Aim: 3D-printed implants could improve the capture of fracture fragments for improved stability of tibial plateau fracture fixation. The aim of this study was to compare the biomechanical strength of fixation constructs using standard and customised 3D-printed proximal tibial locking plates for fixation of tibial plateau fractures.
Methods: This is a biomechanical study utilising six pairs of cadaveric tibiae.
Additive manufacturing of stainless steel is becoming increasingly accessible, allowing for the customisation of structure and surface characteristics; there is little guidance for the post-processing of these metals. We carried out this study to ascertain the effects of various combinations of post-processing methods on the surface of an additively manufactured stainless steel 316L lattice. We also characterized the nature of residual surface particles found after these processes via energy-dispersive X-ray spectroscopy.
View Article and Find Full Text PDFAim: The aim of this study was to assess the feasibility of 3D printing a customised implant at the point of care from a manufacturing and logistics perspective. We hypothesised that customised plate production would be possible within a clinically relevant time frame of 72 hours using currently available technology.
Materials And Methods: This study uses 6 cadaveric lower limbs to simulate real-life surgical patients.
Over the past decade, there has been growing interest in the sagittal alignment of the cervical spine and its correlation to clinical outcomes. It is now known that cervical lordosis is not universally physiological and should not be pursued in all patients undergoing surgery. Rather, it is increasingly understood that it is how these angular parameters (lordosis or kyphosis) interact with translational parameters that is reflective of overall cervical spine and whole spine balance, which in turn impacts patient outcomes.
View Article and Find Full Text PDFUnlabelled: MINI: This is a long-term prospective cohort study comparing the radiographic outcomes of anterior versus posterior instrumentation for Lenke 5 adolescent idiopathic scoliosis. Both approaches were comparable in terms of radiographic outcomes up to 10 years. The posterior approach is more prone to developing proximal junctional kyphosis.
View Article and Find Full Text PDFBackground: The use of bone marrow-derived mesenchymal stem cells (BMSCs) in cartilage repair procedures circumvents some of the limitations of autologous chondrocyte implantation (ACI), but long-term outcomes for this newer procedure are lacking. The authors previously reported comparable outcomes for the 2 procedures at 2-year follow-up.
Purpose/hypothesis: The purpose was to compare the long-term clinical outcomes of ACI versus BMSCs.
Background: A comparative survey from patients and radiographers of the new slump sitting flexion posture and the conventional standing forward bending posture. This study was performed to compare the technical and logistical aspects of the slump sitting versus the forward bending posture. Slump sitting flexes the lumbar spine more than the forward bending and increases the diagnosis rate of sagittal spinal instability up to 40% depending on the diagnostic criteria used.
View Article and Find Full Text PDFIntroduction: Percutaneously-placed sacroiliac (SI) screws are currently the gold-standard fixation technique for fixation of the posterior pelvic ring. The relatively high prevalence of sacral dysmorphism in the general population introduces a high risk of cortical breach with resultant neurovascular damage. This study was performed to compare the accuracy of SI screw placement with and without the use of intraoperative navigation, as well as to externally validate the sacral dysmorphism score in a trauma patient cohort.
View Article and Find Full Text PDFBackground Context: Pelvic incidence (PI)=pelvic tilt (PT)+sacral slope (SS) is an established trigonometric equation which can be expanded from studying the fixed pelvis with the spine to a fixed spinopelvic complex with the remnant spine, in scenarios of spinopelvic fusion or ankylosis. For a fixed spinopelvic complex, we propose the equation termed: lumbar incidence (LI)=lumbar tilt (LT)+lumbar slope (LS).
Purpose: This study aimed to establish reference values for LI, LT, and LS at each lumbar vertebral level, and to show how LI can be used to determine residual lumbar lordosis (rLL).
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, with open true posterior dislocation an even rarer injury. We describe our treatment of a young motorcyclist who was brought into hospital after a road traffic accident, having sustained an open posterior subtalar dislocation. After initial reduction and resuscitation in the emergency department, he was taken to the operating theater for emergent wound debridement and external fixation of his ankle using a unilateral external fixator device.
View Article and Find Full Text PDFBackground Context: Although minimally invasive surgery (MIS)-transforaminal lumbar interbody fusion (TLIF) has many evidence-based short-term benefits over open TLIF, both procedures have similar long-term outcomes. Patients' preference for MIS over open TLIF may be confounded by a lack of understanding of what each approach entails.
Purpose: The study aimed to identify the various factors influencing patients' choice between MIS and open TLIF.
J Orthop Surg (Hong Kong)
January 2017
Objective: While there has been increasing interest in minimally invasive surgery, the expenses incurred by patients undergoing this form of surgery have not been comprehensively studied. The authors compared the costs borne by patients undergoing arthroscopic rotator cuff repair with the standard mini-open repair at a tertiary hospital in an Asian population.
Patients And Methods: This was a retrospective cohort study.
Background Context: The current prevailing school of thought in spinal deformity surgery is to restore sagittal balance with reference to the alignment of the spine when the patient is standing. This strategy, however, likely accounts for increased rates of proximal junctional failure.
Purpose: The purpose of this study was to investigate the differences between the spine in standing and sitting positions as these may elucidate reasons for deformity correction failure.
Background: Surgery on the radial head is usually performed via the Kocher interval. Iatrogenic injury to the posterior interosseous nerve (PIN) and lateral ligamentous complex are known complications of lateral elbow approaches. The extensor digitorum communis (EDC) splitting approach for lateral elbow exposure is known to provide better access to the anterior half of the radial head while reducing the risk of injury to the lateral ligaments.
View Article and Find Full Text PDFBackground: Historically anterior cruciate ligament (ACL) injuries have been diagnosed poorly. A paper published in Injury in 1996 showed that less than 10% of patients with an ACL injury had the diagnosis made by the first physician to see them and that the average delay from first presentation to diagnosis was 21 months. The aim of our study was to investigate whether an improvement has been made over the last two decades in diagnosing ACL injuries.
View Article and Find Full Text PDFObjective: To review the current management of boys with bilateral anorchia and assess whether surgical exploration is necessary when endocrine investigation indicates absent testicular function.
Patients And Methods: The medical records of 11 boys being managed for bilateral anorchia were reviewed in relation to clinical presentation, pituitary-gonadal function, surgical and histological findings.
Results: All boys had absence of testicular function based on undetectable levels of serum anti-Müllerian hormone, elevated basal or peak follicle-stimulating hormone and luteinising hormone levels and no testosterone response to human chorionic gonadotrophin stimulation.