Publications by authors named "Nepola J"

» Suture button fixation has emerged as an effective surgical construct in arthroscopic and open Latarjet and anterior glenoid reconstruction with free autograft bone with high rates of bone block healing.» Biomechanical data suggest that screw and suture button mechanical fixation constructs provide similar load to failure and stability for the Latarjet procedure.» Preliminary bone healing models have identified that flexible fixation may exhibit a higher degree of bone callus maturation, whereas rigid fixation results in excessive callus hyperplasia» Mechanical tensioner use provides consistent tensioning of suture button constructs and improves bone-to-bone healing rates when used for anterior glenoid reconstruction surgery.

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Background: Postoperative radiographs may be performed on different timelines after shoulder arthroplasty. Radiographs obtained in the post-operative recovery unit (PACU) are often of poorer quality. The purpose of the current study was to explore and compare the quality of PACU radiographs and radiographs performed in the radiology suite on post-operative Day 1 (POD1), as well as determine their impact on changes in post-operative management.

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Article Synopsis
  • - The study focuses on understanding the biological changes in the shoulder's synovial environment related to joint instability and how these may contribute to degeneration, specifically analyzing proteins found in synovial fluid after shoulder injuries.
  • - The hypothesis suggests that factors like the direction of instability and bone loss severity affect the proteins present in the synovial fluid of shoulder instability patients.
  • - In a laboratory study with 25 participants, 720 proteins were identified in the synovial fluid, with four proteins notably expressed in patients with anterior instability, and validation of findings was performed using Western blotting.
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A biorepository, also referred to as a "biobank," is a collection of biologic samples that are stored for laboratory research. With the emergence of precision medicine, the importance of leveraging individual patient biomolecular signatures to improve diagnosis, prognosis, and treatment is becoming increasingly recognized. Successful development and sustainment of a biorepository provides the potential for transformative preclinical research.

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Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients.

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Article Synopsis
  • Intramedullary nailing is the preferred surgical method for fixing long bone fractures in the lower leg, but it can lead to rare complications like periprosthetic fractures from additional trauma.
  • A 51-year-old man, with a history of knee surgery using a tibiofemoral nail, suffered a work-related injury that resulted in a fractured proximal tibia and a bent nail.
  • The patient experienced significant limb deformity and a length discrepancy, but was successfully treated by straightening the nail during surgery, allowing him to return to work within three months.
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Background: This study compares effectiveness of two commercially available signals, Pulsed Electromagnetic Field (PEMF) and Combined Magnetic Field (CMF) clinical signals, to stimulate bone healing in rabbit tibial osteotomies.

Methods: One millimeter osteotomies in New Zealand White rabbits, stabilized with external fixators, were exposed daily to either signal for 30 minutes, three or six hours. Osteotomized sham controls received no signal exposure.

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Background: Calcium phosphate materials have been employed clinically as bone void fillers for several decades. These materials are most often provided in the form of small, porous granules that can be packed to fill the wide variety of size and shape of bony defects encountered. ReBOSSIS-85 (RB-85) is a synthetic bioresorbable bone void filler for the repair of bone defects with handling characteristics of glass wool-like (or cotton ball-like).

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Recent estimates suggest an annual incidence of greater than 125,000 femoral neck fractures. Surgical treatment is indicated for the majority of these fractures, which are estimated to double by the year 2050. Most displaced femoral neck fractures in elderly patients are treated with arthroplasty secondary to high complication rates associated with internal fixation.

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Chemotherapy derivatives of the rabbit posterolateral fusion model are considered a challenging environment in which to test bone graft materials. The purpose of this study was to determine the performance characteristics of SiCaP-30 as a bone graft substitute relative to autograft (iliac crest bone graft [ICBG]), Actifuse ABX and β-Tricalcium Phosphate-Bioactive Glass-Type I Collagen (βTCP-BG) in a rabbit posterolateral spine fusion model with concurrent chemotherapy treatment This was a randomized, controlled study in a laboratory setting with blinded assessment of fusion by manual palpation and flexibility testing. Sixty rabbits were entered into the study with 45 used for analysis.

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Background: Aspirin is frequently prescribed following orthopaedic surgery. Although there is substantial evidence that some nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with delayed bone healing, there have been few studies of the effects of aspirin on bone healing and, to our knowledge, none on the effects of physiologic dosages.

Methods: Following ulnar osteotomy, fifty-six rabbits were administered a placebo (nine rabbits), indomethacin (nine rabbits given 12.

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Objective: Cigarette smoking inhibits fracture healing and places the patient at a higher risk of delayed union and nonunion. Nicotine has been implicated as the primary ingredient responsible for these effects. However, an analysis of current published investigations reveals conflicting data, with some evidence that nicotine alone does not significantly affect healing.

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Article Synopsis
  • This study aimed to evaluate the effectiveness of Mastergraft(®) Strip combined with bone marrow aspirate (BMA) as a bone graft extender in a rabbit model for spine fusion.
  • The research involved 36 rabbits undergoing lumbar intertransverse fusions, with three different treatment groups being analyzed for bone fusion success.
  • Results showed that the Mastergraft(®) groups had promising fusion rates comparable to traditional autograft methods, indicating potential for improved bone healing without significant adverse effects.
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Dislocation of the shoulder and proximal humerus fracture with coexistent humeral shaft fracture is a rare injury reported in literature. There have been a total of 20 cases reported in the literature since 19401-13 (see Table 1). These injuries often occur as a result of high velocity trauma and most have been treated, at least partially, with invasive or operative management.

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Study Design: Six groups of 10 animals underwent single level, uninstrumented posterolateral lumbar fusions. Graft sites were implanted with autologous bone, autologous bone plus B2A coated granules with concentrations of 0-, 50-, 100-, or 300 microg/mL, or no graft material. Explanted motion segments were analyzed by Faxitron radiographs, computerized tomography (CT), manual palpation, and histology.

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The purpose of this study was to evaluate the mid- to long- term objective, subjective and radiographic results of patients who underwent anterior-superior transfer of remaining infraspinatus tendon and teres minor tendon for irreparable superior rotator cuff tears. Thirteen patients were identified who underwent infraspinatus tendon transfer to a more superior position on the humeral head between January 1, 1990 and December 31, 2001. Nine shoulders in eight patients were available for clinical examination, radiographs and questionnaire follow-up at an average of 83.

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Objectives: To report the complications and pitfalls in the treatment of complex injuries of the proximal tibia when locking plates are used.

Design, Setting, And Patients: This was a retrospective case series conducted at a university Level I trauma center. Thirty-seven patients with complex proximal tibia fractures (41C1, 41C2, 41C3, 41A2, 42A2) were treated with locking plates.

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Objectives: Assess whether postoperative ankle motion after fixation of a fracture of the tibial plafond, treated with articulated external fixation, leads to a better outcome when compared with similar treatment without postoperative ankle motion.

Design: Multicenter randomized trial.

Setting: Three Level I trauma centers.

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We performed a randomized controlled trial in order to assess the effect silver coating of an external fixator pin has on pin infection. The experimental silver coated pins (SC) were compared to control stainless steel (SS) pins. A clamp design monolateral fixator was used, and pins were randomized to clamp position to allow side-by-side comparisons of pins in a similar environment.

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Capsular attenuation has been seen after thermal capsulorrhaphy surgery. The purpose of this study was to evaluate the mechanical, histologic, and morphologic effects on capsular tissue after cumulative applications of radiofrequency energy. Ovine patellofemoral capsular tissue was treated with 1, 2, 4, or 8 applications of bipolar radiofrequency energy and then analyzed.

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To determine what fracture- and patient-specific variables affect outcome, 29 patients with 32 tibial plafond fractures were evaluated at a minimum of 2 years from the time of injury (range, 24-129 months; average, 46.5 months). The rank order method was used to assess severity of injury and accuracy of articular reduction on radiographs and agreement among the five surgeons was excellent with intraclass correlation coefficients of 0.

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Article Synopsis
  • The study evaluated a porous tricalcium phosphate bone filler (Cellplex TCP) as a substitute for traditional autograft in bone grafting through various methods, including lab tests and animal studies.
  • The material demonstrated favorable characteristics such as appropriate composition, porosity, and strength, while effectively supporting mesenchymal stem cells for bone growth.
  • In rabbit models, the TCP showed comparable or superior mechanical strength and complete bone integration, suggesting it could serve as a viable alternative to autograft in clinical applications.
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