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Yagura T, Oe K, Kobayasi F, Sogawa S, Nakamura T, Iida H, Saito T. Experimental periprosthetic fractures with collarless polished tapered cemented stems. Int Orthop 2024; 48:1171-1178. [PMID: 38443715 DOI: 10.1007/s00264-024-06136-1] [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] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE After cemented total hip arthroplasty, the risk of periprosthetic fracture (PPF) of taper-slip stems is higher than that of composite-beam stems. We aimed to assess the conditions resulting in PPFs of taper-slip stems using a falling weight. METHODS Taper-slip stems were fixed to five types of simulated bone models using bone cement, and the fractures were evaluated by dropping stainless-steel weights from a predetermined height onto the heads. The periprosthetic fracture height in 50% of the bone models (PPFH50) was calculated using the staircase method. RESULTS For the fixation with 0° of flexion, the values for PPFH50 were 61 ± 11, 60 ± 13, above 110, 108 ± 49, and 78 ± 12 cm for the cobalt-chromium-molybdenum alloy, stainless steel alloy (SUS), titanium alloy (Ti), smooth surface, and thick cement mantle models, respectively; for the fixation with 10° of flexion (considering flexure), the PPFH50 values were 77 ± 5, 85 ± 9, 90 ± 2, 89 ± 5, and 81 ± 11 cm, respectively. The fracture rates of the polished-surface stems were 78.6 and 35.7% at the proximal and distal sites, respectively (p < 0.05); the fracture rates of the smooth-surface stems were 14.2 and 100%, respectively (p < 0.05). CONCLUSION The impact tests demonstrated that the conditions that were less likely to cause PPFs were use of Ti, a smooth surface, a thick cement mantle, and probably, use of SUS.
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Affiliation(s)
- Takuma Yagura
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Kenichi Oe
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
| | - Fumito Kobayasi
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Shohei Sogawa
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Tomohisa Nakamura
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Hirokazu Iida
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Takanori Saito
- Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
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Liu F, Jin B, He Q, Zhou Y. Influence of rice husk ash on the mechanical properties of ultra-high strength engineered cementitious composites (UHS-ECC). PLoS One 2024; 19:e0301927. [PMID: 38635748 PMCID: PMC11025938 DOI: 10.1371/journal.pone.0301927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/24/2024] [Indexed: 04/20/2024] Open
Abstract
Generally, UHS-ECC should consume massive cement, which is negative to its sustainability as cement production leads to 8% of global CO2 emissions. To decrease the cost of production and carbon emissions of UHS-ECC, rice husk ash was employed to replace the cement as a supplementary cementitious material in this study. Experiment results illustrate that blending rice husk ash (RHA) would decrease the fluidity of mortar. Furthermore, the green UHS-ECC shows a maximum compressive strength of 130.3 MPa at 28 days when RHA content was 20% of cement. The ultimate tensile strength of UHS-ECCs first increased and then decreased, while both tensile strain and strain energy presented an opposite tendency. At the micro-scale, if RHA content was lower than 20% of cement, incorporating RHA can significantly decreasing fiber bridging complementary energy of UHS-ECC, thus reducing pseudo strain hardening energy (PSHenergy) index, which finely agrees with the degradation of ductility of UHS-ECCs. To guarantee the features of ultra-high strength, acceptable workability, and high tensile ductility, the RHA dosage should not be in excess 20% of cement. These researched results are prospected to the contribution of pozzolanic RHA on the efficient usage of sustainable UHS-ECC.
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Affiliation(s)
- Feifei Liu
- Architectural Engineering Institute, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
| | - Baohong Jin
- School of Civil and Hydraulic Engineering, Ningxia University, Yinchuan, China
| | - Qi He
- Architectural Engineering Institute, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
| | - Yun Zhou
- Architectural Engineering Institute, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
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白 心, 何 金, 陆 松, 李 春, 王 依, 熊 建. [Vertebral fractures combined with prolonged activated partial prothrombin time: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2024; 56:371-374. [PMID: 38595261 PMCID: PMC11004961] [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] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Indexed: 04/11/2024]
Abstract
With the development of modern medical standards, autoimmune diseases and their associated successive osteoporosis have received increasing attention in recent years. Patients with autoimmune diseases, due to the characteristics of the disease and the prolonged use of glucocorticoid hormone therapy, may affect the bone formation and bone absorption of the patient, followed by severe successive osteoporosis, thereby increasing the risk of osteoporotic vertebral fractures. Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures. Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures. However, due to the operation of spinal puncture during the operation, there are serious surgical risks such as bone cement leakage, spinal epidural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage in both PVP and PKP. As a result, it is necessary to evaluate the patient' s body before surgery carefully, especially in the case of blood coagulation. This article reports a case of autoimmune disease patient admitted to Peking University People' s Hospital due to lumbar 4 vertebral compression fracture combined with Sjögren' s syndrome. The patient' s preoperative examination showed that the activated partial thromboplastin time (APTT) was significantly prolonged. After completing the APTT extended screening experiment and lupus anticoagulant factor testing, the multi-disciplinary team (MDT) of Peking University People' s Hospital jointly discussed the conclusion that the patient' s test results were caused by an abnormal self-immunity anti-copulant lupus (LAC). Based on the results of the laboratory examination, the patient was considered to be diagnosed with combined antiphospholipid syndrome (APS). For such patients, compared with the patient' s tendency to bleed, we should pay more attention to the risk of high blood clotting in the lower limbs of the patient, pulmonary clots and so on. With timely anti-coagulation treatment, the patient safely passed the peripheral period and was successfully discharged from the hospital. Therefore, for patients with autoimmune diseases with prolonged APTT in the perioperative period, doctors need to carefully identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.
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Affiliation(s)
- 心竹 白
- 北京大学人民医院创伤骨科, 国家创伤医学中心, 北京 100044Department of Trauma and Orthopaedics, Peking University People's Hospital; National Center for Trauma Medicine, Beijing 100044, China
| | - 金徽 何
- 浙江省人民医院毕节医院创伤科, 贵州毕节 551799Department of Trauma, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie 551799, Guizhou, China
| | - 松松 陆
- 北京大学人民医院检验科, 北京 100044Department of Clinical Laboratory, Peking University People's Hospital, Beijing 100044, China
| | - 春 李
- 北京大学人民医院风湿免疫科, 北京 100044Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - 依林 王
- 北京大学人民医院创伤骨科, 国家创伤医学中心, 北京 100044Department of Trauma and Orthopaedics, Peking University People's Hospital; National Center for Trauma Medicine, Beijing 100044, China
| | - 建 熊
- 北京大学人民医院创伤骨科, 国家创伤医学中心, 北京 100044Department of Trauma and Orthopaedics, Peking University People's Hospital; National Center for Trauma Medicine, Beijing 100044, China
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周 健, 郑 玉, 陈 伟, 常 树, 魏 在, 聂 开, 张 芳, 李 书, 龚 飞. [Preliminary application of antibiotic bone cement directly inducing skin regeneration technology in repairing of wound in lateral toe flap donor area]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2024; 38:474-479. [PMID: 38632069 PMCID: PMC11024528 DOI: 10.7507/1002-1892.202401054] [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] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/17/2024] [Indexed: 04/19/2024]
Abstract
Objective To investigate the feasibility and effectiveness of antibiotic bone cement directly inducing skin regeneration technology in the repairing of wound in the lateral toe flap donor area. Methods Between June 2020 and February 2023, antibiotic bone cement directly inducing skin regeneration technology was used to repair lateral toe flap donor area in 10 patients with a total of 11 wounds, including 7 males and 3 females. The patients' age ranged from 21 to 63 years, with an average of 40.6 years. There were 3 cases of the distal segment of the thumb, 2 cases of the distal segment of the index finger, 1 case of the middle segment of the index and middle fingers, 1 case of the distal segment of the middle finger, and 3 cases of the distal segment of the ring finger. The size of the skin defect of the hand ranged from 2.4 cm×1.8 cm to 4.3 cm×3.4 cm. The disease duration ranged from 1 to 15 days, with an average of 6.9 days. The flap donor sites were located at fibular side of the great toe in 5 sites, tibial side of the second toe in 5 sites, and tibial side of the third toe in 1 site. The skin flap donor site wounds could not be directly sutured, with 2 cases having exposed tendons, all of which were covered with antibiotic bone cement. Results All patients were followed up 6 months to 2 years, with an average of 14.7 months. All the 11 flaps survived and had good appearance. The wound healing time was 40-72 days, with an average of 51.7 days. There was no hypertrophic scar in the donor site, which was similar to the color of the surrounding normal skin; the appearance of the foot was good, and wearing shoes and walking of the donor foot were not affected. Conclusion It is a feasible method to repair the wound in the lateral foot flap donor area with the antibiotic bone cement directly inducing skin regeneration technology. The wound heals spontaneously, the operation is simple, and there is no second donor site injury.
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Affiliation(s)
- 健 周
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 玉岑 郑
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 伟 陈
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 树森 常
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 在荣 魏
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 开瑜 聂
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 芳 张
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 书俊 李
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
| | - 飞宇 龚
- 遵义医科大学附属医院烧伤整形外科(贵州遵义 563003)Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China
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康 永, 吴 永, 芮 永, 张 庆, 马 运, 贾 雪, 张 铭, 周 明, 林 芳. [Application of antibiotic bone cement-coated plates internal fixation for primary treating Gustilo type ⅢB tibiofibular open fracture]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2024; 38:426-431. [PMID: 38632061 PMCID: PMC11024530 DOI: 10.7507/1002-1892.202401099] [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] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/22/2024] [Indexed: 04/19/2024]
Abstract
Objective To explore the effectiveness of using antibiotic bone cement-coated plates internal fixation technology as a primary treatment for Gustilo type ⅢB tibiofibular open fractures. Methods The clinical data of 24 patients with Gustilo type ⅢB tibiofibular open fractures who were admitted between January 2018 and December 2021 and met the selection criteria was retrospectively analyzed. Among them, there were 18 males and 6 females, aged from 25 to 65 years with an average age of 45.8 years. There were 3 cases of proximal tibial fracture, 6 cases of middle tibial fracture, 15 cases of distal tibial fracture, and 21 cases of fibular fracture. The time from injury to emergency surgery ranged from 3 to 12 hours, with an average of 5.3 hours. All patients had soft tissue defects ranging from 10 cm×5 cm to 32 cm×15 cm. The time from injury to skin flap transplantation for wound coverage ranged from 1 to 7 days, with an average of 4.1 days, and the size of skin flap ranged from 10 cm×5 cm to 33 cm×15 cm. Ten patients had bone defects with length of 2-12 cm (mean, 7.1 cm). After emergency debridement, the tibial fracture end was fixed with antibiotic bone cement-coated plates, and the bone defect area was filled with antibiotic bone cement. Within 7 days, the wound was covered with a free flap, and the bone cement was replaced while performing definitive internal fixation of the fracture. In 10 patients with bone defect, all the bone cement was removed and the bone defect area was grafted after 7-32 weeks (mean, 11.8 weeks). The flap survival, wound healing of the affected limb, complications, and bone healing were observed after operation, and the quality of life was evaluated according to the short-form 36 health survey scale (SF-36 scale) [including physical component summary (PCS) and mental component summary (MCS) scores] at 1 month, 6 months after operation, and at last follow-up. Results All 24 patients were followed up 14-38 months (mean, 21.6 months). All the affected limbs were successfully salvaged and all the transplanted flaps survived. One case had scar hyperplasia in the flap donor site, and 1 case had hypoesthesia (grade S3) of the skin around the scar. There were 2 cases of infection in the recipient area of the leg, one of which was superficial infection after primary flap transplantation and healed after debridement, and the other was sinus formation after secondary bone grafting and was debrided again 3 months later and treated with Ilizarov osteotomy, and healed 8 months later. The bone healing time of the remaining 23 patients ranged from 4 to 9 months, with an average of 6.1 months. The scores of PCS were 44.4±6.5, 68.3±8.3, 80.4±6.9, and the scores of MCS were 59.2±8.2, 79.5±7.8, 90.0±6.6 at 1 month, 6 months after operation, and at last follow-up, respectively. The differences were significant between different time points ( P<0.05). Conclusion Antibiotic bone cement-coated plates internal fixation can be used in the primary treatment of Gustilo type ⅢB tibiofibular open fractures, and has the advantages of reduce the risk of infection in fracture fixation, reducing complications, and accelerating the functional recovery of patients.
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Affiliation(s)
- 永强 康
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 永伟 吴
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 永军 芮
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 庆庆 张
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 运宏 马
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 雪原 贾
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 铭煜 张
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 明 周
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
| | - 芳 林
- 无锡市第九人民医院创伤骨科(江苏无锡 214062)Department of Trauma Orthopedics, Wuxi Ninth People’s Hospital, Wuxi Jiangsu, 214062, P. R. China
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Bansal M, Bansal M, Bahrami A, Krishan B, Garg R, Özkılıç YO, Althaqafi E. Influence of pozzolanic addition on strength and microstructure of metakaolin-based concrete. PLoS One 2024; 19:e0298761. [PMID: 38598491 PMCID: PMC11006177 DOI: 10.1371/journal.pone.0298761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/31/2024] [Indexed: 04/12/2024] Open
Abstract
The intent of this study is to explore the physical properties and long-term performance of concrete made with metakaolin (MK) as a binder, using microsilica (MS) and nanosilica (NS) as substitutes for a portion of the ordinary Portland cement (OPC) content. The dosage of MS was varied from 5% to 15% for OPC-MK-MS blends, and the dosage of NS was varied from 0.5% to 1.5% for OPC-MK-NS blends. Incorporation of these pozzolans accelerated the hardening process and reduced the flowability, consistency, and setting time of the cement paste. In addition, it produced a denser matrix, improving the strength of the concrete matrix, as confirmed by scanning electron microscopy and X-ray diffraction analysis. The use of MS enhanced the strength by 10.37%, and the utilization of NS increased the strength by 11.48% at 28 days. It also reduced the penetrability of the matrix with a maximum reduction in the water absorption (35.82%) and improved the resistance to the sulfate attack for specimens containing 1% NS in the presence of 10% MK. Based on these results, NS in the presence of MK can be used to obtain cementitious structures with the enhanced strength and durability.
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Affiliation(s)
- Manisha Bansal
- Civil Engineering Department, M.R.S.P.T.U, Bathinda (Punjab), India
| | - Manjeet Bansal
- Civil Engineering Department, M.R.S.P.T.U, Bathinda (Punjab), India
| | - Alireza Bahrami
- Department of Building Engineering, Energy Systems and Sustainability Science, Faculty of Engineering and Sustainable Development, University of Gävle, Gävle, Sweden
| | - Bal Krishan
- Civil Engineering Department, M.R.S.P.T.U, Bathinda (Punjab), India
| | - Rishav Garg
- Civil Engineering Department, Galgotias College of Engineering and Technology, Greater Noida (Uttar Pradesh), India
| | - Yasin Onuralp Özkılıç
- Department of Civil Engineering, Faculty of Engineering, Necmettin Erbakan University, Konya, Turkey
- Department of Civil Engineering, Lebanese American University, Byblos, Lebanon
| | - Essam Althaqafi
- Civil Engineering Department, College of Engineering, King Khalid University, Abha, Saudi Arabia
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Li L, Pan C, Zhang X, Liu W, Zhang T, Liu Y, Li J, Ma Y, Jia C, Liu X, Shi C. Efficacy of cementless porous tantalum tibial components versus cemented tibial components in primary total knee arthroplasty: A meta-analysis. Medicine (Baltimore) 2024; 103:e37697. [PMID: 38579049 PMCID: PMC10994505 DOI: 10.1097/md.0000000000037697] [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] [Received: 08/03/2023] [Accepted: 03/01/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Total knee arthroplasty involves the use of cemented tibial components for fixation. In recent years, cementless porous tantalum tibial components have been increasingly utilized. The aim of this meta-analysis was to compare the efficacy of cementless porous tantalum tibial components with traditional cemented tibial components in terms of postoperative outcomes following total knee arthroplasty. METHODS Relevant literature was retrieved from Cochrane Library, PubMed, Embase, and Web of Science using the search terms "(trabecular metal OR Porous tantalum)" AND "knee" up to July 2023. The weighted mean difference with a 95% confidence interval was used as the effect size measure to evaluate the functional recovery of the knee joint, radiological analysis, complications, and implant revisions between cementless porous tantalum tibial components and traditional cemented tibial components after total knee arthroplasty. Review Manager 5.3 was utilized to conduct a comparative analysis of all included studies. RESULTS Nine studies with a total of 1117 patients were included in this meta-analysis, consisting of 447 patients in the porous tantalum group and 670 patients in the cemented group. Radiological analysis demonstrated that the porous tantalum group had better outcomes than the cemented group (P < .05). The combined results for the 5-year and 10-year follow-ups, range of motion, Western Ontario and McMaster University Osteoarthritis Index, complications, and implant revisions showed no significant differences between the porous tantalum and cemented groups. CONCLUSION The results of the 5-year and 10-year follow-ups indicate that the use of cementless porous tantalum tibial components is comparable to traditional cemented tibial components, with no significant advantages observed. However, at the 5-year follow-up, the porous tantalum group demonstrated a good bone density in the proximal tibia. Future studies with a larger sample size, long-term clinical follow-up, and radiological results are needed to verify the differences between the 2 implants.
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Affiliation(s)
- Lei Li
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Chao Pan
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Xingyan Zhang
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Wei Liu
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Tingting Zhang
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Yufan Liu
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Jingyi Li
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Yuhang Ma
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Chenfan Jia
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Xinying Liu
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
| | - Chunbao Shi
- Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China
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Tavakoli M, Najafinezhad A, Mirhaj M, Karbasi S, Varshosaz J, Al-Musawi MH, Madaninasab P, Sharifianjazi F, Mehrjoo M, Salehi S, Kazemi N, Nasiri-Harchegani S. Graphene oxide-encapsulated baghdadite nanocomposite improved physical, mechanical, and biological properties of a vancomycin-loaded PMMA bone cement. J Biomater Sci Polym Ed 2024; 35:823-850. [PMID: 38300323 DOI: 10.1080/09205063.2024.2308328] [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] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Polymethyl methacrylate (PMMA) bone cement is commonly used in orthopedic surgeries to fill the bone defects or fix the prostheses. These cements are usually containing amounts of a nonbioactive radiopacifying agent such as barium sulfate and zirconium dioxide, which does not have a good interface compatibility with PMMA, and the clumps formed from these materials can scratch metal counterfaces. In this work, graphene oxide encapsulated baghdadite (GOBgh) nanoparticles were applied as radiopacifying and bioactive agent in a PMMA bone cement containing 2 wt.% of vancomycin (VAN). The addition of 20 wt.% of GOBgh (GOBgh20) nanoparticles to PMMA powder caused a 33.6% increase in compressive strength and a 70.9% increase in elastic modulus compared to the Simplex® P bone cement, and also enhanced the setting properties, radiopacity, antibacterial activity, and the apatite formation in simulated body fluid. In vitro cell assessments confirmed the increase in adhesion and proliferation of MG-63 cells as well as the osteogenic differentiation of human adipose-derived mesenchymal stem cells on the surface of PMMA-GOBgh20 cement. The chorioallantoic membrane assay revealed the excellent angiogenesis activity of nanocomposite cement samples. In vivo experiments on a rat model also demonstrated the mineralization and bone integration of PMMA-GOBgh20 cement within four weeks. Based on the promising results obtained, PMMA-GOBgh20 bone cement is suggested as an optimal sample for use in orthopedic surgeries.
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Affiliation(s)
- Mohamadreza Tavakoli
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Aliakbar Najafinezhad
- Department of Materials Engineering, Advanced Materials Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Marjan Mirhaj
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Saeed Karbasi
- Department of Biomaterials and Tissue Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaleh Varshosaz
- Department of Pharmaceutics, Novel Drug Delivery Systems Research Centre, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mastafa H Al-Musawi
- Department of Clinical Laboratory Science, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
| | - Pegah Madaninasab
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Fariborz Sharifianjazi
- Department of Natural Sciences, School of Science and Technology, University of GA, Tbilisi, Georgia
| | - Morteza Mehrjoo
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
- Iran National Cell Bank, Pasteur Institute of Iran, Tehran, Iran
| | - Saeideh Salehi
- Department of Materials Engineering, Advanced Materials Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Nafise Kazemi
- Department of Materials Engineering, Advanced Materials Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Sepideh Nasiri-Harchegani
- Department of Materials Engineering, Advanced Materials Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
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9
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Zhang J, Xu Y, Lu W, Sun F, Li H. Changes of inflammatory cytokines in vertebral compression fractures patients with percutaneous balloon kyphoplasty. Br J Neurosurg 2024; 38:231-235. [PMID: 33136440 DOI: 10.1080/02688697.2020.1823941] [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: 04/08/2020] [Revised: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
Objective: To explore the changes of a series of cytokines before and after percutaneous balloon kyphoplasty (PKP) and prognostic markers for response to PKP.Methods: From 1 January 2019 to 31 May 2019, all single-level lumbar osteoporotic vertebral compression fracture (OVCF) patients diagnosed by MRI who matched the inclusion and exclusion criteria were enrolled in this study. They were classified into the effective group and the ineffective group based on the outcome after PKP. The levels of a series of inflammatory factors and indices of spinal functions were obtained before and after PKP.Results: A total of 72 patients were included in this study, 59 in the effective group and 13 in the ineffective group. The anterior height (AH) and posterior height (PH) were 77.3 ± 11.2% and 91.2 ± 9.3%, respectively, in the effective group after PKP, which were higher than that in the ineffective group (p<.001). While, the Kyphotic angle, visual analog scale (VAS), and Oswestry Disability Index (ODI) score were 9.1 ± 4.3°, 3.1 ± 1.9, and 19.2 ± 4.1 in the effective group, which was lower than that in ineffective group (p<.001). The serum levels of IL-1β, IL-6, and TNF-α were found significantly decreased after treatment in the effective group (p<.05). The logistic regression showed that the levels of IL-6 TNF-α and AH were significant predictor of outcome.Conclusions: Our results demonstrated that PKP can reduce the serum levels of IL-6, IL-1β, and TNF-α, moreover, the IL-6, TNF-α, and AH were significant predictors of outcome.
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Affiliation(s)
- Jian Zhang
- Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai, PR China
| | - Yanchun Xu
- Department of Pathology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Weiwei Lu
- Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Fengbin Sun
- Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai, PR China
| | - Hongbo Li
- The First Department of General Surgery, Qingdao Municipal Hospital Qingdao, Qingdao, PR China
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10
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Joeris A, Kabiri M, Galvain T, Vanderkarr M, Holy CE, Plaza JQ, Schneller J, Kammerlander C. Nail fixation of unstable trochanteric fractures with or without cement augmentation: A cost-utility analysis in the United States: Cost-utility of cement augmentation. Injury 2024; 55:111445. [PMID: 38428102 DOI: 10.1016/j.injury.2024.111445] [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] [Received: 09/29/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Recent clinical studies have shown favorable outcomes for cement augmentation for fixation of trochanteric fracture. We assessed the cost-utility of cement augmentation for fixation of closed unstable trochanteric fractures from the US payer's perspective. METHODS The cost-utility model comprised a decision tree to simulate clinical events over 1 year after the index fixation surgery, and a Markov model to extrapolate clinical events over patients' lifetime, using a cohort of 1,000 patients with demographic and clinical characteristics similar to that of a published randomized controlled trial (age ≥75 years, 83 % female). Model outputs were discounted costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) over a lifetime. Deterministic and probabilistic sensitivity analyses were performed to assess the impact of parameter uncertainty on results. RESULTS Fixation with augmentation reduced per-patient costs by $754.8 and had similar per-patient QALYs, compared to fixation without augmentation, resulting in an ICER of -$130,765/QALY. The ICER was most sensitive to the utility of revision surgery, mortality risk ratio after the second revision surgery, mortality risk ratio after successful index surgery, and mortality rate in the decision tree model. The probability that fixation with augmentation was cost-effective compared with no augmentation was 63.4 %, 58.2 %, and 56.4 %, given a maximum acceptable ceiling ratio of $50,000, $100,000, and $150,000 per QALY gained, respectively. CONCLUSION Fixation with cement augmentation was the dominant strategy, driven mainly by reduced costs. These results may support surgeons in evidence-based clinical decision making and may be informative for policy makers regarding coverage and reimbursement.
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Affiliation(s)
- Alexander Joeris
- AO Innovation Translation Center Clinical Science, AO Foundation, Davos, Switzerland
| | - Mina Kabiri
- Global Provider and Payer Value Demonstration, Global Health Economics, Johnson & Johnson Medical Devices, New Brunswick, NJ, USA
| | - Thibaut Galvain
- Global Provider and Payer Value Demonstration, Global Health Economics, Johnson & Johnson Medical Devices, New Brunswick, NJ, USA
| | | | - Chantal E Holy
- Medical Device Epidemiology, Johnson & Johnson, New Brunswick, NJ, USA
| | | | - Julia Schneller
- Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany
| | - Christian Kammerlander
- Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany; AUVA Trauma Hospital Styria, Graz, Austria; AUVA Trauma Hospital Styria, Kalwang, Austria.
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11
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Adida S, Tang A, Taori S, Wong VR, Sefcik RK, Zhang X, Gerszten PC. Prediction of 30-day and 1-year postoperative complications after balloon-assisted kyphoplasty in the elderly using the Risk Analysis Index. J Neurosurg Spine 2024; 40:498-504. [PMID: 38215434 DOI: 10.3171/2023.11.spine23951] [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: 08/24/2023] [Accepted: 11/16/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Vertebral compression fracture (VCF) is the most prevalent fragility fracture. When conservative management fails, patients may undergo balloon-assisted kyphoplasty (BAK). In BAK, an expandable balloon preforms a cavity in the fractured vertebra before injection of bone cement. The aim of this study was to compare outcomes in patients stratified by age and frailty assessed by the Risk Analysis Index (RAI). METHODS A retrospective analysis of 334 BAK procedures (280 patients) for osteoporotic VCFs at a single institution was performed (2015-2022). Patients with at least 1 year of follow-up were eligible for inclusion. Patient demographics were recorded, including age, sex, BMI, RAI score, tobacco and steroid use, osteoporosis treatments, and bone density. Patients who underwent outpatient surgery were identified, and length of stay (LOS) was obtained for admitted patients. The rates of additional VCFs after kyphoplasty, 30-day and 1-year postoperative complications, and reoperation were identified. RESULTS The overall rates of additional VCFs, 30-day postoperative complications, 1-year postoperative complications, and reoperation were 16.2%, 5.1%, 12.0%, and 6.3%, respectively. Patients were stratified by age: nonelderly (< 80 years; 220 patients, 263 treated vertebrae) and elderly (≥ 80 years; 60 patients, 71 treated vertebrae). There were no differences in sex (p = 0.593), tobacco use (p = 0.973), chronic steroid use (p = 0.794), treatment for osteoporosis (p = 0.537), bone density (p = 0.056), outpatient procedure (p = 0.273), and inpatient LOS (p = 0.661) between both groups. There were also no differences in the development of additional VCFs (p = 0.862) at an adjacent level (p = 0.739) or remote level (p = 0.814), 30-day and 1-year postoperative complications (p = 0.794 and p = 0.560, respectively), and reoperation rates (p = 0.420). Patients were then analyzed by RAI: nonfrail (RAI score < 30; 203 patients, 243 treated vertebrae) and frail (RAI score ≥ 31; 77 patients, 91 treated vertebrae). There were no differences in tobacco use (p = 0.959), chronic steroid use (p = 0.658), treatment for osteoporosis (p = 0.560), bone density (p = 0.339), outpatient procedure (p = 0.241), inpatient LOS (p = 0.570), and development of additional VCFs (p = 0.773) at an adjacent level (p = 0.390) or remote level (p = 0.689). However, rates of 30-day and 1-year postoperative complications in frail patients more than doubled in comparison with nonfrail patients (p = 0.031 and p = 0.007, respectively), and frail patients trended toward reoperation (p = 0.097). CONCLUSIONS BAK is a safe treatment in the elderly, and age alone should not be used as an exclusion criterion during patient selection. Frailty, which can be assessed reliably using the RAI, may serve as a better predictor for postoperative complications and reoperation following BAK.
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Affiliation(s)
- Samuel Adida
- 1University of Pittsburgh School of Medicine, University of Pittsburgh; and
- 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Anthony Tang
- 1University of Pittsburgh School of Medicine, University of Pittsburgh; and
| | - Suchet Taori
- 1University of Pittsburgh School of Medicine, University of Pittsburgh; and
- 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Victoria R Wong
- 1University of Pittsburgh School of Medicine, University of Pittsburgh; and
| | - Roberta K Sefcik
- 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Xiaoran Zhang
- 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Peter C Gerszten
- 1University of Pittsburgh School of Medicine, University of Pittsburgh; and
- 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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12
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Patel R, Mcconaghie G, Webb J, Laing G, Roach R, Banerjee R. An overview of bone cement: Perioperative considerations, complications, outcomes and future implications. J Perioper Pract 2024; 34:106-111. [PMID: 37243329 DOI: 10.1177/17504589231169861] [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: 05/28/2023]
Abstract
Polymethyl methacrylate is commonly known as bone cement and is widely used for implant fixation in various orthopaedic arthroplasty and trauma surgery. The first bone cement use in orthopaedics is widely accredited to the famous English surgeon, John Charnley, who in 1958, used it for total hip arthroplasty. Since then, there have been many developments in cementing techniques in arthroplasty surgery. This overview aims to cover the perioperative considerations of bone cement, including cementing techniques, current outcomes and complications such as bone cement implantation syndrome. The overview will additionally consider future developments involving bone cement in orthopaedic arthroplasty.
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Affiliation(s)
- Ravi Patel
- Department of Trauma and Orthopaedics, The Princess Royal Hospital, The Shrewsbury and Telford Hospital NHS Trust, Telford, UK
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Greg Mcconaghie
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Jeremy Webb
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Georgina Laing
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Richard Roach
- Department of Trauma and Orthopaedics, The Princess Royal Hospital, The Shrewsbury and Telford Hospital NHS Trust, Telford, UK
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Robin Banerjee
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
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13
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Koob S, Kohlhof H, Randau TM, Wirtz DC. [Acetabular metastatic defect reconstruction using the modular revision support cup MRS-C]. Oper Orthop Traumatol 2024; 36:145-156. [PMID: 37921888 PMCID: PMC11014813 DOI: 10.1007/s00064-023-00834-6] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/24/2023] [Accepted: 03/22/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE Stabilization of metastatic acetabular defects with a bone cement-augmented revision support cup for remobilization of oncological patients in advanced cancer stages. INDICATIONS Metastatic acetabular defects (Metastatic Acetabular Classification, MAC 2-4) in patients with a prognostic medium or long-term survival. CONTRAINDICATIONS Highly limited survival due to metastatic disease (< 6 weeks). Local bone or soft tissue infection. Primary bone tumor with curative treatment option. Advanced pelvic discontinuity. Recent wound compromising systemic therapy. SURGICAL TECHNIQUE Standard hip approach. Curettage of the metastatic defect and careful reaming of the acetabulum before insertion of the cup. Predrilling of the dome und flange screws before application of the bone cement through the center hole of the implant and filling of the acetabular defect. Complete insertion of the screws for compound osteosynthesis. Implant of a modular inlay or dual mobility system. POSTOPERATIVE MANAGEMENT Full weight bearing or mobilization with two crutches according to the level of pain. Adjuvant local radiation therapy after wound consolidation. Continuation of systemic therapy according to tumor board decision. RESULTS Between 2012 and 2019, we treated 14 patients with metastatic acetabular defects using the modular revision support cup "MRS-TITAN® Comfort", MRS-C, Peter Brehm GmbH, Weisendorf, Germany) at our institution. Mean Harris Hip Score improvement was 23.2 with a mean patient's survival of 9.7 months due to the reduced cancer-related prognosis; 13 of the 14 implants endured the patient's prognosis. One implant had to be removed due soft tissue defect-related periprosthetic joint infection.
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Affiliation(s)
- S Koob
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - H Kohlhof
- Unfall‑, Hand- und Orthopädische Chirurgie, St. Antonius Krankenhaus Köln, Köln, Deutschland
| | - T M Randau
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - D C Wirtz
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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14
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Ditta ZM, Laohana P, Tanapongpisit N, Saenrang W, Boonlue S, Sata V, Baalousha M, Chindaprasirt P, Ekprasert J. Mechanical and self-healing properties of cement paste containing incinerated sugarcane filter cake and Lysinibacillus sp. WH bacteria. Sci Rep 2024; 14:6716. [PMID: 38509345 DOI: 10.1038/s41598-024-57492-2] [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: 12/31/2023] [Accepted: 03/19/2024] [Indexed: 03/22/2024] Open
Abstract
Cement is the most widely used construction material due to its strength and affordability, but its production is energy intensive. Thus, the need to replace cement with widely available waste material such as incinerated black filter cake (IBFC) in order to reduce energy consumption and the associated CO2 emissions. However, because IBFC is a newly discovered cement replacement material, several parameters affecting the mechanical properties of IBFC-cement composite have not been thoroughly investigated yet. Thus, this work aims to investigate the impact of IBFC as a cement replacement and the addition of the calcifying bacterium Lysinibacillus sp. WH on the mechanical and self-healing properties of IBFC cement pastes. The properties of the IBFC-cement pastes were assessed by determining compressive strength, permeable void, water absorption, cement hydration product, and self-healing property. Increases in IBFC replacement reduced the durability of the cement pastes. The addition of the strain WH to IBFC cement pastes, resulting in biocement, increased the strength of the IBFC-cement composite. A 20% IBFC cement-replacement was determined to be the ideal ratio for producing biocement in this study, with a lower void percentage and water absorption value. Adding strain WH decreases pore sizes, densifies the matrix in ≤ 20% IBFC biocement, and enhances the formation of calcium silicate hydrate (C-S-H) and AFm ettringite phases. Biogenic CaCO3 and C-S-H significantly increase IBFC composite strength, especially at ≤ 20% IBFC replacement. Moreover, IBFC-cement composites with strain WH exhibit self-healing properties, with bacteria precipitating CaCO3 crystals to bridge cracks within two weeks. Overall, this work provides an approach to produce a "green/sustainable" cement using biologically enabled self-healing characteristics.
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Affiliation(s)
- Zerlinda Mara Ditta
- Bioscience and Bioinnovation for Sustainability Program, Department of Integrated Science, Faculty of Science, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Peerawat Laohana
- School of Physics, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
- Center of Excellence in Advanced Functional Materials, School of Physics, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
| | - Nantawat Tanapongpisit
- School of Physics, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
- Center of Excellence in Advanced Functional Materials, School of Physics, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
| | - Wittawat Saenrang
- School of Physics, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
- Center of Excellence in Advanced Functional Materials, School of Physics, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
| | - Sophon Boonlue
- Department of Microbiology, Faculty of Science, Khon Kaen University, 123 Mitraparp Rd, Muang, Khon Kaen, 40002, Thailand
| | - Vanchai Sata
- Sustainable Infrastructure Research and Development Center, Faculty of Engineering, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Mohammed Baalousha
- Department of Environmental Health Sciences, Center for Environmental Nanoscience and Risks, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Prinya Chindaprasirt
- Sustainable Infrastructure Research and Development Center, Faculty of Engineering, Khon Kaen University, Khon Kaen, 40002, Thailand
- Academy of Science, Royal Society of Thailand, Dusit, Bangkok, Thailand
| | - Jindarat Ekprasert
- Department of Microbiology, Faculty of Science, Khon Kaen University, 123 Mitraparp Rd, Muang, Khon Kaen, 40002, Thailand.
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15
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Yang R, Chen B, Zhang X, Bao Z, Yan Q, Luan S. Degradable Nanohydroxyapatite-Reinforced Superglue for Rapid Bone Fixation and Promoted Osteogenesis. ACS Nano 2024; 18:8517-8530. [PMID: 38442407 DOI: 10.1021/acsnano.4c01214] [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] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Bone glue with robust adhesion is crucial for treating complicated bone fractures, but it remains a formidable challenge to develop a "true" bone glue with high adhesion strength, degradability, bioactivity, and satisfactory operation time in clinical scenarios. Herein, inspired by the hydroxyapatite and collagen matrix composition of natural bone, we constructed a nanohydroxyapatite (nHAP) reinforced osteogenic backbone-degradable superglue (O-BDSG) by in situ radical ring-opening polymerization. nHAP significantly enhances adhesive cohesion by synergistically acting as noncovalent connectors between polymer chains and increasing the molecular weight of the polymer matrix. Moreover, nHAP endows the glue with bioactivity to promote osteogenesis. The as-prepared glue presented a 9.79 MPa flexural adhesion strength for bone, 4.7 times that without nHAP, and significantly surpassed commercial cyanoacrylate (0.64 MPa). O-BDSG exhibited degradability with 51% mass loss after 6 months of implantation. In vivo critical defect and tibia fracture models demonstrated the promoted osteogenesis of the O-BDSG, with a regenerated bone volume of 75% and mechanical function restoration to 94% of the native tibia after 8 weeks. The glue can be flexibly adapted to clinical scenarios with a curing time window of about 3 min. This work shows promising prospects for clinical application in orthopedic surgery and may inspire the design and development of bone adhesives.
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Affiliation(s)
- Ran Yang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei 230026, China
| | - Binggang Chen
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Xu Zhang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Zijian Bao
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei 230026, China
| | - Qiuyan Yan
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Shifang Luan
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei 230026, China
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16
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Reffaee A, Saied M, Hamieda SF, Amin SK. Fabrication of green anti-microbial and anti-static cement building bricks. Sci Rep 2024; 14:6313. [PMID: 38491047 PMCID: PMC10943018 DOI: 10.1038/s41598-024-56514-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
The design cement mix of grade 350 was created in accordance with Egyptian Standards by partially substituting the fine aggregate with WPVC waste in various weight percentages (10, 20, 30, 40, 50, 75, and 100%). A control mix with 0% replacement was also prepared. The W/C ratio was about 0.5 for all mixes. Compressive, flexure strength, bulk density, and absorption tests were studied. For WPVC replacement, until 30%, compressive strength and flexure strength are acceptable with respect to standerds. Thermal treatment at 200 °C improves the compressive strength, flexure strength and water absorption for 20% WPVC only. The dielectric properties of all cement paste mixes before and after heat treatment, over a frequency range (0.1-106 Hz), were measured as a function of frequency. For dielectric properties and conductivity, an improvement was obtained until 30% WPVC. After this percentage, the dielectric properties and the conductivity got worse. So, cement paste with 30% WPVC as replacement of sand is the optimum ratio with conductivity in range of 10-12 S/cm, which is a good choice for antistatic cement paste applications (10-10-10-12 S/cm). The antimicrobial efficacy of the prepared cement samples of WPVC concentrations (0, 20 and 30) % were studied, the number of grown microbial colonies decreased for all the samples compared to control tap water and decreased by introducing WPVC into the cement paste sample. So, it is recommended to use these samples in places that should be carefully shielded from bacterial infections and static electric charge dangers.
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Affiliation(s)
- Abeer Reffaee
- Microwave Physics and Dielectrics Department, National Research Centre, Cairo, Egypt.
| | - Mona Saied
- Microwave Physics and Dielectrics Department, National Research Centre, Cairo, Egypt
| | - Shimaa Farag Hamieda
- Microwave Physics and Dielectrics Department, National Research Centre, Cairo, Egypt
| | - Sh K Amin
- Chemical Engineering and Pilot Plant Department, Engineering and Renewable Energy Research Institute, National Research Centre (NRC), Affiliation ID: 60014618, Giza, Egypt
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Jain S, Lamb JN, Drake R, Entwistle I, Baren JP, Thompson Z, Beadling AR, Bryant MG, Shuweihdi F, Pandit H. Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model. Proc Inst Mech Eng H 2024; 238:324-331. [PMID: 38235693 DOI: 10.1177/09544119231225172] [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: 01/19/2024]
Abstract
This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m2) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at p < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all p > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.
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Affiliation(s)
- Sameer Jain
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Jonathan N Lamb
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Ruth Drake
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ian Entwistle
- Department of Radiography, University of Bradford, Bradford, UK
| | - James P Baren
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Zachary Thompson
- School of Mechanical Engineering, University of Leeds, Leeds, UK
| | | | - Michael G Bryant
- School of Mechanical Engineering, University of Leeds, Leeds, UK
| | | | - Hemant Pandit
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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18
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von Lewinski G, Kühn KD. [PMMA Bone Cement-Part 2]. Orthopadie (Heidelb) 2024; 53:161-162. [PMID: 38407640 DOI: 10.1007/s00132-023-04457-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 02/27/2024]
Affiliation(s)
- Gabriela von Lewinski
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert Koch Str. 40, 37075, Göttingen, Deutschland.
| | - Klaus-Dieter Kühn
- Universitätsklinik für Orthopädie und Orthopädische Chirurgie, Medizinische Universität Graz, Graz, Österreich
- Heraeus Medical GmbH, Wehrheim, Deutschland
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19
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Xia H, Zhou C, Wang Y, Zheng Y. Design of a new detachable pedicle screw based on medical optical imaging inspection to improve osteoporosis and enhance vertebral body revision effect. Med Eng Phys 2024; 125:104137. [PMID: 38508790 DOI: 10.1016/j.medengphy.2024.104137] [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: 12/16/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/22/2024]
Abstract
Osteoporosis is a common bone disease that often leads to difficulty in vertebrae revision. Traditional pedicle screws are often complicated to operate and have poor visibility during implantation. A new detachable pedicle screw is needed to improve the revision effect. The aim of this study was to design a new detachable pedicle screw based on medical optical imaging to improve the outcome of vertebral revision in osteoporosis, and to improve operational feasibility and visibility. In this study, the parameters related to the degree of osteoporosis were obtained by optical imaging detection of the osteoporotic vertebral body. Then a new detachable pedicle screw was designed according to the test results to improve the effect of vertebral body revision. By preparing and optimizing the material and structure of the screw, it is ensured that it has sufficient mechanical strength and stability. Finally, the visibility and operability of the improved screw during implantation were verified by medical optical imaging. Compared with traditional screws, the new detachable pedicle screw can improve the vertebral body revision in the case of osteoporosis. The optical imaging test results show that the new screw has good visibility and maneuverability, providing more accurate guidance and positioning for the vertebral body revision operation.
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Affiliation(s)
- Haipeng Xia
- Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong Province, China
| | - Chao Zhou
- Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong Province, China
| | - Yanguo Wang
- Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong Province, China
| | - Yanping Zheng
- Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong Province, China.
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20
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Hollensteiner M, Sandriesser S, Augat P. Open the pores - Polydimethylsiloxane influences the porous structure of cancellous bone surrogates for biomechanical testing of osteosyntheses. J Biomech 2024; 165:112000. [PMID: 38387369 DOI: 10.1016/j.jbiomech.2024.112000] [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: 11/20/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
Synthetic materials used for valid and reliable implant testing and design should reflect the mechanical and morphometric properties of human bone. Such bone models are already available on the market, but they do not reflect the population variability of human bone, nor are they open-celled porous as human bone is. Biomechanical studies aimed at cementing the fracture or an implant cannot be conducted with them. The aim of this study was to investigate the influence of a cell stabilizer on polyurethane-based cancellous synthetic bone in terms of morphology, compressive mechanics, and opening of the cancellous bone structure for bone cement application. Mechanical properties of cylindrical specimens of the bone surrogates were determined by static compression tests to failure. Furthermore, a morphometric analysis was performed using microcomputed tomography. To prove the open-cell nature of the bone surrogates, an attempt was made to apply bone cement. Effects on the mechanical properties of the polyurethane-based bone surrogates were observed by the addition of polydimethylsiloxane. All mechanical parameters like Young's modulus, ultimate stress and yield stress increased statistically significantly with increasing amounts of cell stabilizer (all p > 0.001), except for yield stress. The analysis of morphometric parameters showed a decrease in trabecular thickness, spacing and connectivity density, which was accompanied by an increase in trabecular number and an increase in pore size. The open-cell nature was proven by the application and distribution of bone cement in specimens with stabilizer, which was visualized by X-ray. In conclusion, the results show that by adding a cell stabilizer, polyurethane-based cancellous bone substrates can be produced that have an open-cell structure similar to human bone. This makes these bone surrogates suitable for biomechanical testing of osteosyntheses and for osteosynthesis cementation issues.
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Affiliation(s)
- Marianne Hollensteiner
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Straße 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria.
| | - Sabrina Sandriesser
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Straße 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
| | - Peter Augat
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Straße 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
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Si X, Shan D, Huo L, Hu Y, Zou C, Wang B, Cao J, Wu W. Effect of percutaneous vertebroplasty versus percutaneous kyphoplasty on post-operative wound pain in patients with osteoporotic vertebral compression fractures. Int Wound J 2024; 21:e14745. [PMID: 38484743 PMCID: PMC10940009 DOI: 10.1111/iwj.14745] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/21/2024] [Indexed: 03/18/2024] Open
Abstract
This research is intended to evaluate the efficacy of percutaneous vertebroplasty (PVP) versus percutaneous kyphoplasty (PKP) in osteoporotic vertebral compression fracture (OVCF), which is associated with post-operative pain. Eligible studies were screened by searching multiple databases and sources such as PubMed, Cochrane and EMBASE for search terms updated to October 2023, and relevant literature sources were searched. Randomized, controlled, prospective or retrospective, and cohort studies were eligible. For the analysis of the primary results, an analysis of the data was carried out, such as mean difference (MD) or odds ratio (OR), and 95% confidence interval (CI). In the present research, 1933 research was screened in 4 databases, and 30 articles were chosen to be examined under strict exclusion criteria. No statistical significance was found in the use of bone cement in the PVP group and PKP (MD, -0.60; 95% CI, -1.40, 0.21, p = 0.15); PKP was associated with a reduced risk of cement leak compared with PVP group (OR, 2.18; 95% CI, 1.38, 3.46, p = 0.0009); no statistical significance was found in the wound VAS score in PVP operation compared with that of PKP (MD, 0.16; 95% CI, -0.07, 0.40, p = 0.17); no statistical significance was found between the time of PVP operation and the time of PKP operation (MD, -2.65; 95% CI, -8.91, 3.60, p = 0.41). Compared with PVP technology, the PKP treatment of osteoporotic vertebral compression fractures reduces post-operative cement leakage, but there is no significant difference in the number of operative cement and wound VAS after operation. Nor did there appear to be a statistically significant difference in time between the two operations.
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Affiliation(s)
- Xiaojing Si
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Dongli Shan
- Department of Bone & Soft Tissue CancerChongqing University Cancer HospitalChongqingChina
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
| | - li Huo
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Yongjun Hu
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Chuanqi Zou
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Boxin Wang
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Junxiong Cao
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
| | - Wenjie Wu
- Department of OrthopedicsPeople's Hospital of Chongqing Banan DistrictChongqingChina
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Yehia A, Al-Zordk W, Elsherbini A, Sakrana AA. A microcomputed tomography analysis of adaptation in premolars with flared root canals restored with different digitally custom fabricated post materials. J Prosthet Dent 2024; 131:457.e1-457.e9. [PMID: 38212155 DOI: 10.1016/j.prosdent.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
STATEMENT OF PROBLEM Preserving and strengthening the remaining tooth structure of compromised flared root canals after endodontic treatment is challenging. PURPOSE The purpose of this in vitro study was to compare the adaptation of milled polymer- infiltrated ceramic, fiber-reinforced composite resin, and high-performance semicrystalline thermoplastic resin posts as used to restore mandibular premolars with flared root canals. MATERIAL AND METHODS Forty sound mandibular premolars were randomly divided into 4 groups: custom Vita Enamic (CV), custom fiber-reinforced composite resin (CF), custom polyetherketoneketone (CP), and prefabricated fiber (RF) posts. After endodontic treatment, each tooth was sectioned 1.5 mm occlusal to the cementoenamel junction. Then, the post space was prepared and flared, except the RF group, to a depth of 9 mm. The post space in RF group was prepared with a post drill. For the CV, CF, and CP groups, the posts were milled, finished, and cemented to their corresponding teeth. Each tooth was scanned using a microcomputed tomography device, and the reconstructed images were analyzed in mesiodistal, buccolingual, and horizontal planes. The cement thickness, cement volume, and volume of voids were measured. The data were analyzed using 3-way ANOVA (cement thickness) and 2-way ANOVA (cement volume and voids volume) tests followed by the post hoc Tukey test (α=.05). RESULTS The 3-way ANOVA test revealed a significant interaction (P<.001) between material type, section, and surface on the cement thickness. The mean cement thickness in the RF group was significantly higher than in the CV group (P=.001) and CF group (P=.005). The least mean cement thickness was at the apical section followed by the cervical and middle sections. Regarding cement volume, the 2-way ANOVA test showed statistically significant interaction between material type and section. The mean cement volume in the RF group was significantly lower than in the CV group (P=.001), CF group (P=.001), and CP group (P=.001). The highest mean cement volume was in the cervical section followed by the middle and apical sections. The 2-way ANOVA test showed statistically significant interaction (P<.001) between material type and section on the volume of voids. Significant differences were found between the mean volume of voids at the cervical and middle sections (P=.001) and the cervical and apical sections (P=.002). CONCLUSIONS Compared with prefabricated fiber posts, digitally fabricated polymer-infiltrated ceramic and fiber-reinforced composite resin posts had a thinner cement layer with minimal thickness at the apical section. The digitally fabricated posts had higher cement volume, especially at the cervical section, than prefabricated fiber posts. High volumes of voids were related to the cervical section of all tested posts.
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Affiliation(s)
- Ahmed Yehia
- Graduate student, Department of Fixed Prosthodontics, Mansoura University, Mansoura, Dkahlia, Egypt
| | - Walid Al-Zordk
- Associate professor, Department of Fixed Prosthodontics, Mansoura University, Mansoura, Dkahlia, Egypt; and Department of Fixed Prosthodontics, Horus University, New Damietta, Egypt
| | - Ahmed Elsherbini
- Graduate student, Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo, Tokyo, Japan
| | - Amal Abdelsamad Sakrana
- Professor, Department of Fixed Prosthodontics, Mansoura University, Mansoura, Dkahlia, Egypt; and Department of Fixed Prosthodontics, Horus University, New Damietta, Egypt.
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23
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Zhang H, Zheng S, Liu Q, Wei P, Gu F, Yu J, Wang Z, Li J, Xu Y, Tang C, Yao Q, Du C, Wang L. 3D-printed antibiotic-loaded bone cement spacers as adjunctive therapy for hip periprosthetic infection after arthroplasty: A clinical assessment. Int J Antimicrob Agents 2024; 63:107080. [PMID: 38163551 DOI: 10.1016/j.ijantimicag.2023.107080] [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: 09/18/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To explore the effect of three-dimensional (3D) printing to create personalized antibiotic-loaded bone cement (ALBC) spacers to assist in treatment of periprosthetic infection after total hip arthroplasty (THA). METHODS The data of 40 patients with postoperative infection after THA were analysed retrospectively. The patients were divided into two groups: the 3D-printing group (age 47-78 years, n = 20) and the conventional group (age 57-78 years, n = 20). In stage I surgery, 3D-printed silicone moulds were used to create ALBC spacers for the 3D-printing group, while traditional manual methods were used to create spacers for the conventional group. After the infection was controlled, both groups underwent conventional hip revision surgery (stage II surgery). All patients were evaluated using the Harris Hip Score (HHS) (primary outcome) for hip function. RESULTS All 40 patients had follow-up data from 3 months after stage I surgery and 12 months after stage II surgery. The intergroup difference in HHS was 11.25 points [97.5% confidence interval (CI) 7.92-14.58; P < 0.01] at 3 months after stage I surgery, and 9.15 points (97.5% CI 4.82-13.48; P < 0.01) at 12 months after stage II surgery. The overall difference between the two groups was 9.55 points (97.5% CI 5.83-13.27; P < 0.01), which was significant (P < 0.05). CONCLUSION During the follow-up period, the hip function of the 3D-printing group was superior to that of the conventional group following the treatment of infections after THA.
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Affiliation(s)
- Huikang Zhang
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China; Nanjing Clinical Nuclear Medicine Centre, Nanjing, Jiangsu Province, China
| | - Suyang Zheng
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qingbai Liu
- Department of Orthopaedics, Lianshui People's Hospital of Kangda College Affiliated to Nanjing Medical University, Huai'an, Jiangsu Province, China; Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Peiran Wei
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Fei Gu
- Department of Orthopaedics, The Second People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China
| | - Jiangping Yu
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China; Nanjing Clinical Nuclear Medicine Centre, Nanjing, Jiangsu Province, China
| | - Zizheng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Nanjing Clinical Nuclear Medicine Centre, Nanjing, Jiangsu Province, China
| | - Jiayi Li
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yan Xu
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Cheng Tang
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qingqiang Yao
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China.
| | - Chuanlin Du
- Department of Orthopaedics, The Ganyu District People's Hospital of Lianyungang City, Lianyungang, Jiangsu, China.
| | - Liming Wang
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China.
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Yamamoto S, Takegami Y, Tokutake K, Nakashima R, Naito K, Ogura K, Kato D, Imagama S. Effect of anaesthesia on cemented hemiarthroplasty -A multicentre retrospective study (TRON study). J Orthop Sci 2024; 29:585-588. [PMID: 36822946 DOI: 10.1016/j.jos.2023.02.005] [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] [Received: 11/02/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION This study aimed to investigate the survival rate, postoperative complications, and walking ability in cemented hemiarthroplasty (HA) for displaced femoral neck fractures according to the anaesthesia method. METHODS We conducted a retrospective study of a multicentre group (the TRON group). Three hundred fifty-eight patients who underwent cemented HA between 2015 and 2019 were selected; 289 patients of ≥75 years of age with no missing data were included. Patient background factors were matched and patients were assigned to spinal anaesthesia (SA) and general anaesthesia (GA) groups. The primary outcome was death at any time during the follow-up period. Secondary outcomes included postoperative complications and walking ability assessed using the Parker mobility score (PMS). Overall survival was evaluated using the Kaplan-Meier method, and differences were compared using the log-rank test. The incidence of each complication and PMS were compared between the two groups using Fisher's exact test. RESULTS Overall survival during follow-up was significantly higher in the SA group in comparison to the GA group (p = 0.037). In the SA and GA groups, the survival rate at 3 months postoperatively was 98.4% and 95.5%, respectively. The incidence of postoperative pneumonia was significantly higher in the GA (p = 0.012), and PMS at 3 months postoperatively was significantly higher in the SA group (p = 0.016). CONCLUSION The survival rate of elderly patients who underwent cemented HA was better in the SA group. General anaesthesia in cemented HA may be associated with lower life expectancy, increased incidence of pneumonia, and decreased walking ability.
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Affiliation(s)
- Shigeto Yamamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Katsuhiro Tokutake
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryo Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenta Naito
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keisuke Ogura
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Daizo Kato
- Department of Orhopedic Surgery, Okazaki City Hospital, Okazaki, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Khalaf K, Nikkhoo M, Shams S, Niu CC, Cheng CH. Impact of osteoporosis and Cement-Augmented fusion on adjacent spinal levels Post-Fusion Surgery: Patient-Specific finite element analysis. J Biomech 2024; 166:112070. [PMID: 38569456 DOI: 10.1016/j.jbiomech.2024.112070] [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: 08/31/2023] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
Cement-augmentation is a technique commonly used during posterior lumbar instrumented fusion (PLIF) to reinforce compromised osteoporotic vertebral bone, minimize the risk of loosening screws, enhance stability, and improve overall surgical outcomes. In this study, we introduce a novel segmented vertebral body regional modeling approach to investigate the effects of osteoporosis and cement-augmented lumbar fusion on disc biomechanics at spinal levels adjacent to the fused vertebrae. Using our previously validated personalized-poroelastic-osteoligamentous FE model of the spine, fusion was simulated at L4-L5, and the biomechanics of adjacent levels were studied for 30 patients (non-osteoporotic patients (N = 15), osteoporotic patients (N = 15)). PLIF models, with and without cement-augmentation, were developed and compared after an 8 h-rest period (200 N), following a 16 h-cyclic compressive loading of 500-1000 N (40 and 20 min, respectively). Movement in different directions (flexion/ extension/ lateral bending/ axial rotation) was simulated using 10Nm moment before and after cyclic loading. The material mapping algorithm was validated by comparing the results of voxel-based and parametric models. The FE cement-augmented models, subject to daily activity loading, demonstrated significant differences in disc height loss and fluid loss as compared to non-cemented models. The calculated axial stress and fiber strain values were also significantly higher for these models. This work demonstrates that although osteoporosis does not significantly alter the time-dependent characteristics of adjacent IVDs post-surgery, cement-augmentation increases the risk of adjacent segment disease (ASD) incidence. A holistic understanding of the trade-offs and long-term complex interplay between structural reinforcement modalities, including cement augmentation, and altered biomechanics warrants further investigation.
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Affiliation(s)
- Kinda Khalaf
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, and Health Engineering Innovation Center, Abu Dhabi, United Arab Emirates.
| | - Mohammad Nikkhoo
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Shohreh Shams
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Chi-Chien Niu
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Bendtsen MAF, Odgaard A, Madsen F, Mosegaard SB, Thomsen JS, Hauge EM, Søballe K, Stilling M. Preoperative proximal tibial bone density, bone microarchitecture, and bone turnover are not associated with postoperative tibial component migration in cemented and cementless medial unicompartmental knee replacements: secondary analyses from a randomized controlled trial. Acta Orthop 2024; 95:121-129. [PMID: 38391197 PMCID: PMC10885816 DOI: 10.2340/17453674.2024.39917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/16/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND AND PURPOSE Cementless arthroplasty fixation relies on early bone ingrowth and may be poor in patients with low proximal tibial bone density or abnormal bone turnover. We aimed first to describe the baseline bone properties in patients undergoing medial unicompartmental knee replacement (UKR), and second to investigate its association with cemented and cementless tibial component migration until 2 years. METHODS A subset investigation of 2 patient groups from a 3-armed randomized controlled trial was conducted. There were 26 cemented and 25 cementless medial UKRs with twin-pegged femoral components. Volumetric bone mineral density (vBMD) and microstructure of the excised medial tibial plateau were ascertained with µCT. Bone turnover was estimated using dynamic histomorphometry (eroded surface/bone surface = ES/BS, osteoid surface/bone surface = OS/BS, mineralizing surface/bone surface = MS/BS). Tibial component migration in 4 feature points was followed for 2 years with radiostereometry. RESULTS At the 2-year follow-up, the cementless tibial components migrated 0.38 mm (95% confidence interval [CI] 0.14-0.62) total translation more than the cemented components at the posterior feature point. The greatest migration in the cementless group was subsidence at the posterior feature point of 0.66 mm (CI 0.48-0.84) until 6 weeks, and from 3 months the components were stable. Cemented tibial components subsided very little. Between 1- and 2-year follow-ups, no cementless but 4 cemented tibial components revealed continuous migration. OS/BS was half of the ES/BS. No µCT or histomorphometric parameters showed any clinically relevant correlation with tibial component migration at the posterior feature point for either cemented or cementless UKR at 6 weeks' or 2 years' follow-up after adjustment for age, BMI, and sex. CONCLUSION Preoperative vBMD, bone turnover, and microstructure were not associated with postoperative tibial component migration of cemented and cementless medial UKR.
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Affiliation(s)
- Mathias Alrø Fichtner Bendtsen
- Department of Clinical Medicine, Aarhus University, Aarhus; AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus.
| | - Anders Odgaard
- Department of Orthopaedic Surgery, Rigshospitalet-Copenhagen University Hospital, Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen
| | - Frank Madsen
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus
| | | | | | | | - Kjeld Søballe
- Department of Clinical Medicine, Aarhus University, Aarhus; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus
| | - Maiken Stilling
- Department of Clinical Medicine, Aarhus University, Aarhus; AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus
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Gao Q, Li Q, Wang L, Cen Y, Yang H. Percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures: an umbrella review protocol of systematic reviews and meta-analyses. BMJ Open 2024; 14:e075225. [PMID: 38382955 PMCID: PMC10882401 DOI: 10.1136/bmjopen-2023-075225] [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: 02/23/2024] Open
Abstract
INTRODUCTION Several systematic reviews and meta-analyses have confirmed that percutaneous vertebroplasty and percutaneous kyphoplasty showed safety and beneficial efficacy in patients with osteoporotic vertebral compression fractures. Whereas, there is wide variation among results, which are not conducive to the evaluation and use of clinicians. This study will investigate the efficacy and safety of percutaneous vertebroplasty and percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures, aiming to provide a more reliable evidence base for clinical practice in treating osteoporotic vertebral compression fractures. METHODS AND ANALYSIS We will retrieve the relevant articles using the five databases(PubMed, Scopus, EMBASE, Cochrane Library and Web of Science) from inception to March 2023 for systematic review and meta-analysis comparing the overall safety and efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty in patients with osteoporotic vertebral compression fractures. Three reviewers will screen citation titles, abstracts and evaluate the full text of each relevant citation based on prespecified eligibility criteria. Any discrepancies in decisions between reviewers will be resolved through discussion. We will assess the methodological quality of the included studies according to A MeaSurement Tool to Assess systematic Reviews 2 checklist. ETHICS AND DISSEMINATION This umbrella review will inform clinical and policy decisions regarding the benefits and harms of percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Neither primary data nor individual patient information will be collected, thus ethics approval is not required. Findings will be reported through a peer-reviewed publication, conference presentations and the popular press. PROSPERO REGISTRATION NUMBER CRD42021268141.
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Affiliation(s)
- Qingyang Gao
- Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiujiang Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liang Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Cen
- Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huiliang Yang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Cho SY, Park S, Shin Y, Jung IY. Randomized clinical trial of pulpotomy using a premixed injectable calcium silicate cement on mature permanent teeth with reversible pulpitis. Sci Rep 2024; 14:2994. [PMID: 38316823 PMCID: PMC10844323 DOI: 10.1038/s41598-024-52818-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable calcium silicate cement, as compared to mineral trioxide aggregate in mature permanent premolar and molar teeth with reversible pulpitis. Included teeth were randomly divided into two groups according to pulpotomy material (ProRoot MTA [PMTA] group, Endocem MTA Premixed [EPM] group). After pulp exposure, the superficial pulp was either removed to a depth of 2 mm (partial pulpotomy) or completely amputated to the level of the root canal orifice (full pulpotomy). A 3-mm layer of either material was randomly placed over the pulp wound, followed by the application of a thin layer of a light-cured glass ionomer composite liner. The restoration procedure was then carried out during the same visit. After one year of treatment, the pulpotomy success rate was 94.4% (67/71), with no significant difference between the PMTA and EPM groups. The success rate was 93.9% in the PMTA group and 97.1% in the EPM group. There were no significant factors related to the procedures. EPM is a viable alternative to PMTA for single-visit pulpotomies of permanent premolars and molars.
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Affiliation(s)
- Sin-Yeon Cho
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-Do, Korea
| | - Seonghun Park
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Yooseok Shin
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Il-Young Jung
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea.
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Gamal S, Mikhail M, Salem N, El-Wakad MT, Abdelbaset R. Effect of using nano-particles of magnesium oxide and titanium dioxide to enhance physical and mechanical properties of hip joint bone cement. Sci Rep 2024; 14:2838. [PMID: 38310142 PMCID: PMC10838278 DOI: 10.1038/s41598-024-53084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024] Open
Abstract
In this work, the effect of adding Magnesium Oxide (MgO) and Titanium Dioxide (TiO2) nanoparticles to enhance the properties of the bone cement used for hip prosthesis fixation. Related to previous work on enhanced bone cement properties utilizing MgO and TiO2, samples of composite bone cement were made using three different ratios (0.5%:1%, 1.5%:1.5%, and 1%:0.5%) w/w of MgO and TiO2 to determine the optimal enhancement ratio. Hardness, compression, and bending tests were calculated to check the mechanical properties of pure and composite bone cement. The surface structure was studied using Fourier transform infrared spectroscopy (FTIR) and Field emission scanning electron microscopy (FE-SEM). Setting temperature, porosity, and degradation were calculated for each specimen ratio to check values matched with the standard range of bone cement. The results demonstrate a slight decrease in porosity up to 2.2% and degradation up to 0.17% with NP-containing composites, as well as acceptable variations in FTIR and setting temperature. The compression strength increased by 2.8% and hardness strength increased by 1.89% on adding 0.5%w/w of MgO and 1.5%w/w TiO2 NPs. Bending strength increases by 0.35% on adding 1.5% w/w of MgO and 0.5% w/w TiO2 NPs, however, SEM scan shows remarkable improvement for surface structure.
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Affiliation(s)
- Safaa Gamal
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt.
- Mechatronics Engineering Department, Canadian International Collage, Cairo, Egypt.
| | - Mina Mikhail
- Mechatronics Engineering Department, Canadian International Collage, Cairo, Egypt
| | - Nancy Salem
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt
| | - Mohamed Tarek El-Wakad
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt
- Biomedical Engineering Department, Faculty of Engineering and Technology, Future University, Cairo, Egypt
| | - Reda Abdelbaset
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt
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Okumura T, Komura S, Hirakawa A, Hirose H, Akiyama H. Two-stage reconstruction using a vancomycin-impregnated cement spacer for finger osteomyelitis with bone and joint destruction. Hand Surg Rehabil 2024; 43:101602. [PMID: 37783387 DOI: 10.1016/j.hansur.2023.09.369] [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] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES Septic arthritis and osteomyelitis are serious infections. Several treatment methods for the small joints and bones of the hands have been reported. We hypothesized that antibiotic-impregnated cement spacers could be useful for purulent finger osteomyelitis with bone and joint destruction. PATIENTS AND METHODS Seven patients with finger osteomyelitis with bone and joint destruction were treated using vancomycin (VCM)-impregnated cement spacers. During the first surgery, a cement spacer was placed in the space created after debridement, maintaining finger length. Intraoperative specimens were tested for bacterial growth. Systemic antibiotic treatment was administered. A second surgery was performed 6-8 weeks after the first. After spacer removal, reconstruction surgeries were performed: arthrodesis using the Masquelet technique (n = 5), vascularized bone grafting (n = 1), and silicone implant arthroplasty (n = 1). We assessed the pathogenic bacteria, duration of antibiotic treatment, infection control, time to bone union, pain on visual analogue scale (VAS) (0 - 100), total active motion (TAM) of the affected fingers, and grip strength. RESULTS The pathogenic bacteria were methicillin-sensitive Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and unknown in 3, 3, and 1 patients, respectively. Mean duration of antibiotic treatment was 6.4 weeks. In all patients, infection resolved without recurrence. One patient underwent joint arthroplasty; otherwise, bone union was achieved in 6 patients. Mean VAS score for pain was 0.9. Mean TAM was 147° for the index and middle fingers and 50° for the thumb. Mean grip strength was 86.4% of that of the unaffected side. CONCLUSION VCM-impregnated cement spacers could be useful for finger osteomyelitis, facilitating effective infection control and the maintenance of finger length, even in severe conditions.
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Affiliation(s)
- Takaomi Okumura
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shingo Komura
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Akihiro Hirakawa
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hitoshi Hirose
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Gong K, Song M, Shang C, Chen S, Shang G, Kou H, Chen X, Mao K, Liu H. Risk Factors for New Adjacent and Remote Vertebral Fracture After Percutaneous Vertebroplasty. World Neurosurg 2024; 182:e644-e651. [PMID: 38065359 DOI: 10.1016/j.wneu.2023.12.010] [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: 09/19/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To analyze the risk factors of new adjacent vertebral fractures (AVF) and remote vertebral fractures (RVF) after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). METHODS Patients who underwent additional PVP for new OVCFs were enrolled. In addition, we set a 1:1 age-, sex-, surgical segment-, and surgical date-matched control group, in which patients underwent PVP without new OVCFs. Data on body mass index, occurrence time of second PVP, vertebral computed tomography (CT) Hounsfield Unit (HU) at the fracture adjacent segment, and RVF segment were collected. RESULTS A total of 44 patients who underwent additional PVP for new OVCFs at our hospital were included. AVF occurred significantly earlier than RVF (13.5 ± 14.1 vs. 30.4 ± 20.1 months, P = 0.007). Compared to the control group, the AVF segment CT HU was significantly lower in patients with AVF (28.7 ± 16.7 vs. 61.3 ± 14.7, P = 0.000), while there was no significant difference between patients with RVF and control group including both adjacent and RVF segment CT HU. Receiver operating characteristic curves identified a cutoff value of 43 for using adjacent segment CT HU to differentiate patients with AVF from controls, with a sensitivity of 80% and a specificity of 88.9%. CONCLUSIONS Our study showed that the risk factors for AVF and RVF after PVP surgery were different. The occurrence of AVF was earlier and associated with low adjacent segment CT HU values, whereas the preoperative CT HU in both adjacent and RVF segments was not found to be associated with RVF.
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Affiliation(s)
- Ke Gong
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengchen Song
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chunfeng Shang
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Songfeng Chen
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guowei Shang
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hongwei Kou
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiangrong Chen
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Keya Mao
- Department of Orthopedics, The Fourth Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Hongjian Liu
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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White-Gibson A, Sheridan GA, Ghetti AC, Keogh P, Kenny P, Cashman JP. The utility of cemented femoral stems in modern THA: a 10-year comparative analysis of the Charnley and Exeter stems. Ir J Med Sci 2024; 193:251-255. [PMID: 37243843 PMCID: PMC10810030 DOI: 10.1007/s11845-023-03381-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/19/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Total hip replacement (THR) is one of the most common surgical procedures performed worldwide. The controversy surrounding the relative merits of a cemented composite beam or cemented taper-slip stem in total hip replacement continues. Our aims primarily were to assess the 10-year outcomes of cemented stems using Charnley and Exeter prostheses with regional registry data and secondarily to assess the main predictors of revision. METHODS We prospectively collected registry data for procedures performed between January 2005 and June 2008. Only cemented Charnley and Exeter stems were included. Patients were prospectively reviewed at 6 months, 2, 5 and 10 years. The primary outcome measure was a 10-year all-cause revision. Secondary outcomes included 're-revision', 'mortality' and functional 'Western Ontario and McMaster Universities Osteoarthritis Index' (WOMAC) scores. RESULTS We recorded a total of 1351 cases in the cohort, 395 Exeter and 956 Charnley stems. The overall all-cause revision rate at 10 years was 1.6%. The revision rate for Charnley stem was 1.4% and 2.3% revision rate for all Exeter stems with no significant difference noted between the two cohorts (p = 0.24). The overall time to revision was 38.3 months. WOMAC scores at 10 years were found to be insignificantly higher for Charnley stems (mean 23.8, σ = 20.11) compared to Exeter stems (mean 19.78, σ = 20.72) (p = 0.1). CONCLUSION There is no significant difference between cemented Charnley and Exeter stems; they both perform well above the international average. The decline in the use of cemented THA is not fully supported by this regional registry data.
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Affiliation(s)
| | | | | | - Peter Keogh
- The National Orthopaedic Hospital, Cappagh, Dublin, Ireland
| | - Paddy Kenny
- The National Orthopaedic Hospital, Cappagh, Dublin, Ireland
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Zhou Y, Höglund L, Samanta A, Procter P, Persson C. Hydroxyapatite particle shape affects screw attachment in cancellous bone when augmented with hydroxyapatite-containing hydrogels. J Mech Behav Biomed Mater 2024; 150:106241. [PMID: 37995601 DOI: 10.1016/j.jmbbm.2023.106241] [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: 09/13/2023] [Revised: 10/31/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
Screw-bone construct failures are a true challenge in orthopaedic implant fixation, particularly in poor quality bone. Whilst augmentation with bone cement can improve the primary stability of screws, there are cements, e.g. PMMA, that may impede blood flow and nutrients and hamper bone remodelling. In this study, soft, non-setting biomaterials based on Hyalectin gels and hydroxyapatite (HA) particles with different morphological parameters were evaluated as potential augmentation materials, using a lapine ex vivo bone model. The pull-out force, stiffness, and work to fracture were considered in evaluating screw attachment. The pull-out force of constructs reinforced with Hyalectin containing irregularly shaped nano-HA and spherically shaped micro-HA particles were found to be significantly higher than the control group (no augmentation material). The pull-out stiffness increased for the micro-HA particles and the work to fracture increased for the irregular nano-HA particles. However, there were no significant augmentation effect found for the spherical shaped nano-HA particles. In conclusion, injectable Hyalectin gel loaded with hydroxyapatite particles was found to have a potentially positive effect on the primary stability of screws in trabecular bone, depending on the HA particle shape and size.
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Affiliation(s)
- Yijun Zhou
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Lisa Höglund
- Division of Macromolecular Chemistry, Department of Chemistry-Ångström, Uppsala University, Uppsala, Sweden
| | - Ayan Samanta
- Division of Macromolecular Chemistry, Department of Chemistry-Ångström, Uppsala University, Uppsala, Sweden
| | - Philip Procter
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Cecilia Persson
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Uppsala University, Sweden.
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Alimohammadi M, Mirzabozorg H, Farahmand F, Kim S, Baril C, Ploeg HL. Statistical distribution of micro and macro pores in acrylic bone cement- effect of amount of antibiotic content. J Mech Behav Biomed Mater 2024; 150:106297. [PMID: 38100980 DOI: 10.1016/j.jmbbm.2023.106297] [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: 07/10/2023] [Revised: 09/02/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
Aseptic loosening due to mechanical failure of bone cement is considered to be a leading cause of revision of joint replacement systems. Detailed quantified information on the number, size and distribution pattern of pores can help to obtain a deeper understanding of the bone cement's fatigue behavior. The objective of this study was to provide statistical descriptions for the pore distribution characteristics of laboratory bone cement specimens with different amounts of antibiotic contents. For four groups of bone cement (Palacos) specimens, containing 0.3, 0.6, 1.2 and 2.4 wt/wt% of telavancin antibiotic, seven samples per group were micro computed tomography scanned (38.97 μm voxel size). The images were first preprocessed in Mimics and then analyzed in Dragonfly, with the level of threshold being set such that single-pixel pores become visible. The normalized pore volume data of the specimens were then used to extract the logarithmic histograms of the pore densities for antibiotic groups, as well as their three-parameter Weibull probability density functions. Statistical comparison of the pore distribution data of the antibiotic groups using the Mann-Whitney non-parametric test revealed a significantly larger porosity (p < 0.05) in groups with larger added antibiotic contents (2.4 and 0.6 wt/wt% vs 0.3 wt/wt%). Further analysis revealed that this effect was associated with the significantly larger frequency of micropores of 0.1-0.5 mm diameter (p < 0.05) in groups with larger antibiotic content (2.4 wt/wt% vs and 0.6 and 0.3 wt/wt%), implying that the elution of the added antibiotic produces micropores in this diameter range mainly. Based on this observation and the fatigue test results in the literature, it was suggested that micropore clusters have a detrimental effect on the mechanical properties of bone cement and play a major role in initiating fatigue cracks in highly antibiotic added specimens.
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Affiliation(s)
- Mahsa Alimohammadi
- Civil Engineering Department, KN Toosi University of Technology, Tehran, Iran; Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Hassan Mirzabozorg
- Civil Engineering Department, KN Toosi University of Technology, Tehran, Iran
| | - Farzam Farahmand
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
| | - Sunjung Kim
- Department of Orthopaedic Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Caroline Baril
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Heidi-Lynn Ploeg
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada.
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Wang B, Zhao Y, Li Y, Tang C, He P, Liu X, Yao J, Chu C, Xu B. NIR-responsive injectable magnesium phosphate bone cement loaded with icariin promotes osteogenesis. J Mech Behav Biomed Mater 2024; 150:106256. [PMID: 38048713 DOI: 10.1016/j.jmbbm.2023.106256] [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: 09/16/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023]
Abstract
There were defects like limited osteogenesis and fast drug release in traditional magnesium phosphate bone cement (MPC). In this study, we loaded icariin in a mesoporous nano silica container modified by polydopamine and then added it and citric acid into MPC (IHP-CA MPCs). The results indicate that IHP-CA MPCs have a long curing time, almost neutral pH value, excellent injectability, and compressive strength. In vitro experiments have shown that IHP-CA MPCs have good biocompatibility and bone promoting ability. These improvements provide feasible solutions and references for the clinical application of MPCs as implants.
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Affiliation(s)
- Bin Wang
- Department of Orthopedics, Jingling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Yanbin Zhao
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Yangyang Li
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Chengliang Tang
- Huadong Medical Institute of Biotechniques, Nanjing, 210002, Jiangsu, China
| | - Peng He
- Department of Orthopedics, Jingling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Xiaowei Liu
- Department of Orthopedics, Jingling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Junyan Yao
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China.
| | - Bin Xu
- Department of Orthopedics, Jingling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.
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Lynch Wong M, Robinson M, Bryce L, Cassidy R, Lamb JN, Diamond O, Beverland D. Reoperation risk of periprosthetic fracture after primary total hip arthroplasty using a collared cementless or a taper-slip cemented stem. Bone Joint J 2024; 106-B:144-150. [PMID: 38425304 DOI: 10.1302/0301-620x.106b2.bjj-2023-0739.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Aims The aim of this study was to determine both the incidence of, and the reoperation rate for, postoperative periprosthetic femoral fracture (POPFF) after total hip arthroplasty (THA) with either a collared cementless (CC) femoral component or a cemented polished taper-slip (PTS) femoral component. Methods We performed a retrospective review of a consecutive series of 11,018 THAs over a ten-year period. All POPFFs were identified using regional radiograph archiving and electronic care systems. Results A total of 11,018 THAs were implanted: 4,952 CC femoral components and 6,066 cemented PTS femoral components. Between groups, age, sex, and BMI did not differ. Overall, 91 patients (0.8%) sustained a POPFF. For all patients with a POPFF, 16.5% (15/91) were managed conservatively, 67.0% (61/91) underwent open reduction and internal fixation (ORIF), and 16.5% (15/91) underwent revision. The CC group had a lower POPFF rate compared to the PTS group (0.7% (36/4,952) vs 0.9% (55/6,066); p = 0.345). Fewer POPFFs in the CC group required surgery (0.4% (22/4,952) vs 0.9% (54/6,066); p = 0.005). Fewer POPFFs required surgery in males with a CC than males with a PTS (0.3% (7/2,121) vs 1.3% (36/2,674); p < 0.001). Conclusion Male patients with a PTS femoral component were five times more likely to have a reoperation for POPFF. Female patients had the same incidence of reoperation with either component type. Of those having a reoperation, 80.3% (61/76) had an ORIF, which could greatly mask the size of this problem in many registries.
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Anthraper MSJ, Chandramouli A, Srinivasan S, Rangasamy J. Lyophilized platelet rich fibrin and gelatin incorporated bioadhesive bone cement composite for repair of mandibular continuity defects. Int J Biol Macromol 2024; 258:129086. [PMID: 38161027 DOI: 10.1016/j.ijbiomac.2023.129086] [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: 10/16/2023] [Revised: 12/02/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Mandibular continuity defects stem from conditions such as malignancies, trauma, cysts, osteomyelitis and osteoradionecrosis, presenting significant challenges. If mandibular reconstruction fails, it can result in facial collapse, causing significant aesthetic and functional concerns for the patient. In the present study we developed a bio-adhesive Bone Cement (BC) enriched with lyophilised PRF and gelatin to enhance bone repair and induce regeneration. The developed BC consisted of a mixture of Tetracalcium Phosphate (TTCP) and O-Phospho-l-serine (OPLS) in addition to lyophilised Platelet Rich Fibrin (PRF) for sustained growth factor release and gelatin (GE) for improved cement resorption. It is primarily designed for in-situ application, conforming to the shape and size of the defect for effective bone repair and regeneration. The study evaluated four groups: (i) BC (control), (ii) BC-GE (control), (iii) BC-PRF, and (iv) BC-GE-PRF. All the four groups were characterised using FTIR, SEM and XRD. The mechanical studies of the prepared beads exhibited a significant increase in the compressive strength of the PRF loaded bone cement composites. In vitro degradation study of the beads over a 60-day period revealed a significantly higher percentage of bone cement resorption in the gelatin-incorporated groups, BC-GE (44 ± 0.5 %), and BC-GE-PRF (45 ± 2 %). The assessment of growth factor release (TGF-β and VEGF) using ELISA revealed a prolonged and sustained release of both growth factors over a 28-day period. In vitro studies were performed on human Dental Follicle Stem Cells (DFSCs) to assess cell attachment, proliferation, mineralisation and osteogenic differentiation. These studies clearly depicted that BC-PRF and BC-GE-PRF showed significantly greater proliferation of DFSCs. Furthermore, BC-PRF and BC-GE-PRF samples exhibited notably elevated expression of Runx2 and OPN (osteogenic markers), as well as a higher intensity of alizarin red stain (mineralisation). Therefore, it was concluded that PRF incorporated bioadhesive bone cement composites greatly enhance the cell attachment, proliferation, mineralisation and osteogenic differentiation of the DFSCs. Thus, the PRF and gelatin incorporated bone cement composites is expected to facilitate effective and faster bone regeneration and healing in a wide range of dental and maxillofacial defects.
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Affiliation(s)
- Mary Susan J Anthraper
- Polymeric Biomaterials Lab, School of Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Arthi Chandramouli
- Polymeric Biomaterials Lab, School of Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Sowmya Srinivasan
- Department of Periodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India
| | - Jayakumar Rangasamy
- Polymeric Biomaterials Lab, School of Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi 682041, India.
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Lin ZP, Zou XG, Huang DB, Chen Y, Li XQ, Zhang J. C-arm CT guided percutaneous vertebroplasty for pain release in cancer patient with cervical 1 vertebral metastases: A case report. Neuro Endocrinol Lett 2024; 45:1-6. [PMID: 38295423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/28/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To evaluate the efficacy and treatment outcome of C-arm CT percutaneous vertebroplasty in the treatment of cervical 1 (C1) vertebral metastases. METHODS This report recruited a male patient diagnosed with hepatocellular carcinoma and C1 vertebral metastases, who had suffered from severe neck pain symptoms and the analgesic showed little soothing effect. Under the guidance of C-arm CT, an 18G coaxial needle was used to puncture the left lateral mass of C1 vertebral metastases from lateral space between thyroid cartilage and the left carotid sheath, with 2 ml bone cement injected. RESULTS Postoperative C-arm CT three-dimensional reconstruction scan showed that the bone cement was well filled and distributed in the left lateral mass of C1 vertebral body, and no leakage of bone cement was observed. The neck pain of the patients was significantly relieved one week after the operation. CONCLUSION Under the guidance of C-arm CT, cement augmentation using percutaneous vertebroplasty in an anterior cervical direction could serve as a safe and effective pain relief approach for patients with C1 vertebral metastases.
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Affiliation(s)
- Zhi-Peng Lin
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
| | - Xu-Gong Zou
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
| | - Da-Bei Huang
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
| | - Yuan Chen
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
| | - Xiao-Qun Li
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
| | - Jian Zhang
- Department of Interventonal Medicine, Zhongshan People's Hospital, Zhongshan, Guangdong 528400, China
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Lübbeke A, Barea C, Zingg M, Lauper N, Hannouche D, Garavaglia G. Radiographic signs and hip pain 5 years after THA with a cemented stem predict future revision for aseptic loosening: a prospective cohort study. Acta Orthop 2024; 95:32-38. [PMID: 38284749 PMCID: PMC10823869 DOI: 10.2340/17453674.2023.26190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 11/02/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND AND PURPOSE We aimed to evaluate the long-term predictive value of radiographic abnormality and/or hip pain assessed 5 years following primary total hip arthroplasty (THA) and the occurrence of revision for aseptic loosening between 5 and 25 years postoperatively. PATIENTS AND METHODS We included all primary THAs performed between 1996 and 2011 (same uncemented cup, polyethylene-ceramic bearing, 28 mm head, cemented stem) and prospectively enrolled in the institutional registry, for whom baseline and follow-up radiographs were available. At 5 years radiographically we assessed femoral osteolysis and/or stem migration. Pain was evaluated with the Harris Hip pain subscore. Kaplan-Meier survival and Cox regression analyses were performed. RESULTS 1,317 primary THAs were included. 25 THAs (2%) were revised for aseptic stem loosening. Any abnormal radiographic sign at 5 years was present in 191 THAs (14%). Occasional hip pain was reported by 20% and slight to severe pain by 12% of patients at 5 years. In patients < 60 years, 10 of the 12 later revised for aseptic stem loosening had abnormal radiographs at 5 years vs. 5 of the 13 later revised in those ≥ 60 years. Hazard ratios (HR) were 34 (95% confidence interval [CI] 7-155) in younger vs. 4 (CI 1-11) in the older group. HR for association of hip pain at 5 years with future revision was 3 (CI 1-5). CONCLUSION The presence of abnormal radiographic signs 5 years after THA was strongly associated with later revision for aseptic stem loosening, especially in patients < 60 years. The association between pain at 5 years and future revision was much weaker.
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Affiliation(s)
- Anne Lübbeke
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
| | - Christophe Barea
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - Matthieu Zingg
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - Nicolas Lauper
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - Didier Hannouche
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
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Yu L, Zhao LJ. [Progress of surgical treatment for osteoporotic vertebral compression fractures and puncture complications]. Zhongguo Gu Shang 2024; 37:3-6. [PMID: 38286444 DOI: 10.12200/j.issn.1003-0034.20231277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Liang Yu
- Department of Spine Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China
| | - Liu-Jun Zhao
- Department of Spine Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China
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Jiang WL, Liu T, Zhang QB, Chen H, Bai JZ, Wang S, Cheng JW, Guo YL, Zhou G, Niu GQ. [Improved unilateral puncture PVP based on 3D printing technology for the treatment of osteoporotic vertebral compression fracture]. Zhongguo Gu Shang 2024; 37:7-14. [PMID: 38286445 DOI: 10.12200/j.issn.1003-0034.20221151] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To investigate the clinical effect of unilateral percutaneous vertebroplasty (PVP) combined with 3D printing technology for the treatment of thoracolumbar osteoporotic compression fracture. METHODS A total of 77 patients with thoracolumbar osteoporotic compression fractures from October 2020 to April 2022 were included in the study, all of which were vertebral body compression fractures caused by trauma. According to different treatment methods, they were divided into experimental group and control group. Thirty-two patients used 3D printing technology to improve unilateral transpedicle puncture vertebroplasty in the experimental group, there were 5 males and 27 females, aged from 63 to 91 years old with an average of (77.59±8.75) years old. Forty-five patients were treated with traditional bilateral pedicle puncture vertebroplasty, including 7 males and 38 females, aged from 60 to 88 years old with an average of(74.89±7.37) years old. Operation time, intraoperative C-arm X-ray times, anesthetic dosage, bone cement injection amount, bone cement diffusion good and good rate, complications, vertebral height, kyphotic angle (Cobb angle), visual analogue scale(VAS), Oswestry disability index (ODI) and other indicators were recorded before and after surgery, and statistically analyzed. RESULTS All patients were followed up for 6 to 23 months, with preoperative imaging studies, confirmed for thoracolumbar osteoporosis compression fractures, two groups of patients with postoperative complications, no special two groups of patients' age, gender, body mass index (BMI), time were injured, the injured vertebral distribution had no statistical difference(P>0.05), comparable data. Two groups of patients with bone cement injection, bone cement dispersion rate, preoperative and postoperative vertebral body height, protruding after spine angle(Cobb angle), VAS, ODI had no statistical difference(P>0.05). The operative time, intraoperative fluoroscopy times and anesthetic dosage were statistically different between the two groups(P<0.05). Compared with the traditional bilateral puncture group, the modified unilateral puncture group combined with 3D printing technology had shorter operation time, fewer intraoperative fluoroscopy times and less anesthetic dosage. The height of anterior vertebral edge, kyphosis angle (Cobb angle), VAS score and ODI of the affected vertebrae were statistically different between two groups at each time point after surgery(P<0.05). CONCLUSION In the treatment of thoracolumbar osteoporotic compression fractures, 3D printing technology is used to improve unilateral puncture PVP, which is convenient and simple, less trauma, short operation time, fewer fluoroscopy times, satisfactory distribution of bone cement, vertebral height recovery and kyphotic Angle correction, and good functional improvement.
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Affiliation(s)
- Wei-Li Jiang
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Tao Liu
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Qing-Bo Zhang
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Hui Chen
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Jian-Zhong Bai
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Shuai Wang
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Jia-Wei Cheng
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Ya-Long Guo
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Gong Zhou
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
| | - Guo-Qi Niu
- Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China
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Zhuang T, Peng R, Zhao Q, Jiang S, Yang X, Shen C, Liu J. Acoustic emission characteristic of sandstone and sandstone like material under multi-path loading. PLoS One 2024; 19:e0297087. [PMID: 38271321 PMCID: PMC10810465 DOI: 10.1371/journal.pone.0297087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Using spline interpolation to select proportions of similar materials, a comparative analysis of the fracturing behavior of sandstone specimens and similar material specimens was conducted through Brazilian splitting tests under multi-path loading. The study revealed that during stepwise loading, both sandstone and similar materials exhibited memory effects and plastic deformation. However, under constant velocity loading, the relationship between force and displacement in sandstone showed linearity after compaction. Employing MATLAB optimization algorithms for the inversion of acoustic emission event information, the distribution of fracture points, and the evolution of cracks were analyzed. The findings indicated that under stepwise loading, both sandstone and similar materials exhibited banded distribution of peak frequencies, with sandstone concentrated in the mid-low-frequency range and similar materials leaning towards the low-frequency range. The amplitude-frequency characteristics of acoustic emission signals suggested that initially, sandstone produced low-frequency, low-amplitude signals. As cracks developed, these signals gradually transformed into high-frequency, high-amplitude signals, ultimately leading to macroscopic failure. The ringing counts and b-values of sandstone displayed an approximate "W" shape distribution, with a subsequent decrease in b-values during final failure. In contrast, the acoustic emission counts were inversely related to b-values. Similar materials exhibited slightly more acoustic emission counts than sandstone, with relatively lower b-values. The crack development process of both sandstone and similar materials was confirmed through these observations. From the perspective of section initiation and local damage, sandstone and similar materials exhibited similar failure characteristics. The proportions of quartz sand: cement: water = 9:1:0.9 in similar materials demonstrated the most similar characteristics to sandstone in terms of mechanical loading, acoustic emission features, and failure morphology. This suggests that these similar materials can be used as substitutes for sandstone in analogous simulation experiments. The study provides theoretical support for understanding rock fracture mechanisms, offers guidance for the selection and proportioning of similar materials, and holds significance for predicting and controlling rock fracture behavior in engineering applications.
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Affiliation(s)
- Tong Zhuang
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
| | - Rui Peng
- School of Safety Engineering, North China Institute of Science and Technology, Beijing, China
| | - Qifeng Zhao
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
| | - Shiyuan Jiang
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
| | - Xuehong Yang
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
| | - Chunyang Shen
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
| | - Jiang Liu
- School of Mine Safety, North China Institute of Science and Technology, Beijing, China
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Mei L, Xiang D, Huang Y. Research on the mechanical properties of EPS lightweight soil mixed with slag. PLoS One 2024; 19:e0297372. [PMID: 38265991 PMCID: PMC10842304 DOI: 10.1371/journal.pone.0297372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
Expanded polystyrene (EPS) bead lightweight soil composites are a new type of artificial geotechnical material with low density and high strength characteristics that can be widely used in engineering projects. To promote the wide application of EPS bead lightweight soil in engineering, when slag is used to replace part of the cement as a binding agent, it can better improve the effect of soil and reduce engineering costs. The mechanical properties of EPS lightweight soil mixed with slag were analyzed by conducting an unconfined compressive strength (UCS) test and triaxial test on lightweight soil with different EPS bead contents and slag contents. The particle sizes of the EPS beads are 1~3 mm, the EPS contents are 1%, 2%, 3%, and 4%, and the slag-cement composite binding agents are 10%, 15%, 20% and 25%. The results show that the UCS decreases significantly with increasing EPS bead content at different EPS bead contents and slag contents; the UCS of the specimen with 30% slag content is the largest; and the UCS of lightweight soil without slag is comparable to that of lightweight soil with a slag content of approximately 60%. The peak stress in triaxial increases with increasing confining pressure, and the modulus of deformation decreases linearly with increasing EPS bead content. the slag-cement composite binding agent has a significantly better reinforcing effect than single mixed cement. The stress‒strain curves of EPS lightweight soil mixed with slag exhibits hardening and softening characteristics. EPS bead content and slag content determine the stress‒strain characteristics of the EPS lightweight soil mixed with slag. The macromechanical properties based on the microscopic mechanism of the EPS lightweight soil mixed with slag shows that different slag contents affect the failure pattern of EPS lightweight soil mixed with slag. The research results can provide a reference for engineering design and application.
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Affiliation(s)
- Lifang Mei
- School of Civil Engineering, Architectural and Environment, Hubei
University of Technology, Wuhan, China
- Hubei Ecological Road Engineering Technology Research Center, Wuhan,
China
| | - Dali Xiang
- School of Civil Engineering, Architectural and Environment, Hubei
University of Technology, Wuhan, China
| | - Yiwen Huang
- School of Civil Engineering, Architectural and Environment, Hubei
University of Technology, Wuhan, China
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Liu W, Hou Y, Yin S, Wang Y, Du H, Zhang M. Mechanical properties and energy damage evolution mechanism of fiber-reinforced cemented sulfur tailings backfill under uniaxial compression. PLoS One 2024; 19:e0290699. [PMID: 38198479 PMCID: PMC10781025 DOI: 10.1371/journal.pone.0290699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/15/2023] [Indexed: 01/12/2024] Open
Abstract
This paper studies mechanical properties and energy damage evolution of fiber-reinforced cemented sulfur tailings (CSTB) backfill. The effects of fiber length and fiber content on the stress, toughness and failure properties of the CSTB were systematically revealed. In addition, the energy index evolution law was studied, and the energy damage evolution mechanism of CSTB was revealed. The results show that the deformation failure of fiber-reinforced CSTB mainly goes through four stages: initial crack compaction, linear elastic deformation, yield failure and post-peak failure. The peak stress and residual stress of the CSTB firstly increase and then decrease with the increase of fiber content and the addition of fiber can promote the change from brittle failure to ductile failure of the CSTB. Adding appropriate amount of fiber can improve the toughness of CSTB, and the influence degree of fiber length on the toughness index of CSTB is 6mm>12mm>3mm. The total strain energy increases linearly along the variation of fiber content, while the elastic strain energy and dissipated energy increase exponentially at the peak stress point. In the process of CSTB deformation and failure, "gentle-linear growth-slow growth-rapid decline" is for elastic strain energy, while "gentle-slow growth-rapid growth-linear growth" is for dissipation energy. The damage and failure of CSTB mainly experienced four stages: initial damage, slow growth of damage, accelerated damage and damage failure, and the damage evolution curve also showed the changing characteristics of "gentle-slow growth-rapid growth-linear growth". The CSTB without added fiber showed obvious "Y-type" and "linear-type" shear failure characteristics and the phenomenon of shear cracks penetrating the backfill appeared. No big shear crack occur when it is damaged, showing that the fiber addition restrain the crack growth and improve the overall crack resistance of the CSTB. Hydration products are obviously distributed on the surface of the fiber, which indicates that the fiber will be evenly dispersed in the CSTB and form a certain bonding force with the cement-tailings matrix, thus improving the overall mechanical properties of the CSTB.
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Affiliation(s)
- Wei Liu
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yongqiang Hou
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, China
| | - Shenghua Yin
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yanli Wang
- The 52nd Research Institute of China Ordnance Industry Group, Yantai, China
| | - Huihui Du
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, China
| | - Minzhe Zhang
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, China
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Weber M, Lenz M, Egenolf P, Prescher A, Walter S, Heck VJ, Eysel P, Scheyerer MJ. Increased stability due to symmetric cement volume in augmented pedicle screws? A biomechanical study. J Biomed Mater Res B Appl Biomater 2024; 112:e35339. [PMID: 37955803 DOI: 10.1002/jbm.b.35339] [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: 12/19/2022] [Revised: 08/01/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023]
Abstract
Pedicle screw instrumentation has become "state of the art" in surgical treatment of many spinal disorders. Loosening of pedicle screws due to poor bone mineral density is a frequent complication in osteoporotic patients. As prevalence of osteoporosis and spinal disorders are increasing with an aging demographic, optimizing the biomechanical properties of pedicle screw constructions and therefore outcome after spinal surgery in osteoporotic patients is a key factor in future surgical therapy. Therefore, this biomechanical study investigated the stability of polymethylmethacrylate (PMMA)-augmented pedicle screw-rod constructions under a deviating distribution of PMMA applied to the instrumentation in osteoporotic human cadaveric vertebrae. We showed that PMMA-augmented pedicle screw-rod constructions tend to be more stable than those with non-augmented pedicle screws. Further, there appears to be a larger risk of screw loosening in unilateral augmented pedicle screws than in non-augmented, therefore a highly asymmetrically distributed PMMA should be avoided.
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Affiliation(s)
- Maximilian Weber
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Maximilian Lenz
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Philipp Egenolf
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Andreas Prescher
- University Hospital RWTH, Institute of Molecular and Cellular Anatomy (MOCA), Aachen, Germany
| | - Sebastian Walter
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Vincent J Heck
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Peer Eysel
- Center for Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Max Joseph Scheyerer
- Department of Trauma and Spine Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
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Li X, Liu J, Wang H, Ding Y. Controlled hypotension technology can improve patient recovery in the early postoperative period after total knee arthroplasty: A prospective, randomized controlled clinical study. Jt Dis Relat Surg 2024; 35:36-44. [PMID: 38108164 PMCID: PMC10746890 DOI: 10.52312/jdrs.2023.1379] [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: 08/15/2023] [Accepted: 10/01/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES The study aimed to analyze the application of controlled hypotension and tourniquets in total knee arthroplasty (TKA) to evaluate their early postoperative period effects in TKA. PATIENTS AND METHODS A total of 183 patients (43 males, 140 females; mean age: 67.8±6.4 years; range, 50 to 84 years) with knee osteoarthritis who needed TKA were recruited for this prospective, randomized controlled clinical study between August 2022 and May 2023. The study included a tourniquet group (group T, 94 patients) and a controlled hypotension group (group H, 89 patients). In group T, an inflatable tourniquet was used throughout the operation, with the pressure of the tourniquet set at 300 mmHg. In group H, controlled hypotension was used, with the mean arterial pressure controlled at 55-65 mmHg. The outcome measures of this study included blood loss, coagulation function, inflammatory mediators, knee joint function, permeation thickness of bone cement around the tibial prosthesis, and cognitive function. RESULTS The baseline demographics and clinical characteristics of the two groups of patients were comparable (p>0.05). Intraoperative blood loss in group H was higher than that in group T (p<0.05), whereas hemoglobin decrease, postoperative drainage flow, hidden blood loss, and total blood loss in group T were higher than in group H (p<0.05). Fibrinogen, D-dimer, C-reactive protein, and interleukin-6 levels were higher in group T than in group H on the first and third postoperative days (p<0.05). The knee joint function of group H was significantly better than that of group T on the fifth day and one month after the operation (p<0.05). There was no significant difference in the penetration thickness of bone cement around the tibial prosthesis between the two groups (p>0.05). There was no significant difference in Mini-Mental State Examination scores between the two groups on the same day (p>0.05). CONCLUSION Controlled hypotension technology in TKA can reduce total blood loss by reducing hidden blood loss and can help to alleviate the postoperative hypercoagulable state, relieve inflammatory reactions, and facilitate early recovery of knee joint function after surgery.
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Affiliation(s)
| | | | - Hongliang Wang
- Anhui Provincial Clinical Medical Research Center for Spinal Deformities, Fuyang, 236000 Anhui, China.
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Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained all-ceramic implant-supported crowns on zirconia abutment: A systematic review and meta-analysis. J Indian Prosthodont Soc 2024; 24:25-35. [PMID: 38263555 PMCID: PMC10896314 DOI: 10.4103/jips.jips_524_23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods. MATERIALS AND METHODS Independent search was conducted in Cochrane Library, EBSCO, and PubMed/PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications. RESULTS A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10). CONCLUSION The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.
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Affiliation(s)
- Shruti S. Potdukhe
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani M. Iyer
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B. Nadgere
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Yin J, Zhang W, Qin L, Yan L. 3D-printed bone-cement mold of intramedullary nail for tibial osteomyelitis: A case report. Asian J Surg 2024; 47:729-730. [PMID: 37914640 DOI: 10.1016/j.asjsur.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Junxiang Yin
- Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China
| | - Wendong Zhang
- Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China
| | - Luyue Qin
- Department of Acupuncture and Moxibustion, Weifang Hospital of Traditional Chinese Medicine, Weifang, 261031, Shandong Province, China
| | - Lianqi Yan
- Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China.
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Graff C, Mathur T. Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature. Eur J Orthop Surg Traumatol 2024; 34:683-688. [PMID: 37639005 PMCID: PMC10771592 DOI: 10.1007/s00590-023-03668-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
Abstract
Antibiotic impregnated cement coated intramedullary nails (ACCINs) have been used in clinical practice for many years and have been shown to help eradicate infection in tibial osteomyelitis while providing stability. We present a novel technique for preparation using bronchoscopy tubing, as well as technical tips and a review of the literature, for ease of preparation and potential subsequent retrieval.
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Affiliation(s)
- Christy Graff
- The University of Adelaide, Adelaide, SA, Australia.
- Department of Orthopaedics, Royal Adelaide Hospital, Adelaide, SA, Australia.
- Department of Orthopaedics, Women's and Children's Hospital, Adelaide, SA, Australia.
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