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International Journal of Orthopaedics
Number of Followers: 2

This is an Open Access Journal

Open Access journal
ISSN (Print) 2311-5106 - ISSN (Online) 2313-1462
Published by ACT Publishing Group Ltd

[11 journals]

Tibialis posterior as a cause of AAFD - ‘Not guilty your
honour’
- Authors: Chandra Pasapula, David Chrastek, Sajid Sharriff, Zeinab Ibrahim-Hashi, Steven Cutts
  Abstract: Recent changes in the perception of the primary lesion responsible for the pathogenesis of adult acquired flatfoot deformity (AAFD) has emerged. Studies question the essential role of the tibialis posterior (TP) and demonstrate its absence does not necessarily lead to planovalgus. The significant role the static restraints play, specifically the spring ligament (SL), its contribution to the medial arch stability, and how its failure precipitates AAFD, are increasingly recognised. It is now addressed as part of the treatment planning [1, 2, 3]. This article aims to evaluate new and existing theories that allow us to draw these conclusions.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Stromal Vascular Fraction for Musculoskeletal Lesions
- Authors: E. Carlos Rodriguez-Merchan, Carlos A. Encinas-Ullan
  Abstract: Several clinical studies appear to demonstrate that intra-tendinous injections of stromal vascular fraction (SVF) are safe and effective in athletes suffering from recalcitrant Achilles tendinopathy and chronic lateral elbow tendinopathy. It has also been reported that intra-articular SVF injections appear to be effective and safe for the treatment of knee osteoarthritis. Local application of SVF has also proven useful in chronic diabetic foot ulcers. Ready-to-use extracellular matrix/SVF gel appears to be a favorable therapeutic approach to facilitating articular cartilage regeneration in patients with chondral lesions. However, there are insufficient high-quality data to recommend SVF for athletes with sports soft-tissue knee injuries. Several experimental studies have suggested that SVF could be a good option to achieve bone regeneration. To confirm the usefulness of SVF in various musculoskeletal injuries and to recommend its routine clinical use, better designed studies are required.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Computational Analysis of Strength and Fracture Location of Different
Types of Femurs under Falling Condition using CT-Image based Finite
Element Method
- Authors: Zaw Linn Htun, Mitsugu Todo, Manabu Tsukamoto, Takuaki Yamamoto, Masaaki Mawatari, Yasuharu Nakashima
  Abstract: Sideways falling has been considered as a leading cause of hip fracture in elderly people with a high risk of morbidity and mortality. Therefore, early investigation of optimum femoral strength and fracture location of people at greatest risk can be clinically very useful for the preventive measures. It is also considered that some typical femoral diseases such as osteoarthritis (OA) and avascular necrosis (AVN) could affect the strength and fracture behaviour of the femurs. In this study, 130 computational femoral models were constructed using CT images of 73 patients. Then, CT image based finite element method combined with the damage mechanics analysis was applied to predict the fracture load as the femoral strength and the fracture location of the femoral models. The computational results exhibited that the fracture load tended to increase with increase of the volumetric bone mineral density estimated in the femoral head and neck region in all the three types of models. The bone fracture behaviour was expressed as expressed as the distribution of failure elements in the head and neck region. Under fall loading, the bone fracture mainly took place in the greater trochanter region for all types of femoral model. In addition, a combination of the greater trochanter and multifarious neck fracture was also observed in all the models. A combination of greater trochanter and intertrochanteric fracture was also observed in the AVN group.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Impact of COVID-19 lockdown on the shear wave speed of professional
football players hamstring muscles
- Authors: javier tejada gallego, Beatriz Álvarez-de-la-Sierra, Patricia Nieto-Moreno, Andrés Valentí
  Abstract: AIM. This work aims to evaluate the impact of COVID-19 lockdown on the shear wave speed (SWS) of hamstrings muscles of professional football players from the Spanish National Football League.MATERIALS AND METHODS. Shear wave elastography examinations were performed on five elite football players´ hamstrings both before and after COVID-19 lockdown in two positions: a slack position and a tense position. The B- mode ultrasound technique was used to detect fibre disruption or unusual echogenicity in hamstring muscles´ areas with previous injuryRESULTS. A statistically significant increase of SWS was found in the biceps femoris (BF) in the right leg (dominant leg for most players) in both of positions, but no significant difference was found in the other muscles. In the slack position, the BF shear wave speed showed a median increase of 1.64(1.15-1.88) and 1.35(1.25-2.82) folds in the superficial and deep proximal-mid third, respectively. In the tense position, the only statistically significant difference in shear wave speed before and after the COVID-19 lockdown was found in the deep proximal-mid third of BF in the right leg. The BF shear wave speed showed a median increase of 2(1.74-2.43) folds in the deep proximal-mid third in the tense position. There were no statistically significant differences in the number of injuries per football player before and after the COVID-19 lockdownCONCLUSION. This is the first study to report that a temporary interruption of physical exertion by football players can decrease the stiffness of the BF, which could reduce the number of hamstrings injuries.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Evaluation methodology for reoperation after intramedullary nailing for
femoral shaft fracture: A quantitative computer tomography-based finite
element analysis
- Authors: Hideyuki Mimata, Yusuke Matsuura, Sei Yano, Seiji Ohtori, Mitsugu Todo
  Abstract: AIM: In a few cases of intramedullary nailing for femoral shaft fractures, nonunion due to insufficient fixation has been experienced. Although good results have been reported with the exchange nailing and the plate augmentation for reoperation, no method has been established to quantitatively evaluate postoperative instability, and it is not clear how the mechanical condition, including callus, is improved. In this study, Quantitative CT-based finite element analysis was used to quantify postoperative instability and to evaluate the mechanical effects of reoperation. MATERIALS AND METHODS: A reoperation model (exchange nailing and plate augmentation) was created in addition to the actual surgery model using a CT of a patient who had an intramedullary nailing for a femoral shaft fracture. Finite element analysis was performed to evaluate the tensile failure risk of the callus at the fracture site, which is considered to contribute significantly to bone union. RESULTS: In the actual surgery model with 11 mm diameter nails, 11.4% of callus showed tensile failure under axial loading of 3 times body weight, but this was reduced to 6.5% when the nail was changed to 13 mm diameter and 5.8% with the augmentation of a 5-hole plate. CONCLUSION: The augmentation plate on the lateral side was mechanistically shown to promote union similar to exchange nailing.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Patient satisfaction with online education and rehabilitation delivery for
primary hip joint arthroplasty
- Authors: James Fryar, Sharon Kermeci, Rachel Vickery, Patrick Weinrauch
  Abstract: Aim Hip arthroplasty involves a complex perioperative period, with both preparation and rehabilitation playing key roles in the overall outcome of the operation. New technologies must be investigated to improve patient experiences in the perioperative period. HealthLnx is a web-based program designed as an adjunct to regular perioperative care, with preoperative education and postoperative rehabilitation components. The study aimed to assess whether patients have positive experiences with a web-based perioperative education and rehabilitation delivery program while undergoing elective hip arthroplasty. Materials and Methods One hundred and fifty-six participants undergoing primary hip joint arthroplasty procedures were enrolled in an online web-based education and rehabilitation program three weeks prior to surgery, ending six weeks post-surgery. Patients opted-in to the program and were able to participate as frequently as desired. Patient-reported experience measures were then completed, with primary outcomes of satisfaction and engagement. Satisfaction was measured using a single 10-point scale, while engagement was defined as accessing the program twice or more times. Results Engagement was high, with a rate of 86.1%. Satisfaction rates among participants were high, with a mean satisfaction rate of 8.1, with a median value of 9/10. No significant differences in satisfaction and engagement existed between patient demographics. Conclusion Overall, patient engagement and satisfaction for the web-based perioperative program were high when used as an adjunct to regular care. Further study should be undertaken to determine whether online programs improve clinical outcomes for patients undertaking hip arthroplasty procedures.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)
Evidence-Based Management of a Deep Sternal Wound Infection and Complete
Thoracic Dehiscence
- Authors: Jose J. Monsivais, Reesha B. White
  Abstract: This report emphasizes the importance of a staged treatment approach that is consistent with evidence- based recommendations for the management of deep sternal wound infection in a patient with multiple risk factors. A 64 year old male patient presented six months following aortic valve replacement via a median sternotomy with a deep sternal wound infection that had resulted in complete dehiscence of the thoracic wall and partial exposure of the pericardial sac. Treatment during the six months prior to the referral included several standard reconstructive attempts consisting of debridement, stainless steel wiring, IV antibiotics, and negative pressure wound therapy without improvement. As he was metabolically decompensated, the metabolic abnormalities were corrected, and the patient underwent full -thickness debridement of the chest wall wound and sternum. The sternum was approximated using the Sternal ZIPFIX® System (DePuy Synthes). The left pectoralis major island flap was used to cover the sternum for re-vascularization to aid with treatment of sepsis and improve bony union. Antibiotic pellets were added prior to closure of the wound. In June 2016, the patient underwent debridement and closure of the chest wound. The patient is now five years post-operative, and is able to carry out all activities including long distance motorcycle riding.
  PubDate: 2022-06-28
  Issue No: Vol. 9 (2022)