The Mason-Loop for Single-Row Full-Thickness Rotator Cuff Repair.

Rotator cuff injuries are common and can lead to pain and functional limitation of the shoulder, sometimes requiring surgical procedure. We describe a surgical approach combining the modified Mason-Allen and lasso-loop techniques for the repair of rotator cuff injuries. This hybrid approach brings the 2 advantages of each suture: the compression provided by the loop and the large quantity of tendons caught by the Mason-Allen in a single repair row.

Online Workshops Versus Live Medical Education on Self-Medication Literacy for Middle School Students. What Is the Best Pedagogic Method?

Objective: This study aimed to determine which pedagogic method, online workshops or live medical education, was the better way to teach about self-medication for middle school students.

Methods: The following groups were formed: group O (students receiving online education), group L (students participating in live medical education animated by a medical practitioner and a science teacher) and group C (students without any medical learning). To compare them, the students answered three multiple choice questions before and after the educational intervention.

Finite element analysis part 2 of 2: Glenohumeral bone stress distribution depends on implant configuration for anatomic and reverse stemless shoulder implants.

Purpose: Our purpose was to quantify stresses in the bone surrounding stemless implants in various configurations.

Methods: A detailed finite element model of the glenohumeral joint was used to simulate abduction kinematics before and after arthroplasty and to measure bone stresses around the implants. Two digital patients were simulated: one healthy and one with supraspinatus muscle impairment (deficiency).

Finite element analysis part 1 of 2: Influence of short stem implant polyethylene configuration on glenohumeral joint biomechanics.

Purpose: Stress shielding in short-stem arthroplasty can cause critical metaphyseal bone loss. If the size and shape of the humeral shaft are important factors, it is unknown whether the shape of the polyethylene component in reverse shoulder arthroplasty (RSA) affects bone stress around or within the stem. We explored the impact of polyethylene shape on humeral and scapular stress distribution using a finite element model.

Impact of Medical Education in Middle School, Directed by a Science Teacher and a Healthcare Professional, on Self-Medication and Care System Literacy. A Comparative Prospective Cohort Study.

To assess the immediate and six-month follow-up effects of medical education simultaneously provided by a practitioner and a science teacher on middle school students regarding self-medication and knowledge of the healthcare system. Two groups were constituted: the learning group (L group), with students receiving an interactive medical education, and the control group (C group), which included students without medical education. Both groups were evaluated by using a six-multiple choice question (MCQ) evaluation form: three times for L group - just before the medical workshop (T0), immediately after the medical workshop (T1) and at six-month follow-up after the medical workshop (T2) - and only the evaluation at T0 for students in C group.

Multidirectional instability of the shoulder: a systematic review with a novel classification.

Purpose: A variety of instabilities are grouped under multidirectional instability (MDI) of the shoulder. This makes understanding its diagnostic process, presentation and treatment difficult due to lack of evidence-based consensus. This review aims to propose a novel classification for subtypes of MDI.

Prospective observational analysis of intraoperative radiation exposure with a mini C-arm intensifier in percutaneous forefoot surgery.

Introduction: Percutaneous forefoot surgery has been associated with higher radiation exposure than the conventional approach. However, there is little data on forefoot surgery using a mini C-arm intensifier. We, therefore, conducted a prospective study to (1) evaluate the intraoperative radiation received by the surgeon during percutaneous forefoot surgery with a mini C-arm; (2) compare the radiation received by the surgeon with the guidelines for occupational exposure issued by the International Commission on Radiological Protection (ICRP) (20 millisieverts per year [mSv/year] for the whole body, 500mSv/year for the hands, and 20mSv/year for the lens of the eye); and (3) compare the radiation received during percutaneous forefoot surgery with that of the open approach, which has already been reported in the literature.

Detection of periprosthetic fractures around the femoral stem by resonance frequency analysis: An study.

Periprosthetic femoral bone fractures are frequent complications of Total Hip Arthroplasty (THA) and may occur during the insertion of uncemented Femoral Stems (FS), due to the nature of the press-fit fixation. Such fracture may lead to the surgical failure of the THA and require a revision surgery, which may have dramatic consequences. Therefore, an early detection of intra-operative fractures is important to avoid worsening the fracture and/or to enable a peroperative treatment.

Return to sports: Rate and time after arthroscopic surgery for chronic lateral ankle instability.

Background: Arthroscopic surgery for treating ankle instability is increasingly popular. Several studies showed similar functional outcomes to those seen after open surgery, with no increase in complications. The objective of this study was to evaluate the return-to-sports (RTS) rate and time after arthroscopic surgery to treat chronic lateral ankle instability.

Proximal femur versus acetabular extra-articular resection of the hip joint for primary malignant bone tumors: a retrospective comparative review of 33 cases.

Introduction: Extra-articular resection (EAR) of the hip joint is prone to significant complications and morbidity. Thus, this study evaluates the cumulative incidences and main reasons of reoperation following EAR of primary malignant bone tumors (PMBT) of the hip to determine whether the outcomes are different between EAR of the pelvis and that of the proximal femur.

Patients And Methods: Thirty-three patients presented with a PMBT of the proximal femur or pelvis were included in this study.

Arthroscopic Capsular Plication for Multidirectional Shoulder Instability in Hypermobile Ehlers-Danlos Syndrome Patients.

Patients with hypermobile Ehlers-Danlos syndrome commonly present with painful shoulder disorders mostly represented by a multidirectional instability and with often painless episode of atraumatic shoulder dislocation and/or subluxation. Because of the generalized soft tissue fragility, most of the surgical treatments of shoulder instability, as the Bankart repair or the Latarjet procedure becomes not effective, exposing a risk of failure. Then, capsular plication has to be considered in order to reduce the articular joint volume and to diminish the mobility of the joint.

Modified Mason-Allen Knot for Arthroscopic Complex Bankart Lesion Repair in Recurrent Anterior Shoulder Instability.

The arthroscopic Bankart repair is a safe and reliable procedure for the treatment of recurrent shoulder instability for the well-indicated patient. Many repair techniques have been described to restore both labral height and width and recreate a dynamic concavity-compression effect. The modified Mason-Allen knot was first described for rotator cuff tear repair and consists of a horizontal mattress knot with a simple vertical stitch on the same anchor.

Editorial Commentary: A Functional Capsule, Not the Type of Bone Graft, Determines Outcome After Shoulder Stabilization in Cases of Anterior Glenoid Bone Deficiency.

Many clinical results of surgical treatment of recurrent anterior shoulder instability confirm the importance of anterior bone grafting of the glenoid defect. Some studies even propose to perform a graft, even when there is no bony defect. Short- and middle-term studies report comparable results between bone grafting and Latarjet procedure.

Open Trillat Procedure for Recurrent Anterior Instability of the Shoulder in Elderly Patients.

Among the many different procedures available in the treatment of shoulder instability, the Trillat procedure remains indicated in case of recurrent shoulder instability in elderly patient with an irreparable cuff tear or in case of hyperlaxity. Despite the constantly increasing number of arthroscopic assisted techniques, the open procedure remains a simple, reliable and fast surgical procedure with a shorter learning curve than the arthroscopic techniques. It consists in a partial osteotomy of the anterior cortical of the coracoid process which is then tilted and fixed with a screw into the anterior part of the scapula downwards and medially to obtain a re-centering effect due to the conjoint tendon on the humeral head when rotational movement are applied.

Arthroscopic Rotator Cuff Repair in Supine Position.

Considering shoulder arthroscopy, lateral decubitus and beach chair are the 2 main employed positionings of the patient. Each include advantages and disadvantages. In our center, we perform all shoulder arthroscopy with the patient in supine position.

Early injection of autologous bone marrow concentrates decreases infection risk and improves healing of acute severe open tibial fractures.

Introduction: Open fractures are at risk of nonunion; surgeons are reluctant to propose early standard bone grafting after open fractures, preferring to wait in order to adequately assess the facture status of infection. Bone marrow contains mesenchymal stem cells (MSCs) and granulocyte and macrophage precursors identified in vitro as colony forming units-granulocyte macrophage (CFU-GM), both of which have a prophylactic action against infection. We therefore tested the hypothesis that early injection of bone marrow concentrate would be useful in these fractures.

Total hip arthroplasty for sickle cell osteonecrosis: guidelines for perioperative management.

The prognosis of sickle cell disease (SCD) has greatly improved in recent years, resulting in an increased number of patients reporting musculoskeletal complications such as osteonecrosis of the femoral head. Total hip arthroplasty (THA) can be utilized to alleviate the pain associated with this disease.Although it is well known that hip arthroplasty for avascular necrosis (AVN) in SCD may represent a challenge for the surgeon, complications are frequent, and no guidelines exist to prevent these complications.

[Main concepts and approaches in total hip prosthesis].

MAIN CONCEPTS AND APPROACHES IN TOTAL HIP PROTHESIS. Hip prothesis are composed of an acetabular cup and a femoral stem articulating with each other to reproduce an artificial spherical joint. If the geometry of the cups between the different manufacturers is similar, it differs more importantly between the different types of femoral stems.

Dependence of the primary stability of cementless acetabular cup implants on the biomechanical environment.

Biomechanical phenomena occurring at the bone-implant interface during the press-fit insertion of acetabular cup implants are still poorly understood. This article presents a nonlinear geometrical two-dimensional axisymmetric finite element model aiming at describing the biomechanical behavior of the acetabular cup implant as a function of the bone Young's modulus , the diametric interference fit (), and the friction coefficient . The numerical model was compared with experimental results obtained from an test, which allows to determine a reference configuration with the parameter set:   0.

A Nano-Dose Protocol For Cobb Angle Assessment in Children With Scoliosis: Results of a Phantom-based and Clinically Validated Study.

Study Design: This was a prospective validation study with technical notes.

Objective: This study aimed to validate a new ultra-low-dose full-spine protocol for reproducible Cobb angle measurements-the "nano-dose" protocol.

Summary Of Background Data: Scoliosis is a 3-dimensional (3D) deformity of the spine characterized by 3D clinical parameters.

Unusual indication of Cell therapy for hip osteonecrosis after pregnancy.

Purpose: Osteonecrosis is a rare event during or after pregnancy. Due to the low number of cases, there is no report of long-term results after conservative surgery in this population.

Method: From 1992 to 2010, 145 consecutive female patients with unilateral symptomatic (94 stage I and 51 stage II) left hip osteonecrosis (ON) related to pregnancy were treated between 4 and 16 months after delivery with percutaneous mesenchymal stem cell (MSC) injection obtained from bone marrow concentration.

Stem cell therapy in bilateral osteonecrosis: computer-assisted surgery versus conventional fluoroscopic technique on the contralateral side.

Purpose: Surgical management of osteonecrosis with core decompression with stem cell therapy is a new procedure. The technique is performed with fluoroscopic guidance. This study attempts to determine if computer-navigated technique can improve the procedure.