Total Humeral Endoprosthetic Reconstruction: A Systematic Review.

Background: Total humeral endoprosthetic reconstruction (THER) is a rare reconstruction option for limb salvage surgery for large humeral neoplasms or bone destruction.

Materials And Methods: Because of the limited data and need for this procedure, we reviewed the literature surrounding THER and assessed functionality, complications, and revisions using the PubMed, Embase, Ovid, and Scopus databases.

Results: Among 29 articles and 175 patients, the most common indication was neoplasm (n=25, 86%), mean follow-up was 61.

Degraded RNA from Human Anterior Cruciate Ligaments Yields Valid Gene Expression Profiles.

Correlating gene expression patterns with biomechanical properties of connective tissues provides insights into the molecular processes underlying the tissue growth and repair. Cadaveric specimens such as human knees are widely considered suitable for biomechanical studies, but their usefulness for gene expression experiments is potentially limited by the unavoidable, nuclease-mediated degradation of RNA. Here, we tested whether valid gene expression profiles can be obtained using degraded RNA from human anterior cruciate ligaments (ACLs).

Pathological analysis of periprosthetic soft tissue and modes of failure in revision total joint arthroplasty patients.

Objectives: Implant failure leading to revision total joint arthroplasty can occur through a variety of different mechanisms which are typically associated with a soft tissue response adjacent to the implant that provide insight into the underlying etiology of implant failure. The objective of this study was to elucidate mechanisms of implant failure as they relate to histological classification and findings of adjacent periprosthetic tissue.

Methods: Histological analysis of soft tissue adjacent to the implant was performed in 99 patients with an average age of 64 years old and grouped into four categories based on the study conducted by Morawietz et al.

Diagnosis and management of primary malignant tumors in the upper extremity.

Bone and soft tissue sarcomas of the upper extremity are relatively uncommon. In many cases, they are discovered incidentally during evaluation of traumatic injuries or common ailments such as rotator cuff tendonitis or tennis elbow. Thus, it is important for all orthopedic surgeons to understand the differential diagnosis, workup, and treatment for upper extremity lesions.

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty.

With an increasing number of joint replacements and the evolution of orthopaedic implants and hardware, there is increased occurrence and awareness of metal-related sensitivity. This has resulted in the development of devices using a variety of different materials to coat the implant. One popular option is to cover the metallic surface with a ceramic.

Spontaneous 180-Degree Rotatory Dislocation of Rotating-Platform Total Knee Arthroplasty.

Rotating-bearing total knee arthroplasty has been theorized to have some advantages in the kinematics and wear characteristics of total knee arthroplasty. A rare complication of rotating-bearing total knee arthroplasty is rotary dislocation, spinout, of the polyethylene component. When these dislocations occur, they typically result in a 90-degree dislocation in respect to the axial axis of the knee.

Do local antibiotics reduce periprosthetic joint infections? A retrospective review of 744 cases.

Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties.

Osteofibrous Dysplasia-like Adamantinoma of the Tibia in a 15-Year-Old Girl.

Osteofibrous dysplasia and adamantinoma are rare lesions of primary benign and malignant bone tumors with an incidence of less than 1%. These lesions arise primarily in long bones with a predilection for the tibia and fibula. Osteofibrous dysplasia is a benign fibro-osseous lesion typically found in children younger than 10 years.

Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome.

Recently heart failure with preserved ejection fraction (HFpEF) has emerged as a huge epidemic. Increasing evidence shows the role of energy deficiency in the pathophysiology of HFpEF. In the current study, we hypothesize that the use of metabolic modulator perhexiline would correct myocardial energy deficiency and improve exercise capacity and diastolic abnormalities in patients with this syndrome.

Degradation of insecticides used for indoor spraying in malaria control and possible solutions.

Background: The insecticide dichloro-diphenyl-trichloroethane (DDT) is widely used in indoor residual spraying (IRS) for malaria control owing to its longer residual efficacy in the field compared to other World Health Organization (WHO) alternatives. Suitable stabilization to render these alternative insecticides longer lasting could provide a less controversial and more acceptable and effective alternative insecticide formulations than DDT.

Methods: This study sought to investigate the reasons behind the often reported longer lasting behaviour of DDT by exposing all the WHO approved insecticides to high temperature, high humidity and ultra-violet light.

Influence of a platelet concentrate on prosthetic bone ingrowth in a rabbit model.

Recent studies have shown that an increase in bone ingrowth by addition of osteogenic growth factors can reduce micro motion and gross implant motion and contribute to joint implant stability through osseointegration. Platelet-rich plasma (PRP) has the potential to provide growth factors that may be conducive to osteointegration at the bone-implant interface. This study analyzed the influence of PRP on bone ingrowth upon a beaded metal implant in distal femurs of 22 rabbits.

Osteochondral autograft transplantation in the porcine knee.

Background: Knee articular cartilage defects are not an uncommon problem. Because articular cartilage is limited in its ability to heal, these defects are difficult to manage.

Hypothesis: Osteochondral autografts will provide less of a cavitary defect and more viable hyaline articular cartilage than will control knees.

Enhanced efficiency of superoxide dismutase-induced cardioprotection by retrograde intracoronary administration.

Objective: We hypothesized that modification of the infusion route may improve the efficiency of superoxide dismutase (SOD)-induced cardioprotection against reperfusion injury. The routes for SOD delivery previously examined were intravenous, via the left atrium, or by a combination of these, all of which can deliver SOD into the ischemic myocardium only after reperfusion. In contrast, retrograde intracoronary infusion may be able to deliver SOD before reperfusion.

Case reports: malignant transformation of aneurysmal bone cysts.

An aneurysmal bone cyst is an uncommon benign primary bone tumor. Careful intralesional curettage through a wide cortical window in addition to cauterization with or without adjuvant therapy (phenol or hydrogen peroxide) and bone grafting or cementation is the preferred surgical treatment. Adjuvant or primary radiation of an aneurysmal bone cyst rarely is used because of its association with malignant transformation of the lesion.

Knee manipulation after total knee arthroplasty.

To determine if any factors are associated with knee stiffness after total knee arthroplasty (TKA), we retrospectively reviewed the medical records and radiographs of patients who had knee manipulation after total knee replacement at Scott & White Memorial Hospital from 1983 to 1993. Twenty-five patients who had knee manipulation after TKA were matched by surgeon, year of surgery, and age (+/- 5 years) with a study group of 25 patients who did not have knee manipulation after TKA. Patients in the manipulated group had decreased flexion at the time of discharge from the hospital after the knee arthroplasty and a decreased final flexion.

Cementless revision of total hip arthroplasty using proximal porous-coated femoral implants.

Thirty patients had 32 cementless total hip arthroplasty revisions and were evaluated postoperatively for clinical function (Harris Hip Score) and radiographic evidence of implant stability. Of the 26 femoral components revised, 16 were revised with anatomic long-stem femoral prostheses, and 10 were revised with straight mid-stem-length components. All components were collared and had circumferential proximal fiber-mesh porous coating.

The first 500 patients with sacral anterior root stimulator implants: general description.

The first 500 patients to have sacral anterior root stimulators implanted for bladder control are described. Of 479 survivors, 424 were using their stimulators when last followed up between 3 months and 16.1 years (mean 4 years) after implantation.

Implant provision of key, pinch and power grips in a C6 tetraplegic.

An 11-channel multiplexed stimulator of nerves and muscles in the left forearm was implanted for hand control in January 1986 in a 21 year old woman who, after sustaining a C6 spinal lesion 7 years earlier, had voluntary shoulder and elbow movement but paralysed hands, trunk and legs. The patient controls the stimulation via a microcomputer control box and an RF transdermal link. We have investigated the control of her stimulated hand with a joystick under her contralateral hand which she moves from the shoulder and elbow.