scholarly journals Arthroscopic Bone Grafting and Arthrodesis of Partial Lunotriquetral Coalition

2020 ◽  
Vol 9 (06) ◽  
pp. 523-527
Author(s):  
Brahman S. Sivakumar ◽  
Nicholas C. Smith
Keyword(s):  
Literature Review ◽  
Bone Graft ◽  
Bone Grafting ◽  
Degenerative Changes ◽  
Arthroscopic Debridement ◽  
Case Description ◽  
Prior Report ◽  
Fusion Site ◽  
Carpal Coalition

Abstract Background Lunotriquetal coalition is the most common carpal coalition that can be symptomatic if trauma disrupts the syndesmosis or synchondrosis or if degenerative changes develop between the abnormal articulating surfaces. Case Description A 15-year-old boy presented with a symptomatic lunotriquetral coalition after a fall 2 years prior. Following appropriate investigation, he was managed via arthroscopic debridement, bone grafting, and lunotriquetral arthrodesis. Literature Review The majority of symptomatic lunotriquetral coalitions have been managed with open arthrodesis. There is only one prior report of arthroscopic arthrodesis of this articulation that did not utilize bone graft. Relevance This report details the procedure to allow arthroscopic lunotriquetral arthrodesis with bone grafting, conveying osteogenic properties, and encouraging incorporation at the fusion site while maintaining the dorsal ligaments.

Bilateral STT Arthrodesis in a Young Patient with Occult Proximal Row Coalition

2021 ◽  
Author(s):  
Rupert M.H. Wharton ◽  
David Ahearne
Keyword(s):  
Literature Review ◽  
Clinical Relevance ◽  
Degenerative Change ◽  
Case Description ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
African Populations ◽  
Carpal Coalition ◽  
Clinical Problems ◽  
Stt Arthrodesis

Abstract Background Carpal coalitions have an incidence of 0.1 to 1% in Caucasians and up to 8 to 9% in African populations. They rarely cause clinical problems requiring investigation or treatment, but are commonly identified on imaging obtained for other indications. Case Description We report a case of a 35-year-old male with progressive degenerative change of incomplete coalitions of the scaphotrapeziotrapezoid joint (STT) in the presence of bilateral complete osseous lunate–triquetral coalitions (Minnaar type 4). He was successfully treated with staged bilateral arthrodesis with excellent symptom resolution and preservation of function. Literature Review In patients with isolated STT coalition six reports of surgery exist, two of which were for arthrodesis. This is the first described case of STT arthrodesis in a patient with coexistent lunate–triquetral coalition. Clinical Relevance The STT arthrodesis remains a safe and effective treatment for STT pain even in cases of occult carpal coalition. Functional range of movement was well preserved. Level of evidence This is a Level V study.

Features of redox homeostasis in patients with liver cirrhosis (literature review and clinical case description)

2020 ◽  
Vol 26 (1) ◽  
pp. 70-86
Author(s):  
M.O. Abrahamovych ◽  
◽  
O.O. Abrahamovych ◽  
O.P. Fayura ◽  
L.R. Fayura ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Literature Review ◽  
Clinical Case ◽  
Redox Homeostasis ◽  
Case Description

scholarly journals Effect of Systemic Zoledronic Acid Dosing Regimens on Bone Regeneration in Osteoporotic Rats

2021 ◽  
Vol 11 (4) ◽  
pp. 1906
Author(s):  
Marwa Y. Shaheen ◽  
Amani M. Basudan ◽  
Abdurahman A. Niazy ◽  
Jeroen J. J. P. van den Beucken ◽  
John A. Jansen ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Femoral Condyle ◽  
Bone Defects ◽  
Histological Evaluation ◽  
Favorable Effect ◽  
Osteoporotic Bone ◽  
Bovine Bone ◽  
Graft Placement ◽  
Regeneration Of Bone

The aim of this study was to evaluate the regeneration of bone defects created in the femoral condyle of osteoporotic rats, following intravenous (IV) zoledronate (ZA) treatment in three settings: pre-bone grafting (ZA-Pre), post-bone grafting (ZA-Post), and pre- plus post-bone grafting (ZA-Pre+Post). Twenty-four female Wistar rats were ovariectomized (OVX). After 12 weeks, bone defects were created in the left femoral condyle. All defects were grafted with a particulate inorganic cancellous bovine bone substitute. ZA (0.04 mg/kg, weekly) was administered to six rats 4 weeks pre-bone graft placement. To another six rats, ZA was given post-bone graft placement creation and continued for 6 weeks. Additional six rats received ZA treatment pre- and post-bone graft placement. Control animals received weekly saline intravenous injections. At 6 weeks post-bone graft placement, samples were retrieved for histological evaluation of the bone area percentage (BA%) and remaining bone graft percentage (RBG%). BA% for ZA-Pre (50.1 ± 3.5%) and ZA-Post (49.2 ± 8.2%) rats was significantly increased compared to that of the controls (35.4 ± 5.4%, p-value 0.031 and 0.043, respectively). In contrast, ZA-Pre+Post rats (40.7 ± 16.0%) showed similar BA% compared to saline controls (p = 0.663). For RBG%, all experimental groups showed similar results ranging from 36.3 to 47.1%. Our data indicate that pre- or post-surgical systemic IV administration of ZA improves the regeneration of bone defects grafted with inorganic cancellous bovine-bone particles in osteoporotic bone conditions. However, no favorable effect on bone repair was seen for continued pre- plus post-surgical ZA treatment.

scholarly journals Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial

2021 ◽  
Vol 18 (12) ◽  
pp. 6220
Author(s):  
Reham AlJasser ◽  
Sundus Bukhary ◽  
Mohammed AlSarhan ◽  
Dalal Alotaibi ◽  
Saleh AlOraini ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Endodontic Treatment ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bony Defect ◽  
Keratinized Tissue ◽  
Group I ◽  
Significant Difference ◽  
Grafting Procedure

The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months’ interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.

scholarly journals Management of Isolated Capitate Nonunion: A Case Series and Literature Review

2018 ◽  
Vol 07 (05) ◽  
pp. 419-423 ◽  
Author(s):  
Rishabh Jethanandani ◽  
Schneider Rancy ◽  
Keith Corpus ◽  
Jeffrey Yao ◽  
Scott Wolfe
Keyword(s):  
Literature Review ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Relevant Literature ◽  
Case Series ◽  
Rare Condition ◽  
Vascular Supply ◽  
Autogenous Bone ◽  
Rare Injury ◽  
Autogenous Bone Grafting

Background Isolated capitate nonunion is rare. No consensus on the appropriate treatment for this condition exists. Case Description We reported two cases of capitate fracture nonunion presenting several months after untreated high-impact wrist trauma. Treatment was delayed as both patients' nonunions were missed on conventional radiographs. Both were ultimately diagnosed with advanced imaging and successfully treated with internal fixation and autogenous bone grafting. The relevant literature pertaining to capitate nonunion was reviewed. Literature Review Immobilization and internal fixation with bone grafting for capitate nonunion have been described in the literature. Loss of vascular supply and progression to avascular necrosis is a concern after capitate nonunion. Clinical Relevance We present two cases and review the literature on the diagnosis and treatment of this rare injury to guide management. Internal fixation with autogenous bone grafting could play a role in management for this rare condition.

Predictors of Failure for Vascularized and Nonvascularized Bone Grafting of Scaphoid Nonunions: A Systematic Review

2021 ◽  
Author(s):  
Schneider K. Rancy ◽  
Scott W. Wolfe ◽  
J. Terrence Jose Jerome
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Failure Time ◽  
Smoking Status ◽  
Meta Analysis ◽  
Fixation Time ◽  
Proximal Fragment ◽  
Arcsine Transformation ◽  
Failed Surgery ◽  
Time From Injury

Abstract Objective This article compares predictors of failure for vascularized (VBG) and nonvascularized bone grafting (NVBG) of scaphoid nonunions. Methods We conducted a systematic literature review of outcomes after VBG and NVBG of scaphoid nonunion. Fifty-one VBG studies (N = 1,419 patients) and 81 NVBG studies (N = 3,019 patients) met the inclusion criteria. Data were collected on surgical technique, type of fixation, time from injury to surgery, fracture location, abnormal carpal posture (humpback deformity and/or dorsal intercalated segmental instability [DISI]), radiographic parameters of carpal alignment, prior failed surgery, smoking status, and avascular necrosis (AVN) as defined by punctate bleeding, magnetic resonance imaging (MRI) with contrast, MRI without contrast, X-ray, and histology. Meta-analysis of proportions was conducted with Freeman–Tukey double arcsine transformation. Multilevel mixed-effects analyses were performed with univariable and multivariable Poisson regression to identify confounders and evaluate predictors of failure. Results The pooled failure incidence effect size was comparable between VBG and NVBG (0.09 [95% confidence interval [CI] 0.05–0.13] and 0.08 [95% CI 0.06–0.11], respectively). Humpback deformity and/or DISI (incidence-rate radios [IRRs] 1.57, CI: 1.04–2.36) and lateral intrascaphoid angle (IRR 1.21, CI: 1.08–1.37) were significantly associated with an increased VBG failure incidence. Time from injury to surgery (IRR 1.09, CI: 1.06–1.12) and height-to-length (H/L) ratio (IRR 53.98, CI: 1.16–2,504.24) were significantly associated with an increased NVBG failure incidence, though H/L ratio demonstrated a wide CI. Decreased proximal fragment contrast uptake on MRI was a statistically significant predictor of increased failure incidence for both VBG (IRR 2.03 CI: 1.13–3.66) and NVBG (IRR 1.39, CI: 1.16–1.66). Punctate bleeding or radiographic AVN, scapholunate angle, radiolunate angle, and prior failed surgery were not associated with failure incidence for either bone graft type (p > 0.05). Conclusion Humpback deformity and/or DISI and increasing lateral intrascaphoid angle may be predictors of VBG failure. Time from injury to surgery may be a predictor of NVBG failure. AVN as defined by decreased contrast uptake on MRI may be a marker of increased failure risk for both bone graft types.

Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss

2017 ◽  
Vol 45 (12) ◽  
pp. 2849-2857 ◽  
Author(s):  
Leo Pauzenberger ◽  
Felix Dyrna ◽  
Elifho Obopilwe ◽  
Philipp R. Heuberer ◽  
Robert A. Arciero ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Humeral Head ◽  
External Rotation ◽  
Glenoid Defect ◽  
Contact Patterns ◽  
Grafting Technique ◽  
The Mean ◽  
The Creation ◽  
Glenoid Reconstruction

Background: The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. Purpose: To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. Results: The creation of a 30% glenoid defect significantly decreased glenohumeral contact areas ( P < .05) but significantly increased contact pressures at all abduction and rotation positions ( P < .05). Glenoid reconstruction restored the contact area and contact pressure back to levels of the native glenohumeral joint in all tested positions. The mean (±SD) force to translate the humeral head anteriorly for 10 mm (60° of abduction: 31.7 ± 12.6 N; 60° of abduction and 60° of external rotation: 28.6 ± 7.6 N) was significantly reduced after the creation of a 30% anterior bone glenoid defect (60° of abduction: 12.2 ± 6.8 N; 60° of abduction and 60° of external rotation: 11.4 ± 5.4 N; P < .001). After glenoid reconstruction with a J-bone graft, the mean peak translational force significantly increased (60° of abduction: 85.0 ± 8.2 N; 60° of abduction and 60° of external rotation: 73.6 ± 4.5 N; P < .001) compared with the defect state and baseline. The mean total graft protrusion under cyclical translation of the humeral head over 3000 cycles was 138.3 ± 169.8 µm, whereas the mean maximal mediolateral graft deflection was 320.1 ± 475.7 µm. Conclusion: Implant-free anatomic glenoid reconstruction with the J-bone grafting technique restored near-native glenohumeral contact areas and pressures, provided secure initial graft fixation, and demonstrated excellent osseous glenohumeral stability at time zero. Clinical Relevance: The implant-free J-bone graft is a viable alternative to commonly used glenoid reconstruction techniques, providing excellent graft fixation and glenohumeral stability immediately postoperatively. The normalization of glenohumeral contact patterns after reconstruction could potentially avoid the progression of dislocation arthropathy.

scholarly journals Painful torticollis due to tubercular atlantoaxial rotatory fixation: A case report

2020 ◽  
Vol 11 ◽  
pp. 440
Author(s):  
Abolfazl Rahimizadeh ◽  
Walter Williamson ◽  
Shaghayegh Rahimizadeh ◽  
Mahan Amirzadeh
Keyword(s):  
Case Report ◽  
Bone Graft ◽  
Laboratory Tests ◽  
Rare Event ◽  
Lateral Mass ◽  
Case Description ◽  
Mass Reduction ◽  
Iliac Bone Graft ◽  
Atlantoaxial Rotatory Fixation ◽  
Rotatory Fixation

Background: Tubercular atlantoaxial, rotary dislocation warranting fixation (AARF) is an extremely rare event. Case Description: AARF was suspected in a 23-year-old female with painful torticollis. When diagnostic studies documented unilateral destruction of the left lateral mass of the atlas, she underwent removal of the lateral mass, reduction of the deformity, and C1-C2 fusion/reconstruction utilizing an iliac bone graft. Laboratory tests and the pathologic surveys were all consistent with the diagnosis of underlying tuberculosis. Conclusion: We present a case of tubercular atlantoaxial, rotary dislocation (AARF) in a patient who warranted C1-C2 decompression, reduction, and fusion.

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