In Vivo Study of Organ and Tissue Stability According to the Types of Bioresorbable Bone Screws.

Biodegradable material, such as magnesium alloy or polylactic acid (PLA), is a promising candidate for orthopedic surgery. The alloying of metals and the addition of rare earths to increase mechanical strength are still questionable in terms of biosafety as absorbent materials. Therefore, the purpose of this study is to understand the effect of substances due to the degradation of various biodegradable substances on organs in the body or surrounding tissues.

Short-Term Outcomes of Arthroscopic Treatment of Freiberg Disease.

Background: Surgical treatment for Freiberg disease (also known as avascular necrosis of the metatarsal head) has not been completely defined. This retrospective study evaluated short-term outcomes after arthroscopic treatment of Freiberg disease.

Methods: From 2015 to 2019, 13 patients (15 feet) diagnosed as having Freiberg disease were enrolled for arthroscopic surgery.

Huge hypertrophic scar secondary to chronic ingrown toe nail mimicking tumor: A case report.

Rationale: A huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease. It is not only causing concerns cosmetically, but also hindering normal daily activities physically and socially. In this paper, we present an unusual case of bilateral ingrown nails with different phases.

Is Subclassification by Number of Fracture Fragments Necessary for Sanders Type IV Calcaneal Fractures?

Background: The Sanders classification is a widely used method for classifying calcaneal fractures. Type IV fractures (>4 fragments) are known to vary in the number of fracture fragments. However, all relevant cases are classified as type IV irrespective of the number of fragments.

Continuous detrimental activity of intra-articular fibrous scar tissue in correlation with posttraumatic ankle osteoarthritis.

Posttraumatic osteoarthritis is primarily characterized by articular cartilage destruction secondary to trauma or fracture events. Even while intra-articular scar tissue can be observed following ankle fractures, little is known about its nature and molecular events linking its biological activity and cartilage deterioration. Here, we investigated scar tissue's histological and molecular characteristics, and its relationship with localized articular cartilage alterations consistent with early osteoarthritic degeneration.

Short-term results of endoscopic calcaneoplasty and retrocalcaneal bursectomy for insertional Achilles tendinopathy.

Although open surgery has traditionally been used as a surgical treatment for insertional Achilles tendinopathy, there is a possibility of serious complications (avulsion, scarring, contracture, sensory changes, and infection) due to the anatomical characteristics of the area. Endoscopic surgery has some advantages due to the smaller incision needed. The purpose of this study was to evaluate the effectiveness of endoscopic surgery in insertional Achilles tendinopathy.

Effect of Bone Morphogenetic Protein-2 Combined With Microfracture for Osteochondral Defect of the Talus in a Rabbit Model.

Background: Osteochondral defects of the talus can be effectively treated using microfracture, which is technically safe, accessible, and affordable. However, fibrous tissue and fibrocartilage comprise the majority of tissue repairs resulting from these procedures. These tissue types lack the mechanical characteristics of native hyaline cartilage and might significantly contribute to the decline in long-term outcomes.

Bone Morphogenetic Protein 2 Promotes Bone Formation in Bone Defects in Which Bone Remodeling Is Suppressed by Long-Term and High-Dose Zoledronic Acid.

The use of long-term and high-dose bisphosphate is associated with severely suppressed bone turnover and the delayed union of fractures. However, therapeutic methods to overcome the negative effects of bisphosphonate use are lacking. Bone morphogenetic proteins (BMPs) are powerful osteoinductive proteins.

Intraosseous Gouty Osteolytic Lesion in Calcaneus.

Tophaceous gout often occurs in soft tissues, and gouty invasion to the bone is rare. To date, only one case of isolated intraosseous gouty invasion to the calcaneus has been reported. We report here a rare case of an intraosseous calcaneal gouty cystic lesion treated with curettage and allogenous and autogenous bone graft.

Mid-term efficacy and safety of Escherichia coli-derived rhBMP-2/hydroxyapatite carrier in lumbar posterolateral fusion: a randomized, multicenter study.

Purpose: This study aimed to evaluate the mid-term efficacy and safety of Escherichia coli-derived bone morphogenetic protein-2 (E.BMP-2)/hydroxyapatite (HA) in lumbar posterolateral fusion (PLF).

Methods: This multicenter, evaluator-blinded, observational study utilized prospectively collected clinical data.

Comparative Osteogenesis and Degradation Behavior of Magnesium Implant in Epiphysis and Diaphysis of the Long Bone in the Rat Model.

Magnesium (Mg), as a biodegradable material, is a promising candidate for orthopedic surgery. Long-bone fractures usually occur in cancellous-bone-rich epiphysis at each end or the cortical-rich diaphysis in the center, with different bone healing processes. Little is known about the differences in results between the two regions when applying Mg implants.

Multifocal Osteonecrosis in the Foot and Ankle After Extracorporeal Membrane Oxygenation: A Case Report.

Osteonecrosis is acknowledged as a relatively uncommon disorder caused by various factors, including autoimmune diseases, drug-induced diseases, inherited metabolic disorders, coagulation disorders, and underlying malignancies. To our knowledge, no previous research has investigated osteonecrosis stemming from extracorporeal membrane oxygenation. Herein, we report a rare case of postperipheral venoarterial extracorporeal membrane oxygenation-induced multifocal osteonecrosis in the foot and ankle that demonstrated a low serpiginous peripheral signal on T1-weighted images and a double-line sign on fat-suppressed or T2-weighted magnetic resonance images.

Use of Lesser Trochanter Profile as a Rotational Alignment Guide in Intramedullary Nailing for Femoral Shaft Fracture.

Background: Malrotation after nailing of femoral shaft fractures occurs in about 25% of cases. It can cause substantial functional problems. The lesser trochanter (LT) profile has been used to assess rotational alignment.

Irreducible Lisfranc injury by tibialis anterior tendon entrapment: A case report.

Rationale: Lisfranc injuries are a dislocation of the metatarsal bones from the tarsal bone. Although closed reduction is possible in most cases of Lisfranc injury when attempted in the early stage, there are some rare cases for which open reduction is required. Herein we report a case of irreducible Lisfranc injury in a 34-year-old man who presented to our institution with painful swelling.

Stabilized Loading of Hyaluronic Acid-Containing Hydrogels into Magnesium-Based Cannulated Screws.

Cannulated screws have a structure for inserting a guide wire inside them to effectively correct complicated fractures. Magnesium, an absorbable metal used to manufacture cannulated screws, may decompose in the body after a certain period of implantation. The hydrogel formed by hyaluronic acid (HA) and polygalacturonic acid (PGA) has been used into Mg-based cannulated screws to prevent bone resorption owing to the rapid corrosion of Mg with unfavorable mechanical properties and a high ambient pH.

Osteogenic Effect of a Biodegradable BMP-2 Hydrogel Injected into a Cannulated Mg Screw.

Cannulated screws, containing an internal hole for inserting a guide pin, are commonly used in the management of bone fractures. Cannulated Mg screws can be biodegraded easily because their increased surface area including that of the inner hole rapidly reacts with body fluids. To delay biodegradation of cannulated Mg screws and improve bone regeneration, we developed a specific type of screw by injecting it with gelatin hydrogels [10 wt % gelatin with 0.

Total Loss of the Intermediate Cuneiform by Posttraumatic Avascular Necrosis: A Case Report.

We report a unique case of the total loss of the intermediate cuneiform by posttraumatic avascular necrosis resulting from a left foot open fracture and dislocation of the navicular bone and medial and intermediate cuneiforms at the Chopart and Lisfranc joints in a 64-year-old woman. The injury was managed with open reduction and internal fixation with Kirschner wires and cannulated screws. During postoperative follow-up, we observed avascular necrosis of the intermediate cuneiform and the total loss of the bone.

Effect of bone morphogenetic protein-2/hydroxyapatite on ankle fusion with bone defect in a rabbit model: a pilot study.

Background: Revision ankle-fusion surgery after a failure of total ankle arthroplasty has a problem with bone-defect management by implant removal. For the reconstruction of bone defects, autogenous bone often causes minor and major complications. Recombinant human-bone morphogenetic protein-2 (rhBMP-2) plays essential roles in bone regeneration strategies, and hydroxyapatite (HA) is beneficial as the rhBMP-2 carrier.

Is it necessary to remove syndesmotic screw before weight-bearing ambulation?

In syndesmosis injury, whether the syndesmosis screw should be removed prior to weight-bearing remains controversial. The aim of this study was to compare the functional outcome between removed screw and retained groups and between recurrence of diastasis and no diastasis groups.Fifty-six patients who had undergone open reduction and internal fixation due to syndesmosis injury were retrospectively evaluated and divided into four groups: (A) removed syndesmotic screw before weight-bearing (postoperative 3 months, n = 28), (B)retained (n = 28), (C) recurrence of diastasis (n = 9), and (D) no diastasis (n = 47).

Multiple calcaneal fibrous dysplasia: A case report.

Rationale: Fibrous dysplasia (FD) is a benign bone tumor due to developmental failure in the process of primitive bone remodeling to mature lamellar bone. The most common locations of monostotic FD of the extremity bones are the proximal femur, tibia, humerus and the radius. FD in the calcaneus is extremely rare and usually manifests clinically as a single bone lesion.

Crystal-Induced Arthritis After Total Ankle Arthroplasty.

The causes of late-onset pain after total ankle replacement (TAR) are various, and include infection, subsidence, polyethylene spacer failure, osteolysis, and wear. There are few reports of late-onset pain caused by gouty attacks after total knee and hip arthroplasty. In addition, no research has reported gouty attacks after total ankle arthroplasty.

Radiographic and histologic effects of bone morphogenetic protein-2/hydroxyapatite within bioabsorbable magnesium screws in a rabbit model.

Background: Hydrogen gas formed by magnesium (Mg) screw corrosion can accumulate around the implant and create bone cysts, long-term osteolysis lesions, and bone healing delay. Thus, several authors currently do not recommend Mg implants for clinical use. In contrast, bone morphogenetic proteins (BMP)-2 have a very strong osteoinductive activity.

Enhancement of bone formation on LBL-coated Mg alloy depending on the different concentration of BMP-2.

To control the bio-absorption rate of Mg alloy and improve its biocompatibility, a BMP-2 of various concentrations (20, 50, and 100 ng/mL) was immobilized in the carrier layer formed by micro-arc oxidation + hydrothermal treatment on the surface of Mg alloy. Their morphological and chemical properties were evaluated by FE-SEM with EDS and XRD. The electrochemical corrosion behavior was examined, and the cytotoxicity was assessed by WST and ALP assay.

Improvement of osteogenesis by a uniform PCL coating on a magnesium screw for biodegradable applications.

A polymer coating as polycaprolactone (PCL) is applied to improve the initial corrosion resistance of biodegradable magnesium. In addition, plasma electrolytic oxidation (PEO) is performed to increase adhesion between the polymer and the metal. However, when a complex-shaped material such as a screw is implanted in a bone, the surface coatings are locally damaged, and the protective role of the coating is not sufficiently maintained.

Arthroscopic Microfracture for Traumatic Arthritis of Lateral Tarsometatarsal Joints .

Conservative treatment is generally successful in treating early tarsometatarsal joint arthritis. However, if such treatment fails, invasive arthrodesis or arthroplasty may be needed. Arthroscopy is a less invasive alternative and can provide a precise diagnosis of early osteoarthritis or cartilage injury.