Impact of NaOH based perfusion-decellularization protocol on mechanical resistance of structural bone allografts.

Introduction: To mitigate the post-operative complication rates associated with massive bone allografts, tissue engineering techniques have been employed to decellularize entire bones through perfusion with a sequence of solvents. Mechanical assessment was performed in order to compare conventional massive bone allografts and perfusion/decellularized massive bone allografts.

Material And Methods: Ten porcine femurs were included.

Adequacy of in-mission training to treat tibial shaft fractures in mars analogue testing.

Long bone fractures are a concern in long-duration exploration missions (LDEM) where crew autonomy will exceed the current Low Earth Orbit paradigm. Current crew selection assumptions require extensive complete training and competency testing prior to flight for off-nominal situations. Analogue astronauts (n = 6) can be quickly trained to address a single fracture pattern and then competently perform the repair procedure.

An Easy-To-Use External Fixator for All Hostile Environments, from Space to War Medicine: Is It Meant for Everyone's Hands?

Long bone fractures in hostile environments pose unique challenges due to limited resources, restricted access to healthcare facilities, and absence of surgical expertise. While external fixation has shown promise, the availability of trained surgeons is limited, and the procedure may frighten unexperienced personnel. Therefore, an easy-to-use external fixator (EZExFix) that can be performed by nonsurgeon individuals could provide timely and life-saving treatment in hostile environments; however, its efficacy and accuracy remain to be demonstrated.

Locoregional lung ventilation distribution in girls with adolescent idiopathic scoliosis and healthy adolescents. The immediate effect of Schroth 'derotational breathing' exercise in a controlled-trial.

Background: Scoliosis curves present transverse plane deviations due to vertebral rotation. The Schroth method supports thoracic derotation by training patients to exert "derotational" breathing based on assumed enhanced ventilation in areas called "humps" in scoliosis and a patient's ability to voluntarily direct ventilation in less ventilated areas called "flats."

Objective: To assess the asymmetric ventilation distribution and the ability of patients to direct their ventilation to perform derotational breathing.

Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones.

Background: External fixation improves open fracture management in emerging countries. However, sophisticated models are often expensive and unavailable. We assessed the biomechanical properties of a low-cost external fixation system in comparison with the Hoffmann® 3 system, as a reference.

Lower Limb Kinematics Using Inertial Sensors during Locomotion: Accuracy and Reproducibility of Joint Angle Calculations with Different Sensor-to-Segment Calibrations.

Inertial measurement unit (IMU) records of human movement can be converted into joint angles using a sensor-to-segment calibration, also called functional calibration. This study aims to compare the accuracy and reproducibility of four functional calibration procedures for the 3D tracking of the lower limb joint angles of young healthy individuals in gait. Three methods based on segment rotations and one on segment accelerations were used to compare IMU records with an optical system for their accuracy and reproducibility.

Accuracy of Thyroid Cartilage Fenestration During Montgomery Medialization Thyroplasty.

Introduction: Accuracy of thyroid cartilage fenestration during Montgomery thyroplasty (MTIS) is considered a key success factor. The primary aim of the study was to retrospectively evaluate the accuracy of fenestration. Furthermore, recent publications indicate a possible discrepancy in MTIS voice outcomes related to gender.

Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy.

Objectives: To measure passive musculoarticular ankle stiffness (PMAAS) and its intra- and interday reliability in adult control subjects without ankle disorders. We also sought to quantify PMAAS in children, adolescents and young adults with haemophilia (CAAwH) taking into account the accurate tibiotalar and subtalar joints structural status obtained by magnetic resonance imaging (MRI).

Methods: We included 23 CAAwH and 23 typically developing boys (TDB) matched by age, weight and height, along with 25 healthy volunteers for reliability assessment.

Gait in patients with adolescent idiopathic scoliosis. Effect of surgery at 10 years of follow-up.

Purpose: To assess radiological and gait biomechanical changes before, at one and 10 years after surgery in AIS patients.

Methods: This clinical prospective study included fifteen adult women (mean[SD] age: 26 [1] years) diagnosed with thoraco-lumbar/lumbar AIS and operated 10 years ago. Clinical, radiological and gait variables, including kinematics, electromyography (EMG), mechanics and energetics were compared between presurgery (S0), 1 year (S1) and 10 years (S2) postsurgery period using a one way repeated measure ANOVA.

Pedicle screw insertion accuracy in terms of breach and reposition using a new intraoperative cone beam computed tomography imaging technique and evaluation of the factors associated with these parameters of accuracy: a series of 695 screws.

Purpose: The goals of this study were to assess the accuracy of pedicle screw insertion using an intraoperative cone beam computed tomography (CBCT) system, and to analyze the factors potentially influencing this accuracy.

Methods: Six hundred and ninety-five pedicle screws were inserted in 118 patients between October 2013 and March 2016. Screw insertion was performed using 2D-fluoroscopy or CBCT-based navigation.

Accuracy of a new intraoperative cone beam CT imaging technique (Artis zeego II) compared to postoperative CT scan for assessment of pedicle screws placement and breaches detection.

Purpose: The goal of this study was to compare the accuracy of a novel intraoperative cone beam computed tomography (CBCT) imaging technique with that of conventional computed tomography (CT) scans for assessment of pedicle screw placement and breach detection.

Methods: Three hundred and forty-eight pedicle screws were inserted in 58 patients between October 2013 and March 2016. All patients had an intraoperative CBCT scan and a conventional CT scan to verify the placement of the screws.

Accuracy of Computer-Aided Techniques in Orthopaedic Surgery: How Can It Be Defined, Measured Experimentally, and Analyzed from a Clinical Perspective?

Surgical accuracy is multifactorial. Therefore, it is crucial to consider all influencing factors when investigating the accuracy of a surgical procedure, such as the surgeon's experience, the assistive technologies that may be used by the surgeon, and the patient factors associated with the specific anatomical site. For in vitro preclinical investigations, accuracy should be linked to the concepts of trueness (e.

Radiation exposure to the patients in thoracic and lumbar spine fusion using a new intraoperative cone-beam computed tomography imaging technique: a preliminary study.

Purpose: The goals of this paper are to assess the ionizing radiation exposure to the patients during thoracic and lumbar spinal fusion using a new intraoperative 3D imaging system and to evaluate the factors that could explain the variability in the observed doses.

Method: We retrospectively reviewed 97 patients who underwent posterior instrumented thoracic and/or lumbar spinal fusion from December 2013 to November 2014. Primary data were the total dose area product (total DAP, Gy cm) and total skin dose (total SD, mGy).

Delta method and bootstrap in linear mixed models to estimate a proportion when no event is observed: application to intralesional resection in bone tumor surgery.

Resecting bone tumors requires good cutting accuracy to reduce the occurrence of local recurrence. This issue is considerably reduced with a navigated technology. The estimation of extreme proportions is challenging especially with small or moderate sample sizes.

Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients.

Pelvic bone tumor resection is challenging due to complex geometry, limited visibility, and restricted workspace. Accurate resection including a safe margin is required to decrease the risk of local recurrence. This clinical study reports 11 cases of pelvic bone tumor resected by using patient-specific instruments.

MRI evaluation of resection margins in bone tumour surgery.

In 12 patients operated on for bone sarcoma resection, a postoperative magnetic resonance imaging of the resection specimens was obtained in order to assess the surgical margins. Margins were classified according to MRI in R0, R1, and R2 by three independent observers: a radiologist and two orthopaedic surgeons. Final margin evaluation (R0, R1, and R2) was assessed by a confirmed pathologist.

MRI-Based Assessment of Safe Margins in Tumor Surgery.

Introduction. In surgical oncology, histological analysis of excised tumor specimen is the conventional method to assess the safety of the resection margins. We tested the feasibility of using MRI to assess the resection margins of freshly explanted tumor specimens in rats.

Improved accuracy with 3D planning and patient-specific instruments during simulated pelvic bone tumor surgery.

In orthopaedic surgery, resection of pelvic bone tumors can be inaccurate due to complex geometry, limited visibility and restricted working space of the pelvis. The present study investigated accuracy of patient-specific instrumentation (PSI) for bone-cutting during simulated tumor surgery within the pelvis. A synthetic pelvic bone model was imaged using a CT-scanner.

Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis.

Background: Resection of bone tumors within the pelvis requires good cutting accuracy to achieve satisfactory safe margins. Manually controlled bone cutting can result in serious errors, especially due to the complex three-dimensional geometry, limited visibility, and restricted working space of the pelvic bone. This experimental study investigated cutting accuracy during navigated and non-navigated simulated bone tumor cutting in the pelvis.

Toward the next generation of simulator for intraoperative navigation of scoliotic spine surgeries.

Surgical navigation systems are useful for planning pedicle screw positioning and guiding drilling trajectories. However, it is not yet possible to intraoperatively predict the correction of the scoliotic spine resulting from specific screw and rod configuration and instrumentation maneuvers. In this context, the objective of this study is to develop a novel intraoperative simulator for navigated scoliotic spine surgeries.

Computer-Navigated Bone Cutting in the Resection of a Pelvic Bone Tumor and Reconstruction with a Massive Bone Allograft.

Introduction: We present here a surgical technique using a navigation system and an oscillating saw for the resection of a pelvic bone tumor combined with an allograft reconstruction.

Step 1 Preoperative Planning: The surgeon and radiologist together delineate the tumor on each magnetic resonance imaging (MRI) slice; then the surgeon defines target planes for tumor resection and transfers them to the allograft.

Step 2 Patient Positioning And Surgical Exposure: With the patient in the lateral decubitus position, combine ilioinguinal with iliocrural and obturator surgical approaches to expose the ilium.

Computer-assisted resection and reconstruction of pelvic tumor sarcoma.

Pelvic sarcoma is associated with a relatively poor prognosis, due to the difficulty in obtaining an adequate surgical margin given the complex pelvic anatomy. Magnetic resonance imaging and computerized tomography allow valuable surgical resection planning, but intraoperative localization remains hazardous. Surgical navigation systems could be of great benefit in surgical oncology, especially in difficult tumor location; however, no commercial surgical oncology software is currently available.

Computer-assisted and robot-assisted technologies to improve bone-cutting accuracy when integrated with a freehand process using an oscillating saw.

Background: In orthopaedic surgery, many interventions involve freehand bone cutting with an oscillating saw. Such freehand procedures can produce large cutting errors due to the complex hand-controlled positioning of the surgical tool. This study was performed to investigate the potential improvements in cutting accuracy when computer-assisted and robot-assisted technologies are applied to a freehand bone-cutting process when no jigs are available.