A Cadaveric Evaluation of Pin and Tension Band Configuration Strength for Tibial Tuberosity Osteotomy Fixation

2019 ◽  
Vol 33 (01) ◽  
pp. 009-014 ◽  
Author(s):  
Amy N. Zide ◽  
Stephen C. Jones ◽  
Alan S. Litsky ◽  
Nina R. Kieves
Keyword(s):  
Tensile Force ◽  
Tibial Tuberosity ◽  
Tension Band ◽  
Patellar Ligament ◽  
Tension Band Wire ◽  
Significant Strength ◽  
Significant Difference ◽  
Mode Of Failure ◽  
Vertically Aligned ◽  
And Control

Abstract Objective The purpose of this study was to compare the load at failure and mode of failure of four constructs used to stabilize a tibial tuberosity osteotomy, including two vertically aligned pins (V), two horizontally aligned pins (H), two vertically aligned pins with a tension band wire (V-TB) and two horizontally aligned pins with a tension band wire (H-TB). Study Design Eighteen pairs of cadaveric tibiae were randomized to receive a TB or no TB. One limb was randomized to be in the H or V group. The contralateral limb was then assigned to the opposite configuration. One pair of limbs was used as a control. A tensile force was applied to the patellar ligament until construct failure. Results There was no significant difference between the mean load at failure of the H (595 N) and V (556 N) groups or between H-TB (1032 N) and V-TB groups (1034 N) (p = 0.487 and p = 0.238, respectively). The TB constructs were significantly stronger than the pin only constructs (p < 0.001). The mode of failure was similar for the pin only constructs, regardless of pin orientation. The TB constructs and control tibias failed at similar loads, most commonly by patellar ligament rupture. Conclusion The use of vertically aligned pins versus horizontally aligned pins does not affect construct strength. These results support the placement of pins in a vertically or horizontally aligned fashion. When performing a tibial tuberosity osteotomy, the addition of a TB adds significant strength to the construct.

Combined Tibial Plateau Levelling Osteotomy and Tibial Tuberosity Transposition: An Ex Vivo Mechanical Study

2018 ◽  
Vol 31 (02) ◽  
pp. 124-130
Author(s):  
Ryan Birks ◽  
Michael Kowaleski
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Tibial Plateau ◽  
Ex Vivo ◽  
Tensile Force ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Fixation Failure ◽  
Significant Difference ◽  
Mode Of Failure

Objectives The purpose of this study is to compare the load at failure and mode of failure between (1) tibial plateau levelling osteotomy (TPLO) and combined TPLO and tibial tuberosity transposition (TPLO-TTT) (Phase I) and (2) TPLO-TTT and tibial tuberosity transposition (TTT) (Phase II). Methods Seven pairs of cadaveric tibiae were tested in each of the Phase I (TPLO vs. TPLO-TTT) and Phase II (TPLO-TTT vs. TTT) experiments. One limb of each pair was randomly assigned to one of two groups for each experimental phase. A tensile force was applied to the patellar ligament until construct failure occurred. Results There was a significant difference in mean load at failure between TPLO (2092.8 N) and TPLO-TTT (1067.8 N), p = 0.004. All TPLO constructs failed by fracture of the tibial crest. The TPLO-TTT constructs failed by cranial displacement of the distal tibial crest. Additionally, the tibial plateau was displaced in the majority of limbs. There was a significant difference in mean load at failure between TPLO-TTT (1157.6 N) and TTT (1394.0 N), p = 0.025. The TTT constructs demonstrated a similar mode of failure as TPLO-TTT. Clinical Significance Although ex vivo mechanical testing does not replicate the postoperative clinical scenario, these results demonstrate reduced construct strength of the combined TPLO-TTT technique compared with TPLO or TTT alone. When performing TPLO-TTT, meticulous technique and implants of adequate strength must be employed to create a robust construct and minimize postoperative tibial crest fixation failure.

Tibial Tuberosity Transposition Fixation with a Locking Plate during Medial Patellar Luxation Surgery: An Ex Vivo Mechanical Study

2021 ◽  
Author(s):  
Esa V. Eskelinen ◽  
Ari P. Suhonen ◽  
Juha V. Virolainen ◽  
William D. Liska
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Locking Plate ◽  
Ex Vivo ◽  
Tibial Tuberosity ◽  
Tension Band ◽  
Patellar Ligament ◽  
Raccoon Dog ◽  
Tension Band Wire ◽  
Lower Load

Abstract Objectives The purpose of this study was to compare the load at failure, stiffness and mode of failure between three types of tibial tuberosity transposition fixation techniques: (a) pin and figure-8 tension band wire (Pin-TBW), (b) locking plate with pin and a tension band wire (Plate-Pin-TBW) and (c) locking plate with a pin (Plate-Pin). Methods Six pairs of raccoon dog cadaveric tibiae were tested in Phase I Pin-TBW versus Plate-Pin-TBW and seven pairs in Phase II Plate-Pin-TBW versus Plate-Pin. One limb of each pair was randomly assigned to one of two groups for each phase. A tensile force was applied to the patellar ligament until construct failure. Results Pin-TBW (342N ± 54.7N) failed at a lower load than Plate-Pin-TBW (469N ± 77.3N), p = 0.00748, with all Pin-TBW failing by fracture and the majority of Plate-Pin-TBW failing by rupture of patellar ligament. Pin-TBW group Phase I, normalized with Plate-Pin-TBW Phase I, failed at a lower load than Plate-Pin group Phase II, normalized with Plate-Pin-TBW Phase II, p = 0.00467. There was no significant difference in mean load at failure, stiffness or mode at failure between the groups in the Phase II study. Clinical Significance Although ex vivo mechanical testing does not replicate the postoperative live dog or cat, these results demonstrate lower construct strength of the Pin-TBW construct compared with the Plate-Pin construct in the raccoon dog cadaver model.

scholarly journals Radiographic changes of the patellar ligament in dogs after tibial tuberosity advancement

2013 ◽  
Vol 82 (2) ◽  
pp. 215-218
Author(s):  
Ladislav Stehlík ◽  
Pavel Proks ◽  
Petra Fedorová ◽  
Alois Nečas
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Radiographic Examination ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Rupture

Patellar desmopathy in dogs after tibial plateau levelling osteotomy has been described in many studies. Tibial tuberosity advancement is a biomechanically different technique. It is assumed that the patellar ligament is loaded with little force similarly as after tibial plateau levelling osteotomy. Various aspects related to secondary patellar desmopathy are not completely understood. This study deals with computed radiography measurement of patellar ligament thickness after tibial tuberosity advancement in dogs with cranial cruciate ligament rupture. The thickness of the patellar ligament in exactly predetermined locations was measured from mediolateral radiographs of stifle joints. A total of 18 dogs (20 knee joints) with cranial cruciate ligament (ligamentum cruciatum craniale) rupture underwent three radiographic examinations of the knee (preoperative examination and control examination 7 and 15 weeks after the surgery). Significant difference was found between the thickness of the patellar ligament in the first and second examinations. Some of the demographic factors possibly related to patellar ligament thickness (age, sex, body weight, type of cranial cruciate ligament rupture, arthrotomy, cage size, meniscal injury, time between surgery and radiographic examination) were analyzed. However, statistical analyses did not show any effect of these factors on the thickness of the patellar ligament, except for the time between surgery and radiographic examination. These findings can extend the surgeons’ knowledge of biomechanical aspects of tibial tuberosity advancement.

scholarly journals Outcome of Inferior Patellar Pole Avulsion Fractures

2016 ◽  
Vol 4 (2) ◽  
pp. 84
Author(s):  
Ruban Raj Joshi ◽  
Rajeev Dwivedi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Internal Fixation ◽  
Hospital Stay ◽  
Open Reduction ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patellar Ligament ◽  
Suture Repair ◽  
Avulsion Fractures ◽  
Inferior Pole ◽  
Tension Band Wire

Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a) internal fixation of the pole fragment and (b) resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring.   Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and  group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared.   Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10) or with open reduction internal fixation with tension band wiring (n=10). Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005). Complications were seen more often in Goup-T compared to Group-R (p=0.005). Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001) and range of movement (p<0.05).   Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

IOP Lowering Effects of Ocimum basilicum Seed Extract in Two Rabbit Models of Ocular Hypertension

2019 ◽  
Vol 4 (1) ◽  
pp. 39
Author(s):  
Renu Agarwal ◽  
SK Gupta ◽  
Sushma Srivastava ◽  
Rohit Saxena
Keyword(s):  
Ocular Hypertension ◽  
Antioxidant Properties ◽  
Ocimum Basilicum ◽  
Seed Extract ◽  
Water Loading ◽  
Antiglaucoma Medication ◽  
Lowering Effect ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Introduction: Ocimum basilicum (OB), a herb known for its antihypertensive, anticholinesterase and antioxidant properties was investigated for possible intraocular pressure (IOP) lowering effects in rabbits with ocular hypertension (OHT). Methods: The IOP lowering effect of a single drop of OB extract (OBE) was evaluated in oculonormotensive rabbits using three concentrations (0.25, 0.5 and 1% w/v). The concentration showing maximum IOP reduction was further evaluated in rabbits with water-loading and steroid-induced OHT. Results: IOP lowering effect of OBE 0.5% in oculonormotensive rabbit eyes was significantly greater compared to OBE 0.25% (p<0.05) but was comparable (p>0.05) to OBE 1%. Therefore, 0.5% concentration was selected for further evaluation. Pretreatment with OBE (0.5%) caused significantly lower increase in IOP after water loading amounting to 23.39% above baseline as compared to 54.00% in control eye, 15 minutes post water loading. At 60 minutes, post water loading, mean IOP rise was 95.12% and 63.58% in control and test eyes, respectively. Significant difference between the mean IOP of two eyes persisted during the 2nd hr. In rabbits with steroid induced OHT, OBE 0.5% produced a mean IOP reduction of 24.73% at the end of first hr and the mean peak IOP reduction of 31.63% was observed at the end of 2 hr. A significant difference between the IOP of test and control eyes persisted from 1 to 6 hr. Conclusions: Ocimum basilicum seed extract showed significant IOP lowering effect in rabbits with water loading and steroid induced OHT, however, its utility as an effective antiglaucoma medication needs further investigations.

Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Coconut Oil ◽  
Test Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Virgin Coconut Oil ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.

Enrichment of common carp (Cyprinus carpio) diet with Malic acid: Effects on skin mucosal immunity, antioxidant defecne and growth performance

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Roghieh Safari ◽  
Seyed Hossein Hoseinifar ◽  
Maryam Dadar ◽  
Hien Van Doan
Keyword(s):  
Common Carp ◽  
Cyprinus Carpio ◽  
Malic Acid ◽  
Control Group ◽  
Skin Mucus ◽  
Antioxidant Genes ◽  
Treatment Comparison ◽  
Genes Expression ◽  
Significant Difference ◽  
And Control

AbstractThe present study investigated possible effects of dietary malic acid on the expression of immunity, antioxidant and growth related genes expression as well as skin mucus immune parameters in common carp. Common carp (Cyprinus carpio) fingerlings were fed diets supplemented with different levels (0 [control], 0.5%, 1%, 2%) of malic acid (MA) for 60 days. The results revealed highest expression levels of immune-related genes (tnf-alpha, il1b, il8 and lyz) in skin of common carp fed 2% MA (P < 0.05). Regarding 1% MA treatment comparison with control group, significant difference was noticed just in case of lyz (P < 0.05). Evaluation of growth related genes expression revealed no significant difference between treatments (P > 0.05). The study of antioxidant related genes (gsta and gpx) in common carp skin fed with MA, showed significant difference between treated groups and control (P < 0.05). Carps fed with 2% MA had highest alkaline phosphatase activity in skin mucus compared other treated groups and control (P < 0.05). There were no significant difference between 0.5% and 1% and control (P > 0.05). The study of total protein and total immunoglobulin (Ig) in common carp skin musus revealed no alteration following MA treatment (P > 0.05). The present data demonstrated that feeding with MA altered immune and antioxidant genes expression in skin mucus of common carp.

THE EFFECT OF THE ATTITUDE TOWARD BREASTFEEDING CONCEPT BASED COMIC ON THE ADOLESCENCE'S ATTITUDE TOWARD EXCLUSIVE BREASTFEEDING

2017 ◽  
Vol 1 (2) ◽  
pp. 138
Author(s):  
Mekar Dwi Anggraeni ◽  
Lutfatul Latifah ◽  
Aprilia Kartikasari ◽  
Ima Rismawati
Keyword(s):  
Exclusive Breastfeeding ◽  
Nuclear Family ◽  
T Test ◽  
Breastfeeding Duration ◽  
Control Group ◽  
Marriage Age ◽  
First Marriage ◽  
Significant Difference ◽  
Post Test ◽  
And Control

Background and purpose: The earlier development of the attitude toward exclusive breastfeeding produces the longer exclusive breastfeeding duration. Considering the first marriage age among Indonesian, the attitude toward exclusive breastfeeding should be developed at the adolescence age. The purpose of this study was to examine the effect of the attitude toward breastfeeding concept based comic on the adolescent's attitude toward exclusive breastfeeding. Method: This was a quasy experimental posttest only with control group study. The respondents were provided an comic. The respondent's attitude toward exclusive breastfeeding was measured using The Breastfeeding Attitude Questionnaire. Data were analyzed using independent and dependent t test. Results: The majority of respondents were aged 17 years old in both intervention (70%) and control grup (63%), first child in both intervention (23,3%) and control grup (26,7%), and had a nuclear family in both intervention (80%) and control grup (90%). The independent t test showed that there was a significant difference between post-test scores among the intervention and control groups (t = 5,602, p < 0,01). Conclusion and recommendation: Nurses may use the Attitude Toward Breastfeeding based comic to increase the Adolescence's attitude toward breastfeeding.Keywords: Comic, Attitudes Toward Exclusive Breastfeeding, Adolescence

Stick Figure and Think, Talk And Write: Integrating Media With Teaching Strategy For A Better Writing Competence

2017 ◽  
Vol 2 (1) ◽  
pp. 46
Author(s):  
Eva Sudarwati ◽  
Shynta Amalia
Keyword(s):  
Teaching Strategy ◽  
T Test ◽  
Narrative Writing ◽  
Control Groups ◽  
Stick Figure ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Mean Differences ◽  
And Control ◽  
Writing Competence

Abstract This study attempts to see the effect of Think, Talk, and Write strategy on the students’ narrative writing competence. Considering the importance of the use of teaching media, this study tries to integrate Stick Figure as a teaching media in Think, Talk, and Write Strategy. A quasi experimental study was conducted to see the improvement of the students’ narrative writing competence. It involved 42 students who were selected on the basis of convenience sampling and assigned into two groups; experimental and control groups. The statistical analyses of paired sample t-test in experimental group showed that there was significant improvement on the students’ writing competence before (M=5.77, SD= 2.342) and after (M= 11.79, SD= 2.342), t(21)=12.059, p<0.05.Moreover, the result of independent t-test between experimental and control groups showed a significant difference. It can be seen that the mean differences was 3.79545 and the significance value is lower than 0.05, 0.000<0.05.

Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spinal Surgery ◽  
Control Group ◽  
Control Groups ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Surgical Data ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

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