A New Approach to Elbow Arthroplasty

1981 ◽  
Vol 10 (2) ◽  
pp. 59-64 ◽  
Author(s):  
W A Souter
Keyword(s):  
Body Weight ◽  
Methyl Methacrylate ◽  
Clinical Results ◽  
Medial Epicondyle ◽  
New Approach ◽  
Articular Surfaces ◽  
Two Component ◽  
And Function

The development of a two component endoprosthesis, the articular surfaces of which are modelled very closely on those of the normal trochlear joint, is described. Fixation is achieved through the use of methyl methacrylate cement around a keel and stem on the ulnar side and around a supracondylar metal stirrup with projecting flanges in the capitellum and medial epicondyle in the humerus. In vitro studies suggest that this fixation should be adequate to resist the forces normally transmitted across the elbow, these forces ranging according to the activity from half to three times body weight. Early clinical results have proved very satisfactory with regard to relief of pain and recovery of flexion, pronation, supination, power and function as a whole. The recovery of lost extension has proved more elusive. A much longer follow-up of two to five years will be required in order to ascertain whether the problem of loosening has been solved.

Craniofacial reconstruction with a fast resorbing polymer: a 6- to 12-month clinical follow-up review

2004 ◽  
Vol 16 (3) ◽  
pp. 1-3 ◽  
Author(s):  
Steven R. Cohen ◽  
Ralph E. Holmes ◽  
Hal S. Meltzer ◽  
Michael L. Levy ◽  
Miles Z. Beckett
Keyword(s):  
Fibrous Dysplasia ◽  
Surgical Procedures ◽  
Bone Healing ◽  
Clinical Studies ◽  
Clinical Results ◽  
Craniofacial Reconstruction ◽  
Bone Fixation ◽  
Study Support

Object Resorbable polymer implants have become a compelling option in the treatment of acquired and congenital craniofacial deformities. In particular, the resorbable polylactide and polyglycolide polymers have demonstrated excellent safety profiles in multiple in vitro, animal, and clinical studies and are currently being used in a wide variety of craniofacial applications. In pediatric craniofacial reconstruction a desirable attribute of fixation is early resorption, which may limit the duration of any effect on cranial growth. In this paper the authors discuss the biomaterial properties of a fast resorbing polymer (FRP) and the clinical results in a series of patients who participated in a 6- to 12-month study. Methods The authors performed craniofacial reconstruction by using FRP implants in 29 patients beginning in August 2002. All patients experienced maintenance of stable bone fixation followed by bone healing. Cosmetic results were rated satisfactory or excellent, except for one unsatisfactory cosmetic result caused by disease progression. Conclusions Results of this study support the effectiveness of an FRP implant in a variety of craniofacial surgical procedures including craniosynostoses, fibrous dysplasia, cranial defects, and encephaloceles.

Clinical, Molecular, Functional, and Structural Characterization of CYP17A1 Mutations in Brazilian Patients with 17-Hydroxylase Deficiency

2020 ◽  
Vol 52 (03) ◽  
pp. 186-193 ◽  
Author(s):  
Fernanda Borchers Coeli-Lacchini ◽  
Livia M. Mermejo ◽  
Aline Faccioli Bodoni ◽  
Lucila Leico Kagohara Elias ◽  
Wilson Araújo Silva Jr ◽  
...  
Keyword(s):  
Three Dimensional ◽  
External Genitalia ◽  
Structural Modeling ◽  
Primary Amenorrhea ◽  
Compound Heterozygous ◽  
Hydroxylase Deficiency ◽  
Vitro Analysis ◽  
And Function

Abstract17-Hydroxylase-deficiency (17OHD) is a rare form of congenital adrenal hyperplasia. The aim of the work was to study clinical, biochemical, and the follow up of 17OHD patients and evaluate the function and structure of CYP17A1 mutations. Brazilian patients (three 46, XX and four 46, XY; 17±1.9 years) with combined 17-hydroxylase/17,20-lyase deficiency were evaluated. CYP17A1 gene was sequenced. Functional analysis was performed transfecting COS7 cells, which were exposed to progesterone or 17α-hydroxypregnolone substrates. Hormones were determined by RIA or LC-MS/MS. Three-dimensional structural modeling was performed by Modeller software. All patients presented prepubertal female external genitalia, primary amenorrhea, hypergonadotrophic hypogonadism, hypokalemic hypertension, decreased cortisol, and increased ACTH and corticosterone levels. Five patients presented previously described mutations: p.W406R/p.W406R, IVS2–2A>C/p.P428L, and p.P428L/p.P428L. Two patients presented the compound heterozygous p.G478S/p.I223Nfs*10 mutations, whose CYP17A1 activity and the three dimensional structural modeling are originally studied in this paper. CYP17A1 activity of p.G478S was 13 and 58% against progesterone and 17-hydroxypregnenolone, respectively. The p.I223Nfs*10 caused a truncated inactive protein. Three-dimensional p.G478S structural modeling showed different internal hydrophobic interaction with W313 and created an additional chain side contact with L476 residue. Due to the rarity of 17OHD, the long term follow up (15.3±3.1 years) of our patients will help endocrinologists on the management of patients with 17OHD. The mutation p.G478S/pI223Nfs*10 led to severe 17OHD and impaired CYP17A1 structure and function. The integration of in silico and in vitro analysis showed how the amino acid changes affected the CYP17A1 activity and contributed to clarify the molecular interactions of CYP17A1.

scholarly journals Total ankle arthroplasty incorporating a total talar prosthesis

2019 ◽  
Vol 101-B (4) ◽  
pp. 443-446 ◽  
Author(s):  
H. Kurokawa ◽  
A. Taniguchi ◽  
S. Morita ◽  
Y. Takakura ◽  
Y. Tanaka
Keyword(s):  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Custom Made ◽  
The Mean ◽  
Ct Data ◽  
End Stage ◽  
And Function

AimsTotal ankle arthroplasty (TAA) has become the most reliable surgical solution for patients with end-stage arthritis of the ankle. Aseptic loosening of the talar component is the most common complication. A custom-made artificial talus can be used as the talar component in a combined TAA for patients with poor bone stock of the talus. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA.Patients and MethodsTen patients (two men, eight women; ten ankles) treated using a combined TAA between 2009 and 2013 were matched for age, gender, and length of follow-up with 12 patients (one man, 11 women; 12 ankles) who underwent a standard TAA. All had end-stage arthritis of the ankle. The combined TAA features a tibial component of the TNK ankle (Kyocera, Kyoto, Japan) and an alumina ceramic artificial talus (Kyocera), designed using individualized CT data. The mean age at the time of surgery in the combined TAA and standard TAA groups was 71 years (61 to 82) and 75 years (62 to 82), respectively. The mean follow-up was 58 months (43 to 81) and 64 months (48 to 88), respectively. The outcome was assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Ankle Osteoarthritis Scale (AOS), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).ResultsThe mean preoperative JSSF score of the combined TAA and standard TAA groups was 44 (sd 11) and 49 (sd 10), respectively. The mean postoperative JSSF scores were 89 (sd 6.1) and 72 (sd 15), respectively. The mean postoperative JSSF score of the combined TAA group was significantly higher (p = 0.0034). The mean preoperative AOS scores for pain and function in the combined TAA and standard TAA groups were 5.8 (sd 3.3) and 5.5 (sd 3.1), and 8.6 (sd 1.3), and 7.1 (sd 2.9), respectively. The mean postoperative AOS scores of pain and function were 2.5 (sd 2.5) and 2.2 (sd 1.9), and 2.5 (sd 3.3) and 3.4 (sd 2.9), respectively. There were no significant differences between the two groups in terms of postoperative AOS scores. The mean postoperative SAFE-Q scores were: for pain, 76 (sd 23) and 70 (sd 23); for physical function, 66 (sd 25) and 55 (sd 27); for social function, 73 (sd 35) and 62 (sd 34); for shoe-related, 73 (sd 19) and 65 (sd 26); and for general health, 78 (sd 28) and 67 (sd 29), respectively. There were no significant differences between the two groups in terms of postoperative SAFE-Q scores.ConclusionCombined TAA resulted in better clinical results than standard TAA. Cite this article: Bone Joint J 2019;101-B:443–446.

scholarly journals Eruption of Bioengineered Teeth: A New Approach Based on A Polycaprolactone Biomembrane

Nanomaterials ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1315
Author(s):  
Céline Stutz ◽  
François Clauss ◽  
Olivier Huck ◽  
Georg Schulz ◽  
Nadia Benkirane-Jessel ◽  
...  
Keyword(s):  
Optimal Solution ◽  
Test Group ◽  
Titanium Implants ◽  
Recipient Site ◽  
New Approach ◽  
Adult Mice ◽  
Functional Tooth ◽  
Bioengineered Tooth

Obtaining a functional tooth is the ultimate goal of tooth engineering. However, the implantation of bioengineered teeth in the jawbone of adult animals never allows for spontaneous eruption due mainly to ankylosis within the bone crypt. The objective of this study was to develop an innovative approach allowing eruption of implanted bioengineered teeth through the isolation of the germ from the bone crypt using a polycaprolactone membrane (PCL). The germs of the first lower molars were harvested on the 14th day of embryonic development, cultured in vitro, and then implanted in the recipient site drilled in the maxillary bone of adult mice. To prevent the ankylosis of the dental germ, a PCL membrane synthesized by electrospinning was placed between the germ and the bone. After 10 weeks of follow-up, microtomography, and histology of the implantation site were performed. In control mice where germs were directly placed in contact with the bone, a spontaneous eruption of bioengineered teeth was only observed in 3.3% of the cases versus 19.2% in the test group where PCL biomembrane was used as a barrier (p < 0.1). This preliminary study is the first to describe an innovative method allowing the eruption of bioengineered tooth implanted directly in the jawbone of mice. This new approach is a hope for the field of tooth regeneration, especially in children with oligodontia in whom titanium implants are not an optimal solution.

scholarly journals Muscle Quality Revisited: Biopsy Energetics, MR Spectroscopy, and Muscle Power and Strength

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 125-126
Author(s):  
Anne Newman ◽  
Adam Santanasto ◽  
Elsa Strotmeyer ◽  
Barbara Nicklas ◽  
Paul Coen ◽  
...  
Keyword(s):  
Mr Spectroscopy ◽  
Muscle Power ◽  
Muscle Quality ◽  
Strongly Correlated ◽  
Quality Aspects ◽  
And Function ◽  
Loss Of Strength

Abstract With age, strength may decline faster than muscle mass pointing to a deterioration in muscle quality. Aspects of muscle quality and function are being measured in SOMMA; we hypothesized that in vitro and in vivo bioenergetics capacity of muscle would be related to muscle strength and power. Associations differed between men and women. In men (n=48, ATPMAX, 70, max OXPHOS and max ETS) but not women (n=68, ATPMAX, n=103, max OXPHOS and max ETS), muscle ATP regeneration by 31P MR spectroscopy was correlated with leg power (r = 0.27, p= 0.05). Energy production in tissue was similarly more strongly correlated with power in men than women, though not statistically significant. Correlations between the tissue measures and strength were also stronger in men than women. In ongoing follow-up, we will be able to determine what role that muscle tissue energetics plays in explaining the loss of strength and power with aging.

Ceravital in ossiculoplasty: experimental studies and early clinical results

1986 ◽  
Vol 100 (12) ◽  
pp. 1359-1366 ◽  
Author(s):  
A. W. Blayney ◽  
J.-P. Bebear ◽  
K. R. Williams ◽  
M. Portmann
Keyword(s):  
Experimental Studies ◽  
Clinical Results ◽  
Type Ii ◽  
Short Term ◽  
Implant Surface ◽  
Interface Reactions ◽  
Hearing Result

AbstractThe biocompatibility of the bioactive glass-ceramic Ceravital was investigated experimentally both in vivo and in vitro. In the former, ceramic discs were interposed in 30 rat middle ears for periods ranging from 6 weeks to 12 months. In the latter, Ceravital otological prosthesis were placed in human fibroblast culture.Reactions to the biomaterial were assessed by means of scanning electron microscopy (SEM) with chemical analysis facilities (EDAX, WDAX) and light microscopy.The interface reactions were similar in both in vivo and in vitro studies and confirmed the findings of other authors regarding the implants& biocompatibility and bioactivity. The technique of ion etching, however, enabled clear demonstration of this bioactivity on the implant surface, exposed merely to the middle-ear secretions, thus questioning the necessity of placing bone pate on the implant head at surgery, in order to encourage bioactive bonding with the overlying drum.A clinical trial of Ceravital in 128 patients with an average follow-up period of 2 years is reported. Forty per cent of these patients underwent a type II tympanoplasty, 60 per cent a type III. Though relatively short-term, the results to date have been encouraging: 88 per cent of the implants have been well-tolerated; 70 per cent of the cases have yielded a satisfactory hearing result; and only 3 per cent of the implanted prostheses have been extruded.

Results of Trabecular-Metal Total Ankle Arthroplasties With Transfibular Approach

2019 ◽  
Vol 41 (4) ◽  
pp. 411-418 ◽  
Author(s):  
Hannu Tiusanen ◽  
Sami Kormi ◽  
Ia Kohonen ◽  
Mikhail Saltychev
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Trabecular Metal ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Functional Scores ◽  
Component Loosening ◽  
And Function

Background: Total ankle arthroplasty is an alternative for arthrodesis. The objective of this study was to investigate the safety of trabecular-metal ankle prosthetic system with transfibular approach and external frame and its association with changes in clinical and functional scores. Methods: Between May 2013 and June 2017, a total of 104 consecutive patients underwent primary total ankle arthroplasty with a trabecular metal implant. The prospective clinical and radiographic data were collected. The mean follow-up time was 43.6 (14.6) months. Results: Of 104 patients, 88 (89%) reported improved functioning and 65 (66%) were very satisfied with the surgery. Of the patients, 51 (50%) did not report any pain at the end of follow-up at all. The average Kofoed score was 37.6 (SD 17.4) points at baseline and 74.8 (SD 20.6) points at the end of follow-up. There were 37 additional procedures, and the complication rate was nearly 20%. Conclusion: Trabecular-metal total ankle prosthesis showed promising clinical results concerning pain and function. At 5-year follow-up, osteolysis and component loosening were rare. Level of Evidence: Level IV, case series.

A new approach in the treatment of hydrocephalus

1987 ◽  
Vol 66 (2) ◽  
pp. 213-226 ◽  
Author(s):  
Christian Sainte-Rose ◽  
Michael D. Hooven ◽  
Jean-François Hirsch
Keyword(s):  
Variable Parameter ◽  
Clinical Results ◽  
Mean Value ◽  
Differential Pressure ◽  
New Approach ◽  
Content Type ◽  
Csf Drainage ◽  
Third Stage ◽  
Flow Through

✓ To date, most patients suffering from hydrocephalus have been treated by insertion of differential-pressure valves that have fairly constant resistance. Since intracranial pressure (ICP) is a variable parameter (depending on such factors as patient's position and rapid eye movement sleep) and since cerebrospinal fluid (CSF) secretion is almost constant, it may be assumed that some shunt complications are related to too much or too little CSF drainage. The authors suggest a new approach to treating hydrocephalus, the aim of which is to provide CSF drainage at or below the CSF secretion rate within a physiological ICP range. This concept has led the authors to develop a three-stage valve system. The first stage consists of a medium-pressure low-resistance valve that operates as a conventional differential-pressure valve until the flow through the shunt reaches a mean value of 20 ml/hr. A second stage consists of a variable-resistance flow regulator that maintains flow between 20 and 30 ml/hr at differential pressures of 80 to 350 mm H2O. The third stage is a safety device that operates at differential pressures above 350 mm H2O (inducing a rapid increase in CSF flow rate) and therefore prevents hyper-elevated ICP. An in vitro study is described that demonstrates the capability of this system to maintain flow rates close to CSF production under a range of pressures similar to those observed under various human physiological and postural conditions. Promising clinical results in 19 patients shunted with this valve are summarized.

scholarly journals Modified gift box technique for acute compound posttraumatic Achilles tendon repair in young patients

2018 ◽  
Vol 4 (2) ◽  
pp. 302
Author(s):  
Tushar Singhi ◽  
Ashith Rao ◽  
Abhay Agarwal ◽  
Sunil Shetty ◽  
Prakash Samant
Keyword(s):  
Achilles Tendon ◽  
Primary Repair ◽  
Achilles Tendon Rupture ◽  
Young Patients ◽  
Clinical Results ◽  
Tendon Injury ◽  
Active Patients ◽  
Toe Walking

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Treatment of Achilles tendon rupture in young active patient remains controversial. Open primary repair remains the mainstay of treatment with prolonged rehabilitation and high wound complication rate (20%). In compound injuries it becomes the default treatment. Newer techniques are being tried to decrease re-rupture rate, decrease local complications and facilitate early rehabilitation. Modified gift box technique of open repair, which has shown higher strength of repair in in-vitro studies and good clinical results in the hands of its inventor. The aim of our study was to evaluate the clinical results of this technique in young active patients with compound Achilles tendon injury.</span></p><p class="abstract"><strong>Methods:</strong> This is a retrospective study. The parameters recorded at follow up included general demography, ability to single toe raise (on neutral, incline, decline), toe walking for 40 feet, and pain on VAS scale. Achilles tendon total rupture score and modified Rupp score were administered.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of the 8 patients included in the study, 7 patients had unilateral tear and 1 patient had bilateral tear. The mean age was 27 yrs (20-35) and mean duration of follow up was 17.4 months (08-24 months). Single toe raise and toe walking for 40 ft. was possible in all patients. Two patients complained of grade 2 pain on VAS Scale. The ATRS score was 97.1 (94-99) and modified Rupp score was 28.3 (26-29)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Modified gift box technique gives excellent results in young active patients with compound Achilles tendon injury with no re-rupture and return of pre-injury activity<span lang="EN-IN">.</span></p>

Abstract 3634: Association of Weight Loss and Changes in Left Ventricular Geometry and Function - Results of the longitudinal population based MONICA/KORA-Survey

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jan Stritzke ◽  
Marcello R Markus ◽  
Wolfgang Lieb ◽  
Andreas Luchner ◽  
Angela Döring ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Gain ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry ◽  
And Function

Background: Obesity is related to left ventricular (LV) hypertrophy and diastolic dysfunction. However it remains unclear if changes in life style resulting in loss of body weight also have beneficial effects on left ventricular remodeling. In this study we evaluated the effects of weight loss on left ventricular geometry and function during ten years of follow-up. Methods: Subjects (n=1005, aged 25 to 74 years) who originated from a gender and age stratified random sample of German residents of the Augsburg area were examined by standardized echocardiography at baseline and again after ten years. The associations between weight loss and long-term changes of left ventricular end-diastolic diameter (LVEDD), wall thickness (WT), left ventricular mass (LVM), and left atrial diameter (LA) were assessed. Mean relative changes and odds ratios were computed by statistical models adjusting for gender, age, body height, systolic blood pressure and body weight at baseline. Results: After ten years of follow-up 305 individuals presented with a loss of body weight (−3.5+/−3.4kg on average). Whereas 700 subjects presented with an increase of body weight (+5.4+/−4.7kg). Ageing related changes in LV geometry were significantly different in the two groups. Specifically, individuals with weight loss displayed a favorable geometry with relative changes of WT (+5.9% [CI-95% 4.3, 7.5] vs. + 8.1% [7.0, 9.2], p=0.024), LVEDD (−0.6% [−1.5, 0.2] vs. 30.8% [0.2, 1.4], p=0.008), LVM (+6.5% [4.3, 8.8] vs. +11.9% [10.4, 13.5], p<0.001) and LA (−0.9% [−2.1, 0.2] vs. +2.5% [1.7, 3.3], p<0.001), as compared to individuals with weight gain. Moreover, the risk for incident left ventricular hypertrophy (OR 2.5 [1.5– 4.3], p=0.001) and incident diastolic dysfunction (OR 1.9 [1.1–3.4], p=0.023) was significantly higher in individuals presenting with an increase in body weight. Conclusions: As compared to weight gain, weight loss is associated with a significant deceleration of left ventricular remodeling during ageing of the heart. Nevertheless, even in the weight loss group there was no regression in left ventricular mass detectable. Consequently, early interventions especially in young obese individuals are essential for prevention of premature onset of cardiac remodeling.

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