Off-label: The results of adjunctive bone morphogenetic protein for challenging femur fractures; a review of two cases.

Background: Although bone morphogenetic proteins (BMPs) are used as an adjunct to promote healing, they may have unintended effects such as heterotopic ossification (HO). The literature is limited regarding the effect of using off-label BMPs for femur fractures.

Case Presentation: We report two outcomes after off-label use of BMPs for the treatment of femur fractures and propose a possible explanation for the difference.

Procedure coding in the American Joint Replacement Registry.

In October 2015, the Centers for Medicare & Medicaid Services transitioned from the 9th version of the International Classification of Diseases (ICD-9) codes for reporting patient diagnosis and medical procedures to the 10th version (ICD-10). The multitude of coding options for total joint arthroplasty in ICD-10-procedural coding (ICD-10-PCS) poses some challenges for the American Joint Replacement Registry (AJRR) in identifying precise procedures being reported. While AJRR participating hospitals are familiar with ICD-10-PCS, this new coding may not have been introduced to most AJRR participating surgeons.

Effect of rotational prosthetic alignment variation on tibiofemoral contact pressure distribution and joint kinematics in total knee replacement.

In total knee replacement surgery, implant alignment is one of the most important criteria for successful long-term clinical outcome. During total knee replacement implantation, femoral and tibial alignment are determined through appropriate bone resections, which could vary based on patient anatomy, implant design and surgical technique and further influence loading conditions and clinical outcomes. The current research focused on three critical alignment parameters for total knee replacement insertion: femoral component internal/external (I/E) rotation, varus-valgus tibiofemoral angulation and posterior tibial slope.

Help, my rating looks bad! Coding comorbidities in arthroplasty.

In medicine today, there is a trend toward increasing transparency. Higher quality and better value are being sought, and one of the methods being used is publicly reported health care outcomes. However, there is a problem that comes from our loss of anonymity.

A risk assessment example for soil invertebrates using spatially explicit agent-based models.

Current risk assessment methods for measuring the toxicity of plant protection products (PPPs) on soil invertebrates use standardized laboratory conditions to determine acute effects on mortality and sublethal effects on reproduction. If an unacceptable risk is identified at the lower tier, population-level effects are assessed using semifield and field trials at a higher tier because modeling methods for extrapolating available lower-tier information to population effects have not yet been implemented. Field trials are expensive, time consuming, and cannot be applied to variable landscape scenarios.

MicroRNA-27b regulates the expression of matrix metalloproteinase 13 in human osteoarthritis chondrocytes.

Objective: Aberrant posttranscriptional regulation of matrix metalloproteinases (MMPs) by microRNA has emerged as an important factor in human diseases. The aim of this study was to determine whether the expression of MMP-13 in human osteoarthritis (OA) chondrocytes is regulated by microRNA.

Methods: Chondrocytes were stimulated with interleukin-1beta (IL-1beta) in vitro.

Green tea polyphenol epigallocatechin-3-gallate inhibits advanced glycation end product-induced expression of tumor necrosis factor-alpha and matrix metalloproteinase-13 in human chondrocytes.

Introduction: The major risk factor for osteoarthritis (OA) is aging, but the mechanisms underlying this risk are only partly understood. Age-related accumulation of advanced glycation end products (AGEs) can activate chondrocytes and induce the production of proinflammatory cytokines and matrix metalloproteinases (MMPs). In the present study, we examined the effect of epigallocatechin-3-gallate (EGCG) on AGE-modified-BSA (AGE-BSA)-induced activation and production of TNFalpha and MMP-13 in human OA chondrocytes.

Evaluation of intra-annual variation in U.S. Geological Survey National Water Quality Assessment ground water quality data.

Assessment of ground-water quality trends under the U.S. Geological Survey National Water-Quality Assessment Program (NAWQA) included the analysis of samples collected on a quarterly basis for 1 yr between 2001 and 2005.

Exchange femoral nailing: a new technique for removal of a broken nail.

Exchange femoral nailing is the preferred method for treating femoral nonunions. When the index femoral nail is broken, the difficulty of exchange nailing increases dramatically. In this article, we describe a new technique for removing a broken retrograde nail--advancing it out of the proximal end of the femur.

Atrophic femoral nonunion with bone loss: treatment with monorail transport: a case report.

Nonunions are an uncommon outcome of femoral fractures. Atrophic nonunions with a leg length discrepancy secondary to bone loss are often the most difficult to treat, and the treatment options are limited. We present a case that uses concomitant monolateral external fixation and intramedullary nailing to heal a nonunion and perform a simultaneous 7-cm lengthening procedure in a 33-year-old female.