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1.
Cureus ; 16(5): e60201, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38868274

RESUMO

In the evolving field of orthopedic surgery, the integration of three-dimensional printing (3D printing) has emerged as a transformative technology, particularly in addressing the rising incidence of degenerative joint diseases. The integration of 3D printing technology in hip arthroplasty offers substantial advantages throughout the surgical process. In preoperative planning, 3D models enable meticulous assessments, aiding in accurate implant selection and precise surgical strategies. Intraoperatively, the technology contributes to precise prosthesis design, reducing operation duration, X-ray exposures, and blood loss. Beyond surgery, 3D printing revolutionizes medical equipment production, imaging, and implant design, showcasing benefits such as enhanced osseointegration and reduced stress shielding with titanium cups. Challenges include a higher risk of postoperative infection due to the porous surfaces of 3D-printed implants, technical complexities in the printing process, and the need for skilled manpower. Despite these challenges, the evolving nature of 3D printing technologies underscores the importance of relying on existing orthopedic surgical practices while emphasizing the need for standardized guidelines to fully harness its potential in improving patient care.

2.
J Clin Orthop Trauma ; 51: 102417, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38751750

RESUMO

Introduction: Achilles tendon rupture is one of the most common musculoskeletal injuries and accounts to 20 % of all large tendon ruptures The surgical choice of a procedure might play a role in the incidence of postoperative complications. This study aimed to estimate and compare the incidence of complications occurring within a 30-day window following primary surgical repair of the Achilles tendon with or without a graft. Methods: A retrospective cohort study was conducted using the ACS NSQIP database from 2005 to 2021. Patients were divided into 2 cohorts (primary surgical repair with and without graft). Results: A total of 7010 patients were included in the analysis. Among the graft group, 10.9 % reported any complication which was double the percentage of complications in the no graft group. Only 3.8 % of the no graft patients had reported systemic complications compared to 8.3 % in the graft group. Chronic steroid use was found to be an effect modifier in the incidence of any complications after primary surgical repair when comparing graft versus no graft (P-value 0.016). Conclusion: Surgical repairwith tendon graft develops more complications than repairing without graft. Therefore, it is imperative for physicians to strive for an early diagnosis, as any delay in treatment significantly raises the likelihood of complications. Levels of evidence: III, Retrospective Cohort Study.

3.
Orthop Rev (Pavia) ; 16: 94240, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38505136

RESUMO

Menisci are crucial for knee joint functions and meniscal tears are common injuries, especially in sports activities. Platelet-rich plasma (PRP), which enhances healing, has emerged as a promising additive treatment for meniscus injuries, utilizing the regenerative properties of platelets and growth factors for improved clinical outcomes. In studies with a follow-up period of less than one year, the use of platelet-rich plasma (PRP) therapy for meniscus injuries showed significant improvements in knee symptoms and daily activity. Patients experienced enhanced outcomes in terms of pain reduction and increased sports activity, with MRI scans indicating stable meniscus conditions after six months. Studies with a follow-up of more than one year, however, did not find significant differences between groups treated with PRP and groups not treated with PRP in terms of various outcome measures, including pain and knee function. The vascularization of the menisci is vital for their proper function, and insufficient blood supply can affect healing of meniscal injuries. PRP therapy is used to enhance meniscal healing by introducing growth factors and anti-inflammatory agents. PRP therapy may enable athletes with meniscal tears to return to sports more quickly and has less rehabilitation duration. While PRP seems promising as an alternative to failed treatment or as an adjunct to treatment in the short term, its long-term effectiveness remains inconclusive. Patient preferences, commitment to therapy rehabilitation, and cost should all be considered on an individual basis.

4.
Ultrasonics ; 128: 106888, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36402114

RESUMO

BACKGROUND: Ultrasound neurostimulation (USNS) is a non-invasive neuromodulation technique that might hold promise for treating neuropsychiatric disorders with regards to its noninvasiveness, penetration depth, and high resolution. OBJECTIVE: We sought in this experimental study to provide detailed and optimized protocol and methodology for a successful ultrasonic neurostimulation of the Primary Motor Cortex (M1) in mice addressed to young researchers/students beginning their research in the field of ultrasonic neurostimulation and encountering practical challenges. METHODS: A 500 kHz single-element transducer was used for stimulating the primary motor cortex at different acoustic pressures in C57BL/6 mice at various anesthesia levels. To further illustrate the effect of anesthesia, real time visual observations of motor responses validated with video recordings as well as electromyography were employed for evaluating the success and reliability of the stimulations. RESULTS: Detailed experimental procedure for a successful stimulations including targeting and anesthesia is presented. Our study demonstrates that we can achieve high stimulation success rates (91 % to 100 %) at acoustic pressures ranging from 330 kPa to 550 kPa at anesthesia washout period. CONCLUSIONS: This study shows a reliable and detailed methodology for successful USNS in mice addressed to beginners in ultrasonic brain stimulation topic. We showed an effective USNS protocol. We offered a simple and consistent non-invasive technique for locating and targeting brain zones. Moreover, we illustrated the acoustic pressure and stimulation success relationship and focused on the effect of anesthesia level for successful stimulation.


Assuntos
Córtex Motor , Animais , Camundongos , Camundongos Endogâmicos C57BL , Reprodutibilidade dos Testes , Ultrassom , Acústica
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2019: 3738-3741, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946687

RESUMO

Balance quality measurement is a key element in the evaluation of numerous conditions, including frailty. Four parameters were extracted from the balance quality assessment for older subjects: Rising Rate (RR), Duration of the stabilization segment (ZD), Stabilogram Area (SA) and Average Velocity of the Trajectory (TV). These are then scored and weighted, thus creating an overall indicator of balance quality. The reliability, the absolute reliability and the minimum difference of the four parameters were evaluated using the intra-class correlation coefficient (ICC), the standard error measurement (SEM) and the Minimal Detectable Change (MDC), respectively. Reproducibility was very high, with ICC values of 0.83, 0.85, 0.88 and 0.95 for RR, ZD, SA and TV, respectively. These results revealed that the parameters are a reliable measure for evaluating balance quality measurement.


Assuntos
Modalidades de Fisioterapia , Equilíbrio Postural , Humanos , Reprodutibilidade dos Testes
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