24370273 PMCID: PMC3881018 DOI: 10.1186/1471-2407-13-605] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
Background Advanced prostate cancer commonly metastasizes to bone leading to osteoblastic and osteolytic lesions. Although an osteolytic component governed by activation of bone resorbing osteoclasts is prominent in prostate cancer metastasis, the molecular mechanisms of prostate cancer-induced osteoclastogenesis are not well-understood. Methods We studied the effect of soluble mediators released from human prostate carcinoma cells on osteoclast formation from mouse bone marrow and RAW 264.7 monocytes. Results Soluble factors released from human prostate carcinoma cells significantly increased viability of naïve bone marrow monocytes, as well as osteoclastogenesis from precursors primed with receptor activator of nuclear factor κ-B ligand (RANKL). The prostate cancer-induced osteoclastogenesis was not mediated by RANKL as it was not inhibited by osteoprotegerin (OPG). However inhibition of TGFβ receptor I (TβRI), or macrophage-colony stimulating factor (MCSF) resulted in attenuation of prostate cancer-induced osteoclastogenesis. We characterized the signaling pathways induced in osteoclast precursors by soluble mediators released from human prostate carcinoma cells. Prostate cancer factors increased basal calcium levels and calcium fluctuations, induced nuclear localization of nuclear factor of activated t-cells (NFAT)c1, and activated prolonged phosphorylation of ERK1/2 in RANKL-primed osteoclast precursors. Inhibition of calcium signaling, NFATc1 activation, and ERK1/2 phosphorylation significantly reduced the ability of prostate cancer mediators to stimulate osteoclastogenesis. Conclusions This study reveals the molecular mechanisms underlying the direct osteoclastogenic effect of prostate cancer derived factors, which may be beneficial in developing novel osteoclast-targeting therapeutic approaches.
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Affiliation(s)
| | - Svetlana V Komarova
- Department of Anatomy and Cell Biology, Faculty of Medicine, 3640 University Street, Montreal, Quebec H3A 2B2, Canada.
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14207
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Kotake S, Nanke Y. Effect of TNFα on osteoblastogenesis from mesenchymal stem cells. Biochim Biophys Acta Gen Subj 2013; 1840:1209-13. [PMID: 24361610 DOI: 10.1016/j.bbagen.2013.12.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 11/20/2013] [Accepted: 12/09/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Bone destruction and osteoporosis are accelerated in chronic inflammatory diseases, such as rheumatoid arthritis (RA) and periodontitis, in which many studies have shown the proinflammatory cytokines, especially TNFα, play an important role; TNFα causes osteoclast-induced bone destruction as well as the inhibition of osteoblastogenesis. SCOPE OF REVIEW Here we review our current understanding of the mechanism of the effect of TNFα on osteoblastogenesis from mesenchymal stem cells (MSCs). We also highlight the function of MSC in the pathogenesis of autoimmune diseases. MAJOR CONCLUSIONS Many studies have revealed that TNFα inhibits osteoblastogenesis through several mechanisms. On the other hand, it has been also reported that TNFα promotes osteoblastogenesis. These discrepancies may depend on the cellular types, the model animals, and the timing and duration of TNFα administration. GENERAL SIGNIFICANCE A full understanding of the role and function of TNFα on osteoblastogenesis from MSC may lead to targeted new therapies for chronic inflammation diseases, such as RA and periodontitis.
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Affiliation(s)
- Shigeru Kotake
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku, Tokyo 162-0054, Japan.
| | - Yuki Nanke
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku, Tokyo 162-0054, Japan
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14208
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Filipović K, Subin-Teodosijević S, Zvekić- Svorcan J, Tomašević-Todorović S. COMPARISON BETWEEN ULTRASONOGRAPHY RESULTS AND RESULTS OF MAGNETIC RESONANCE IN SHOULDER PATHOLOGY – CASE REPORT. AMM 2013. [DOI: 10.5633/amm.2013.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14209
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Wegmann K, Gundermann S, Siewe J, Eysel P, Delank KS, Sobottke R. Correlation of reduction and clinical outcome in patients with degenerative spondylolisthesis. Arch Orthop Trauma Surg 2013; 133:1639-44. [PMID: 24077801 DOI: 10.1007/s00402-013-1857-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Prospective cohort study. INTRODUCTION Operative treatment is increasingly implemented for the treatment of degenerative lumbar listhesis, with lumbar fusion the most common intervention. Prediction of clinical outcomes after such procedures is of ongoing relevance, and the correlation of radiologic parameters with clinical outcome remains controversial. In particular, clinical studies have not determined conclusively whether reduction of slipped vertebrae is beneficial. METHODS We performed a monocenter prospective analysis of a comprehensive set of quality of life scores (QLS) (Core Outcome Measure Index, Oswestry Low Back Pain Disability Index, SF-36) of 40 patients, who underwent a standardized PLIF procedure for symptomatic, Spondylolisthesis. Follow-up was 24 months. The correlations between the radiologic parameters (degree of slippage, sagittal rotation) and the clinical scores before surgery as well as 12 and 24 months post-operatively were examined. RESULTS All QLS showed a statistically significant improvement after 12 and 24 months post-operatively (p < 0.05). The mean amount of the anterior slippage was 34.2 ± 14.7 % (minimum 12 %, maximum 78 %). After 12 months, there was an average 19.1 % decrease to 15.1 ± 8.3 % (minimum 2 %, maximum 38 %, p < 0.000) and after 24 months it was decreased by 18.0-16.2 ± 9.0 % (minimum 2.9 %, maximum 40 %, p < 0.000). Average sagittal rotation measured 67.3° ± 16.6° initially (minimum 35°, maximum 118) and decreased by 4.3° to an average of 63.0° ± 15.2° at 12 months post-surgery (minimum 15°, maximum 101°, p = 0.065,), and by 5.7° to an average of 61.6° ± 13.0° at 24 months (minimum 15°, maximum 90°, p = 0.044). The data show positive correlations between the amount of reduction of the slipped vertebra as well as the amount of correction of the sagittal rotation and the improvement of the clinical outcomes(r = 0.31-0.54, p < 0.05). CONCLUSION The current study indicates a modest advantage for the best possible reposition in respect of the clinical outcome.
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14210
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14211
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Abstract
The knowledge about the bone cement is of paramount importance to all Orthopaedic surgeons. Although the bone cement had been the gold standard in the field of joint replacement surgery, its use has somewhat decreased because of the advent of press-fit implants which encourages bone in growth. The shortcomings, side effects and toxicity of the bone cement are being addressed recently. More research is needed and continues in the field of nanoparticle additives, enhanced bone-cement interface etc.
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Affiliation(s)
- Raju Vaishya
- Prof, Senior Consultant, Department of Orthopaedic & Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India,Corresponding author.
| | - Mayank Chauhan
- Orthopaedic Registrar, Department of Orthopaedic & Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Abhishek Vaish
- Post Graduate Student (Orthopaedics), Department of Orthopaedics, Sancheti Institute of Orthopaedics, Pune, India
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14212
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Derzsi Z, Gozar H, Gurzu S, Prisca R, Nagy O. Congenital clubfoot in children after walking age: management and evaluation of 41 feet with the dimeglio score. J Clin Diagn Res 2013; 7:2841-3. [PMID: 24551653 PMCID: PMC3919406 DOI: 10.7860/jcdr/2013/7361.3772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 10/20/2013] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Congenital Clubfoot (CC) is one of the most frequent orthopedic lesions in patients younger than 10-15 years. The surgical correction is more difficult in children over 1.5 years, compared to newborns, due to advanced osteoarticular development and higher rigidity of the foot. The aim of this study was to report the results of our experience regarding the combined orthopedic-surgical treatment of CC and the follow-up prognostic value of Dimeglio score in children aged between 1.5 to 12 years. MATERIAL AND METHODS From June 2009 and May 2012, 31 consecutive patients with CC, aged between 1.5 to 12 years, underwent surgical treatment. To assess the results, pre-operative and post-operative Dimeglio scores, at 6 months after surgery, were compared in each of the cases. An adapted Ponseti-Mitchelle orthosis-bar was used for aftercare. RESULTS The mean age of patients enrolled in this study was 4.32±2.04 years old. From the 31 patients, 10 had bilateral deformity; surgical intervention was performed for a total of 41 feet. Independently by the age of patients, between pre-operative and post-operative evaluation, the Dimeglio score regressed from a mean of 11.70±7.43 (ranged between 4 and 18) to 3.80±0.96 (ranged between 0 and 12). Unfavorable outcome was observed in 5 feet; the success correction rate was 85.37%. CONCLUSION This study reveals that CC can also be treated in older children by using a proper orthopedic, surgical and post-operative management. The Dimeglio score is useful, easy to use and relevant also in children over 1.5 years.
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Affiliation(s)
- Zoltan Derzsi
- Department of Pediatric Surgery, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Horea Gozar
- Department of Pediatric Surgery, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Radu Prisca
- Department of Pediatric Surgery, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Ors Nagy
- Department of Orthopedic Surgery, University of Medicine and Pharmacy, Tirgu-Mures, Romania
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14213
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Ovaska MT, Mäkinen TJ, Madanat R, Kiljunen V, Lindahl J. A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation. Int Orthop 2013; 38:83-8. [PMID: 24252973 DOI: 10.1007/s00264-013-2168-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 01/11/2023]
Abstract
PURPOSE The present study aimed to determine the most common surgical errors resulting in early re-operation following ankle fracture surgery. METHODS We performed a chart review to determine the most common types of malreductions that led to early re-operation following ankle fracture surgery. From 2002 to 2011, we identified 5,123 consecutive ankle fracture operations in 5,071 patients. Seventy-nine patients (1.6%) which underwent re-operation due to malreduction detected in postoperative radiographs. These patients were compared with an equal number of age- and sex-matched controls which did not need further surgery. RESULTS The most common indication for re-operation was syndesmotic malreduction (47 of 79 patients, 59%). Four main types of errors related to syndesmotic reduction or fixation were identified, with the most common being fibular malpositioning within the tibiofibular incisura. Other indications for re-operation were fibular shortening and malreduction of the medial malleolus. Fracture dislocation, fracture type, posterior malleolar fracture, associated medial malleolar fracture, duration of index surgery, and fixation of an associated medial malleolar fracture with other than two parallel screws were also associated with re-operation. Correction of the malreduction was successfully achieved in the majority (84%) of cases needing further surgery. CONCLUSION Early re-operation after ankle fracture surgery was most commonly caused by errors related to syndesmotic reduction or failure to restore fibular length. In the majority of cases, postoperative malreduction was successfully corrected in the acute setting.
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Affiliation(s)
- Mikko T Ovaska
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland,
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14214
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Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med 2013; 49:323-9. [DOI: 10.1136/bjsports-2013-092787] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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14215
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Pereira RC, Scaranari M, Benelli R, Strada P, Reis RL, Cancedda R, Gentili C. Dual effect of platelet lysate on human articular cartilage: a maintenance of chondrogenic potential and a transient proinflammatory activity followed by an inflammation resolution. Tissue Eng Part A 2013; 19:1476-88. [PMID: 23360471 DOI: 10.1089/ten.tea.2012.0225] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Platelet-rich plasma (PRP), a cocktail of platelet growth factors and bioactive proteins, has been proposed as a therapeutic agent to restore damaged articular cartilage. We report the biological effect of the platelet lysate (PL), a PRP derivative, on primary human articular chondrocytes cultured under both physiological and inflammatory conditions. When added to the culture medium, PL induced a strong mitogenic response in the chondrocytes. The in vitro expanded cell population maintained a chondrogenic redifferentiation potential as revealed by micromass culture in vitro and ectopic cartilage formation in vivo. Further, in chondrocytes cultured in the presence of the proinflammatory cytokine interleukin-1α (IL-1α), the PL induced a drastic enhancement of the synthesis of the cytokines IL-6 and IL-8 and of neutrophil-gelatinase associated lipocalin, a lipocalin expressed during chondrocyte differentiation and inflammation. These events were mediated by the p38 MAP kinase and NF-κB pathways. We observed that inflammatory stimuli activated phospo-MAP kinase-activated protein kinase 2, a direct target of p38. The proinflammatory effect of the PL was a transient phenomenon; after an initial upregulation, we observed significant reduction of the NF-κB activity together with the repression of the inflammatory enzyme cyclooxygenase-2. Moreover, the medium of chondrocytes cultured in the simultaneous presence of PL and IL-1α, showed a significant enhancement of the chemoattractant activity versus untreated chondrocytes. Our findings support the concept that the platelet products have a direct beneficial effect on articular chondrocytes and could drive in sequence a transient activation and the resolution of the inflammatory process, thus providing a rational for their use as therapeutic agents in cartilage inflammation and damage.
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Affiliation(s)
- Rui Cruz Pereira
- Dipartimento di Medicina Sperimentale, Universita' di Genova, Genova, Italy
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14216
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Caderby T, Yiou E, Peyrot N, Begon M, Dalleau G. Influence of gait speed on the control of mediolateral dynamic stability during gait initiation. J Biomech 2013; 47:417-23. [PMID: 24290175 DOI: 10.1016/j.jbiomech.2013.11.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 11/04/2013] [Accepted: 11/06/2013] [Indexed: 02/07/2023]
Abstract
This study investigated the influence of gait speed on the control of mediolateral dynamic stability during gait initiation. Thirteen healthy young adults initiated gait at three self-selected speeds: Slow, Normal and Fast. The results indicated that the duration of anticipatory postural adjustments (APA) decreased from Slow to Fast, i.e. the time allocated to propel the centre of mass (COM) towards the stance-leg side was shortened. Likely as an attempt at compensation, the peak of the anticipatory centre of pressure (COP) shift increased. However, COP compensation was not fully efficient since the results indicated that the mediolateral COM shift towards the stance-leg side at swing foot-off decreased with gait speed. Consequently, the COM shift towards the swing-leg side at swing heel-contact increased from Slow to Fast, indicating that the mediolateral COM fall during step execution increased as gait speed rose. However, this increased COM fall was compensated by greater step width so that the margin of stability (the distance between the base-of-support boundary and the mediolateral component of the "extrapolated centre of mass") at heel-contact remained unchanged across the speed conditions. Furthermore, a positive correlation between the mediolateral extrapolated COM position at heel-contact and step width was found, indicating that the greater the mediolateral COM fall, the greater the step width. Globally, these results suggest that mediolateral APA and step width are modulated with gait speed so as to maintain equivalent mediolateral dynamical stability at the time of swing heel-contact.
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Affiliation(s)
- Teddy Caderby
- Laboratoire DIMPS-CURAPS, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, 117 rue du Général Ailleret, 97430 Le Tampon, Ile de la Réunion.
| | - Eric Yiou
- Laboratoire CIAMS, Team RIME, UFR STAPS, Université Paris-Sud, 91440 Orsay Cedex, France
| | - Nicolas Peyrot
- Laboratoire DIMPS-CURAPS, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, 117 rue du Général Ailleret, 97430 Le Tampon, Ile de la Réunion
| | - Mickaël Begon
- Laboratoire de Simulation et Modélisation du Mouvement, Département de Kinésiologie, Université de Montréal, Laval, QC, Canada
| | - Georges Dalleau
- Laboratoire DIMPS-CURAPS, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, 117 rue du Général Ailleret, 97430 Le Tampon, Ile de la Réunion
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14217
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Yesilaras M, Aksay E, Atilla OD, Sever M, Kalenderer O. The accuracy of bedside ultrasonography as a diagnostic tool for the fifth metatarsal fractures. Am J Emerg Med 2013; 32:171-4. [PMID: 24342871 DOI: 10.1016/j.ajem.2013.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/01/2013] [Accepted: 11/05/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Musculoskeletal ultrasonography is a technique that is becoming more popular in diagnosing injuries of emergency department (ED) patients especially for the diagnosis of fractures. In this study, we determined the reliability of ultrasonography for the diagnosis of fractures of the fifth metatarsal. METHOD This is a prospective blind study. Patients over 14 years old who were admitted to the ED with acute foot injury and who had tenderness on the fifth metatarsal were consecutively enrolled into the study. A bedside ultrasonography exam was performed by an emergency physician, and antero-posterior and oblique views were obtained. X-rays were blindly evaluated by an orthopedic surgeon and were considered to be the gold-standard for diagnosing fractures. In patients with noncomminuted fractures, bone displacement was measured by both radiologically and sonographically. RESULTS Eighty-four patients were included in this study. Their mean age was 36.0, and 42.9% were male. Fractures were diagnosed by both x-ray and ultrasonography in 33 patients. In one patient, the x-ray was positive for fracture, while ultrasonography yielded a negative result. For the fractures of fifth metatarsal, the diagnostic sensitivity of ultrasonography was 97.1%, the specificity was 100%, the positive likelihood ratio was infinity, the negative likelihood ratio was 0.03. Mean displacement was 1.2 ± 0.7 mm with x-ray and 1.8 ± 1.5 mm with ultrasonography. The intraclass correlation coefficient of displacement measured by x-ray and ultrasonography was κ: 0.388. CONCLUSION Ultrasonography is a reliable diagnostic tool for acute fifth metatarsal fractures.
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Affiliation(s)
- Murat Yesilaras
- Department of Emergency Medicine, Izmir Tepecik Research and Educational Hospital, Izmir, Turkey.
| | - Ersin Aksay
- Department of Emergency Medicine, Izmir Tepecik Research and Educational Hospital, Izmir, Turkey
| | - Ozge Duman Atilla
- Department of Emergency Medicine, Izmir Tepecik Research and Educational Hospital, Izmir, Turkey
| | - Mustafa Sever
- Department of Emergency Medicine, Izmir Tepecik Research and Educational Hospital, Izmir, Turkey
| | - Onder Kalenderer
- Department of Orthopedics and Traumatology, Izmir Tepecik Research and Educational Hospital, Izmir, Turkey
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14218
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Khashan M, Amar E, Drexler M, Chechik O, Cohen Z, Steinberg EL. Superior outcome of strut allograft-augmented plate fixation for the treatment of periprosthetic fractures around a stable femoral stem. Injury 2013; 44:1556-60. [PMID: 23755973 DOI: 10.1016/j.injury.2013.04.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 03/25/2013] [Accepted: 04/18/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE This study was designed to compare the outcome of two surgical approaches for treating femoral periprosthetic fractures around a stable femoral stem. The hypothesis was that plate fixation alone might be associated with a higher complication rate due to insufficient mechanical stability. We also considered that the addition of a strut allograft would contribute to fracture healing by means of osteoconduction. METHODS We retrospectively assessed the outcome of 21 patients who sustained periprosthetic fractures around a total hip replacement system (Vancouver type B1 and type C fractures) and who were treated in our department (January 2006 and August 2011) either by plate fixation alone or by plate fixation and a strut allograft. The mean postoperative follow-up was 23 months (range 9-69 months). Eleven patients were treated by plate fixation alone (Plate Group), and 10 patients were treated by plate fixation and a deep frozen cortical strut allograft (AG Group). Functional outcome was rated by the Harris Hip scoring system. Postoperative radiographs were assessed for evidence of fracture union. Surgical failure was defined as any complication requiring surgical revision. RESULTS The 21 patients included 17 females and 4 males. The average age was 79 years (range, 73-88) for the Plate Group and 82 years (range, 53-94) for the AG Group, and the average time to fracture union was 12 weeks (range, 2.5-6 months) and 12.95 weeks (range, 1.5-3) respectively. The overall failure rate was significantly higher in the Plate Group: 5 of them required revision surgery compared to none in the AG Group (p=0.014). CONCLUSION The results of this analysis indicate that a strut allograft augmentation approach to Vancouver type B1 and type C periprosthetic fractures results in a better outcome than plate fixation alone by apparently adding mechanical stability and enhancing the biological healing process.
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Affiliation(s)
- Morsi Khashan
- Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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14219
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McEvoy MT, Shander A. Anemia, bleeding, and blood transfusion in the intensive care unit: causes, risks, costs, and new strategies. Am J Crit Care 2013; 22:eS1-13; quiz eS14. [PMID: 24186829 DOI: 10.4037/ajcc2013729] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The definition of anemia is controversial and varies with the sex, age, and ethnicity of the patient. Anemia afflicts half of hospitalized patients and most elderly hospitalized patients. Acute anemia in the operating room or intensive care unit is associated with increased morbidity as well as other adverse outcomes, including death. The risks of anemia are compounded by the added risks associated with transfusion of red blood cells, the most common treatment for severe anemia. The causes of anemia in hospitalized patients include iron deficiency, suppression of erythropoietin and iron transport, trauma, phlebotomy, coagulopathies, adverse effects of and reactions to medications, and stress-induced gastrointestinal bleeding. The types and causes of anemia and the increased health care utilization and costs associated with anemia and undetected internal bleeding are described. The potential benefits and risks associated with transfusion of red blood cells also are explored. Last, the strategies and new tools to help prevent anemia, allow earlier detection of internal bleeding, and avoid unnecessary blood transfusions are discussed.
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Affiliation(s)
- Michael T. McEvoy
- Michael T. McEvoy is a critical care registered nurse in the Department of Cardiothoracic Surgery at Albany Medical Center in Albany, New York. Aryeh Shander is an anesthesiologist in the Department of Anesthesiology, Critical Care Medicine, Pain Management, and Hyperbaric Medicine at Englewood Hospital and Medical Center in Englewood, New Jersey
| | - Aryeh Shander
- Michael T. McEvoy is a critical care registered nurse in the Department of Cardiothoracic Surgery at Albany Medical Center in Albany, New York. Aryeh Shander is an anesthesiologist in the Department of Anesthesiology, Critical Care Medicine, Pain Management, and Hyperbaric Medicine at Englewood Hospital and Medical Center in Englewood, New Jersey
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14220
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Abstract
Objectives: Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical therapy approach with perturbation exercises on patients with knee OA. Methods: This was a prospective observational cohort study of 15 patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment tolerance were primary outcome measures. Patients received perturbation balance exercises along with a manual physical therapy approach, twice weekly for 4 weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the program. Results: Mean total WOMAC score significantly improved (P = 0.001) after the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 months, 57). Mean improvements were similar to previously published trials of manual physical therapy without perturbation exercises. The GROC score showed a minimal clinically important difference (MCID)≥+3 in 13 patients (87%) at 4 weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No patients reported exacerbation of symptoms within 72 hours following each treatment session. Discussion: A manual physical therapy approach that also included perturbation exercises was well tolerated and resulted in improved outcome scores in patients with knee OA.
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Affiliation(s)
- Daniel Rhon
- Madigan Army Medical Center, Department of Physical Medicine, Tacoma, WA, USA
| | - Gail Deyle
- Brooke Army Medical Center, San Antonio, TX, USA
| | - Norman Gill
- Brooke Army Medical Center, San Antonio, TX, USA
| | - Daniel Rendeiro
- Occupational and Physical Therapy Service, Warrior Transition Brigade, Fort Hood, TX, USA
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14221
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Abstract
It is known that there are close relationships between bone destruction and tumor growth in bone metastasis. RANKL is a central factor in bone metastasis, inducing osteoclastogenesis mediated by its receptor RANK. Recent reports demonstrate that RANKL has important roles in organogenesis stimulating proliferation and differentiation of epithelial and stroma cells. RANKL is induced not only by cytokines and hormones but also by UV-irradiation, inflammation and carcinogens. Expression of RANK and RANKL is found in several human cancer cell lines, and RANK signaling stimulates proliferation, migration and epithelial–mesenchymal transition of cancer cells, which may be involved in metastasis via an autocrine/paracrine mechanism. RANKL regulates the number of Tregs that produce RANKL, which may affect cancer metastasis. In this review we discuss the multifunctional roles of RANKL/RANK in osteoclastogenesis, organogenesis, and the metastasis and tumorigenesis of cancer cells.
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Affiliation(s)
- Akiko Kukita
- Department of Microbiology, Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan
| | - Toshio Kukita
- Molecular Cell Biology & Oral Anatomy, Kyushu University, Maidashi, Fukuoka, Japan
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14222
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Lee YJ, Aruin AS. Isolated and combined effects of asymmetric stance and pushing movement on the anticipatory and compensatory postural control. Clin Neurophysiol 2013; 125:768-776. [PMID: 24161607 DOI: 10.1016/j.clinph.2013.09.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 09/06/2013] [Accepted: 09/30/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate effects of symmetric and asymmetric stance and pushing movement on anticipatory and compensatory postural adjustments (APAs and CPAs). METHODS Ten healthy volunteers stood symmetrically (feet parallel) or asymmetrically (one foot forward and the other backward) and pushed a handle with both hands or right or left hand. Bilateral EMG activity of the trunk and leg muscles and center of pressure (COP) displacements in the anterior-posterior (AP) and medial-lateral (ML) directions were recorded and analyzed during the APAs and CPAs. RESULTS Isolated asymmetry of stance was associated with larger muscle activity of the backward leg while isolated asymmetry of pushing movement induced larger trunk muscle activity on the contralateral side. A combined asymmetry of stance and pushing movement resulted in the increase or decrease of the thigh muscle activity and ML COP displacement depending on whether both asymmetries were induced on the same side of the body or on opposite sides. CONCLUSIONS Both isolated and combined asymmetries affect APAs and CPAs in pushing. Using combined asymmetry of stance and arm movement might be beneficial in performing pushing activity. SIGNIFICANCE The outcome of the study provides a basis for studying postural control in individuals with unilateral impairment while performing daily tasks involving pushing.
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Affiliation(s)
- Yun-Ju Lee
- University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Alexander S Aruin
- University of Illinois at Chicago, Chicago, IL 60612, United States.
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14223
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Abstract
OBJECTIVE Isolated cuboid stress fractures are rare. The purpose of this study was to evaluate the MRI appearance of this condition. MATERIALS AND METHODS A retrospective search for patients with the diagnosis of a cuboid stress fracture was performed for a 19-year period. All patients underwent an initial three-view radiographic foot series for pain. MRI was performed because symptoms persisted beyond 4 weeks. RESULTS Ten patients, nine of whom were women, were diagnosed with isolated cuboid stress fractures. These patients were divided into an athletic group (mean age, 36.3 years) and nonathletic group (mean age, 55.0 years). In the athletic group, there were five runners, one ballet dancer, and one gymnast, and in the nonathletic group, there was one with osteoporosis, one with a plantar fascia rupture, and one who recently underwent a fasciotomy. Eight stress fractures were linear and two were stellate and all were surrounded by marrow edema. Six fractures were located inferolaterally, one superolaterally, one laterally, one medially, and one was subchondral in location. All but one involved the peroneal sulcus and cuboid crest region. Nine of 10 feet showed pathology in the plantar fascia, seven in the peroneal tendons, and four in the posterior tibial tendon. CONCLUSION An isolated stress fracture of the cuboid is most likely to occur in the lateral aspect of the cuboid. The cause is likely multifactorial and may include compressive and tensile forces, but plantar fascia dysfunction and age-related bone loss, which are more prevalent in women, may be additional contributing factors.
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14224
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Elfering A, Zahno J, Taeymans J, Blasimann A, Radlinger L. Acute effects of stochastic resonance whole body vibration. World J Orthop 2013; 4:291-298. [PMID: 24147265 PMCID: PMC3801249 DOI: 10.5312/wjo.v4.i4.291] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/15/2013] [Accepted: 09/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the acute effects of stochastic resonance whole body vibration (SR-WBV) training to identify possible explanations for preventive effects against musculoskeletal disorders.
METHODS: Twenty-three healthy, female students participated in this quasi-experimental pilot study. Acute physiological and psychological effects of SR-WBV training were examined using electromyography of descending trapezius (TD) muscle, heart rate variability (HRV), different skin parameters (temperature, redness and blood flow) and self-report questionnaires. All subjects conducted a sham SR-WBV training at a low intensity (2 Hz with noise level 0) and a verum SR-WBV training at a higher intensity (6 Hz with noise level 4). They were tested before, during and after the training. Conclusions were drawn on the basis of analysis of variance.
RESULTS: Twenty-three healthy, female students participated in this study (age = 22.4 ± 2.1 years; body mass index = 21.6 ± 2.2 kg/m2). Muscular activity of the TD and energy expenditure rose during verum SR-WBV compared to baseline and sham SR-WBV (all P < 0.05). Muscular relaxation after verum SR-WBV was higher than at baseline and after sham SR-WBV (all P < 0.05). During verum SR-WBV the levels of HRV were similar to those observed during sham SR-WBV. The same applies for most of the skin characteristics, while microcirculation of the skin of the middle back was higher during verum compared to sham SR-WBV (P < 0.001). Skin redness showed significant changes over the three measurement points only in the middle back area (P = 0.022). There was a significant rise from baseline to verum SR-WBV (0.86 ± 0.25 perfusion units; P = 0.008). The self-reported chronic pain grade indicators of pain, stiffness, well-being, and muscle relaxation showed a mixed pattern across conditions. Muscle and joint stiffness (P = 0.018) and muscular relaxation did significantly change from baseline to different conditions of SR-WBV (P < 0.001). Moreover, muscle relaxation after verum SR-WBV was higher than after sham SR-WBV (P < 0.05).
CONCLUSION: Verum SR-WBV stimulated musculoskeletal activity in young healthy individuals while cardiovascular activation was low. Training of musculoskeletal capacity and immediate increase in musculoskeletal relaxation are potential mediators of pain reduction in preventive trials.
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14225
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Franklyn M, Field B. Experimental and finite element analysis of tibial stress fractures using a rabbit model. World J Orthop 2013; 4:267-278. [PMID: 24147262 PMCID: PMC3801246 DOI: 10.5312/wjo.v4.i4.267] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/26/2013] [Accepted: 09/18/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine if rabbit models can be used to quantify the mechanical behaviour involved in tibial stress fracture (TSF) development.
METHODS: Fresh rabbit tibiae were loaded under compression using a specifically-designed test apparatus. Weights were incrementally added up to a load of 30 kg and the mechanical behaviour of the tibia was analysed using tests for buckling, bone strain and hysteresis. Structural mechanics equations were subsequently employed to verify that the results were within the range of values predicted by theory. A finite element (FE) model was developed using cross-sectional computer tomography (CT) images scanned from one of the rabbit bones, and a static load of 6 kg (1.5 times the rabbit's body weight) was applied to represent running. The model was validated using the experimental strain gauge data, then geometric and elemental convergence tests were performed in order to find the minimum number of cross-sectional scans and elements respectively required for convergence. The analysis was then performed using both the model and the experimental results to investigate the mechanical behaviour of the rabbit tibia under compressive load and to examine crack initiation.
RESULTS: The experimental tests showed that under a compressive load of up to 12 kg, the rabbit tibia demonstrates linear behaviour with little hysteresis. Up to 30 kg, the bone does not fail by elastic buckling; however, there are low levels of tensile stress which predominately occur at and adjacent to the anterior border of the tibial midshaft: this suggests that fatigue failure occurs in these regions, since bone under cyclic loading initially fails in tension. The FE model predictions were consistent with both mechanics theory and the strain gauge results. The model was highly sensitive to small changes in the position of the applied load due to the high slenderness ratio of the rabbit’s tibia. The modelling technique used in the current study could have applications in the development of human FE models of bone, where, unlike rabbit tibia, the model would be relatively insensitive to very small changes in load position. However, the rabbit model itself is less beneficial as a tool to understand the mechanical behaviour of TSFs in humans due to the small size of the rabbit bone and the limitations of human-scale CT scanning equipment.
CONCLUSION: The current modelling technique could be used to develop human FE models. However, the rabbit model itself has significant limitations in understanding human TSF mechanics.
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14226
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Abstract
The purpose of this review article is to explore the role of therapeutic exercise in managing the pain associated with knee osteoarthritis (OA). Therapeutic exercise is often recommended as a first-line conservative treatment for knee OA, and current evidence supports exercise as an effective pain-relieving intervention. We explore the current state of evidence for exercise as a pain-relieving intervention for knee OA. Next, the mechanisms by which knee OA pain occurs and the potential ways in which exercise may act on those mechanisms are discussed. Clinical applicability and future research directions are suggested. Although evidence demonstrates that exercise reduces knee OA pain, optimal exercise mode and dosage have not been determined. In addition, it is not clearly understood whether exercise provides pain relief via peripheral or central mechanisms or a combination of both. Published clinical trials have explored a variety of interventions, but these interventions have not been specifically designed to target pain pathways. Current evidence strongly supports exercise as a pain-relieving option for those with knee OA. Future research needs to illuminate the mechanisms by which exercise reduces the pain associated with knee OA and the development of therapeutic exercise interventions to specifically target these mechanisms.
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Affiliation(s)
- Allyn M Susko
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - G Kelley Fitzgerald
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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14227
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Blatt SH. Joined at the hip? A paleoepidemiological study of developmental dysplasia of the hip and its relation to swaddling practices among indigenous peoples of North America. Am J Hum Biol 2013; 25:821-34. [PMID: 24123551 DOI: 10.1002/ajhb.22458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/29/2013] [Accepted: 08/30/2013] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Clinical prevalence of developmental dysplasia of the hip (DDH) is the highest among modern indigenous populations of North America, yet no systematic study of the paleoepidemiology of this group exists. This study discusses the skeletal criteria, epidemiology, pathophysiology, and risk factors for DDH. A range of cases of DDH from an archaeological Native American population are described, and the clinical and prehistoric prevalence of DDH among indigenous populations of North America are calculated and discussed within a biocultural perspective. METHODS Pelves of 390 adults from the Late Prehistoric (1490 BP ± 70) Buffalo site, West Virginia were examined for DDH. Morphology of true and false acetabula was classified and other changes of the pelvis, lower limb, and spine were noted along with cranial deformation, providing evidence of infant restriction. Prevalence of DDH among living and archaeological indigenous peoples of North America were calculated and compared. RESULTS DDH was identified in eighteen adults from Buffalo, resulting in a prevalence of 46.15, within the range reported in modern indigenous groups in North America. However, there is a significant difference between the DDH prevalence in prehistory and today in the target population. CONCLUSIONS Indigenous peoples of North America have the highest reported global prevalence of DDH today and in prehistory. The etiology of DDH suggests that components of both genetic predisposition and swaddling practices have combined to create a high-risk environment for the development of DDH, contributing to its high prevalence within archaeological populations, like Buffalo, and modern Native American/Aboriginal groups within North America.
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Affiliation(s)
- Samantha H Blatt
- Department of Anthropology, Boise State University, Boise, Idaho, 83725-1950
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14228
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Yang LC, Lu TJ, Lin WC. The prebiotic arabinogalactan of Anoectochilus formosanus prevents ovariectomy-induced osteoporosis in mice. J Funct Foods 2013. [DOI: 10.1016/j.jff.2013.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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14229
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Fehring TK, Fehring K, Odum SM, Halsey D. Physical therapy mandates by Medicare administrative contractors: effective or wasteful? J Arthroplasty 2013; 28:1459-62. [PMID: 23796555 DOI: 10.1016/j.arth.2013.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 05/20/2013] [Indexed: 02/01/2023] Open
Abstract
Documentation of medical necessity for arthroplasty has come under scrutiny by Medicare. In some jurisdictions three months of physical therapy prior to arthroplasty has been mandated. The purpose of this study was to determine the efficacy and cost of this policy to treat advanced osteoarthritis. A systematic review was performed to assimilate efficacy data for physical therapy in patients with advanced osteoarthritis. The number of arthroplasties performed annually was obtained to calculate cost. Evidence-based studies documenting the efficacy of physical therapy in treating advanced arthritis are lacking with a potential cost of 36-68 million dollars. Physical therapy mandates by administrative contractors are not only ineffective but are costly without patient benefit. Medical necessity documentation should be driven by orthopedists not retroactively by Medicare contractors.
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14230
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Uthman OA, van der Windt DA, Jordan JL, Dziedzic KS, Healey EL, Peat GM, Foster NE. Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. BMJ 2013; 347:f5555. [PMID: 24055922 PMCID: PMC3779121 DOI: 10.1136/bmj.f5555] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2013] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine whether there is sufficient evidence to conclude that exercise interventions are more effective than no exercise control and to compare the effectiveness of different exercise interventions in relieving pain and improving function in patients with lower limb osteoarthritis. DATA SOURCES Nine electronic databases searched from inception to March 2012. STUDY SELECTION Randomised controlled trials comparing exercise interventions with each other or with no exercise control for adults with knee or hip osteoarthritis. DATA EXTRACTION Two reviewers evaluated eligibility and methodological quality. Main outcomes extracted were pain intensity and limitation of function. Trial sequential analysis was used to investigate reliability and conclusiveness of available evidence for exercise interventions. Bayesian network meta-analysis was used to combine both direct (within trial) and indirect (between trial) evidence on treatment effectiveness. RESULTS 60 trials (44 knee, two hip, 14 mixed) covering 12 exercise interventions and with 8218 patients met inclusion criteria. Sequential analysis showed that as of 2002 sufficient evidence had been accrued to show significant benefit of exercise interventions over no exercise control. For pain relief, strengthening, flexibility plus strengthening, flexibility plus strengthening plus aerobic, aquatic strengthening, and aquatic strengthening plus flexibility, exercises were significantly more effective than no exercise control. A combined intervention of strengthening, flexibility, and aerobic exercise was also significantly more effective than no exercise control for improving limitation in function (standardised mean difference -0.63, 95% credible interval -1.16 to -0.10). CONCLUSIONS As of 2002 sufficient evidence had accumulated to show significant benefit of exercise over no exercise in patients with osteoarthritis, and further trials are unlikely to overturn this result. An approach combining exercises to increase strength, flexibility, and aerobic capacity is likely to be most effective in the management of lower limb osteoarthritis. The evidence is largely from trials in patients with knee osteoarthritis. PROTOCOL REGISTRATION PROSPERO (www.crd.york.ac.uk/prospero/) No CRD42012002267.
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Affiliation(s)
- Olalekan A Uthman
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG, UK
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14231
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Liu HF, Chen ZG, Fang TL, Arnold P, Lineaweaver WC, Zhang J. Changes of the donor nerve in end-to-side neurorrhaphies with epineurial window and partial neurectomy: A long-term evaluation in the rat model. Microsurgery 2013; 34:136-44. [PMID: 24014345 DOI: 10.1002/micr.22167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 07/03/2013] [Accepted: 07/10/2013] [Indexed: 12/16/2022]
Affiliation(s)
- Hai-Fei Liu
- Department of Orthopedic Surgery, Zhongshan Hospital; Fudan University; Shanghai China
- Department of Orthopedic Surgery, the Affiliated Hospital of Medical College; Qingdao University; Shandong China
| | - Zeng-Gan Chen
- Department of Orthopedic Surgery, Zhongshan Hospital; Fudan University; Shanghai China
| | - Tao-Lin Fang
- Department of Orthopedic Surgery, Zhongshan Hospital; Fudan University; Shanghai China
- Division of Plastic Surgery; University of Mississippi; Jackson Mississippi
| | - Peter Arnold
- Division of Plastic Surgery; University of Mississippi; Jackson Mississippi
| | | | - Jian Zhang
- Department of Orthopedic Surgery, Zhongshan Hospital; Fudan University; Shanghai China
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14232
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Hinarejos P, Piñol I, Torres A, Prats E, Gil-Gómez G, Puig-Verdie L. Highly crosslinked polyethylene does not reduce the wear in total knee arthroplasty: in vivo study of particles in synovial fluid. J Arthroplasty 2013; 28:1333-7. [PMID: 23507066 DOI: 10.1016/j.arth.2013.01.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/05/2012] [Accepted: 01/21/2013] [Indexed: 02/01/2023] Open
Abstract
The aim was to assess if the reduction in polyethylene wear with highly crosslinked polyethylene suggested by studies with knee simulators is confirmed in patients with a knee arthroplasty. The use of a conventional or a highly crosslinked polyethylene was randomly assigned intraoperatively. Twelve months after surgery a knee arthrocentesis was performed and the synovial fluid of 17 patients in each group was studied analysing the number, size and shape of the polyethylene particles by scanning electron microscope. We found no significant differences in the concentration, size or morphology of polyethylene particles between groups. The great variability in the number of particles between individuals suggests that in vivo polyethylene wear depends on many factors and probably the type of polyethylene is not the most significant.
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14233
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Dingenen B, Staes FF, Janssens L. A new method to analyze postural stability during a transition task from double-leg stance to single-leg stance. J Biomech 2013; 46:2213-9. [DOI: 10.1016/j.jbiomech.2013.06.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/13/2013] [Accepted: 06/24/2013] [Indexed: 01/10/2023]
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14234
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Abstract
BACKGROUND The diagnosis and validation of thoracic outlet syndrome/brachial plexopathy (TOS) remains a difficult challenge for surgeons, neurologists, and radiologists. This is due to the fact that the responses of standard elevated arm stress tests can be considered somewhat subjective and can vary. Therefore, non-vascular TOS cases are presently diagnosed clinically, and any objective diagnosis has been controversial. METHODS This is a technique paper describing the use of dynamic neuromusculoskeletal ultrasound to assist in the diagnosis of thoracic outlet/brachial plexus pathology. We propose a new way to observe the brachial plexus dynamically, so that physical verification of nerve compression between the anterior and middle scalene muscles can be clearly made at the onset of clinical symptoms. This gives a way to objectively identify clinically significant brachial plexus compression. RESULTS Dynamic testing can add objective analysis to tests such as the elevated arm stress tests and can correlate the onset of symptoms with plexus compression between the anterior and middle scalene muscles. With this, the area of pathologic compression can be identified and viewed while performing the dynamic testing. If compression is seen and the onset of symptoms ensues, this is a positive confirmatory test for the presence of TOS and a clinically significant disease. CONCLUSIONS This paper offers a simple, objective, and visual diagnostic test that can validate the presence or absence of brachial plexus compression during arm elevation in patients with brachial plexus injury and thoracic outlet syndrome.
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Affiliation(s)
| | - Levon N. Nazarian
- />Department of Radiology, Division of Diagnostic Ultrasound, Thomas Jefferson University Hospital, 7th Floor, Main Building, Philadelphia, PA USA
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14235
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14236
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Nishio M, Kanaji A, Horiuchi K, Funayama A, Oishi T, Toyama Y, Yamada H. Crowe type IV dislocated hip treated by total hip arthroplasty with subtrochanteric step-cut femoral shortening osteotomy and Wagner cone stem. Current Orthopaedic Practice 2013. [DOI: 10.1097/bco.0b013e31829fc260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14237
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Roberts D, Batta N. Paralabral cyst of the hip. Radiopaedia.org 2013. [DOI: 10.53347/rid-24600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
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14238
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Abstract
Men undergo gradual bone loss with aging, resulting in fragile bones. It is estimated that one in five men will suffer an osteoporotic fracture during their lifetime. The prognosis for men after a hip fracture is very grim. A major cause is reduction of free testosterone. Many other factors result in secondary osteoporosis, including treatment for other diseases such as cancer and diabetes. Patients should be screened not only for bone density but also assessed for their nutritional status, physical activity, and drug intake. Therapy should be chosen based on the type of osteoporosis. Available therapies include testosterone replacement, bisphosphonates, and nutritional supplementation with calcium, vitamin D, fatty acids, and isoflavones, as well as certain specific antibodies, like denosumab and odanacatib, and inhibitors of certain proteins.
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Affiliation(s)
- Jameela Banu
- Coordinated Program in Dietetics, College of Health Sciences and Human Services and Department of Biology, College of Science and Mathematics, University of Texas-Pan American, Edinburg, TX 78539, USA.
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14239
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Marchigiani R, Gordy S, Cipolla J, Adams RC, Evans DC, Stehly C, Galwankar S, Russell S, Marco AP, Kman N, Bhoi S, Stawicki SPA, Papadimos TJ. Wind disasters: A comprehensive review of current management strategies. Int J Crit Illn Inj Sci 2013; 3:130-42. [PMID: 23961458 PMCID: PMC3743338 DOI: 10.4103/2229-5151.114273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Wind disasters are responsible for tremendous physical destruction, injury, loss of life and economic damage. In this review, we discuss disaster preparedness and effective medical response to wind disasters. The epidemiology of disease and injury patterns observed in the early and late phases of wind disasters are reviewed. The authors highlight the importance of advance planning and adequate preparation as well as prompt and well-organized response to potential damage involving healthcare infrastructure and the associated consequences to the medical response system. Ways to minimize both the extent of infrastructure damage and its effects on the healthcare system are discussed, focusing on lessons learned from recent major wind disasters around the globe. Finally, aspects of healthcare delivery in disaster zones are reviewed.
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Affiliation(s)
- Raffaele Marchigiani
- Department of Surgery, Temple St Luke's Medical School, Bethlehem, Pennsylvania, United States of America
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14240
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Elfering A, Arnold S, Schade V, Burger C, Radlinger L. Stochastic resonance whole-body vibration, musculoskeletal symptoms, and body balance: a worksite training study. Saf Health Work 2013; 4:149-55. [PMID: 24106645 PMCID: PMC3791086 DOI: 10.1016/j.shaw.2013.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/17/2013] [Accepted: 07/17/2013] [Indexed: 12/11/2022] Open
Abstract
Background Stochastic resonance whole-body vibration training (SR-WBV) was tested to reduce work-related musculoskeletal complaints. Methods Participants were 54 white-collar employees of a Swiss organization. The controlled crossover design comprised two groups each given 4 weeks of exercise and no training during a second 4-week period. Outcome was daily musculoskeletal well-being, musculoskeletal pain, and surefootedness. In addition, participants performed a behavioral test on body balance prior to when SR-WBV started and after 4 weeks of SR-WBV. Results Across the 4-week training period, musculoskeletal well-being and surefootedness were significantly increased (p < 0.05), whereas musculoskeletal pain was significantly reduced only in those who reported low back pain during the last 4 weeks prior to the study (p < 0.05). Body balance was significantly increased by SR-WBV (p < 0.05). Conclusion SR-WBV seems to be an efficient option in primary prevention of musculoskeletal complaints and falls at work.
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Affiliation(s)
- Achim Elfering
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
- Corresponding author. Department of Psychology, University of Berne, Fabrikstrasse 8, 3012 Bern, Switzerland.
| | - Sibille Arnold
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
| | - Volker Schade
- Centre for Human Resource Management and Organizational Engineering, Bern, Switzerland
| | - Christian Burger
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
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14241
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Parlamas G, Hannon CP, Murawski CD, Smyth NA, Ma Y, Kerkhoffs GM, van Dijk CN, Karlsson J, Kennedy JG. Treatment of chronic syndesmotic injury: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013; 21:1931-9. [PMID: 23620248 DOI: 10.1007/s00167-013-2515-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/15/2013] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study is to systematically review and meta-analyse the available literature on the treatment of chronic syndesmotic injuries of the ankle. METHODS A systematic review of the PubMed/MEDLINE and EMBASE databases was conducted in August 2012 utilizing the keywords (treatment OR intervention) AND (injury OR sprain OR rupture) AND (syndesmosis OR syndesmotic OR "high ankle" OR "anterior inferior tibiofibular ligament" OR AITFL OR "posterior inferior tibiofibular ligament" OR PITFL OR tibiofibular diastasis). Studies that reported the outcomes of the surgical treatment of chronic syndesmotic injury were included in our review. Chronic was defined as symptoms longer than 6 months. Meta-analysis based on random-effects models was performed to pool the rates of success for different treatment methods. RESULTS The search yielded 416 publications from PubMed/MEDLINE and 473 publications from EMBASE. After abstract and full-text review, 15 articles were included in this review. Treatment methods were placed into three broad surgical treatment categories: screw fixation, arthrodesis and arthroscopic debridement. The most common treatment strategy employed was screw fixation. The pooled rates of success for screw fixation, arthrodesis and arthroscopic debridement were 87.9, 79.4 and 78.7 %, respectively. CONCLUSION The current evidence on the treatment of chronic syndesmosis injuries in the ankle is limited to prospective and retrospective case series. The pooled success rates for screw fixation, arthrodesis and arthroscopic debridement each exceeded 78 %. Future high-level studies are required to discern the most appropriate treatment strategy(ies) for chronic syndesmotic injuries of the ankle.
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Affiliation(s)
- George Parlamas
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
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14242
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Abolaeha OA, Weber J, Ross LT. Finite element simulation of a scoliotic spine with periodic adjustments of an attached growing rod. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2012:5781-5. [PMID: 23367243 DOI: 10.1109/embc.2012.6347308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Early Onset Scoliosis (EOS) is a deformity of spine which occurs during growth. Spinal growing rod instrumentation is currently a procedure of early onset scoliosis management and newer technologies to treat scoliosis without fusion hold the exciting promise of a new paradigm in spinal deformity care. A Finite Element Model (FEM) of a scoliotic spine was created and enhanced to simulate spine growth after the attachment of a growing rod. Growing rod instrumentation was included utilizing FEA to accurately simulate the required 3D forces and moments to achieve the desired correction. We measured forces on the rods and the spine during adjustment periods (for correction of the spinal deformity) and during growth periods. For this study, a two-year period was simulated with adjustments at six month intervals. The FEM allowed us to collect data during growth periods from sensors which are only accessible during the surgical procedures.
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Affiliation(s)
- O A Abolaeha
- Electrical Engineering Department, University of Dayton, Dayton, OH 45469, USA.
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14243
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Sawant A, Ponnazhagan S. Myeloid-derived suppressor cells as osteoclast progenitors: a novel target for controlling osteolytic bone metastasis. Cancer Res 2013; 73:4606-10. [PMID: 23887974 DOI: 10.1158/0008-5472.can-13-0305] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Immune cells and their secreted growth factors play major roles in tumor growth and metastasis. Interplay between the growing tumor and infiltrating immune cells determines the nature of immune response and ultimately, tumor fate. Increased infiltration of protumorigenic immune cells promotes tumor growth as well as dissemination to distant sites. These cells induce immunosuppression that inhibits proliferation and functions of cells of antitumor immune response. One population of immunosuppressive cells that is increasingly gaining attention is myeloid-derived suppressor cells (MDSC). MDSCs are immature myeloid progenitors that suppress T-cell effector functions and promote angiogenesis. MDSC numbers are elevated at both the primary tumor and metastatic sites, including bone. In addition to immunosuppressive functions of MDSCs, we and others have recently discovered a novel function for MDSCs as osteoclast progenitors. Osteolysis is a common complication in the carcinomas of breast, lung, prostate, and multiple myeloma with poor prognosis. Therefore, targeting the functions of MDSCs may exert dual therapeutic effects on immunosuppression and bone pathology. Cancer Res; 73(15); 4606-10. ©2013 AACR.
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Affiliation(s)
- Anandi Sawant
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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14244
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Wang C, Ma X, Wang X, Huang J, Zhang C, Chen L. Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis. Int Orthop. 2013;37:1755-1763. [PMID: 23873173 DOI: 10.1007/s00264-013-1999-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 06/20/2013] [Indexed: 12/13/2022]
Abstract
No consensus had been reached about the optimal method for syndesmotic fixation. The present study analysed syndesmotic fixation based on the highest level of clinical evidence in order to obtain more reliable results. Medline, Embase and Cochrane database were searched through the OVID retrieval engine. Manual searching was undertaken afterward to identify additional studies. Only randomized controlled trials (RCT) and prospective comparative studies were selected for final inclusion. Study screening and data extraction were completed independently by two reviewers. All study characteristics were summarized into a table. The extracted data were used for data analysis. Twelve studies were finally included: six of them were RCTs, two were quasi-randomized studies and four were prospective comparative studies. Four comparisons with traditional metallic screw were identified in terms of bioabsorbable screws, tricortical fixation method, suture-button device as well as non-fixation choice in low syndesmotic injuries. Both absorbable screws and the tricortical fixation method showed almost no better results than traditional quadricortical metallic screw (p > 0.05). Additionally, existing studies could not illustrate their efficiency of reducing hardware removal rate. The suture button technique had significantly better functional score (p = 0.003), ankle motion (p = 0.02), time to full weightbearing (p < 0.0001) and much less complications (p = 0.0008) based on short and intermediate term follow-up data. Transfixation in low syndesmotic injuries showed poorer results than the non fixed group in all outcome measurements, but didn't reach a significant level (p > 0.05). The present evidence still couldn't find superior performance of the bioabsorbable screw and tricortical fixation method. Their true effects in decreasing second operation rate need further specific studies. Better results of the suture-button made it a promising technique, but it still needs long-term testing and cost-efficiency studies. The patients with low syndemotic injuries should be well assessed before fixation determination and the indication of screw placement in such conditions needs to be further defined.
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14245
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Abstract
Arthritis is one of the most frequent musculoskeletal problems, causing pain, disability, and a significant economic burden. In this article, we discuss current nonsurgical injectable treatment options as well as future trends for cartilage lesions and early arthritis of the knee. We cover some potential treatments for knee osteoarthritis, including stem cell and gene therapies.
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14246
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Pandit SK, Westendorp B, de Bruin A. Physiological significance of polyploidization in mammalian cells. Trends Cell Biol 2013; 23:556-66. [PMID: 23849927 DOI: 10.1016/j.tcb.2013.06.002] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 01/26/2023]
Abstract
Programmed polyploidization occurs in all mammalian species during development and aging in selected tissues, but the biological properties of polyploid cells remain obscure. Spontaneous polyploidization arises during stress and has been observed in a variety of pathological conditions, such as cancer and degenerative diseases. A major challenge in the field is to test the predicted functions of polyploidization in vivo. However, recent genetic mouse models with diminished polyploidization phenotypes represent novel, powerful tools to unravel the biological function of polyploidization. Contrary to a longstanding hypothesis, polyploidization appears to not be required for differentiation and has no obvious impact on proliferation. Instead, polyploidization leads to increased cell size and genetic diversity, which could promote better adaptation to chronic injury or stress. We discuss here the consequences of reducing polyploidization in mice and review which stress responses and molecular signals trigger polyploidization during development and disease.
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Affiliation(s)
- Shusil K Pandit
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
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14247
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Gugala Z. On a quest to dethrone the long-reigning king: commentary on an article by Christopher W. DiGiovanni, MD, et al.: "Recombinant Human platelet-derived growth factor-BB and beta-tricalcium phosphate (rhPDGF-BB/β-TCP): an alternative to autogenous bone graft". J Bone Joint Surg Am 2013; 95:e95. [PMID: 23824400 DOI: 10.2106/jbjs.m.00677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Zbigniew Gugala
- The University of Texas Medical Branch at Galveston, Galveston, TX, USA
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14248
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Perler AD, Nwosu V, Christie D, Higgins K. End-stage osteoarthritis of the great toe/hallux rigidus: a review of the alternatives to arthrodesis: implant versus osteotomies and arthroplasty techniques. Clin Podiatr Med Surg 2013; 30:351-95. [PMID: 23827492 DOI: 10.1016/j.cpm.2013.04.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Hallux rigidus is defined as end-staged arthrosis of the first metatarsophalangeal joint. Although the literature supports arthrodesis as being the gold standard for the treatment of end-staged hallux rigidus, there are several other treatments available that can either prolong the life of the remaining joint or artificially mimic the original biomechanics by replacing a portion of or the entire joint with the added advantage of preserving joint mobility. There are several new and emerging joint preservative techniques that may delay or prevent the need for a joint-destructive procedure, such as arthrodesis or arthroplasty.
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Affiliation(s)
- Adam D Perler
- Saint Vincent's Hospital System, Indianapolis, IN, USA.
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14249
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Abstract
BACKGROUND Dislocation and leg length discrepancy are major complications following total hip arthroplasty (THA). Many surgical approaches for THA have been described, but none suggest a capsular incision that assures good exposure while maintaining adequate capsule integrity in closure. PURPOSES Modified anterolateral approach for stable hip (MAASH) is a modification of the classical Hardinge approach, but specifically preserves the anterior iliofemoral lateral ligament and pubofemoral ligament excising the "weak area" of the capsule, in the so called "internervous safe zone" and introducing the "box concept" for the anterior approach to the hip. This is the main difference of the MAASH approach. This technique can be used as a standard for all THA standard models, but we introduce new devices to make it easier. METHODS From November 2007 to May 2012, data were collected for this observational retrospective consecutive case study. We report the results of 100 THA cases corresponding to the development curve of this new concept in THA technique. RESULTS MAASH technique offers to hip surgeons, a reliable and reproducible THA anterolateral technique assuring accurate reconstruction of leg length and a low rate of dislocation. Only one dislocation and six major complications are reported, but most of them occurred at the early stages of technique development. CONCLUSION MAASH technique proposes a novel concept on working with the anterior capsule of the hip for the anterolateral approach in total hip arthroplasty, as well as for hemiarthroplasty in the elderly population with high dislocation risk factors. MAASH offers maximal stability and the ability to restore leg length accurately.
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Affiliation(s)
- Felipe G. Delgado
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
- Arthrocat SLP, Group of Orthopedic Surgery and Sports Medicine, Sant Celoni, Spain
| | - Albert Broch
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
- Arthrocat SLP, Group of Orthopedic Surgery and Sports Medicine, Sant Celoni, Spain
| | - Francisco Reina
- Medicals Sciences Department, NEOMA Group Research, Faculty of Medicine, University of Girona, Girona, Catalonia Spain
| | - Lluís Ximeno
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
| | - David Torras
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
| | - Francesc García
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
| | - Antoni Salvador
- Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain
- Arthrocat SLP, Group of Orthopedic Surgery and Sports Medicine, Sant Celoni, Spain
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14250
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Campbell KJ, Boykin RE, Wijdicks CA, Erik Giphart J, LaPrade RF, Philippon MJ. Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy. Knee Surg Sports Traumatol Arthrosc 2013; 21:1684-8. [PMID: 23052123 DOI: 10.1007/s00167-012-2232-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/24/2012] [Indexed: 12/13/2022]
Abstract
This report presents a 27-year-old male professional soccer player who developed heterotopic ossification of his hip capsule and gluteus minimus tendon after an arthroscopic hip procedure. After removal of the heterotopic bone, the patient had a symptomatic deficiency of his hip capsule and gluteus minimus tendon. A series of orthobiologic treatments with platelet-rich plasma and bone marrow aspirate concentrate improved the patient's pain and strength as well as the morphologic appearance of the hip capsule and gluteus minimus tendon on magnetic resonance imaging. A series of motion analyses demonstrated significant improvement in his stance-leg ground reaction force and hip abduction, as well as linear foot velocity at ball strike and maximum hip flexion following ball strike in his kicking leg. Level of evidence IV.
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Affiliation(s)
- Kevin J Campbell
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, CO 81657, USA
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