Implant survival at four years for hemiarthroplasty and total shoulder arthroplasty in the treatment of atraumatic avascular necrosis of the humeral head.

Aims: Hemiarthroplasty (HA) and total shoulder arthroplasty (TSA) are often the preferred forms of treatment for patients with atraumatic avascular necrosis of the humeral head when conservative treatment fails. Little has been reported about the survival of HA and TSA for this indication. The aim of this study was to investigate the differences in revision rates between HA and TSA in these patients, to determine whether one of these implants has a superior survival and may be a better choice in the treatment of this condition.

National and regional trends in the prevalence of Perthes' disease among the male population in South Korea.

Aims: We evaluated the national and regional trends from 2013 to 2022, in the prevalence of Perthes' disease among adolescent males in South Korea.

Methods: This retrospective, nationwide, population-based study included a total of 3,166,669 Korean adolescent males examined at regional Military Manpower Administration (MMA) offices over ten years. Data from the MMA were retrospectively collected to measure the national and regional prevalence per 100,000 and 95% CI of Perthes' disease according to the year (1 January 2013 to 31 December 2022) and history of pelvic and/or femoral osteotomy in South Korea.

Use of platelet-rich plasma in rheumatic diseases.

Platelet-rich plasma (PRP) has gained increasing recognition as a promising therapeutic agent in managing rheumatic diseases. Conventional treatments, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs), primarily act on reducing inflammation but fail to address the underlying mechanisms of connective tissue degradation. PRP, an autologous preparation enriched with growth factors and bioactive molecules, is pivotal in modulating inflammation and fostering tissue regeneration.

Non-operative treatment in advanced atraumatic osteonecrosis of the humeral head in patients under 50 years old: an observational study.

The humeral head is the second most common anatomical site of osteonecrosis after the femoral head. Studies have reported satisfactory clinical outcomes after shoulder arthroplasty to treat osteonecrosis of the humeral head (ONHH). However, there are concerns regarding implant longevity in relatively young patients.

Radiological Outcomes According to the Matta Score After the Surgical Fixation of Acetabular Fractures.

Background Acetabular fractures, a rising concern in developing countries, pose a significant challenge due to their complexity and association with post-operative complications. Often caused by high-energy mechanisms like falls and motor vehicle accidents, these fractures require accurate reduction to prevent long-term issues and the potential need for hip replacement. This study investigates the radiological outcomes of acetabular fracture surgery at six months, focusing on the effectiveness of achieving anatomical reduction using the Matta criteria in a low-and middle-income country (LMIC) setting.

Aiding Diagnosis and Classifying of Early Stage Osteonecrosis of the Femoral Head with Convolutional Neural Network Based on Magnetic Resonance Imaging.

Introduction: The Steinberg classification system is commonly used by orthopedic surgeons to stage the severity of patients with osteonecrosis of the femoral head (ONFH), and it includes mild, moderate, and severe grading of each stage based on the area of the femoral head affected. However, clinicians mostly grade approximately by visual assessment or not at all. To accurately distinguish the mild, moderate, or severe grade of early stage ONFH, we propose a convolutional neural network (CNN) based on magnetic resonance imaging (MRI) of the hip joint of patients to accurately grade and aid diagnosis of ONFH.

Talus Osteonecrosis after Chemotherapy: A Case Report.

This paper described a case of talus osteonecrosis in a 13-year-old female with a diagnosis of T-type acute lymphocytic leukemia, who underwent chemotherapy and treatment with glucocorticoids, attended at the Orthopedics and Traumatology Sector of our institution. After approximately six months of treatment, the patient began to complain of sporadic pain in her left ankle with progressive worsening. Bone scintigraphy and magnetic resonance imaging of the ankles showed the presence of avascular osteonecrosis of the bilateral talar body.

Metal-backed versus all-poly tibia in the original cartier unicompartmental knee arthroplasty: outcomes and survivorship at long-term follow-up.

Purpose: Unicompartmental knee arthroplasty (UKA) is a viable option for localized osteoarthritis (OA) or avascular osteonecrosis with several advantages over total knee arthroplasty (TKA). UKA implants may feature a tibial component either all-polyethylene (AP) or metal-backed (MB). This study aims to retrospectively compare the clinical outcomes and survivorship of 74 UKAs over 16 years, focusing on comparing the results and survivorship of MB versus AP tibial tray.

Is There an Ideal Concentration of Ozonized Oil for the Prevention and Modulation of Zoledronate-Induced Mandibular Osteonecrosis? A Study on Senescent Rats.

This study aimed to identify whether there is an ideal concentration for applying ozonized oil (OZ) in the post-exodontic alveoli of senescent rats treated with zoledronate (ZOL). Thirty-five female rats, aged 18 months, were divided into five groups: ZOL; ZOL+OZ500; ZOL+OZ600; ZOL+OZ700; and SAL. The groups treated with ZOL, and other concentrations of OZ received applications at a dose of 100 μg/kg, while the SAL group received saline.

Fibula flap reconstruction for maxillary stage 3 medication-related osteonecrosis of the jaw from recipient and donor site perspectives: a preliminary single-center study.

Background: While the surgical treatment of mandibular stage 3 medication-related osteonecrosis of the jaw (MRONJ) is well-documented, research on maxillary stage 3 MRONJ is limited. Antiresorptive medications can induce MRONJ and atypical femoral fracture (AFF), but their impact on the feasibility of using fibula flaps for reconstruction remains controversial. This study aimed to assess the surgical outcomes and functional recovery of fibula flap reconstruction for maxillary stage 3 MRONJ, considering both recipient and donor site outcomes.

Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head.

Purpose: The Japanese Investigation Committee (JIC) classification for osteonecrosis of the femoral head (ONFH) is based on the necrotic area relative to the weight-bearing surface on anteroposterior (AP) radiographs or central coronal MRI. Discrepancies exist between these methods, potentially related to the AP necrosis area. This study evaluated these discrepancies and the extent of AP necrotic lesions.

3D-printed zinc oxide nanoparticles modified barium titanate/hydroxyapatite ultrasound-responsive piezoelectric ceramic composite scaffold for treating infected bone defects.

Clinically, infectious bone defects represent a significant threat, leading to osteonecrosis, severely compromising patient prognosis, and prolonging hospital stays. Thus, there is an urgent need to develop a bone graft substitute that combines broad-spectrum antibacterial efficacy and bone-inductive properties, providing an effective treatment option for infectious bone defects. In this study, the precision of digital light processing (DLP) 3D printing technology was utilized to construct a scaffold, incorporating zinc oxide nanoparticles (ZnO-NPs) modified barium titanate (BT) with hydroxyapatite (HA), resulting in a piezoelectric ceramic scaffold designed for the repair of infected bone defects.

Outcomes for Younger Patients with Femoral Neck Fractures.

Background: There is a paucity of longer-term outcome data in younger adult patients who undergo fixation for an intracapsular hip fracture. The aims of this study were to evaluate the outcomes for young adult patients undergoing intracapsular hip fracture fixation and to assess factors associated with failure and patient-reported outcome measures (PROMs).

Methods: From 2008 to 2018, 112 consecutive patients ≤60 years of age (mean age, 48 years [range, 20 to 60 years]; 54% male) were retrospectively identified as having undergone fixation of an intracapsular hip fracture.

18F-FDG PET/CT Revealed Bone Infarction as the Cause of Unexplained Fever.

An 18F-FDG PET/CT was conducted on a 44-year-old man with a history of dermatomyositis and avascular necrosis of left femoral head, due to a fever of unknown origin. The scan revealed patchy and cloudy high densities within the medullary cavities of bilateral distal femur and proximal tibia, exhibiting peripheral high 18F-FDG avidity. Subsequent MRI confirmed bone infarction.

In silico biophysics and rheology of blood and red blood cells in Gaucher Disease.

Gaucher Disease (GD) is a rare genetic disorder characterized by a deficiency in the enzyme glucocerebrosidase, leading to the accumulation of glucosylceramide in various cells, including red blood cells (RBCs). This accumulation results in altered biomechanical properties and rheological behavior of RBCs, which may play an important role in blood rheology and the development of bone infarcts, avascular necrosis (AVN) and other bone diseases associated with GD. In this study, dissipative particle dynamics (DPD) simulations are employed to investigate the biomechanics and rheology of blood and RBCs in GD under various flow conditions.

Biological Augmentation With Retro-Drilling Core Decompression in Early Stage of Femoral Head Avascular Necrosis.

Osteonecrosis of the femoral head can lead to end-stage osteoarthritis when left untreated. The incidence has been on the rise since the onset of the COVID-19 pandemic. Core decompression of the femoral head is usually the first line of surgical treatment when conservative options fail.

Retrospective Analysis of the Clinical and Radiological Outcomes Following Modified Dunn Osteotomy in Patients with Stable, Moderate-to-severe Chronic Slipped Capital Femoral Epiphysis.

 The management of slipped capital femoral epiphysis (SCFE) has been completely transformed by modified Dunn osteotomy, a subcapital realignment osteotomy achieved through a safe surgical dislocation technique originally described by Ganz. The purpose of this study was to evaluate the clinical and radiological outcomes of patients with moderate to severe SCFE after modified Dunn osteotomy.  A total of 15 patients (16 hips, with one bilateral case; 12 males, 3 females) aged from 10.

Transcriptomic integration and ligand-receptor crosstalk reveal the underlying molecular mechanisms between hip cartilage and subchondral bone in osteonecrosis of femoral head.

Osteonecrosis of femoral head (ONFH) is characterized not only by ischemic bone tissue necrosis but also by cartilage degeneration, which plays an essential role in the pathogenesis of ONFH. The molecular communication between tissues contributes to disease progression, however the communication between cartilage and subchondral bone in the progression of ONFH remains unclear. In this study, we integrated transcriptomic data from ONFH cartilage and subchondral bone, exploring common differentially expressed genes (DEGs), pathway and function enrichment analyses, the protein-protein interaction (PPI) network, and hub genes to comprehensively study molecular integration.

Techniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.

Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur.

The VIDIA BONE score as a patient- and fracture-related risk score for the occurrence of fracture sequelae in proximal humerus fractures.

Purpose: The aim of the study was to determine preoperative patient- and fracture-related risk factors for estimating the risk of fracture sequelae after surgically treated proximal humerus fractures (PHF) using locking plate osteosynthesis. The purpose was to develop a fracture sequelae risk score as an additional tool to facilitate the treatment strategy for PHF.

Methods: All patients with PHF who underwent surgery with locking plate osteosynthesis were included.

Non-healing extraction socket: a diagnostic challenge for general dental practitioners.

Introduction In the UK, more than 18 million extractions are performed annually. Healing after extraction is often uneventful, but there are rare cases where weeks or months pass and an extraction socket does not heal.Aim The aim of this study is to provide a review of cases in which a non-healing extraction socket is attributed to a serious systemic disease or malignancy, or an adverse consequence of systemic therapy.

Subtrochanteric shortening osteotomy in adult sickle cell disease patients with cemented total hip arthroplasty for hip deformities secondary to childhood osteonecrosis: is healing a challenge?

Purpose: Hip deformity is frequent after childhood osteonecrosis in patients with sickle cell disease (SCD). When they are adults, they present a challenge as candidates for total hip arthroplasty (THA) because of abnormal bone development, their relative youth, and also because of their disease. Performing subtrochanteric osteotomy associated with THA is technically challenging, and healing of osteotomies has never been reported in this population with frequent osteonecrotic bone, whether using cemented or uncemented arthroplasties.

Ipsilateral femoral head and intertrochanteric fractures with posterior subluxation of the hip: A rare case report.

Introduction: Hip fractures are common in elderly patients, often accompanied by comorbidities. These fractures can be combined with other injuries, such as a femoral head, neck, or shaft dislocation. The cause of this complex injury is not well-established, but factors like high-energy trauma or falls from a certain height may contribute.

Tocilizumab for Cystoid Macular Edema Secondary to Immune Recovery Uveitis in a Patient with Contraindications to Long-Term Systemic Corticosteroid.

: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. : The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. : A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis.

Scaphoid Fractures and Nonunion: A Survey-based Review of Hand Surgeon's Practice and the Evidence.

Purpose: The Evidence-Based Practice Committee of the American Society for Surgery of the Hand set out to assess the membership's practice patterns (PPs) and familiarity with evidence-based principles for scaphoid fracture and nonunion management.

Methods: Using a consensus-generated 25-item online survey, all the American Society for Surgery of the Hand members were invited to participate via email in September 2023. Two question types were used including evidence-based practice (EBP) and PPs.