• Title/Summary/Keyword: orthopedics

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Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis

  • Erdogan, Sinan;Polat, Baris;Atici, Yunus;Ozyalvac, Osman Nuri;Ozturk, Cagatay
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.577-585
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    • 2019
  • Objective : Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). Methods : Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. Results : Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. Conclusion : There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

The Evaluation of Exogenous Melatonin Administration in Supraspinatus Overuse Tendinopathy in an Experimental Rat Model

  • Kocadal, Onur;Pepe, Murad;Akyurek, Nalan;Gunes, Zafer;Surer, Hatice;Aksahin, Ertugrul;Ogut, Betul;Aktekin, Cem Nuri
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.79-86
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    • 2019
  • Background: Increased oxidative stress and inflammation play a critical role in the etiopathogenesis of chronic tendinopathy. Melatonin is an endogenous molecule that exhibits antioxidant and anti-inflammatory activity. The aim of this study was to evaluate the biochemical and histopathological effects of exogenous melatonin administrations in supraspinatus overuse tendinopathy. Methods: Fifty rats were divided into the following four groups: cage activity, melatonin treatment, corticosteriod therapy, and control. Melatonin (10 mg/kg, intraperitoneal; twice a day) and triamcinolone (0.3 mg/kg, subacromial; weekly) were administered to the treatment groups after the overuse period. Biochemical and histopathological evaluations were performed on serum samples and biopsies obtained from rats. Plasma inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were evaluated biochemically. Results: The TAS, TOS, OSI, iNOS, and VEGF values were significantly lower than the pre-treatment levels in rats receiving exogenous melatonin treatment (3 or 6 weeks) (p<0.05). TOS, iNOS, VEGF, and OSI values after 3 weeks of triamcinolone administration, and TOS, VEGF, and OSI levels after 6 weeks of triamcinolone application, were significantly lower than the pre-treatment levels (p<0.05). Conclusions: Exogenous melatonin application in overuse tendinopathy reduces oxidative stress and inflammation. Melatonin might be an alternative potential molecule to corticosteroids in the treatment of chronic tendinopathy.

Mid- to long-term success rate and functional outcomes of acromioclavicular injections in patients with acromioclavicular osteoarthritis

  • Nienke Miedema;Inger Sierevelt;Tjarco Dirk Willem Alta;Roderick Jan Maximiliaan Vossen;Arthur van Noort
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.175-181
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    • 2023
  • Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

  • Sitanshu Barik;Vikash Raj;Sant Guru Prasad;Richa;Varun Garg;Vivek Singh
    • Hip & pelvis
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    • v.35 no.2
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    • pp.73-87
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    • 2023
  • The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials

  • Vishnu Baburaj;Sandeep Patel;Vishal Kumar;Siddhartha Sharma;Mandeep Singh Dhillon
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.72-78
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    • 2024
  • Background: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. Methods: A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. Results: Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. Conclusions: Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes.

A Real-Time Pattern Recognition for Multifunction Myoelectric Hand Control

  • Chu, Jun-Uk;Moon, In-Hyuk;Mun, Mu-Seong
    • 제어로봇시스템학회:학술대회논문집
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    • 2005.06a
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    • pp.842-847
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    • 2005
  • This paper proposes a novel real-time EMG pattern recognition for the control of a multifunction myoelectric hand from four channel EMG signals. To cope with the nonstationary signal property of the EMG, features are extracted by wavelet packet transform. For dimensionality reduction and nonlinear mapping of the features, we also propose a linear-nonlinear feature projection composed of PCA and SOFM. The dimensionality reduction by PCA simplifies the structure of the classifier, and reduces processing time for the pattern recognition. The nonlinear mapping by SOFM transforms the PCA-reduced features to a new feature space with high class separability. Finally a multilayer neural network is employed as the pattern classifier. We implement a real-time control system for a multifunction virtual hand. From experimental results, we show that all processes, including virtual hand control, are completed within 125 msec, and the proposed method is applicable to real-time myoelectric hand control without an operation time delay.

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Unusual intraosseous transmigration of impacted tooth

  • Kumar, Santosh;Urala, Arun Srinivas;Kamath, Abhay Taranath;Jayaswal, Priyanka;Valiathan, Ashima
    • Imaging Science in Dentistry
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    • v.42 no.1
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    • pp.47-54
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    • 2012
  • Transmigration of an impacted tooth through the symphyseal suture is a rare and special developmental anomaly of unknown etiology that is unique to the mandibular canine. Maxillary canine transmigration is even rarer. Transmigrated canines are particularly significant due to the aesthetic and functional importance. A maxillary lateral incisor crossing the mid-palatal suture has never been reported in the literature. The aim of this report is to present the first case of simultaneous transmigration of a lateral incisor and canine in the maxilla. The paper also reports four unusual cases of unilateral canine transmigration in the maxilla and mandible and successful eruption of one of the transmigrated mandibular canines following orthodontic traction. Etiology of transmigration and its clinical considerations are also discussed.

Unusual chromosomal features in a child with gradual disappearance of right ulna (mono ostolic osteolysis)

  • Goswami, Hit K.;Shrivastava, Nirhhay;Gopal, Shiv Kumar;Sharna, Sanjay;Chandorkar, Manoj;Lee, In-Hwan;Chang, Sung-Ik
    • Journal of Genetic Medicine
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    • v.1 no.1
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    • pp.11-16
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    • 1997
  • A nine month old male child presenting degenerating right ulna (massive osteolysis) has been followed up for two years. The bone completely disappeared due to abscesses on the right forearm and without orthopedic or haematological complications. Repeated lymphocyte cultures showed somatic pairing (mostly chromosome pair 5), end to end association involving chromosome 14, 21, 21 and 16, and satellite enlargement in a high proportion of cells with an otherwise normal 46,XY karyotype. These observations are compared with 13 other types of orthopaedic patients, and we opine that cumulative picture of chromosomal aberrations appears to correspond with the present rare anomaly "Mono Ostolic Osteolysis" involving right ulna. None of the controls or any other orthopaedic anomaly studied hereunder exhibits this chromosomal picture.

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Surgical treatment of spinal cord compression in client owned dogs with different grades of neurological dysfunction

  • Kuricova, Maria;Ledecky, Valent;Liptak, Tomas
    • Korean Journal of Veterinary Research
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    • v.56 no.2
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    • pp.113-116
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    • 2016
  • Our retrospective study reports the clinical findings and population characteristics of 81 surgically treated dogs for spinal cord compression. We compared the outcome of dogs with different grades of neurological dysfunction due to spinal cord compression and focused on the long-term outcome of surgical treatment, for which there are only a few recent records. We recorded a 13.6% recurrence, regardless of the degree of dysfunction. However, the degree of dysfunction negatively affected the recovery length.

Comparative analysis of craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders: a cross-sectional study

  • Anita Pradhan;Preeti Bhattacharya;Shivani Singh;Anil Kumar Chandna;Ankur Gupta;Ravi Bhandari
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.125-134
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    • 2023
  • Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.