Is WALANT Really Necessary in Outpatient Surgery?

: The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has revolutionized outpatient hand surgery, enabling procedures such as carpal tunnel release and trigger finger release without a tourniquet. Its benefits include patient cooperation during surgery, especially for tendon repairs. However, WALANT has limitations, including a steep learning curve, longer operative preparation time, and risks such as digital ischemia and adrenaline-induced cardiac ischemia.

Polydeoxynucleotide-Loaded Visible Light Photo-Crosslinked Gelatin Methacrylate Hydrogel: Approach to Accelerating Cartilage Regeneration.

Articular cartilage faces challenges in self-repair due to the lack of blood vessels and limited chondrocyte concentration. Polydeoxyribonucleotide (PDRN) shows promise for promoting chondrocyte growth and cartilage regeneration, but its delivery has been limited to injections. Continuous PDRN delivery is crucial for effective cartilage regeneration.

Treatment Outcomes in Spinal Tumors According to Patients' Perspectives: A Focus on Indeterminate Spinal Instability.

The objective of this study was to analyze treatment approaches and outcomes according to patients' perspectives for patients with indeterminate spinal instability caused by neoplastic lesions. Data were collected from 31 patients with a total of 147 spinal neoplastic lesions, 29 of whom had lesions classified as indeterminate. These lesions were divided into two groups: the low indeterminate group (SINS 7-9) and the high indeterminate group (SINS 10-12).

The Relevance of the Virchow Node and Virchow Triad in Renal Cancer Diagnosis.

The purpose of this article is to overview the clinical significance of left supraclavicular adenopathy and review the etiology of inferior vena cava (IVC) thrombosis, starting from a presentation of a rare case of renal cell carcinoma (RCCs) with Xp11.2 translocation involving TFE3 gene fusion. This article also aims to review the literature to understand the characteristics of this rare type of renal tumor.

Multi-Ligament Reconstruction in an Adolescent Female Affected by Congenital Femoral Deficiency and Complete Anterior and Posterior Cruciate Ligament agenesis: A Case Report.

Multi-ligament reconstruction in adolescent patients affected by congenital femoral deficiency is an extremely rare and delicate surgical procedure. There are very few reported cases of complete anterior and posterior cruciate ligament agenesis in these patients. We present a complex case of a 16-year-old girl affected by congenital femoral deficiency and ipsilateral tibial hypoplasia who was treated successfully for a complete agenesis of the anterior (ACL) and posterior (PCL) cruciate ligament with single-sitting ACL and PCL reconstruction.

Digital Image Analysis of Vertebral Body S1 and Its Ossification Center in the Human Fetus.

Objectives: The aim of the present study was to examine the growth dynamics of the first sacral vertebra and its ossification center in the human fetus, based on their linear, planar, and volumetric parameters.

Methods: The examinations were carried out on 54 human fetuses of both sexes (26 males and 28 females) aged 18-30 weeks of gestation, which had been preserved in 10% neutral formalin solution. Using CT, digital image analysis software, 3D reconstruction, and statistical methods, the size of the first sacral vertebra and its ossification center was evaluated.

Integrating Modern Technologies into Traditional Anterior Cruciate Ligament Tissue Engineering.

The anterior cruciate ligament (ACL) is one of the most injured ligaments, with approximately 100,000 ACL reconstructions taking place annually in the United States. In order to successfully manage ACL rupture, it is of the utmost importance to understand the anatomy, unique physiology, and biomechanics of the ACL, as well as the injury mechanisms and healing capacity. Currently, the "gold standard" for the treatment of ACL ruptures is surgical reconstruction, particularly for young patients or athletes expecting to return to pivoting sports.

Hip Arthroscopy and Its Impact on Performance in National Hockey League Players Using Team-Based Advanced Performance Statistics.

Background: Ice hockey players have a high rate of hip pathology, which can lead to hip arthroscopy. Previous studies have not utilized team-based advanced performance statistics in the setting of hip arthroscopy in National Hockey League (NHL) players.

Purpose/hypothesis: The purpose of this study was to use team-based advanced performance statistics to evaluate postoperative performance after hip arthroscopy in NHL players in comparison with their preoperative performance and matched controls of uninjured skaters.

Single-Session Surgical Intervention with Resection of a Primary Cranial Osteosarcoma and Cranioplasty using a 3D-Printed Craniotomy Template and Cranioplasty Molds.

Although osteosarcomas are the most frequent primary malignant bone tumors, the primary cranial manifestation of this condition is very rare with only a limited number of cases presented in the literature. We present the case of a 20-year-old male patient who underwent single-session surgical intervention for resection of right frontal osteosarcoma with a tailor-made craniotomy and cranioplasty using virtually designed 3D-printed templates and molds. Subsequently, the patient was treated according to the EURAMOS protocol and received adjuvant systemic chemotherapy.

Biosynthesis of Lysosomally Escaped Apoptotic Bodies Inhibits Inflammasome Synthesis in Macrophages.

Hyperglycemia and bacterial colonization in diabetic wounds aberrantly activate Nod-like receptor protein 3 (NLRP3) in macrophages, resulting in extensive inflammatory infiltration and impaired wound healing. Targeted suppression of the NLRP3 inflammasome shows promise in reducing macrophage inflammatory disruptions. However, challenges such as drug off-target effects and degradation via lysosomal capture remain during treatment.

Platelet rich plasma and anterior cruciate ligament repair: A new frontier, or a short term adjunct.

Platelet rich plasma (PRP) is an autologous blood product rich in platelets, showing promise in reducing inflammation and accelerating healing. While extensively utilized in plastic surgery, dermatology, and osteoarthritis treatment, its application in anterior cruciate ligament (ACL) injuries is limited. This article examines PRP's potential in ACL reconstruction (ACLR), exploring its history, current usage, controversies and future directions.

Reduce electrical overload via threaded Chinese acupuncture in nerve electrical therapy.

Bioelectrical stimulation is a powerful technique used to promote tissue regeneration, but it can be hindered by an "electrical overload" phenomenon in the core region of stimulation. We develop a threaded microneedle electrode system that protects against "electrical overload" by delivering medicinal hydrogel microspheres into the core regions. The threaded needle body is coated with polydopamine and chitosan to enhance the adhesion of microspheres, which are loaded into the threaded grooves, allowing for their stereoscopic release in the core regions.

Diagnostic Challenge of Phenotypic Variability in COL2A1-Related Disorders: Four Novel Variants and Expanding the Clinical Spectrum.

Objective: Heterozygous COL2A1 gene mutations are associated with type 2 collagenopathies, characterized by a wide, diverse, and overlapping clinical spectrum in related diseases. Our goal is to describe the clinical, radiological, and molecular findings of patients with COL2A1-related dysplasia and investigate the phenotype-genotype correlation. We also aim to emphasize the challenge of categorizing COL2A1-related diseases with similar clinical and radiological phenotypes.

Healing beyond bone: a qualitative study of the core decompression experience of physically active patients with stage II hip avascular necrosis.

Background: Avascular necrosis (AVN) of the femoral head is a degenerative condition characterized by ischemic bone death, resulting in pain and impaired mobility. Core decompression, a surgical intervention, is widely performed for stage II AVN to alleviate symptoms and delay disease progression. While clinical and radiological outcomes are well-documented, the psychosocial dimensions of recovery remain underexplored.

Biomechanical insights through finite element analysis of Bennett fracture fixation: a comparative study of four surgical techniques.

Background And Objectives: Bennett fractures are intra-articular fractures of the first metacarpal, typically resulting from axial loading. The optimal surgical method for fixation remains a topic of ongoing debate. This study aims to evaluate and compare the biomechanical properties of different fixation techniques.

Design features of the rotating head total hip arthroplasty by Weber-Huggler- a forgotten technical solution to reduce wear.

Total hip arthroplasty (THA) is a very successful operation. Once the problem of implant fixation was solved with the use of bone cement, the next development steps focused on improving the bearing. Weber, a Swiss surgeon, introduced the first modular heads in THA.

"Mechanical Integrity Assessment of Polymethylmethacrylate Bone Cement Incorporating Local Anesthetics: Implications for Joint Arthroplasty".

Background: Effective management of postsurgical pain following arthroplasty remains a challenge, lacking a definitive gold standard. As most knee and hip arthroplasties are cemented or hybrid, we used the property of bone cement as a drug carrier and added powdered local anesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) to the polymethylmethacrylate (PMMA) as analgesics. However, the addition of drugs to bone cement may compromise its mechanical properties, necessitating a thorough analysis.

Automatic path planning for pelvic fracture reduction with multi-degree-of-freedom.

Background And Objectives: Computer-assisted orthopedic surgical techniques and robotics has improved the therapeutic outcome of pelvic fracture reduction surgery. The preoperative reduction path is one of the prerequisites for robotic movement and an essential reference for manual operation. As the largest irregular bone with complicated morphology, the rotational motion of pelvic fracture fragments impacts the reduction process directly.

The Effect of Early Mobilization on Pain and Mobility Levels in Patients Undergoing Total Knee Prosthesis.

Purpose: This study was conducted to determine the effect of early mobilization on pain and mobility levels in individuals undergoing total knee arthroplasty.

Design: Randomized controlled clinical trial.

Methods: This study was carried out in the orthopedic and traumatology department of a public hospital in Turkey.

Etiological Insights and the Role of Individual Factors in Infectious Spondylodiscitis.

Spondylodiscitis can be caused by various microorganisms and has shown a continuous rise in incidence and mortality. The purpose of our study was to analyze the demographic and laboratory data, as well as comorbidities of patients that were surgically treated for spondylodiscitis in our hospital. The causative pathogens involved in the etiology of spinal infections were also assessed.

Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review.

Introduction: Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instability, particularly in cases involving ligament deficiencies such as ACL and PCL insufficiencies.

Evaluation of the relationship between the bone alignment of the lower extremity and the importance of Q angle in male athletes.

Introduction: Evaluating the mechanical-anatomical alignment and angles of the knee joint is crucial for athletes. We aimed to analyse the relationship between lower extremity bone alignment and the importance of the Q angle (QA) in male athletes.

Methods: We included 38 male professional football athletes without any alignment or varus-valgus deformity who actively played football in various football clubs in Istanbul.

Understanding Hip Contact Stress Based on Types of Physical Activity: A Systematic Review.

Background And Aims: High contact stresses involving the hip have been shown to increase the risk of developing hip osteoarthritis (OA). Although several risk factors have been identified for OA, a holistic approach to predicting contributed factors toward increased hip contact stresses have not been explored. This study was conducted to comprehensively understand the effects of physical activity on high hip contact stress as predisposing factors of OA.

Association Between Rotator Cuff Tears and Shoulder MRI Parameters: Importance of Arthroscopic Validation in Coronal Acromiohumeral Interval Measurement.

Background: Magnetic resonance imaging (MRI) measurement parameters-the standard noninvasive diagnostic method for rotator cuff tears (RCTs)-have been used to compare groups with and without RCTs. Arthroscopy is used in definitive diagnosis and treatment.

Purposes: To evaluate the association between RCT and shoulder angles and distances on MRI in patients with and without arthroscopically validated RCT and to determine whether the degree of rotator cuff fatty degeneration affects the MRI measurements.

Quantitative relationships between elastic modulus of rod and biomechanical properties of transforaminal lumbar interbody fusion: a finite element analysis.

Background: Currently, some novel rods with lower elastic modulus have the potential as alternatives to traditional titanium alloy rods in lumbar fusion. However, how the elastic modulus of the rod (rod-E) influences the biomechanical performance of lumbar interbody fusion remains unclear. This study aimed to explore the quantitative relationships between rod-E and the biomechanical performance of transforaminal lumbar interbody fusion (TLIF).