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Objectives: The mechanical behavior of cadaveric femurs after intramedullary reaming using the Reamer-Irrigator-Aspirator (RIA) for autogenous bone graft harvest has not been fully described. We hypothesized that reamed femurs, regardless of starting point, would adequately withstand cyclic loading simulating postoperative single-leg stance.
Methods: Twenty-one cadaveric pairs were randomly assigned to one of three groups based on starting point: Group 1 (trochanteric), Group 2 (piriformis fossa), and Group 3 (retrograde). Each femur underwent dual-energy x-ray absorptiometry scanning and radiographs. Each test femur was reamed to 15 mm using the RIA with the contralateral femur serving as the control. The specimens were loaded to 1400 N of axial compression with 2 degrees simultaneous torsion for 10,000 cycles. If the femur survived cyclic loading, it was then loaded to failure in axial compression. Comparisons regarding survival of cyclic loading were made using Fisher exact test.
Results: No differences were seen between groups regarding age, sex, and T-score. The mean T-score for the femurs was -2.531 +/- 1.372. Overall, 18 of 21 (86%) test femurs and 20 of 21 (95%) control femurs withstood cyclic loading (P = 0.606). Statistical significance was not reached for the three pairwise comparisons between test groups. The femurs failed in patterns consistent with simple pertrochanteric, basicervical, midcervical, or subcapital fractures.
Conclusions: Intramedullary reaming for bone graft harvest using the RIA without subsequent intramedullary stabilization did not significantly degrade the mechanical behavior of cadaveric femurs in simulated single-leg stance regardless of reamer starting point. It appears safe to allow single-leg stance weightbearing on a reamed, unstabilized femur after bone graft harvesting using the RIA.
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http://dx.doi.org/10.1097/BOT.0b013e3181b04383 | DOI Listing |
Acta Med Acad
December 2024
University of Rijeka, Faculty of Medicine, Rijeka, Croatia.
This paper presents a comprehensive and updated overview of inborn errors of immunity (IEIs), focusing on the optimal treatment strategies. IEIs or primary immunodeficiencies (PIDs) are a heterogeneous group of approximately 500 disorders, classified into ten categories according to the affected component of the immune system. The clinical presentation varies, based on the type of the disorder and the patient's age.
View Article and Find Full Text PDFArch Bone Jt Surg
January 2024
Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
Objectives: Volar locking plate (VLP) fixation is a very common procedure due to the high incidence of distal radius fractures (DRFs). Attritional flexor tendon rupture is a rare, but recognized complication after VLP fixation. There is no current consensus to prevent the condition.
View Article and Find Full Text PDFInt J Nanomedicine
December 2024
Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
Musculoskeletal disorders are a series of diseases involving bone, muscle, cartilage, and tendon, mainly caused by chronic strain, degenerative changes, and structural damage due to trauma. The disorders limit the function of patients due to pain and significantly reduce their quality of life. In recent years, adipose-derived mesenchymal stem cells have been extensively applied in regeneration medicine research due to their particular abilities of self-renewal, differentiation, and targeted homing and are more easily accessed compared with other sources.
View Article and Find Full Text PDFShanghai Kou Qiang Yi Xue
October 2024
Hefei Clinical College of Stomatology of Anhui Medical University; Fifth Clinical College of Anhui Medical University; Hefei Stomatology Hospital. Hefei 230000, Anhui Province, China. E-mail:
Purpose: To compare the clinical efficacy of autologous bone block graft and guided bone regeneration (GBR) in horizontal bone augmentation.
Methods: A total of 42 patients were included and divided into two groups. Group A included 20 patients, in whom autologous bone block graft was performed.
Clin Genitourin Cancer
December 2024
Medical Oncology Department, Public Assistance - Hospitals of Marseille, La Timone hospital, Marseille, France.
Background: After failure of first-line chemotherapy, standard of care for advanced urothelial cancer (aUC) is immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 pathway. Several prognostic models (Bajorin and Bellmunt scores) have been evaluated, but only in the context of chemotherapy.
Objective: To study whether the variables in these scores and new emerging clinical and biological criteria have an impact on the probability of objective response in aUC treated with ICIs in 2nd-line setting and beyond.
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