Publications by authors named "Jason Shih Hoellwarth"

Background: Some amputees with transfemoral osseointegration (TFOI) have ipsilateral hip arthritis which can be addressed with total hip arthroplasty (THA). This study reported the medium-term outcomes of THA in association with TFOI (THA + TFOI).

Methods: Retrospective review was performed for eight patients with THA + TFOI performed at least 2 years prior.

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Article Synopsis
  • Patients using traditional socket prostheses after transtibial amputation face frequent repairs, high skin ulceration rates, and limited mobility, leading to the exploration of Trans-Tibial Osseointegration (TTOI) as a potential solution.
  • This study analyzes mobility, quality of life, and safety in the largest cohort of patients (21 adults) who underwent TTOI after socket prosthesis failure, with follow-ups of at least two years.
  • Results showed significant improvements in mobility outcomes, suggesting that TTOI could enhance patient experiences and reduce issues associated with traditional prosthetics.
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Background: Transcutaneous osseointegration for amputees (TOFA) has proven to consistently, significantly improve the quality of life and mobility for the vast majority of amputees, as compared with the use of a socket prosthesis. As with any implant, situations such as infection, aseptic loosening, or implant fracture can occur, which may necessitate hardware removal. Although it may eventually occur, to date no osseointegration implant has ever required removal in the setting of periprosthetic fracture.

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  • The systematic review examined outcomes of two salvage options for failed total knee replacements: transfemoral amputation (TFA) and knee arthrodesis (KA), focusing on factors like ambulatory status, infections, and quality of life.
  • A total of 44 studies were analyzed, revealing that TFA patients had lower ambulatory capacity and higher infection rates compared to KA patients, but similar rates of needing revision surgery.
  • The lack of randomized controlled trials highlights possible selection bias in the data, suggesting that KA patients generally have better outcomes in terms of mobility compared to those undergoing TFA.
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Introduction: Tibial deformities are common, but substantial concern may be associated with corrective osteotomy regarding major complications reported in classic literature. Such studies chiefly focused on high tibial osteotomy, with relatively little investigation of other areas and types of deformity. The primary aim of this study was to identify the rate of compartment syndrome, vascular injury, nerve injury, and other major complications after elective tibial osteotomy.

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Context: Rehabilitation following lower extremity amputation presents multiple challenges, many related to the traditional prosthesis (TP) socket. Without skeletal loading, bone density also rapidly decreases. Transcutaneous osseointegration for amputees (TOFA) surgically implants a metal prosthesis attachment directly into the residual bone, facilitating direct skeletal loading.

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Importance: Transcutaneous osseointegration post amputation (TOPA) creates a direct linkage between residual bone and an external prosthetic limb, providing superior mobility and quality of life compared with a socket prosthesis. The causes and potential risks of mortality after TOPA have not been investigated.

Objective: To investigate the association between TOPA and mortality and assess the potential risk factors.

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Cases: Two patients with periprosthetic femur fracture proximal to a femoral osseointegration had surgical stabilization. These cases produced operative challenges because commonly used intraoperative traction methods cannot be used for patients with transfemoral osseointegration.

Conclusion: We describe a novel technique to apply traction and rotation to the osseointegrated extremity: using the implant's antirotation propeller handle.

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Background: Management of total knee replacement (TKR) infection may sometimes prompt knee fusion (KF) or transfemoral amputation (TFA), both associated with low mobility and quality of life (QOL). Transcutaneous osseointegration for amputees provides superior mobility and QOL vs traditional socket prostheses but has not been studied for patients with a history of infected TKR. This study investigates the following hypothesis: Patients who have had TFA or KF following infected TKR achieve better mobility and QOL following transfemoral osseointegration.

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Article Synopsis
  • Transcutaneous osseointegration for amputees (TOFA) involves a metal endoprosthesis that connects a limb to an exoprosthesis and has evolved since the 1940s.* -
  • Despite significant advancements in TOFA, current literature often overlooks foundational research, which may lead to repeating past mistakes.* -
  • This review aims to compile early research and advancements in TOFA to help clinicians and researchers understand its origins and support future innovations in the field.*
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Unlabelled: The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI).

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There are multiple forms of enchondromatosis with Ollier's and Maffucci's being the most prevalent types. Limb length discrepancy is a common problem in patients with Ollier's and Maffucci's enchondromatosis. There are multiple reports about lengthening bones in patients with enchondromatosis using external fixators.

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Case: A 14-year-old boy with dyskeratosis congenita (DKC), status-post unrelated bone marrow transplant (BMT), sustained a femoral shaft fracture. Despite immediate fixation with the widest possible titanium elastic nails, fixation construct rigidity was insufficient and malunion occurred with refracture 5 years later. Revision fixation with rigid intramedullary nailing has maintained position for 1 year, although callus formation remains meager.

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Case: A 12-year-old male patient sustained a multisegmental both-bone forearm fracture. Definitive stabilization was ulna intramedullary pinning, with stainless steel plating of the radius followed by a titanium plate stacked atop and extending internal fixation. Currently, 36 months after surgery, he experiences no limitations or complications.

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  • * Post-surgery, two patients achieved independent walking, while the third still needs crutches due to nerve complications.
  • * The study suggests that osseointegration is a promising option to enhance recovery and rehabilitation for those with CRPS1 after amputation.
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Article Synopsis
  • Osseointegrated prostheses enhance mobility and satisfaction for amputees compared to traditional socket prostheses.
  • Various implant designs, surgical methods, and rehab protocols exist, each with unique advantages and disadvantages.
  • Although risks like infection and fracture are present, they are not common enough to pose significant problems, and these implants can integrate with high-tech sensory and motor prosthetics.
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Tumor-to-tumor metastasis is an unusual phenomenon wherein one distinct malignancy is present within the substance of another independent tumor. This event is rare, difficult to detect with imaging, and, due to conflicting terminology in the literature, can be challenging to classify. This article reports the first documented case of tumor-to-tumor metastasis involving prostatic adenocarcinoma and myxoid liposarcoma, reviews the available literature for carcinoma metastatic to sarcoma, and discusses the current situation within the context of the established criteria for the classification of combination tumors.

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Background: Toll-like receptor (TLR) ligands have been explored as vaccine adjuvants for tumor and virus immunotherapy, but few TLR ligands affecting schistosoma vaccines have been characterized. Previously, we developed a partially protective DNA vaccine encoding the 26-kDa glutathione S-transferase of Schistosoma japonicum (pVAX1-Sj26GST).

Methodology/principal Findings: In this study, we evaluated a TLR7/8 ligand (R848) and a TLR9 ligand (CpG oligodeoxynucleotides, or CpG) as adjuvants for pVAX1-Sj26GST and assessed their effects on the immune system and protection against S.

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