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Nișcoveanu C, Refi D, Obada B, Dragosloveanu S, Scheau C, Baz RO. Beyond the Bony Fragment: A Review of Limbus Vertebra. Cureus 2024; 16:e60065. [PMID: 38746486 PMCID: PMC11093693 DOI: 10.7759/cureus.60065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 05/16/2024] Open
Abstract
Vertebral limbus is a condition characterized by the intraspongious herniation of a portion of the nucleus pulposus. It is often asymptomatic, but it can sometimes cause nonspecific symptoms such as local pain and muscle spasm, or, in rare cases, radiculopathies, which is why it can be confused with vertebral fractures, spondyloarthropathies, infectious or tumoral processes. Early recognition of this pathology is preferable for a correct diagnosis and adequate treatment, the latter ranging from conservative approaches (such as personalized exercise programs and physical therapy) to surgical interventions reserved for severe cases with nerve compression.
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Affiliation(s)
- Cosmin Nișcoveanu
- Department of Radiology, Sf. Apostol Andrei County Hospital, Constanta, ROU
- Department of Radiology and Medical Imaging, Faculty of Medicine, Ovidius University, Constanta, ROU
| | - Deria Refi
- Department of Radiology, Sf. Apostol Andrei County Hospital, Constanta, ROU
| | - Bogdan Obada
- Department of Orthopaedics and Traumatology, Sf. Apostol Andrei County Hospital, Constanta, ROU
| | - Serban Dragosloveanu
- Department of Orthopaedics, Foisor Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, Bucharest, ROU
- Department of Orthopaedics and Traumatology, The Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Cristian Scheau
- Department of Radiology and Medical Imaging, Foisor Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, Bucharest, ROU
- Department of Physiology, The Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Radu Octavian Baz
- Department of Radiology, Sf. Apostol Andrei County Hospital, Constanta, ROU
- Department of Radiology and Medical Imaging, Faculty of Medicine, Ovidius University, Constanta, ROU
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Periferakis A, Periferakis AT, Troumpata L, Dragosloveanu S, Timofticiuc IA, Georgatos-Garcia S, Scheau AE, Periferakis K, Caruntu A, Badarau IA, Scheau C, Caruntu C. Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction. Biomimetics (Basel) 2024; 9:154. [PMID: 38534839 DOI: 10.3390/biomimetics9030154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
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Affiliation(s)
- Argyrios Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Aristodemos-Theodoros Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Lamprini Troumpata
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Iosif-Aliodor Timofticiuc
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Spyrangelos Georgatos-Garcia
- Tilburg Institute for Law, Technology, and Society (TILT), Tilburg University, 5037 DE Tilburg, The Netherlands
- Corvers Greece IKE, 15124 Athens, Greece
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Konstantinos Periferakis
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Pan-Hellenic Organization of Educational Programs (P.O.E.P.), 17236 Athens, Greece
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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Hu J, Shao J, Huang G, Zhang J, Pan S. In Vitro and In Vivo Applications of Magnesium-Enriched Biomaterials for Vascularized Osteogenesis in Bone Tissue Engineering: A Review of Literature. J Funct Biomater 2023; 14:326. [PMID: 37367290 DOI: 10.3390/jfb14060326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
Bone is a highly vascularized tissue, and the ability of magnesium (Mg) to promote osteogenesis and angiogenesis has been widely studied. The aim of bone tissue engineering is to repair bone tissue defects and restore its normal function. Various Mg-enriched materials that can promote angiogenesis and osteogenesis have been made. Here, we introduce several types of orthopedic clinical uses of Mg; recent advances in the study of metal materials releasing Mg ions (pure Mg, Mg alloy, coated Mg, Mg-rich composite, ceramic, and hydrogel) are reviewed. Most studies suggest that Mg can enhance vascularized osteogenesis in bone defect areas. Additionally, we summarized some research on the mechanisms related to vascularized osteogenesis. In addition, the experimental strategies for the research of Mg-enriched materials in the future are put forward, in which clarifying the specific mechanism of promoting angiogenesis is the crux.
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Affiliation(s)
- Jie Hu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Jiahui Shao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Gan Huang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Jieyuan Zhang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Shuting Pan
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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Dragosloveanu S, Dragosloveanu C, Petre M, Gherghe ME, Cotor DC. The Impact of Tourniquet Usage on TKA Outcome: A Single-Center Prospective Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050870. [PMID: 37241102 DOI: 10.3390/medicina59050870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/03/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Total knee arthroplasties (TKAs) are the most effective surgical treatment for end-stage knee osteoarthritis. The tourniquet is used to reduce intraoperative blood loss, improving surgical field visualization. There is much controversy regarding the effectiveness and safety of using a tourniquet during total knee arthroplasties. The purpose of this prospective study is to determine the effect of tourniquet usage during TKAs on early functional outcomes and pain in our center. Materials and Methods: We conducted a randomized controlled trial of patients following a primary total knee replacement between October 2020 and August 2021. We recorded presurgical data, which included age, sex and knee range of motion. Intraoperatively, we measured the amount of blood aspiration and the surgical room time. After the surgery, we measured the amount of blood aspirated through the drains and the hemoglobin. We measured flexion, extension, Visual Analogue Scale (VAS) scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC score) scores for the functional evaluation. Results: We included 96 patients in the T group and 94 in the NT group, respectively, who remained until the last follow-up. Regarding blood loss, the NT group demonstrated significantly lower levels: 245 ± 97.8 mL intraoperative and 324.8 ± 151.65 mL postoperative, compared to the T group, where we recorded 276 ± 109.2 mL during the surgical procedures and 353.44 ± 101.55 mL after the surgery, (p < 0.05). We also recorded significantly shorter operative room time for the NT group, (p < 0.05). During the follow-up, we noticed postoperative improvements but without significant differences between the groups. Conclusions: We found a significant decrease in bleeding after no tourniquet usage during total knee replacements and shorter operative times. On the other hand, the knee function demonstrated no significant differences between the groups. Further studies may be required in order to assess complications.
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Affiliation(s)
- Serban Dragosloveanu
- Department of Orthopaedics, "Foisor" Orthopaedics Hospital, 030167 Bucharest, Romania
- "Carol Davila" Faculty of Medicine, University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Christiana Dragosloveanu
- "Carol Davila" Faculty of Medicine, University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 030167 Bucharest, Romania
| | - Mihnea Petre
- Department of Orthopaedics, "Foisor" Orthopaedics Hospital, 030167 Bucharest, Romania
| | - Mihai E Gherghe
- Department of Orthopaedics, "Foisor" Orthopaedics Hospital, 030167 Bucharest, Romania
| | - Dragos C Cotor
- Department of Orthopaedics, "Foisor" Orthopaedics Hospital, 030167 Bucharest, Romania
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Grigorescu O, Dragu A, Bönke F, Schreiber M, Rammelt S. Personalized approach for complex bilateral calcaneal osteomyelitis and defect reconstruction with bilateral abductor digiti minimi flaps. Innov Surg Sci 2022; 7:65-70. [DOI: 10.1515/iss-2022-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
The best treatment for displaced, intra-articular fractures of the calcaneus remains controversial and it is generally agreed, that there is no single method that is suitable for all patients.
Case presentation
Here we report a rare case of bilateral calcaneal osteomyelitis with fistula formation following open reduction and plate fixation via an extensile lateral approach that could be salvaged with an interdisciplinary approach including orthopedic and plastic surgeons. We are not aware of a similar case in the literature. Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site. This treatment protocol resulted in minimal donor-site morbidity and good bone remodeling in the further course. We believe that it may be of use for complicated courses even with limited resources.
Conclusions
Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site.
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Affiliation(s)
- Oana Grigorescu
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden , Dresden , Germany
| | - Adrian Dragu
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden , Dresden , Germany
| | - Florian Bönke
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden , Dresden , Germany
| | - Martin Schreiber
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden , Dresden , Germany
| | - Stefan Rammelt
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden , Dresden , Germany
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Numerical Analysis of the Calcaneal Nail C-NAIL. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The presented article investigates the biomechanics of the calcaneal nail C-NAILTM by numerical calculations and, partially, experimentally. This nail is widely used in trauma and orthopaedics. A numerical model of implants directly interacting with the bone tissue model obtained from CT scans was calculated. The material properties of the bone tissue can be described by several models; in this work, a non-homogeneous material model with isotropic elements and prescribed elastic modulus was used to provide a more accurate model of the applied force distribution on the individual parts of the implants. The critical areas of the nail and its fixtures were investigated using finite element strength calculations to verify their strength and reliability, contributing to the safety and faster and easier treatment of patients. These analyses suggest that the strength of the calcaneal nail C-NAIL, as well as the stabilization of bone fragments resulting from its use, are sufficient for clinical practice.
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