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Elçi S, Özkul E, Alemdar C, Atiç R, Akar MS. How successful is synthetic graft treatment for children with pathological hip fractures? Hip Int 2024; 34:390-395. [PMID: 38146063 DOI: 10.1177/11207000231212423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
PURPOSE To determine whether synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children. METHODS Paediatric patients treated for pathological fractures of the proximal femur between 2013 and 2020 were evaluated retrospectively. 17 patients with a mean age of 10.7 years (range 6-16 years) were assessed. The definitive histopathological diagnoses were SBC (simple bone cyst) (12) and ABC (aneurysmal bone cyst) (5). The median duration of follow-up was 37 months (range 12-70 months). RESULTS All patients returned to their normal daily routine within 3-8 months following surgery. The mean post-op recovery time was 3.2 months (range 3-6 months). Graft was incorporated at approximately 12 months. No significant radiographic healing was observed in 2 patients. In the remaining 15 patients, the mean duration of healing was 14 months (range 8-24 months). CONCLUSION Synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children.
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Affiliation(s)
- Serhat Elçi
- Department of Orthopaedics and Traumatology, Sultan Private Hospital, Diyarbakır, Turkey
| | - Emin Özkul
- Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Celil Alemdar
- Department of Orthopaedics and Traumatology, Medipol University Medical Faculty, Istanbul, Turkey
| | - Ramazan Atiç
- Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Mehmet Sait Akar
- Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, Turkey
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Suzuki K, Takahashi Y, Shiozawa T, Matsuo K, Shimizu H, Tanaka K. Full-Circumference Prosthetic Grafts for Replacing a Retrohepatic Inferior Vena Cava Segment During Hepatectomy for Tumor. Am Surg 2024; 90:607-615. [PMID: 37768646 DOI: 10.1177/00031348231204910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Although hepatectomy including inferior vena cava (IVC) resection is becoming more common, some details remain uncertain such as use of artificial materials to replace a tumor-involved, damaged, or narrowed retrohepatic IVC segment. METHODS Surgical outcomes of 12 patients who underwent hepatectomy with IVC resection including reconstruction using synthetic tubular grafts were investigated to clarify safety and feasibility. RESULTS Operative time (median, 573 min; range, 268 to 774) and the blood loss (1076 mL; 155 to 2960) were acceptable. In-hospital mortality was 8% (1/12), and morbidity was 42% (5/12). Among the 12 patients, 2 were planned to undergo IVC reconstruction without an artificial graft. In one patient, prosthetic repair was adopted because of massive bleeding from the IVC wall during dissection of tumor from the IVC. In the other, severe stricture became evident during attempted direct closure of the partially resected IVC wall. DISCUSSION Ongoing experience has increased our acceptance of combined liver and IVC resection. We believe that segmental IVC resection and reconstruction with a prosthetic tubular graft could be chosen more frequently in managing liver tumors suspected to involve the IVC.
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Affiliation(s)
- Kaori Suzuki
- General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yuki Takahashi
- General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Toshimitsu Shiozawa
- General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kenichi Matsuo
- General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Hiroaki Shimizu
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Kuniya Tanaka
- General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan
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Matić P, Atanasijević I, Stojković VM, Soldatović I, Tanasković S, Babić S, Gajin P, Lozuk B, Vučurević G, Đoković A, Živić R, Đulejić V, Nešković M, Babić A, Ilijevski N. Impact of haemoglobin A1c on wound infection in patients with diabetes with implanted synthetic graft. J Wound Care 2024; 33:136-142. [PMID: 38329828 DOI: 10.12968/jowc.2024.33.2.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The aim of this study was to assess the relationship between haemoglobin A1c (HbA1c) values and operative wound infection. METHOD During the period from 2013-2016, consecutive patients with type 2 diabetes were prospectively evaluated. Data were retrospectively analysed. All included patients were admitted for an elective surgical procedure, requiring the use of prosthetic graft in a groin wound. The patients were divided into two groups according to their preoperative HbA1c values. The main outcome was groin wound infection. The association between preoperative long-term glycoregulation and wound infection was evaluated, as well as the impact of postoperative glycaemic values, regardless of the level of HbA1c. RESULTS Of the 93 participating patients, wound infection occurred in 20 (21.5%). Wound infection occurred in 28.2% of patients with uncontrolled diabetes (HbA1c >7%) and 16.7% of patients with controlled diabetes (HbA1c <7%); however, the difference did not reach statistical significance (p=0.181). In regression modelling, operative time (p=0.042) was a significant predictor of wound infection, while patients' age (p=0.056) was on the borderline of statistical significance. Females had a higher probability for wound infection (odds ratio (OR): 1.739; 95% confidence interval (CI):0.483-6.265), but there was no statistical significance (p=0.397). Patients with elevated levels of HbA1c had a higher chance of wound infection compared with patients with controlled diabetes (OR: 2.243; 95% CI: 0.749-6.716), nevertheless, this was not statistically significant (p=0.149). CONCLUSION We found no statistically significant correlation between elevated values of preoperative HbA1c and postoperative groin wound infection.
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Affiliation(s)
- Predrag Matić
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor Atanasijević
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Vera Maravić Stojković
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Ivan Soldatović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Slobodan Tanasković
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Srđan Babić
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Predrag Gajin
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branko Lozuk
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Goran Vučurević
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Aleksandra Đoković
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Hospital Center "Bežanijska Kosa", Belgrade, Serbia
| | - Rastko Živić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Hospital Center "Dr Dragiša Mišović", Belgrade, Serbia
| | - Vuk Đulejić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mihailo Nešković
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Aleksandar Babić
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
| | - Nenad Ilijevski
- Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Tanos P, Neo C, Tong E, Volpin A. The Use of Synthetic Graft for MPFL Reconstruction Surgery: A Systematic Review of the Clinical Outcomes. Med Sci (Basel) 2023; 11:75. [PMID: 38132916 PMCID: PMC10744733 DOI: 10.3390/medsci11040075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/04/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
(1) Background: Acute patella dislocation (APD) is a prevalent knee injury, with rates between 5.8-77.8 per 100,000. APD often results in repeat lateral patella dislocations due to the instability of the medial patellofemoral ligament (MPFL). Non-operative treatments have a 50% recurrence rate. While autologous grafting for MPFL has been favored, surgeons are now exploring synthetic grafts. We aimed to assess the effectiveness of synthetic grafts in MPFL reconstruction surgeries for repeated patellar dislocations; (2) Methods: Our research was based on a thorough search from the National Institute of Health and Clinical Excellence Healthcare Databases, using the Modified Coleman Methodology Score for quality assessment; (3) Results: Six studies met the inclusion criteria. A total of 284 patients and 230 knees were included. Seventy-five percent of patients were graded to have excellent-good clinical outcomes using the Crosby and Insall Grading System. International Knee Documentation Committee score and Knee injury and Osteoarthritis Outcome Score scores showed 59% and 60% post-operative improvement, respectively; (4) Conclusions: All studies showed improvement in post-operative functional outcomes and report no serious adverse events. The 6 mm, LARS (Orthomedic Ltd., Dollard-des-Ormeaux, QC, Canada) proved to have the most improvement in post-operative outcomes when used as a double bundle graft.
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Affiliation(s)
- Panayiotis Tanos
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK;
| | - Chryssa Neo
- Queen Elizabeth Hospital Gateshead, Gateshead Health NHS Foundation Trust, Gateshead NE9 6SX, UK;
| | - Edwin Tong
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen AB25 2ZN, UK;
| | - Andrea Volpin
- Trauma and Orthopaedics, Dr Gray’s Hospital, NHS Grampian, Elgin IV30 1SN, UK
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Ozsay O, Aydin MC, Karabulut K, Basoglu M, Dilek ON. Venous reconstruction thrombosis after pancreaticoduodenectomy with superior mesenteric/portal vein resection due to pancreatic cancer: an 8 years single institution experience. Acta Chir Belg 2023:1-8. [PMID: 37767719 DOI: 10.1080/00015458.2023.2264630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Superior mesenteric/portal vein reconstruction (SMPVR) thrombosis remains a challenging complication following pancreaticoduodenectomy concomitant with venous resection. In this context, we aimed to present our SMPVR experiences and identify potential clinicopathological factors that increased SMPVR thrombosis. METHODS A total of 33 patients who underwent SMPVR during pancreaticoduodenectomy were analyzed. Of these, 26 patients who experienced pancreatic head ductal adenocarcinoma met our inclusion criteria. Patients' data were compared as classified by SMPVR type and the development of SMPVR thrombosis. All interposition grafts were Dacron in this cohort. RESULTS Types of SMPVR included: tangential resection with primary repair (n = 12); segmental resection with splenic vein preservation and either primary anastomosis (n = 8) or 14 mm tubular Dacron grafting (n = 1); segmental resection with splenic vein division either 14 mm tubular Dacron grafting (n = 2) or 14/7 mm 'Y'-shaped Dacron grafting (n = 3). A total of four patients having 14/7 mm 'Y'-shaped (n = 3) and 14 mm tubular Dacron (n = 1) developed SMPVR thrombosis (p = .001). Dacron grafting (p = .001) and splenic vein division (p = .010) were associated with SMPVR thrombosis. The median time to detection of SMPVR thrombosis was 4.3 months (2.5-21.0 months). The median follow-up time was 12.2 months (3.0-45 months). CONCLUSIONS During pancreaticoduodenectomy for pancreatic head ductal carcinoma, extended venous resection requiring SMPVR with 'Y'-shaped and use of Dacron interposition grafts appeared to be associated with the development of SMPVR thrombosis. This result warrants further investigations.
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Affiliation(s)
- Oguzhan Ozsay
- Department of Gastrointestinal Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Mehmet Can Aydin
- Department of Gastrointestinal Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Kagan Karabulut
- Department of General Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Mahmut Basoglu
- Department of General Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Osman Nuri Dilek
- Department of General Surgery, Katip Çelebi University School of Medicine, İzmir, Turkey
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Fairbairn P, Kilner S, O'Hooley D, Fish A, Kurtzman GM. Sinus Augmentation for Implant Placement Utilizing a Novel Synthetic Graft Material with Delayed Immediate Socket Grafting: A 2-Year Case Study. J Clin Med 2023; 12:jcm12072485. [PMID: 37048568 PMCID: PMC10095567 DOI: 10.3390/jcm12072485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Frequently, sinus augmentation is required when replacing failing or missing molars in the maxilla due to loss of alveolar bone related to periodontal disease, pneumatization of the sinus or a combination of the two factors. Various materials have been advocated and utilized; these fall into the categories of allograft, xenograft and synthetic materials. This article shall discuss a study of 10 cases with a 2-year follow-up utilizing a novel synthetic graft material used for sinus augmentation either simultaneously with implant placement or in preparation for sinus augmentation and implant placement in the posterior maxilla. The results of the 10 cases in the study found consistent results over the 2-year study period with maintenance of the alveolar height at the maxillary sinus. A lack of complications or failures in the study group demonstrates the technique has useful applications in increasing ridge height to permit implant placement inferior to the sinus floor.
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Affiliation(s)
- Peter Fairbairn
- Dental Clinic, School of Dentistry, University of Detroit Mercy, 2700 Martin Luther King Jr Blvd, Detroit, MI 48208, USA
- Private Practice, London, UK
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Wahed SB, Dunstan CR, Boughton PA, Ruys AJ, Faisal SN, Wahed TB, Salahuddin B, Cheng X, Zhou Y, Wang CH, Islam MS, Aziz S. Functional Ultra-High Molecular Weight Polyethylene Composites for Ligament Reconstructions and Their Targeted Applications in the Restoration of the Anterior Cruciate Ligament. Polymers (Basel) 2022; 14:polym14112189. [PMID: 35683861 PMCID: PMC9182730 DOI: 10.3390/polym14112189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
The selection of biomaterials as biomedical implants is a significant challenge. Ultra-high molecular weight polyethylene (UHMWPE) and composites of such kind have been extensively used in medical implants, notably in the bearings of the hip, knee, and other joint prostheses, owing to its biocompatibility and high wear resistance. For the Anterior Cruciate Ligament (ACL) graft, synthetic UHMWPE is an ideal candidate due to its biocompatibility and extremely high tensile strength. However, significant problems are observed in UHMWPE based implants, such as wear debris and oxidative degradation. To resolve the issue of wear and to enhance the life of UHMWPE as an implant, in recent years, this field has witnessed numerous innovative methodologies such as biofunctionalization or high temperature melting of UHMWPE to enhance its toughness and strength. The surface functionalization/modification/treatment of UHMWPE is very challenging as it requires optimizing many variables, such as surface tension and wettability, active functional groups on the surface, irradiation, and protein immobilization to successfully improve the mechanical properties of UHMWPE and reduce or eliminate the wear or osteolysis of the UHMWPE implant. Despite these difficulties, several surface roughening, functionalization, and irradiation processing technologies have been developed and applied in the recent past. The basic research and direct industrial applications of such material improvement technology are very significant, as evidenced by the significant number of published papers and patents. However, the available literature on research methodology and techniques related to material property enhancement and protection from wear of UHMWPE is disseminated, and there is a lack of a comprehensive source for the research community to access information on the subject matter. Here we provide an overview of recent developments and core challenges in the surface modification/functionalization/irradiation of UHMWPE and apply these findings to the case study of UHMWPE for ACL repair.
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Affiliation(s)
- Sonia B. Wahed
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
- Correspondence: (S.B.W.); (S.A.)
| | - Colin R. Dunstan
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Philip A. Boughton
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Andrew J. Ruys
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Shaikh N. Faisal
- ARC Centre of Excellence for Electromaterials Science & Intelligent Polymer Research Institute, Australian Institute of Innovative Materials, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Tania B. Wahed
- Department of Pharmacy, Jahangirnagar University, Savar 1342, Bangladesh;
| | - Bidita Salahuddin
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Xinying Cheng
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Yang Zhou
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Chun H. Wang
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Mohammad S. Islam
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Shazed Aziz
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia;
- Correspondence: (S.B.W.); (S.A.)
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Dar PMUD, Kaur S, Kumar V, Ghoshal S, Alam J, Kumar A, Kumar S, Sagar S. Blunt Trauma to Brachiocephalic Artery: Presentation and Management. Am Surg 2021:31348211056265. [PMID: 34851196 DOI: 10.1177/00031348211056265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Isolated innominate artery injury is very rare and accounts for less than 3% of recognized arterial injuries. Surgical exploration of the artery, especially at the origin of the artery from the arch of the aorta, is surgically challenging. Due to its rarity, any 1 surgeon's experience in dealing with innominate artery injury is bound to be limited. We report 2 cases of innominate artery injury post-blunt chest trauma. Both patients underwent thoracotomy and innominate artery Dacron graft repair and both had an uneventful postoperative course.
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Affiliation(s)
- Parvez M U Din Dar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Supreet Kaur
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vivek Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Soumya Ghoshal
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Junaid Alam
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Abhinav Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Subodh Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sushma Sagar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre (JPNATC), 28730All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Kentel M, Barnaś M, Witkowski J, Reichert P. Treatment results and safety assessment of the LARS system for the reconstruction of the anterior cruciate ligament. ADV CLIN EXP MED 2021; 30:379-386. [PMID: 33908197 DOI: 10.17219/acem/132037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture. OBJECTIVES To assess the long-term safety of implementing a synthetic ligament with the Ligament Advanced Reinforcement System (LARS) in primary reconstruction of the ACL. MATERIALS AND METHODS The retrospective analysis involved 403 patients who had undergone ACL reconstruction with the same results in clinical and functional assessments. The patients comprised 2 groups. In group I, a LARS graft was implemented, while in group II, an autograft was used. The Lachman test, anterior drawer test, pivot-shift test, Lysholm scale, IKDC 2000, pain posited to be experienced, the possibility of postoperative complications, the time required to return to work, and revision surgery were all considered and analyzed. RESULTS The visual analogue scale (VAS) pain score in group I ranged from 37.34 ±8.22 mm on day 3 to 17.21 ±5.45 mm on day 28. In group II, it ranged from 64.72 ±10.20 mm on day 3 (p < 0.05) to 18.67 ±6.57 mm on day 28. The period of time taken to return to office work in group I was 7.04 ±1.82 weeks, and 9.21 ±1.75 weeks in group II (p < 0.05). The time taken to return to physical work in group I was 20.50 ±2.91 weeks, and 21.12 ±3.12 weeks in group II. Postoperative scar and local complications were statistically less prominent in group I. The cost and number of revision surgeries were greater in the first group. CONCLUSIONS Reconstruction of the ACL using a synthetic graft such as LARS yields similar results to an autograft in a cohort follow-up. Long-term results show a large number of revision surgeries when LARS is used. This method should be used with caution.
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Affiliation(s)
- Maciej Kentel
- Orthopedics and Traumatology Department, eMKa MED Medical Centre, Wrocław, Poland
| | - Michał Barnaś
- Orthopedics and Traumatology Department, eMKa MED Medical Centre, Wrocław, Poland
| | - Jarosław Witkowski
- Division of Sports Medicine, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Paweł Reichert
- Department of Trauma and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, Poland
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Fukuba S, Okada M, Nohara K, Iwata T. Alloplastic Bone Substitutes for Periodontal and Bone Regeneration in Dentistry: Current Status and Prospects. Materials (Basel) 2021; 14:1096. [PMID: 33652888 DOI: 10.3390/ma14051096] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022]
Abstract
Various bone graft products are commercially available worldwide. However, there is no clear consensus regarding the appropriate bone graft products in different clinical situations. This review is intended to summarize bone graft products, especially alloplastic bone substitutes that are available in multiple countries. It also provides dental clinicians with detailed and accurate information concerning these products. Furthermore, it discusses the prospects of alloplastic bone substitutes based on an analysis of the current market status, as well as a comparison of trends among countries. In this review, we focus on alloplastic bone substitutes approved in the United States, Japan, and Korea for use in periodontal and bone regeneration. According to the Food and Drug Administration database, 87 alloplastic bone graft products have been approved in the United States since 1996. According to the Pharmaceuticals and Medical Devices Agency database, 10 alloplastic bone graft products have been approved in Japan since 2004. According to the Ministry of Health and Welfare database, 36 alloplastic bone graft products have been approved in Korea since 1980. The approved products are mainly hydroxyapatite, β-tricalcium phosphate, and biphasic calcium phosphate. The formulations of the products differed among countries. The development of new alloplastic bone products has been remarkable. In the near future, alloplastic bone substitutes with safety and standardized quality may be the first choice instead of autologous bone; they may offer new osteoconductive and osteoinductive products with easier handling form and an adequate resorption rate, which can be used with growth factors and/or cell transplantation. Careful selection of alloplastic bone graft products is necessary to achieve predictable outcomes according to each clinical situation.
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Çiçek ÖF, Kadiroğullari E, Günertem E, Diken A, Yalçınkaya A, Çiçek MC, Uzun A, Çağlı K. Successful long-term limb salvage using cephalic and small saphenous vein grafts: A case report. Int J Crit Illn Inj Sci 2020; 10:140-142. [PMID: 33409129 PMCID: PMC7771617 DOI: 10.4103/ijciis.ijciis_60_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/16/2020] [Accepted: 02/25/2020] [Indexed: 11/24/2022] Open
Abstract
In this case report, we present a patient scheduled for operation due to critical leg ischemia in whom a bilateral great saphenous vein (GSV) had already been used during previous cardiac and peripheral vascular surgeries. The patient underwent femorofemoral crossover bypass from left to right with a small saphenous vein and right femoropopliteal bypass with cephalic vein (CV) during the same session. Distal pulses became palpable, and symptoms regressed dramatically following the operation. A control computed tomographic angiography scan revealed no signs of graft stenosis 32 months after the surgery. Despite the recent advances in synthetic graft materials, small saphenous and CVs should be remembered as alternative long-standing conduits in the absence of the GSV.
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Affiliation(s)
- Ömer Faruk Çiçek
- Department of Cardiovascular Surgery, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Ersin Kadiroğullari
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Eren Günertem
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Adem Diken
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Adnan Yalçınkaya
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Mustafa Cüneyt Çiçek
- Department of Cardiovascular Surgery, Konya Education and Research Hospital, Konya, Turkey
| | - Alper Uzun
- Department of Cardiovascular Surgery, Ankara Education and Research Hospital, Ankara, Turkey
| | - Kerim Çağlı
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
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Ghanad I, Polanik MD, Trakimas DR, Knoll RM, Castillo-Bustamante M, Black NL, Kozin ED, Remenschneider AK. A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty. Laryngoscope 2020; 131:392-400. [PMID: 33176008 DOI: 10.1002/lary.28914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. METHODS A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. RESULTS The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small-intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air-bone gap of 5.6 dB was found in the 23% of studies reporting this metric. CONCLUSIONS The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392-400, 2021.
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Affiliation(s)
- Iman Ghanad
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Marc D Polanik
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.,Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A
| | - Danielle R Trakimas
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
| | - Renata M Knoll
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | | | - Nicole L Black
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - Elliott D Kozin
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Aaron K Remenschneider
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.,Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A
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13
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Kalinin RE, Suchkov IA, Pshennikov AS, Egorov AA, Gerasimov AA, Zaĭtsev OV, Iudin VA, Klimentova ÉA, Tsaregorodtsev AA, Karpov VV, Agapov AB, Vinogradov SA. [Successful treatment of an aortoduodenal fistula after operation on the abdominal portion of the aorta]. Angiol Sosud Khir 2020; 26:170-174. [PMID: 32597899 DOI: 10.33529/angio2020213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Gastrointestinal haemorrhage is a common cause of emergency admission of patients to surgical hospitals. Within the structure of nosological entities, not unreasonably referred to the rarest causes of gastrointestinal bleeding is the formation of an aortointestinal fistula whose early diagnosis is of paramount importance. The clinical picture may be different but it is mostly represented by gastrointestinal haemorrhage. The incidence of gastrointestinal fistulas following a surgical intervention ranges from 0.6 to 2.3%. Unless timely diagnosed and with incorrect therapeutic decision-making, the mortality rate amounts to 90%. In this article we present a clinical case report regarding successful treatment of a patient presenting with a secondary aortoduodenal fistula occurring 5 years after previously performed aortofemoral bypass grafting and complicated by relapsing intestinal bleeding and acute ischaemia of the right lower extremity.
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Affiliation(s)
- R E Kalinin
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia
| | - I A Suchkov
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia
| | - A S Pshennikov
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
| | - A A Egorov
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
| | | | - O V Zaĭtsev
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
| | - V A Iudin
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
| | - É A Klimentova
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
| | | | - V V Karpov
- Regional Clinical Hospital, Ryazan, Russia
| | - A B Agapov
- Regional Clinical Hospital, Ryazan, Russia
| | - S A Vinogradov
- I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia
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Kattimani V, Lingamaneni KP, Yalamanchili S, Mupparapu M. Use of eggshell-derived nano-hydroxyapatite as novel bone graft substitute-A randomized controlled clinical study. J Biomater Appl 2019; 34:597-614. [PMID: 31324126 DOI: 10.1177/0885328219863311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Vivekanand Kattimani
- 1 Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, India
| | | | - Samatha Yalamanchili
- 2 Department of Oral Medicine and Radiology, Sibar Institute of Dental Sciences, Guntur, India
| | - Muralidhar Mupparapu
- 3 Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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15
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Ranebo MC, Björnsson Hallgren HC, Norlin R, Adolfsson LE. Long-term clinical and radiographic outcome of rotator cuff repair with a synthetic interposition graft: a consecutive case series with 17 to 20 years of follow-up. J Shoulder Elbow Surg 2018; 27:1622-1628. [PMID: 29731397 DOI: 10.1016/j.jse.2018.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Treatment options for irreparable cuff tears include synthetic interposition grafts, but whether such grafts can maintain acceptable shoulder function and prevent cuff tear arthropathy in the long-term is unknown. METHOD This was a retrospective case series of 13 consecutive patients treated with a synthetic interposition graft made of Dacron (DuPont, Wilmington, DE, USA). Patients were examined with bilateral ultrasonography, bilateral x-ray imaging, Constant-Murley score, and Western Ontario Rotator Cuff score. RESULTS After a mean of 18 years (range, 17-20 years), 1 patient had died, and 12 were available for x-ray imaging and 10 also for ultrasonography and clinical scores. Cuff tear arthropathy (Hamada grade ≥2) had developed in 9 of 12 (75%; 95% confidence interval, 43%-95%), including 3 patients operated on with arthroplasty in the follow-up period. The mean absolute Constant-Murley score was 46 (standard deviation, 26), and the mean Western Ontario Rotator Cuff score was 59 (standard deviation, 20). In 7 of 10 patients (70%) with available ultrasonography, the graft was interpreted as not intact. All patients had a contralateral full-thickness tear, and 7 of 12 patients (58 %; 95% confidence interval, 28%-85%) had contralateral cuff tear arthropathy. The number of patients with cuff tear arthropathy was not significantly different between the shoulder repaired with a Dacron graft and the contralateral shoulder (P = .667). CONCLUSION These results indicate that a synthetic interposition graft with screw fixation could not prevent cuff tear arthropathy and preserve cuff integrity in a long-term perspective.
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Affiliation(s)
- Mats C Ranebo
- Department of Orthopedics, Kalmar County Hospital, Kalmar, Sweden; Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
| | | | - Rolf Norlin
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Lars E Adolfsson
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Orthopedics, Linköping University Hospital, Linköping, Sweden
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16
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Triantafyllopoulos IK, Lampropoulou-Adamidou K, Schizas NP, Karadimas EV. Surgical treatment of acute type V acromioclavicular joint dislocations in professional athletes: an anatomic ligament reconstruction with synthetic implant augmentation. J Shoulder Elbow Surg 2017; 26:e369-e375. [PMID: 28739299 DOI: 10.1016/j.jse.2017.05.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/17/2017] [Accepted: 05/27/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Most acromioclavicular (AC) joint injuries occur in men in their third decade of life during high-speed or high-impact body contact sports. The management of acute complete AC joint dislocation is surgical. Current surgical techniques include anatomic reconstruction of the main restraints of the AC joint and aim to improve functional outcomes and to reduce the complication rate. METHODS We present 10 cases of acute type V AC joint dislocation in professional athletes treated surgically with anatomic reconstruction of the coracoclavicular and AC ligaments and augmentation with the use of a synthetic polyester tape. The minimum follow-up of the patients was 2 years (mean, 48 months; range, 24-86 months). The postoperative functional outcome was assessed at 1 year and 2 years using the Constant-Murley, American Shoulder and Elbow Surgeons, and modified University of California-Los Angeles scoring systems. RESULTS In all cases, the postoperative scores were significantly improved (P < .005 in all comparisons with the preoperative scores), and all patients returned to their preinjury high level of activity 6 months postoperatively. Radiographs at 1 month and 6 months revealed the maintenance of reduction. There were no complications. CONCLUSION According to the results of our series of patients, demanding cases of acute AC joint dislocation Rockwood type V, in professional athletes, require anatomic fixation of both coracoclavicular and AC ligaments for return to sports as soon as possible and at the preinjury level of performance.
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Affiliation(s)
- Ioannis K Triantafyllopoulos
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis," Medical School, National and Kapodistrian University of Athens, General Hospital of Athens KAT, Athens, Greece.
| | - Kalliopi Lampropoulou-Adamidou
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis," Medical School, National and Kapodistrian University of Athens, General Hospital of Athens KAT, Athens, Greece
| | - Nikitas P Schizas
- 4th Orthopaedic Department, General Hospital of Athens KAT, Athens, Greece
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17
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Cottino U, Deledda D, Rosso F, Blonna D, Bonasia DE, Rossi R. Chronic knee extensor mechanism lesions in total knee arthroplasty: a literature review. Joints 2016; 4:159-164. [PMID: 27900308 DOI: 10.11138/jts/2016.4.3.159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Knee extensor mechanism rupture is a serious complication of total knee arthroplasty (TKA). Its prevalence ranges from 1 to 10% and it is commonly observed as a chronic multifactorial pathology with the patellar tendon as the most common site of rupture. Knee extensor mechanism reconstruction can be performed using allogenic or synthetic grafts. In the literature it is still not clear whether one of these techniques is superior to the other and the choice is usually tailored to the patient case by case. Allografts allow better restoration of the anatomical landmarks, whereas the mesh technique is more reproducible and the graft does not elongate over time. Allografts carry an increased risk of infection compared with synthetic reconstructions, while the mesh technique is cheaper and more readily available. In this paper, we review the etiology, diagnosis and treatment of this pathology, drawing on the most recent literature.
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Affiliation(s)
- Umberto Cottino
- Department of Orthopedic Surgery Mauriziano "Umberto I" Hospital, Torino, Italy
| | - Davide Deledda
- Department of Orthopedic Surgery Mauriziano "Umberto I" Hospital, Torino, Italy
| | - Federica Rosso
- Department of Orthopedic Surgery Mauriziano "Umberto I" Hospital, Torino, Italy
| | - Davide Blonna
- Department of Orthopedic Surgery Mauriziano "Umberto I" Hospital, Torino, Italy
| | | | - Roberto Rossi
- Department of Orthopedic Surgery Mauriziano "Umberto I" Hospital, Torino, Italy
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18
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Kitrou P, Spiliopoulos S, Karnabatidis D, Katsanos K. Cutting balloons, covered stents and paclitaxel-coated balloons for the treatment of dysfunctional dialysis access. Expert Rev Med Devices 2016; 13:1119-1126. [PMID: 27791450 DOI: 10.1080/17434440.2016.1254548] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Percutaneous transcatheter balloon angioplasty has evolved to the current mainstay treatment for salvage of dysfunctional dialysis access. Nonetheless, it is frequently associated with recurrent vessel restenosis and the need for multiple repeat treatments in order to maintain hemodynamic patency. Cutting-balloons, covered stents or stent-grafts, and paclitaxel-coated balloons have been extensively tested and investigated with the aim to improve immediate anatomical and long-term clinical results. Areas covered: In the present overview, we discuss the background and appraise relevant medical literature on the aforementioned technologies and provide a more in-depth synthesis of the results of different clinical studies for each device category. We will also discuss the limitations in the mode of action of each group of devices and envision what the future holds for the challenging field of dialysis access interventions. Expert commentary: We propose a good practice algorithm for the treatment of thrombosed or dysfunctional dialysis access.
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Affiliation(s)
- Panagiotis Kitrou
- a Department of Interventional Radiology , Patras University Hospital, School of Medicine , Rion , Greece
| | - Stavros Spiliopoulos
- b 2nd Department of Radiology, Interventional Radiology Unit , ATTIKO Athens University Hospital , Athens , Greece
| | - Dimitris Karnabatidis
- a Department of Interventional Radiology , Patras University Hospital, School of Medicine , Rion , Greece
| | - Konstantinos Katsanos
- a Department of Interventional Radiology , Patras University Hospital, School of Medicine , Rion , Greece
- c Department of Interventional Radiology , Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners , London , UK
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Buser Z, Brodke DS, Youssef JA, Meisel HJ, Myhre SL, Hashimoto R, Park JB, Tim Yoon S, Wang JC. Synthetic bone graft versus autograft or allograft for spinal fusion: a systematic review. J Neurosurg Spine 2016; 25:509-516. [PMID: 27231812 DOI: 10.3171/2016.1.spine151005] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The purpose of this review was to compare the efficacy and safety of synthetic bone graft substitutes versus autograft or allograft for the treatment of lumbar and cervical spinal degenerative diseases. Multiple major medical reference databases were searched for studies that evaluated spinal fusion using synthetic bone graft substitutes (either alone or with an autograft or allograft) compared with autograft and allograft. Randomized controlled trials (RCT) and cohort studies with more than 10 patients were included. Radiographic fusion, patient-reported outcomes, and functional outcomes were the primary outcomes of interest. The search yielded 214 citations with 27 studies that met the inclusion criteria. For the patients with lumbar spinal degenerative disease, data from 19 comparative studies were included: 3 RCTs, 12 prospective, and 4 retrospective studies. Hydroxyapatite (HA), HA+collagen, β-tricalcium phosphate (β-TCP), calcium sulfate, or polymethylmethacrylate (PMMA) were used. Overall, there were no differences between the treatment groups in terms of fusion, functional outcomes, or complications, except in 1 study that found higher rates of HA graft absorption. For the patients with cervical degenerative conditions, data from 8 comparative studies were included: 4 RCTs and 4 cohort studies (1 prospective and 3 retrospective studies). Synthetic grafts included HA, β-TCP/HA, PMMA, and biocompatible osteoconductive polymer (BOP). The PMMA and BOP grafts led to lower fusion rates, and PMMA, HA, and BOP had greater risks of graft fragmentation, settling, and instrumentation problems compared with iliac crest bone graft. The overall quality of evidence evaluating the potential use and superiority of the synthetic biological materials for lumbar and cervical fusion in this systematic review was low or insufficient, largely due to the high potential for bias and small sample sizes. Thus, definitive conclusions or recommendations regarding the use of these synthetic materials should be made cautiously and within the context of the limitations of the evidence.
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Affiliation(s)
- Zorica Buser
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Darrel S Brodke
- Department of Orthopedics, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | | | | | - Jong-Beom Park
- Department of Orthopaedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Uijongbu, Korea; and
| | - S Tim Yoon
- Department of Orthopedics, Emory Spine Center, Emory University, Atlanta, Georgia
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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Bas G, Ozkan OV, Alimoglu O, Eryilmaz R, Sahin M, Okan I, Cevikbas U. The role of n-butyl-2-cyanoacrylate in the repair of traumatic diaphragmatic injuries. Int J Clin Exp Med 2015; 8:5876-5882. [PMID: 26131179 PMCID: PMC4483802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/17/2015] [Indexed: 06/04/2023]
Abstract
Diaphragmatic injuries either by blunt or penetrating trauma require prompt surgical intervention and are often exigent to repair. N-butyl-2-cyanoacrylate (n-butyl-2-CA) is a tissue adhesive which has gained wide application in many areas of surgery including emergency. To repair the extensive injuries of the diaphragm it may be necessary the use of synthetic mesh by fixing it with sutures or staples. The use of tissue adhesives may circumvent the potential problems associated with mesh fixation. This study aimed to evaluate the efficacy and safety of tissue adhesives usage for mesh fixation in diaphragmatic injury repair. Twenty-four rats were divided into 3 groups each of them containing 8 rats. A 1- cm diaphragmatic defect was created in all rats. The defect was repaired by polypropylene suture in Group I, by mesh fixed with sutures in group II and by mesh fixed with n-butyl-2-CA in group III. The rats were sacrificed after 1 month. The episode of hernia and the adhesions were assessed by adhesion density score. Also, the abscess and inflammation in the repaired tissue were evaluated microscopically. The Kruskal-Wallis test was performed for the histopathological analysis. No diaphragmatic hernia was detected in any group. While Group III had higher adhesion density scores than group I (P: 0.027), there were no differences between group III and II (P: 0.317) and group II and I (P = 0.095) regarding adhesion density scores. The inflammation grade was higher in group III than group I and II (P < 0.001) and was higher in group II than group I (P < 0.05). There was no differences between each groups, concerning microabcsess formation (P > 0.05). Repair of traumatic diaphragmatic injury in penetrating wound, with polypropylene mesh fixed by n-butyl-2-CA in rats appears to be as efficacious and safe as conventional methods in early period. However, further experimental and clinical study are needed to compare the long-term results of adhesive mesh repair with those of the traditional sutured techniques.
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Affiliation(s)
- Gurhan Bas
- Department of Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Orhan Veli Ozkan
- Department of Surgery, School of Medicine, University of Sakarya Sakarya, Turkey
| | - Orhan Alimoglu
- Department of Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Ramazan Eryilmaz
- Department of Surgery, School of Medicine, University of Akdeniz Antalya, Turkey
| | - Mustafa Sahin
- Department of Surgery, Vakif Gureba Training and Research Hospital Istanbul, Turkey
| | - Ismail Okan
- Department of Surgery, Vakif Gureba Training and Research Hospital Istanbul, Turkey
| | - Ugur Cevikbas
- Department of Pathology, School of Medicine, University of Istanbul Istanbul, Turkey
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Gerrah R, Sunstrom Pa-C RE, Hohimer AR. Pretreatment of synthetic vascular grafts with heparin before implantation, a simple technique to reduce the risk of thrombosis. Vascular 2014; 23:513-8. [PMID: 25406265 DOI: 10.1177/1708538114560455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Thrombosis of synthetic grafts commonly used in cardiovascular surgery is a major complication. We examined whether pretreatment of the graft with heparin reduces the risk of early thrombosis. A circuit was assembled to compare two pairs of shunts simultaneously in the same animal. The study shunts were pretreated with heparin. After 2 hours of circulation, clot formation was evaluated by image analysis techniques. The pretreated grafts had fewer blood clots adhered to the surface by direct visual inspection. The image analysis showed 5 vs. 39 clots, 0.01% vs. 1.8% clotted area, and 62 vs. 5630 clot pixel area between the treated and non-treated grafts respectively, p < 0.05. Pretreatment of the synthetic graft with heparin prior to implantation reduces the risk of early clot formation. This simple practice might be helpful to prevent initial thrombosis of the graft and later occlusion.
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Affiliation(s)
- Rabin Gerrah
- Division of Cardiothoracic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | - Alan R Hohimer
- Division of Maternal/Fetal Medicine, Oregon Health and Science University, Portland, OR, USA
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