Long-term maintenance of a fragility fracture initiative.

Introduction: Fragility fractures are common and have an increased chance of refracture and mortality. A process improvement project was initiated including standardized orders to improve treatment of osteoporosis-related fractures. The primary objective was to determine the implementation and maintenance of this process over time.

Feasibility of predicting changes in gait biomechanics following muscle strength perturbations using optimal control in patients with transfemoral amputation.

Bone-anchored limbs (BALs) are socket prosthesis alternatives, directly fixing to residual bone osseointegrated implant. There is a need to quantify multi-level effects of rehabilitation for transfemoral BAL users (i.e.

Effects of static exercises on hip muscle fatigue and knee wobble assessed by surface electromyography and inertial measurement unit data.

Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training.

The Management of Aneurysmal Degeneration of Lower Extremity Cryopreserved Saphenous Vein Bypass Grafts.

Background: The use of cryopreserved saphenous veins (CSVs) for the treatment of lower extremity peripheral arterial disease is an attractive option when there is no available autogenous vein. Prior studies found CSVs are at risk for aneurysmal degeneration requiring reoperation. As the management of these complications and patient outcomes is not well described, the objective of this case series is to describe the open and endovascular management of degenerative CSVs at a tertiary community center.

Do all patients with history of pelvic ring injuries need a cesarean section? - A survey of orthopaedic and obstetric providers.

Objective(s): The recommended mode of delivery following pelvic ring fractures with surgical fixation is unclear. The objective of this study was to assess expert opinions from orthopaedic surgeons and obstetrician gynecologists on their recommended delivery recommendations for pregnant individuals with a history of pelvic ring injury, and to see if there was any difference in recommendations between the two specialties, and what factors influenced recommendations.

Study Design: An electronic, web-based survey was administered to a convenience sample of orthopaedic surgeons and obstetrician gynecologists, via advertisement to members of the Orthopaedic Trauma Association (OTA), the Society for Maternal Fetal Medicine, and querying obstetrician gynecologists practicing within the Military Health System.

Biomechanical comparison of composite and cadaveric humeri models in experiments on operated humeral shaft fractures.

A study was undertaken to determine how well contacting fracture fragments of composite bone replicated the behavior of fracture fragments in real bone. Ten composite and ten real humeral diaphyses were transected and reconstructed with limited-contact dynamic-compression plates. Two screws were placed on each side of the transection site and a calibrated electronic sensor sheet was placed between the imitated fracture fragments.

Feasibility Study of Experimental Protocol for the Time-Dependent Mechanical Response of Synthetic Tibia.

In this research, an experimental biomechanics construct was developed to reveal the mechanics of distal tibial fracture by submitting synthetic tibiae to cyclic loading, resulting in a combined stress state due to axial compression and bending loads. The synthetic tibia was fixed at the knee but allowed to rotate in the coronal and sagittal planes at the ankle. The first three loading regimes lasted for 4000 cycles/each, and the final until ultimate failure.

Are methods to quantify osseous exposure in orthopedic surgery reliable?

Background: Our study examined if there were any limitations when using various measurement techniques in the literature to quantify osseous exposure. Additionally, we also examined if surface contour had any influence on obtained measurements, which no previous study has attempted.

Materials And Methods: Three methods used to quantify osseous exposure area were identified, one in which involves manually applying mesh over exposure area.

Eye of the Carpenter: How Well do Orthopaedic Surgeons Estimate Angular Measurements in Derotational Osteotomies?

Background: Femoral derotational osteotomies are used by orthopaedic surgeons to decrease version in a variety of pathologies. Intraoperatively, the goal of the surgery is to decrease the rotation of the femur to within physiological range. Surgeons generally visually estimate the angle of correction based on bone markers at the rotating cylindrical portion of the femur.

Aponeurosis structure-function properties: Evidence of heterogeneity and implications for muscle function.

Aponeurosis is a sheath-like connective tissue that aids in force transmission from muscle to tendon and can be found throughout the musculoskeletal system. The key role of aponeurosis in muscle-tendon unit mechanics is clouded by a lack of understanding of aponeurosis structure-function properties. This work aimed to determine the heterogeneous material properties of porcine triceps brachii aponeurosis tissue with materials testing and evaluate heterogeneous aponeurosis microstructure with scanning electron microscopy.

Consensus and Equipose in the Management of Military Trainee Femoral Neck Stress Fractures: A Survey of Military Surgeons.

Background: Femoral neck stress fractures (FNSFs) are a unique injury pattern not commonly treated in the civilian trauma population; however, it is particularly high with military trainees engaged in basic combat training. To date, no study has surveyed a population of military orthopedic surgeons on treatment preferences for military service members (SMs) with FNSF.

Questions: We aim to evaluate the extent of clinical equipoise that exists in the management of these injuries, hypothesizing that there would be consensus in the factors dictating surgical and non-surgical intervention for FNSF.

Orphan receptor GPR158 serves as a metabotropic glycine receptor: mGlyR.

Glycine is a major neurotransmitter involved in several fundamental neuronal processes. The identity of the metabotropic receptor mediating slow neuromodulatory effects of glycine is unknown. We identified an orphan G protein-coupled receptor, GPR158, as a metabotropic glycine receptor (mGlyR).

Complications of surgically treated pelvic ring injuries with associated genitourinary injuries.

Objective: Pelvic ring injuries are often associated with vascular and intrapelvic organ injuries including damage to the genitourinary system. The purpose of this study was to examine the relationship between surgically treated pelvic ring injuries and genitourinary injuries. The primary outcome was to determine the rate of post-operative complications including infection, urinary dysfunction, and sexual dysfunction.

How the geometry and mechanics of bighorn sheep horns mitigate the effects of impact and reduce the head injury criterion.

Male bighorn sheep () participate in seasonal ramming bouts that can last for hours, yet they do not appear to suffer significant brain injury. Previous work has shown that the keratin-rich horn and boney horncore may play an important role in mitigating brain injury by reducing brain cavity accelerations through energy dissipating elastic mechanisms. However, the extent to which specific horn shapes (such as the tapered spiral of bighorn sheep) may reduce accelerations post-impact remains unclear.

Short-term vancomycin and buffer soaking does not change rabbit achilles tendon tensile material properties.

Background: Allograft tendons are commonly used during orthopedic surgery to reconstruct tissue that is severely damaged. Soaking the tendon in an antibiotic solution, specifically vancomycin, has been shown to lower the risk of post-operative infections. While some material properties of tendon and ligament after antibiotic soaking have previously been characterized, extensive sub-failure allograft tendon material properties after soaking in antibiotic solutions have not.

Examination of the nutritional intake of patients undergoing opioid replacement therapy: A systematic review.

Aim: This systematic review aimed to determine the level of existing research that investigates the intake, specifically macro and micronutrient intake, of patients undergoing opioid replacement therapy.

Methods: A systematic review was conducted across PubMed, Embase, Cochrane and CINAHL databases using a pre-determined protocol. Studies published between 2001 and 2022 assessing macronutrient or micronutrient intake in opioid replacement therapy patients were included.

A biomechanical comparison of superior ramus plating versus intramedullary screw fixation for unstable lateral compression pelvic ring injuries

Introduction: Management of the anterior component of unstable lateral compression (LC) pelvic ring injuries remains controversial. Common internal fixation options include plating and superior pubic ramus screws. These constructs have been evaluated in anterior-posterior compression (APC) fracture patterns, but no study has compared the two for unstable LC patterns, which is the purpose of this study.

Controlling axonal regeneration with acellular nerve allograft limits neuroma formation in peripheral nerve transection: An experimental study in a swine model.

Background: Symptomatic neuromata are a common indication for revision surgery following amputation. Previously described treatments, including traction neurectomy, nerve transposition, targeted muscle re-innervation, and nerve capping, have provided inconsistent results or are technically challenging. Prior research using acellular nerve allografts (ANA) has shown controlled termination of axonal regrowth in long grafts.

Nanotopography modulates cytoskeletal organization and dynamics during T cell activation.

Exposure to MHC-antigen complexes on the surface of antigen-presenting cells (APCs) activates T cells, inducing the formation of the immune synapse (IS). Antigen detection at the APC surface is thus a critical step in the adaptive immune response. The physical properties of antigen-presenting surfaces encountered by T cells in vivo are believed to modulate T cell activation and proliferation.

Patellofemoral joint load and knee abduction/adduction moment are sensitive to variations in femoral version and individual muscle forces.

Torsional profiles of the lower limbs, such as femoral anteversion, can dictate gait and mobility, joint biomechanics and pain, and functional impairment. It currently remains unclear how the interactions between femoral anteversion, kinematics, and muscle activity patterns contribute to joint biomechanics and thus conditions such as knee pain. This study presents a computational modeling approach to investigating the interactions between femoral anteversion, muscle forces, and knee joint loads.

Société de Biomécanique Young Investigator Award 2021: Numerical investigation of the time-dependent stress-strain mechanical behaviour of skeletal muscle tissue in the context of pressure ulcer prevention.

Background: Pressure-induced tissue strain is one major pathway for Pressure Ulcer development and, especially, Deep Tissue Injury. Biomechanical investigation of the time-dependent stress-strain mechanical behaviour of skeletal muscle tissue is therefore essential. In the literature, a viscoelastic formulation is generally assumed for the experimental characterization of skeletal muscles, with the limitation that the underlying physical mechanisms that give rise to the time dependent stress-strain behaviour are not known.

Effects of Marijuana Use in Patients with Orthopaedic Trauma.

➢: The use of cannabis and cannabis-related products has increased dramatically in the last 2 decades. As states continue to legalize cannabis products, it is important for surgeons to understand the effects they may have on patients who have sustained orthopaedic trauma.

➢: Cannabinoids have been shown to decrease the severity of certain symptoms related to traumatic brain injury as well as posttraumatic stress disorder.

Comparison of Prognostic Scoring Systems to Predict Durable Pain Relief After Microvascular Decompression for Trigeminal Neuralgia.

Background: Microvascular decompression (MVD) is an effective treatment for trigeminal neuralgia, but pain recurs in a substantial minority of patients. Two recently published scoring systems by Hardaway et al. and Panczykowski et al.

The thalamus in trigeminal neuralgia: structural and metabolic abnormalities, and influence on surgical response.

Background: Medically-refractory trigeminal neuralgia (TN) can be treated successfully with operative intervention, but a significant proportion of patients are non-responders despite undergoing technically successful surgery. The thalamus is a key component of the trigeminal sensory pathway involved in transmitting facial pain, but the role of the thalamus in TN, and its influence on durability of pain relief after TN surgery, are relatively understudied. We aimed to test the hypothesis that variations in thalamic structure and metabolism are related to surgical non-response in TN.

Does operative treatment of geriatric pelvic ring injuries lead to a high risk of one-year mortality?

Introduction: Non-operative management of pelvic ring injuries in the elderly is associated with a high risk of one-year mortality. The majority of these injuries are the result of a low-energy mechanism, however, due to the multiple medical comorbidities in this patient population the injuries are associated with a high degree of morbidity. The purpose of this study was to determine the one-year mortality risk after operative treatment of pelvic ring injuries in a geriatric patient population and the effect of patient and injury characteristics on the risk of mortality.