Comparison of Cemented and Non-cemented Allografts in Dogs with Osteosarcoma

1998 ◽  
Vol 11 (04) ◽  
pp. 178-184 ◽  
Author(s):  
D. Steinheimer ◽  
R. D. Park ◽  
B. E. Powers ◽  
R. C. Straw ◽  
N. Endenburg ◽  
...  
Keyword(s):  
Scoring System ◽  
Implant Loosening ◽  
Allograft Failure ◽  
Histological Score ◽  
Radiographic Score ◽  
Fresh Frozen ◽  
Local Tumour ◽  
Relative Delay ◽  
The Mean ◽  
Graft Interface

SummaryThis study compares the radiographic and histological appearance of cemented and non-cemented massive cortical allografts in dogs that underwent a limb sparing procedure for osteosarcoma of the distal radius. Treatment consisted of removal of the affected bone and pancarpal arthrodesis using non-cemented (n = 13) or cemented (n = 47) fresh-frozen allografts. Allografts were evaluated using a radiographic and histological scoring system and compared statistically between groups. Allografts with better healing received a higher radiographic score and a lower histological score. The mean radiographic scores, for proximal union and distal union, were significantly greater in the non-cemented group at most evaluation periods. Complications after the operation included screw, plate, allograft and host bone failure, infection and local tumour recurrence. Screw failure in the allograft and allograft failure were significantly more common in the non-cemented group. Histological examination was performed on 44 dogs and cement increased the mean combined histological scores, and mean healing scores of the distal host-graft interface significantly. The use of cemented allografts significantly decreases complications associated with implant loosening or allograft failure but may slightly delay allograft healing. At this point, the clinical relevance of the delay in healing is questionable and the benefits of intramedullary PMMA would appear to outweigh this relative delay in healing.This study evaluated 60 radial allografts after limb sparing procedures using a standardized radiological and histological scoring system. The use of cemented allografts significantly decreased complications associated with implant loosening or allograft failure but may slightly delay allograft healing.

scholarly journals Assessment of Intra- and Inter-observer Measurement Variability in a Radiographic Metacarpophalangeal Joint Osteophytosis Scoring System for the Horse

2020 ◽  
Vol 7 (2) ◽  
pp. 39
Author(s):  
Luca Lacitignola ◽  
Annarita Imperante ◽  
Francesco Staffieri ◽  
Rocco De Siena ◽  
Pasquale De Luca ◽  
...  
Keyword(s):  
Scoring System ◽  
Metacarpophalangeal Joint ◽  
Veterinary Students ◽  
Measurement Variability ◽  
Group I ◽  
Veterinary Surgeons ◽  
Radiographic Score ◽  
Reference Images ◽  
The Mean ◽  
Different Levels

The study evaluated the intra- and inter-observer measurement variability of an osteophytosis metacarpophalangeal joint scoring system. Ten (n = 10) dorso/palmar, latero/medial, and oblique views of equine metacarpophalangeal joints affected by osteoarthritis were examined. Nine assessment points were graded (scale: 0–3) twice by five veterinary students (inexperienced group, I) and four equine veterinary surgeons (expert group, E). The grades for each of the nine factors were summed to obtain the osteophytosis score. The variability between the two measurements was −2.04 ± 3.5, 95% CI −3.04 to −1.03 for the I group. For the E group, they were 0 ± 1.43, 95% CI −0.45 to 0.45. In the evaluation of the same radiographs, the I group had a coefficient of variability (CV) of 37.29%. The correlation was r = 0.90%. The CV between groups was 28.85%. The mean difference between the two observations was -0.03 ± 0.29 in the E group and 0.22 ± 0.77 in the I group. The I group showed a greater CV when the score was low (r = −0.78) compared to the E group, where the CV was independent of severity of osteophytosis (r = −0.47). The osteophytosis scoring system is an easily applicable and feasible system to be used by observers with different levels of experience, but inexpert observers may need additional training or may need to be helped by reference images. These data are validated by the low inter- and intra-observer measurement variability results in the E group. Therefore, the scoring system proposed seems to be a repeatable instrument applicable to the radiographic score of the severity of metacarpophalangeal joint osteoarthritis.

The Hallux Metatarsophalangeal Capsule: An Anatomic Study With Respect to Percutaneous Hallux Valgus Correction

2021 ◽  
pp. 107110072110272
Author(s):  
Kenneth M. Chin ◽  
Nicholas S. Richardson ◽  
John T. Campbell ◽  
Clifford L. Jeng ◽  
Matthew W. Christian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Metatarsal Head ◽  
Cadaveric Study ◽  
Anatomic Study ◽  
Orthopedic Surgeons ◽  
Popular Knowledge ◽  
Fresh Frozen ◽  
The Mean ◽  
Anatomic Relationship

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

scholarly journals Comparative Study of Flexor Hallicus Longus Tendon Length through Single Incision or Accessory Plantar Medial Incision: A Cadaver Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Caitlin Curtis Crocker ◽  
Eildar Abyar ◽  
Sean Young ◽  
Fatemah Razaghi ◽  
Gerald McGwin ◽  
...  
Keyword(s):  
Single Incision ◽  
Plantar Flexion ◽  
Cadaver Study ◽  
Tendon Graft ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Tunnel Length ◽  
Exact Test ◽  
Fresh Frozen ◽  
The Mean

Category: Ankle; Hindfoot Introduction/Purpose: Flexor Hallucis Longus (FHL) tendon transfer to the calcaneus is a common adjuvant procedure in the treatment of Achilles pathology. The FHL tendon can be harvested using a posterior incision where the tendon is dissected along its course into the fibroosseous tunnel. Alternatively, the FHL may be harvested through a separate plantar medial incision as it crosses the flexor digitorium longus at the Knot of Henry. This study aims to quantify FHL tendon lengths achieved through the two common approaches utilizing pair matched cadavers. Methods: Seven pair matched fresh-frozen cadaver legs without signs of musculoskeletal abnormalities were used for this assessment. One leg in each pairing underwent a single incision harvest while the contralateral leg underwent an accessory medial plantar harvest. After dissecting the tendon, a calcaneus tunnel was prepared from dorsal to plantar in both calcanei in standard fashion. Two measurements were obtained. The first measurement was taken from the distal aspect of the muscle belly to the distal end of the tendon. The tendon was then pulled through the calcaneus, and the foot was held in tension at 20 degrees of plantar flexion. The second measurement was taken from site where tendon entered the calcaneous to the distal end of the tendon graft. The measurements were analyzed using Wilcoxon Signed Ranks Test and Fischer Exact Test. Results: Using a posterior incision, the mean tendon measurement from calcaneous tunnel to the distal end of the tendon was 4.0 cm. Using an accessory plantar medial incision, the mean tendon measurement from the calcaneous tunnel to the distal end of the tendon was 7.2 cm. The average tunnel length obtained using an accessory medial incision was significantly greater than the length obtained using the single incision approach (p= 0.0003, p=0.0022, and p=0.0016). The accessory plantar medial incision obtained an FHL tendon tunnel length that was an average of 2.9 cm greater than the posterior incision. Conclusion: The single incision approach provided sufficient length to safely anchor the FHL into the calcaneus which suggests that the accessory plantar medial approach is not necessary for routine FHL transfers to the calcaneus with interference screw fixation. However, if additional length is needed for other applications such as posterior tibialis tendon dysfunction or peritoneal tendon tears, the accessory incision does provide an average of 2.9 cm of additional length.

scholarly journals Effects of implementing rotational thromboelastometry in cardiac surgery: A retrospective cohort study

2021 ◽  
pp. 175045892095066
Author(s):  
Minna Kallioinen ◽  
Mika Valtonen ◽  
Marko Peltoniemi ◽  
Ville-Veikko Hynninen ◽  
Tuukka Saarikoski ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prothrombin Complex Concentrate ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Rotational Thromboelastometry ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
The Mean ◽  
To Receive ◽  
Frozen Plasma

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.

ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 157-159 ◽  
Author(s):  
Piyapong Tiyaworanan ◽  
Surut Jianmongkol ◽  
Tala Thammaroj
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Study ◽  
Medial Epicondyle ◽  
Anatomical Location ◽  
Greater Tuberosity ◽  
Lateral Epicondyle ◽  
Surgical Exploration ◽  
Fresh Frozen ◽  
The Mean ◽  
Proximal Border

The incidence and the anatomical location of the arcade of Struthers as related to the arm length were studied in 62 arms of adult fresh-frozen cadavers. The distance between the greater tuberosity and the lateral epicondyle was designated as the arm length. The arcades of Struthers were identified in 85.4%. The mean arm length was 27.85 ± 1.3 cm. The mean of the distance between proximal border of the arcade of Struthers and the medial humeral epicondyle was 8.24 ± 2.06 cm. The mean ratio between the distance from the proximal border of the arcade to the tip of the medial epicondyle and arm length was 0.29 ± 0.07. We concluded that the anatomical location of the arcade as related to the arm length was 29% proximally, from the tip of the medial epicondyle. This report of the anatomical location of the arcade of Struthers related to the arm length can be useful to identify this structure in the arms which have differences in arm length during the surgical exploration and anterior transposition of the ulnar nerve procedures.

CT Scan versus Saline Load Test for Detection of Traumatic Wrist Arthrotomy

2021 ◽  
Author(s):  
Eric Perloff ◽  
Andrew Posner ◽  
Hamza Murtaza ◽  
Khushdeep Vig ◽  
Michael Smith ◽  
...  
Keyword(s):  
Ct Scan ◽  
Distal Radioulnar Joint ◽  
Load Test ◽  
Portal Site ◽  
Radioulnar Joint ◽  
Radiocarpal Joint ◽  
Fresh Frozen ◽  
The Mean ◽  
Midcarpal Joint ◽  
Cadaveric Model

Abstract Background Traumatic arthrotomy of the wrist is most commonly detected using the saline load test (SLT); however, little data exists on the effectiveness of the SLT to this specific joint. The use of computed tomography (CT) scan has been validated as an alternative method to detect traumatic arthrotomy of the knee, as the presence of intra-articular air can be seen when there is violation of the joint capsule. Question/Purpose The purpose of this study was to determine the ability of CT scan to identify arthrotomy of the wrist capsule and compare the diagnostic performance of CT versus traditional SLT. Materials and Methods Ten fresh frozen cadavers which had undergone transhumeral amputation were initially used in this study. A baseline CT scan was performed to ensure no intra-articular air existed prior to intervention. After baseline CT, an arthrotomy was created at the 6R radiocarpal portal site. The wrists then underwent a postarthrotomy CT to identify the presence or absence of intra-articular air. Following CT, the wrists were subjected to the SLT to detect the presence of extravasation from the arthrotomy. Results Nine cadavers were included following baseline CT scan. Following arthrotomy, intra-articular air was visualized in eight of the nine cadavers in the postarthrotomy CT scan. Air was seen in the radiocarpal joint in eight of the nine wrists; midcarpal joint in seven of the nine wrists; and distal radioulnar joint in six of the nine wrists. All wrists (nine of the nine) demonstrated extravasation during the SLT. The mean volume of extravasation occurred at 3.7 mL (standard deviation = 2.6 mL), with a range of 1 to 7 mL. Conclusion CT scan correctly identified eight of the nine simulated traumatic arthrotomies. Injection of 7 mL during the SLT was necessary to identify 100% of the arthrotomies. Clinical Relevance CT scan is a sensitive modality for detection of traumatic arthrotomy of the wrist in a cadaveric model.

Injury to the Anterior Cruciate Ligament during Alpine Skiing

2002 ◽  
Vol 30 (4) ◽  
pp. 537-540 ◽  
Author(s):  
Sharon L. Hame ◽  
Daniel A. Oakes ◽  
Keith L. Markolf
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Alpine Skiing ◽  
Full Extension ◽  
Flexion Extension ◽  
Fresh Frozen ◽  
Full Flexion ◽  
The Mean ◽  
Anterior Cruciate ◽  
Knee Flexion Position

Background The anterior cruciate ligament has been shown to be particularly susceptible to injury during alpine skiing. Tibial torque is an important injury mechanism, especially when applied to a fully extended or fully flexed knee. Purpose We wanted to record the forces generated in the anterior cruciate ligament with application of tibial torque to cadaveric knees in different positions. Study Design Controlled laboratory study. Methods Thirty-seven fresh-frozen cadaveric knees were instrumented with a tibial load cell that measured resultant force in the anterior cruciate ligament while internal and external tibial torques were applied to the tibia at full extension, 90° of flexion, full flexion, and forced hyperflexion. Results At each knee flexion position, mean force generated by 10 N·m of internal tibial torque was significantly higher than the mean generated by 10 N·m of external tibial torque. Mean forces generated by tibial torque at 90° of flexion were relatively low. During flexion-extension without tibial torque applied mean forces were highest (193 N) when the knee was hyperflexed. Conclusions Application of internal tibial torque to a fully extended or fully flexed knee represents the most dangerous loading condition for injury from twisting falls during skiing. Clinical Relevance Understanding of the mechanisms of falls can be used to design better equipment and to better prevent or treat injury.

Mathematical Examination of Dual Individualization Principles (III): Development of a Scoring System for Pneumonia Staging and Quantitation of Response to Antibiotics: Results in Cefmenoxime-Treated Patients

1992 ◽  
Vol 26 (11) ◽  
pp. 1358-1365 ◽  
Author(s):  
Aileen Luzier ◽  
Thomas F. Goss ◽  
Thomas J. Cumbo ◽  
Jerome J. Schentag
Keyword(s):  
Clinical Improvement ◽  
Antimicrobial Therapy ◽  
Scoring System ◽  
Time Course ◽  
Clinical Course ◽  
Clinical Status ◽  
Gram Stain ◽  
Retrospective Data Collection ◽  
The Mean ◽  
Important Time

OBJECTIVE: In order to quantitatively express the important, time-related aspects of response to antimicrobial therapy in patients with pneumonia, we required validated measures of the time course of events during the infection. To quantitate the changes in clinical status in relation to changes in cultures, we developed a scoring system to be used for patient assessment during therapy. DESIGN: Retrospective data collection, prospective analysis of factors. SETTING: Intensive care unit, Millard Fillmore Hospital. PATIENTS: Twenty-eight patients with nosocomial pneumonia. MAIN OUTCOME MEASURES: Clinical parameters were assessed daily for the duration of antimicrobial therapy. Using linear regression, the rate of clinical change in each patient treated was quantified. Eradication of the pathogen was determined by serial cultures of the infection site. RESULTS: Seventeen of the patients demonstrated eradication of the organism, and 11 demonstrated persistence of the pathogen (7 were considered colonization). The system described the patients at baseline in that the mean baseline scores were similar in both groups of patients (p=0.79). Patients in whom the pathogen was eradicated showed a rate of clinical improvement significantly different from those who had persistence of the organism (p=0.04). In patients demonstrating eradication, the time to eradication inversely correlated with the rate of clinical improvement (p<0.05). Of the ten parameters descriptive of the disease, those most sensitive to change after eradication of bacteria were body temperature, bacterial Gram stain, white blood cell Gram stain, and volume of sputum. CONCLUSIONS: In this set of pneumonia patients, the scoring system effectively quantified both baseline and time-related changes in clinical status. The system distinguished between the clinical course of the patient with organism eradication versus organism persistence. A shorter time to eradication was associated with a better clinical response. Prospective study of the system will determine its sensitivity.

The Peroneal Groove Deepening Procedure: A Biomechanical Study of Pressure Reduction

2005 ◽  
Vol 26 (6) ◽  
pp. 442-448 ◽  
Author(s):  
Craig I. Title ◽  
Hung-Geun Jung ◽  
Brent G. Parks ◽  
Lew C. Schon
Keyword(s):  
Biomechanical Study ◽  
Posterior Tibial Tendon ◽  
Peroneal Tendon ◽  
Foot And Ankle ◽  
Calcaneofibular Ligament ◽  
Significant Difference ◽  
Mean Pressure ◽  
Fresh Frozen ◽  
The Mean ◽  
Pressure Changes

Background: The goal of this study was to identify pressure changes throughout the peroneal groove after a groove deepening procedure. We hypothesized that pressures would decrease. Methods: Twelve fresh-frozen foot and ankle specimens were used. A thin pressure strip containing four sensor pads was secured within the peroneal groove with pads 1 through 4 positioned at the calcaneofibular ligament (CFL) and at the distal, middle, and proximal groove, respectively. The midstance phase of gait was simulated with loads applied to the plantar foot and posterior tibial tendon and to the peroneus longus and brevis tendons. Pressures were recorded with the ankle in neutral, plantarflexion, dorsiflexion, inversion, and eversion. Groove deepening was done by osteotomizing the posterior fibular wall. Pressure readings were then recorded. Average pressures for each of the four sensor pads after the procedure were compared to those obtained before the procedure. Results: The mean pressure overlying the CFL increased at all five ankle positions; however, these changes were not significant. Significant decreases in pressure were noted within the distal and middle groove at all ankle positions after the peroneal groove deepening procedure. Pressure within the proximal groove increased at all but one position, with a significant difference noted in neutral and plantarflexion. Conclusion: Pressures within the middle and distal peroneal groove significantly decreased after a groove deepening procedure. Combining this technique with peroneal tendon debridement may be advantageous for treatment of partial peroneal tendon tears or recalcitrant peroneal tendinitis.

NCOG-31. GIANT PITUITARY ADENOMA (GPA) SCORE: A NOVEL SCORING SYSTEM TO PREDICT POSTOPERATIVE OUTCOMES OF GIANT PITUITARY ADENOMAS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi158-vi158
Author(s):  
Syed Ather Enam ◽  
Fauzan Alam Hashmi ◽  
Sanam Mir Ghazi ◽  
Ahsan Ali Khan ◽  
Muhammad Bilal Tariq ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Linear Regression ◽  
Pituitary Adenomas ◽  
Scoring System ◽  
Tumor Resection ◽  
Maximum Diameter ◽  
Giant Pituitary Adenoma ◽  
Giant Pituitary Adenomas ◽  
The Mean ◽  
Suprasellar Extension

Abstract BACKGROUND Giant pituitary adenomas (GPA) are uncommon and highly variable in morphology and extension. There is no scoring system that considers all the dimensions of adenoma invasion. We developed a new Giant Pituitary Adenoma score and report our surgical experience and evaluate outcomes after resection of these tumors in accordance with the preoperative score. METHODS We developed a novel scoring system for classifying giant pituitary adenomas, and 11-year data of GPA surgery at our center was collected retrospectively, based on this scoring system. GPA Score considered tumor’s parasellar extension, encasement of cavernous internal carotid artery (ICA), suprasellar extension &gt; 2 cm, suprasellar extension &gt; 4cm and retrosellar extension. Maximum possible score was 9. The scoring system was applied to 53 patients of GPA who underwent surgical resection between January 1, 2006, and December 2017. The Lundin-Pederson (ABC/2) method was used to calculate the tumor volume both pre- and post-resection and linear regression was used to assess the relationship between extent of tumor resection and GPA score. RESULTS The median age of the study population was 42.08 ± 16.49 years. The mean maximum diameter of the pituitary adenomas was 5.0 cm (range 4.0 cm-8.5cm) while the mean volume of the adenomas was 27.3 cm3 (range 10 cm3-149 cm3). There were 3 cases of score 2, 5 cases of score 3, 13 cases of score 4, 20 cases of score 5, 9 cases of score 6 and 3 cases of score 7. The range of tumor volumes of tumors for scores from 2-7 was 17.3 cm3 to 65.8 cm3 and GPA score was correlated with the percent residual tumor using linear regression that was statistically significant (p= 0.001). CONCLUSION GPA Score is a reliable scoring system to predict the extent and subsequent difficulty in tumor resection in GPA.

Sign in / Sign up

Export Citation Format

Share Document