MedWorm: Orthopaedics

Bone morphogenetic protein signaling implicated in ra

MedWire News - Bone Health — Thu, 08 Jan 2009 10:51:17 +0100

Bone morphogenetic protein signaling pathways play a role in the pathogenesis of rheumatoid arthritis and are downregulated although not completely inactivated by antirheumatic therapy, results show. (Source: MedWire News - Bone Health)

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Rehabilitation for those with transtibial osteomyoplastic amputation.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

An alternative to the standard amputation method is osteomyoplastic transtibial amputation, commonly called the Ertl procedure, which aims to maximize the regenerative process following amputation through remodeling guided by surgical reconstruction and post-operative rehabilitation. A standard for physical therapy management following osteomyoplastic transtibial amputation needs to be described in order to guide future controlled study. This paper describes the typical clinical presentation and current physical therapy management practiced in patients with osteomyoplastic transtibial amputation, the Ertl procedure.Page: 64DOI: 10.1097/JPO.0b013e318195c140Authors: Dionne, Carol P. PT, PhD, OCS, Cert MDT; Ertl, William J. J. MD; Day, Jonathan D. CPO (Source: JPO Journal of Prosthetics and O...

Cranial remolding helmet treatment of plagiocephaly: comparison of results and treatment length in younger versus older infant populations.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

This study aimed to determine if there is a difference between results of cranial remolding orthosis therapy for children with plagiocephaly who complete at least half of the therapy earlier than 12 months of age (young group) and those who complete at least half of treatment at or after 12 months of age (old group). Results showed similar amounts of asymmetry correction with the old group as with the young; however treatment length was almost doubled, thus highlighting the advantage of starting treatment early.Page: 55DOI: 10.1097/JPO.0b013e318195b7cfAuthors: Grigsby, Katrina BS (Source: JPO Journal of Prosthetics and Orthotics)

Effects of shoe heel height on the roll-over shapes of prosthetic ankle-foot systems: implications for heel-height-adjustable components.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

This study examined the effects of shoe heel height on the roll-over shapes of seven prosthetic ankle foot systems. The systems could not adapt to small changes in shoe heel height without experiencing changes in the orientation, measured as forward shifting, of their roll-over shapes. Alignment changes to properly orient the roll-over shape when wearing shoes of different heel heights requires a manual adjustment. Future designs could attempt to provide systems that can adapt automatically to changes in shoe heel height, perhaps using an invariant roll-over shape as a design constraint.Page: 48DOI: 10.1097/JPO.0b013e318191c902Authors: Hansen, Andrew H. PhD; Childress, Dudley S. PhD (Source: JPO Journal of Prosthetics and Orthotics)

Decreased heart rate in a geriatric client after physical therapy intervention and accommodation with the c-leg.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

Nine months after a transfemoral amputation, a deconditioned 82-year-old man was fit with a C-Leg as a component of the definitive prosthesis. As a result of physical therapy intervention, the C-Leg knee prosthesis and personal goals, this patient retained the ability to care for his dependent wife. This case highlights the importance of incorporating objective, evidence-based measures in the justification for reimbursement of prosthetic componentry. Simple, low-cost, minimally technical and time-intensive measures such as heart rate, THR calculation and walking tests are useful as adjuncts to clinical prosthetic patient management and for tracking patient progress between components, through physical therapy treatment and simply over time.Page: 43DOI: 10.1097/JPO.0b013e318193ee0bAuthors: ...

Perceived stability, function, and satisfaction among transfemoral amputees using microprocessor and nonmicroprocessor controlled prosthetic knees: a multicenter survey.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

Using a non-randomized pre-test/post-test self-reported assessment with a 50-question survey instrument, 368 unilateral transfemoral amputees evaluated perceived comfort, security, maneuverability, cosmetic attributes, adverse effects and safety of the microprocessor-controlled C-Leg and non-microprocessor controlled passive prosthetic knees. Participants characterized the C-Leg microprocessorcontrolled prosthesis as better according to the response percentages with regard to these parameters: socket fit (72.9%), confidence/security (88.1%), gait and maneuverability (88.4%), physical attributes (65.8%), physical effects (61.5%), and negative attributes/limiting factors (85.3%).Page: 32DOI: 10.1097/JPO.0b013e318195b1d1Authors: Berry, Dale CP, FAAOP; Olson, Mark D. PhD; Larntz, Kinley PhD (S...

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Functional stability of transfemoral amputee gait using the 3r80 and total knee 2000 prosthetic knee units.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

This study used gait analysis to objectively evaluate the stability characteristics of two types of prosthetic knee designs, the polycentric Total Knee 2000 (Ossur, Aliso Viejo, CA) and the single axis 3R80 stance control knee (Otto Bock Healthcare, Minneapolis, MN).Page: 18DOI: 10.1097/JPO.0b013e318195b917Authors: Silver-Thorn, M Barbara PhD; Glaister, Christine L. MS (Source: JPO Journal of Prosthetics and Orthotics)

Jpo self-assessment examination.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

Page: 16DOI: 10.1097/JPO.0b013e31819311e1 (Source: JPO Journal of Prosthetics and Orthotics)

The safety of c-leg: biomechanical tests.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 07:27:04 +0100

This study was designed to identify biomechanical differences that would permit objective evaluation of the relative safety in critical situations of three different prosthetic knee joint designs: the 3C1 (Mauch SNS hydraulic system), 3R80 (rotary hydraulic system) and C-Leg (electronically controlled hydraulic system).Page: 2DOI: 10.1097/JPO.0b013e318192e96aAuthors: Blumentritt, Siegmar PhD; Schmalz, Thomas PhD; Jarasch, Rolf CPO (Source: JPO Journal of Prosthetics and Orthotics)

Editor's comments.

JPO Journal of Prosthetics and Orthotics — Thu, 08 Jan 2009 00:55:27 +0100

Page: 1DOI: 10.1097/JPO.0b013e3181969956Authors: Boone, David CP, MPH, PhD (Source: JPO Journal of Prosthetics and Orthotics)

Pre-participation screening of young competitive athletes for prevention of sudden cardiac death

Medscape Orthopaedics Headlines — Wed, 07 Jan 2009 21:31:48 +0100

What have we learned from 25 years of screening young athletes in Italy? Should all athletes undergo a 12-lead ECG prior to competition as part of a prevention strategy for SCD? Journal of the American College of Cardiology (Source: Medscape Orthopaedics Headlines)

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Prosthetic joint infection risk increased in ra patients

MedWire News - Bone Health — Wed, 07 Jan 2009 11:37:04 +0100

Patients with rheumatoid arthritis who undergo total hip or knee replacement are at increased risk for prosthetic joint infection, US researchers report. (Source: MedWire News - Bone Health)

Mr arthrography is more accurate than mr in diagnosing shoulder tears

Bones / Orthopaedics News From Medical News Today — Wed, 07 Jan 2009 09:00:00 +0100

MR arthrography of the shoulder allows physicians to better identify tears and provides patients with an accurate diagnosis to determine whether or not surgery is needed, according to a study performed at Neuroskeletal Imaging in Merritt Island, Florida. The study included 150 patients who underwent both 3T MRI and MR arthrography examinations of the shoulder. (Source: Bones / Orthopaedics News From Medical News Today)

Skate through winter sports injury free

Bones / Orthopaedics News From Medical News Today — Wed, 07 Jan 2009 09:00:00 +0100

For some, wintertime offers an opportunity to stay inside with a blanket and a good book -- but for others, the season brings with it a whole new excitement of sports and outdoor activities for children and adults alike. Hockey, ice skating, sledding, skiing (http://orthoinfo.aaos.org/topic. (Source: Bones / Orthopaedics News From Medical News Today)

Gender differences in trochlear groove orientation and rotational kinematics of human knees

Journal of Orthopaedic Research — Wed, 07 Jan 2009 05:00:00 +0100

Knowledge of the morphology and kinematics of the male and female knees is important for understanding gender-related dimorphism in knee pathology and improvement of related surgical treatments. Twelve male and 12 female subjects with healthy knees were recruited, and each subject performed a single leg lunge while images of the knee were recorded by two fluoroscopes. Tibiofemoral joint motion was then reproduced using bony models matched to the fluoroscopic images. Femoral trochlear groove orientation was also measured in each knee. While many of the measured parameters were found to be similar between the genders, a few interesting differences were also noted. Females showed greater external tibial rotation at 0° flexion (-5.4° vs. -1.3 °, p = 0.03), smaller internal rotation at 30° ...

Comparison of opioid requirements and analgesic response in opioid-tolerant versus opioid-naive patients after total knee arthroplasty

Medscape Orthopaedics Headlines — Tue, 06 Jan 2009 16:43:57 +0100

After total knee arthroplasty, did patients tolerant to opioids require more opioids than did opioid-naive patients? Pharmacotherapy (Source: Medscape Orthopaedics Headlines)

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Minimal invasive epiphysiodesis using a modified “canale”-technique for correction of angular deformities and limb leg length discrepancies

Journal of Children's Orthopaedics — Tue, 06 Jan 2009 16:17:13 +0100

Conclusion Definitive epiphysiodesis using this modified Canale technique is a safe, minimal invasive method to correct leg length discrepancy and angular deformities if preoperative planning is performed properly. Content Type Journal ArticleCategory Original Clinical ArticleDOI 10.1007/s11832-008-0155-4Authors Leonhard E. Ramseier, University of Zurich Department of Orthopaedics Balgrist, Forchstrasse 340 8008 Zurich SwitzerlandAtul Sukthankar, University of Zurich Department of Orthopaedics Balgrist, Forchstrasse 340 8008 Zurich SwitzerlandG. Ulrich Exner, University of Zurich Department of Orthopaedics Balgrist, Forchstrasse 340 8008 Zurich Switzerland Journal Journal of Children's OrthopaedicsOnline ISSN 1863-2548Print ISSN 1863-2521 (Source: Journal of Chi...

Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

European Spine Journal — Tue, 06 Jan 2009 16:16:58 +0100

Abstract Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the...

Interventions to improve inpatient osteoporosis management following first osteoporotic fracture: the prevent project

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:10 +0100

Conclusion The implementation of programs to improve osteoporosis treatment is very useful for ensuring adherence in the management of osteoporosis following admission due to fragility fracture. Content Type Journal ArticleCategory Osteoporotic Fracture ManagementDOI 10.1007/s00402-008-0809-1Authors Pedro Carpintero, University Hospital Reina Sofia Mejorana 45 14012 Cordoba SpainEnrique Gil-Garay, University Hospital La Paz Madrid SpainDaniel Hernández-Vaquero, University Hospital San Agustin Aviles SpainHumbert Ferrer, Hospital Mutua De Tarrasa Tarrasa SpainLuis Munuera, University Hospital La Paz Madrid Spain Journal Archives of Orthopaedic and Trauma SurgeryOnline ISSN 1434-3916Print ISSN 0936-8051 (Source: Archives of Orthopaedic and Trauma Surgery)

Resurfacing versus nonresurfacing the patella in total knee arthroplasty: a critical appraisal of the available evidence

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:10 +0100

Abstract A systematic literature search for evidences comparing treatment effect and harm of resurfacing versus nonresurfacing the patella in total knee arthroplasty was conducted and yielded five meta-analysis (MA), one systematic review (SR) and six randomized controlled trials not included in previous MAs/SR. The evidence suggests that patellar resurfacing would reduce the risk of anterior knee pain, as well as the risk of patella-related reoperation. Furthermore, patients not undergoing patella resurfacing would experience more knee pain during stair climbing and be less satisfied with surgery. No significant difference in range of motion can be expected with or without patellar resurfacing. Importantly, methodological limitations were observed in all retrieved studies...

Long-term results of surgical release of trigger finger and trigger thumb in adults

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:10 +0100

Conclusion We recommend open surgery of trigger finger and trigger thumb. Content Type Journal ArticleCategory Orthopaedic SurgeryDOI 10.1007/s00402-008-0802-8Authors Dorothee Lange-Rieß, Neumarkt Clinic Research Unit Orthopedics and General Surgery 92318 Neumarkt GermanyRalph Schuh, Orthopädische Gemeinschaftspraxis Weiden GermanyWolfgang Hönle, Neumarkt Clinic Department of Orthopedic Surgery 92318 Neumarkt GermanyAlexander Schuh, Neumarkt Clinic Research Unit Orthopedics and General Surgery 92318 Neumarkt Germany Journal Archives of Orthopaedic and Trauma SurgeryOnline ISSN 1434-3916Print ISSN 0936-8051 (Source: Archives of Orthopaedic and Trauma Surgery)

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Cervical and upper thoracic screwing for spinal fusion: strategy for its safe insertion to avoid major complications

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:10 +0100

In this study, we introduce our strategy for safe screwing and its clinical results. Our strategy is as follows: lateral mass screw for C1, 3, 4, 5, 6 and pedicle screw for C2, 7, and thoracic level. When the C2 pedicle is thinner than 3.5 mm, we use C2 laminar screws. We do not use Magerl transarticular screw or facet screw; 146 screws were inserted in 17 patients. There were no major complications such as spinal cord and nerve root injury. We did not observe vertebral arterial injury either. Of the 146 screws, 141 (97.0%) were accurately inserted. As for lateral mass screwing by Roy-Camille’s technique and C2 laminar screwing, all screws were inserted in the appropriate site (100%) without any complications. Five pedicle screws were misplaced. Of the 57 pedicle screws, 5 sho...

Arthroscopically assisted anterior decompression for femoroacetabular impingement: technique and early clinical results

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:09 +0100

Conclusions Treatment of anterior femoroacetabular impingement through an arthroscopically assisted mini-open anterior approach can reduce pain and improve function in a short-term observation period. Femoral osteochondroplasty as well as surgical treatment of acetabular cartilage and labrum lesions are possible, but the access is limited to the anterior and anterolateral part of the hip joint. Content Type Journal ArticleCategory Orthopaedic SurgeryDOI 10.1007/s00402-008-0806-4Authors Albrecht Hartmann, University Hospital Carl Gustav Carus Department of Orthopedic Surgery Fetscherstraße 74 01307 Dresden GermanyKlaus-Peter Günther, University Hospital Carl Gustav Carus Department of Orthopedic Surgery Fetscherstraße 74 01307 Dresden Germany Journal Archive...

Oncogenic osteomalacia: two case reports with surprisingly different outcomes

Archives of Orthopaedic and Trauma Surgery — Tue, 06 Jan 2009 16:16:07 +0100

We present two cases of oncogenic osteomalacia associated with phosphaturic mesenchymal tumors, which were histologically similar, but presented a completely different evolution. In the first patient, the tumor developed on the sole of the foot. Following removal of the mass, the symptoms resolved and biochemical and radiological parameters returned to normal. However, in the second patient, a liver tumor developed and resection did not resolve the disease. Multiple lesions appeared in several locations during follow-up. This disease usually remits with complete tumor resection. Nevertheless, if this is not possible, oral treatment with phosphate, calcium and calcitriol can improve the symptoms. If scintigraphy of the tumor shows octreotide receptors, patients may respond partially t...

Microarray identifies 32 osteoporosis candidate genes

MedWire News - Bone Health — Tue, 06 Jan 2009 11:29:48 +0100

Functional changes in osteogenic, adipogenic, and hematopoietic cell populations appear to be involved in the pathogenesis of osteoporosis, Australian scientists have shown. (Source: MedWire News - Bone Health)

Difusion to mitigate surgical site infections that affect an estimated 780,000 patients in the usa each year

Bones / Orthopaedics News From Medical News Today — Tue, 06 Jan 2009 08:00:00 +0100

DiFUSION Technologies, Inc., a medical device company targeting the orthopaedic market, today announced its corporate launch. The company will focus on reducing the rising incidence of Surgical Site Infections (SSIs) in spinal surgeries. "In large studies, five out of 100 spine cases result in SSIs often leading to second surgeries that are extremely costly and difficult for the patient," said Dr. (Source: Bones / Orthopaedics News From Medical News Today)

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Obesity linked to ovarian cancer

MedicineNet Osteoporosis General — Tue, 06 Jan 2009 07:00:00 +0100

Title: Obesity Linked to Ovarian CancerCategory: Health NewsCreated: 1/6/2009 2:00:00 AMLast Editorial Review: 1/6/2009 (Source: MedicineNet Osteoporosis General)

Juvenile idiopathic scoliosis treated with posterior arthrodesis and segmental pedicle screw instrumentation before the age of 9 years: a 5-year follow-up

Scoliosis — Tue, 06 Jan 2009 05:00:00 +0100

Conclusion: In juvenile idiopathic curves of Risser 0 patients with open triradiate cartilages, routine combined anterior fusion to prevent crankshaft may not be warranted by posterior segmental pedicle screw instrumentation. (Source: Scoliosis)

Women warned: eat less or weigh more

MedicineNet Osteoporosis General — Mon, 05 Jan 2009 07:00:00 +0100

Title: Women Warned: Eat Less or Weigh MoreCategory: Health NewsCreated: 1/5/2009Last Editorial Review: 1/5/2009 (Source: MedicineNet Osteoporosis General)

Prenatal nutrition, postnatal allergy protection

MedicineNet Osteoporosis General — Mon, 05 Jan 2009 07:00:00 +0100

Title: Prenatal Nutrition, Postnatal Allergy ProtectionCategory: Health NewsCreated: 1/5/2009 2:00:00 AMLast Editorial Review: 1/5/2009 (Source: MedicineNet Osteoporosis General)

Physical characteristics of the back are not predictive of low back pain in healthy workers: a prospective study

BMC Musculoskeletal Disorders — Mon, 05 Jan 2009 05:00:00 +0100

Conclusions: This study showed that, in a population of young workers with no or limited antecedents of LBP at baseline, physical examinations, as routinely assessed in occupational medicine, are not useful to predict workers at risk for the development of back disorders one year later. (Source: BMC Musculoskeletal Disorders)

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Wrist working splints reduce pain in ra

MedWire News - Bone Health — Mon, 05 Jan 2009 00:00:00 +0100

Wrist working splints are highly effective in alleviating wrist pain in patients with rheumatoid arthritis, a randomized controlled study has shown. (Source: MedWire News - Bone Health)

Changes in the coordination of hip and pelvis kinematics with mode of locomotion.

Gait and Posture — Sat, 03 Jan 2009 05:00:00 +0100

Authors: Franz JR, Paylo KW, Dicharry J, Riley PO, Kerrigan DC Limited hip extension mobility has been proposed as a possible cause of both increased anterior pelvic tilt and subsequent exaggerated lumbar lordosis during walking and running. The purpose of the present study was to examine the coordinated sagittal plane kinematic patterns of the hip and pelvis during walking and running in a substantial group of adult recreational runners. The kinematics of 73 healthy adult runners (age: 34+/-11years) were examined on an instrumented treadmill at self-selected walking and running speeds using a three-dimensional motion capture system. Although stride length increased considerably from walking to running, the range of hip extension utilized during running was not significantly greater th...

Effects of multiple chondroitinase abc applications on tissue engineered articular cartilage

Journal of Orthopaedic Research — Sat, 03 Jan 2009 05:00:00 +0100

This study tested the hypothesis that multiple applications of chondroitinase ABC (C-ABC), a glycosaminoglycan (GAG) degrading enzyme, could increase construct tensile properties in a scaffold-less approach for articular cartilage tissue engineering. Developing constructs were treated with C-ABC at 2 weeks, 4 weeks, or both 2 and 4 weeks. At 4 and 6 weeks, construct sulfated GAG composition, collagen composition, and compressive and tensile biomechanical properties were assessed, along with immunohistochemistry (IHC) for collagens type I, II, and VI, and the proteoglycan decorin. At 6 weeks, the tensile modulus and ultimate tensile strength of the group treated at both 2 and 4 weeks were significantly increased over controls by 78% and 64%, reaching values of 3.4 and 1.4 MPa, respectively....

Bisphosphonates increase rather than decrease number of osteoclasts

Medscape Orthopaedics Headlines — Fri, 02 Jan 2009 17:20:37 +0100

Findings from a study of bone biopsies from women who took alendronate to prevent postmenopausal osteoporosis indicate that long-term treatment with the bisphosphonate actually increases rather than decreases the number of osteoclasts, as had been theorized. Reuters Health Information (Source: Medscape Orthopaedics Headlines)

Weight bearing exercise in adolescence best for strong bones in older age

Bones / Orthopaedics News From Medical News Today — Fri, 02 Jan 2009 08:00:00 +0100

Weight bearing exercise during adolescence seems to be the best for maintaining bone strength in older life, indicates a small study published ahead of print in the British Journal of Sports Medicine. The research team assessed the impact of exercise between the ages of 12 and 18 on preserving bone strength in later life among 46 women. The women were all aged from 52 to 73, and had already gone through the menopause. (Source: Bones / Orthopaedics News From Medical News Today)

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Osteoporosis drugs work, but how?

MedicineNet Osteoporosis General — Fri, 02 Jan 2009 07:00:00 +0100

Title: Osteoporosis Drugs Work, but How?Category: Health NewsCreated: 1/2/2009Last Editorial Review: 1/2/2009 (Source: MedicineNet Osteoporosis General)

Study links osteoporosis drugs to jaw trouble

MedicineNet Osteoporosis General — Fri, 02 Jan 2009 07:00:00 +0100

Title: Study Links Osteoporosis Drugs to Jaw TroubleCategory: Health NewsCreated: 1/2/2009 2:00:00 AMLast Editorial Review: 1/2/2009 (Source: MedicineNet Osteoporosis General)

Genes predict chances of breast cancer's spread

MedicineNet Osteoporosis General — Fri, 02 Jan 2009 07:00:00 +0100

Title: Genes Predict Chances of Breast Cancer's SpreadCategory: Health NewsCreated: 1/2/2009 2:00:00 AMLast Editorial Review: 1/2/2009 (Source: MedicineNet Osteoporosis General)

Surgical treatment for non-union of the mid-shaft clavicle using a reconstruction plate: scapular malposition is related to poor results.

Injury — Fri, 02 Jan 2009 05:00:00 +0100

Surgical treatment for non-union of the mid-shaft clavicle using a reconstruction plate: Scapular malposition is related to poor results. Injury. 2009 Jan 2; Authors: Huang TL, Lin FH, Hsu HC A retrospective study was performed to evaluate the use of an AO reconstruction plate in open reduction and internal fixation for non-union of the mid-shaft clavicle, examining the relationship between the position of the scapula and final functional results and whether perioperative variables such as clavicular reconstruction ratio and period of non-union influence the position of the scapula. From January 1998 to January 2005, data on 21 people with symptomatic non-union of the mid-shaft clavicle were collected; 17 non-unions were atrophic and 4 were hypertrophic. Initially, treatment wa...

Injuries from leopard attacks in kashmir.

Injury — Fri, 02 Jan 2009 05:00:00 +0100

Injuries from leopard attacks in Kashmir. Injury. 2009 Jan 2; Authors: Nabi DG, Tak SR, Kangoo KA, Halwai MA Increased incidence of wild-animal attacks has made these a serious threat to public health in Kashmir. To establish patterns of injury and management, 35 case histories were reviewed. After resuscitation, of paramount importance were vigorous irrigation, removal of all foreign material, administration of antibiotics, and prophylaxis against rabies and tetanus as indicated. A multidisciplinary approach and aggressive management are necessary to prevent death and provide acceptable cosmetic and functional results. PMID: 19121828 [PubMed - as supplied by publisher] (Source: Injury)

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Gait patterns in subjects with rheumatoid arthritis cannot be explained by reduced speed alone.

Gait and Posture — Fri, 02 Jan 2009 05:00:00 +0100

Authors: Eppeland SG, Myklebust G, Hodt-Billington C, Moe-Nilssen R The aim of this study was to investigate the characteristics of gait in subjects with rheumatoid arthritis (RA) by comparing gait parameters obtained from these subjects and controls. Seventeen subjects with RA in functional class II (mean age 51.1 years, S.D. 6.2 years) and 20 controls (mean age 50.4 years, S.D. 5.3 years) were instructed to walk a straight walkway at five different self-selected speeds. Speed-dependent variables were analysed by an interpolation procedure to estimate scores at a normalized speed of 0.8m/s. At self-selected speed the RA group walked significantly slower, with a shorter step length and longer stance phase. There was no difference in cadence and step width. When controlling for speed, t...

Influence of different artificial disc kinematics on spine biomechanics.

Clinical Biomechanics — Fri, 02 Jan 2009 05:00:00 +0100

Authors: Zander T, Rohlmann A, Bergmann G BACKGROUND: There are several different artificial discs for the lumbar spine in clinical use. Though clinically established, little is known about the biomechanical advantages of different disc kinematics. METHODS: A validated finite element model of the lumbosacral spine was used to compare the results of total disc arthroplasty at level L4/L5 performed by simulating the kinematics of three established artificial disc prostheses (Charité, ProDisc, Activ L). For flexion, extension, lateral bending, and axial torsion, the intervertebral rotations, the locations of the helical axes of rotation, the intradiscal pressures, and the facet joint forces were evaluated at the operated and adjacent levels. FINDINGS: After insertion of an artificial...

Biomechanical comparison of traditional and minimally invasive intradural tumor exposures using finite element analysis.

Clinical Biomechanics — Fri, 02 Jan 2009 05:00:00 +0100

Authors: Ogden AT, Bresnahan L, Smith JS, Natarajan R, Fessler RG BACKGROUND: Minimally invasive approaches to intradural pathology have evolved in part in an effort to reduce approach related destabilization of the spine. No biomechanical data exist however evaluating the effects of traditional and minimally invasive exposures. METHODS: A finite element model of the lumbar spine was generated, and a simulated open laminectomy and a modified hemilaminectomy at L4 were performed. Forces were applied to assess changes in flexion, extension, axial rotation, and lateral bending. FINDINGS: Open laminectomy produced much greater changes in extension, flexion, and axial rotation than the modified hemilaminectomy from the intact. Lateral bending was similarly unaffected for both exposures. INT...

The role of dynamic flexion in spine injury is altered by increasing dynamic load magnitude.

Clinical Biomechanics — Fri, 02 Jan 2009 05:00:00 +0100

Authors: Parkinson RJ, Callaghan JP BACKGROUND: Evidence indicates that loads and postures that an individual is exposed to alter their risk of reporting low back pain or incurring a spine injury. In vitro research indicates cyclic flexion under static compressive loads can lead to disc herniation, while repetitive compression in neutral or flexed postures leads to vertebral failure. However, no research has examined the likelihood of altering injury site (disc vs. bone) when dynamic load exposures are varied concurrently with cyclic flexion. METHODS: Fifty porcine cervical spinal units were assigned to one of five groups based on peak normalized loads of 10%, 30%, 50%, 70% and 90% of the unit's predicted tolerance. Specimens underwent passive range of motion tests to determine individ...

The postural response of the pelvic floor muscles during limb movements: a methodological electromyography study in parous women without lumbopelvic pain.

Clinical Biomechanics — Fri, 02 Jan 2009 05:00:00 +0100

The postural response of the pelvic floor muscles during limb movements: A methodological electromyography study in parous women without lumbopelvic pain. Clin Biomech (Bristol, Avon). 2009 Jan 2; Authors: Sjödahl J, Kvist J, Gutke A, Oberg B BACKGROUND: Pregnancy-related lumbopelvic pain is common. More than 30% of women have persistent pain 3 months after giving birth. There is no consensus regarding the pathology. However, coordination of muscle activity by appropriate timing and amplitude is necessary for maintaining adequate stability in the lumbopelvic area. The aim was to develop a method using surface electromyography to detect a feed-forward response in the pelvic floor muscles during limb movements performed at a comfortable speed applicable in future studies for...

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What's new in sports medicine

JBJS [Am] — Fri, 02 Jan 2009 05:00:00 +0100

(Source: JBJS [Am])

Current hand surgery literature as an educational tool for the orthopaedic in-training examination

JBJS [Am] — Fri, 02 Jan 2009 05:00:00 +0100

(Source: JBJS [Am])

Economic viability of a community-based level-ii orthopaedic trauma system

JBJS [Am] — Fri, 02 Jan 2009 05:00:00 +0100

(Source: JBJS [Am])

Maintenance of certification for orthopaedic surgeons

JBJS [Am] — Fri, 02 Jan 2009 05:00:00 +0100

(Source: JBJS [Am])