Antiseptic Use in Orthopaedic Wounds

2020 ◽  
pp. 46-61
Author(s):  
Fahima A. Begum ◽  
Tiffanie-Marie Borg ◽  
Hamed Mazoochy ◽  
Nima Heidari
Keyword(s):  
Strong Evidence ◽  
Case Reports ◽  
Single Agent ◽  
Case Series ◽  
Human Studies ◽  
In Vivo Studies ◽  
Foot And Ankle ◽  
Skin Preparation ◽  
Systemic Complications

Objectives: The aim of this study is to review the available literature addressing the safety and efficacy of antiseptics in surgical wounds. The different antiseptic solutions, irrigation volumes, time scales and delivery methods have been compared so that evidence-based recommendations on antiseptic use in orthopaedic, foot and ankle surgical procedures can be proposed. Methods: A literature search was performed using the online databases Medline and EMBase to identify in-vitro and in-vivo studies pertaining to antiseptic use in an orthopaedic context. Terms including antiseptic, irrigation fluid, bacitracin, hydrogen peroxide, povidone-iodine and chlorhexidine were searched. Literature published in English from inception to July 2020 in which the full text was accessible was considered for inclusion. Cellular and animal studies were included on the basis that authors analysed antiseptic efficacy and/or toxic effect of antiseptic on cells present in orthopaedic wounds. Clinical studies that met the criteria for inclusion in this review assessed antiseptic use in a surgical context, with a focus on foot and ankle procedures.         These included case reports, case series, case control, prospective and retrospective studies as well as randomised controlled trials. Studies were categorised as in-vitro, animal and human studies. Twenty-three, eleven and forty-four studies were identified as in-vitro, animal and       human studies respectively. These have been summarised and presented herein in a narrative format. Results: There is strong evidence that skin preparation with antiseptics before orthopaedic procedures reduces the risk of post-operative infection. Conclusion: Routine prophylactic intra-operative antiseptic use should be performed with caution as they increase the risk of local and systemic complications. However, there is strong evidence supporting the use of antiseptics pre-operatively when preparing the skin. Determining the best antiseptic preparation remains a matter of debate since a single agent or solution is not effective against all organisms. Further research is therefore needed to assess the efficacy of antiseptics in prevention and treatment of infections.

Effects of Probiotics in the Management of Infected Chronic Wounds: From Cell Culture to Human Studies

2020 ◽  
Vol 15 (3) ◽  
pp. 193-206
Author(s):  
Brognara Lorenzo ◽  
Salmaso Luca ◽  
Mazzotti Antonio ◽  
Di M. Alberto ◽  
Faldini Cesare ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Animal Experiments ◽  
Multidrug Resistant ◽  
Preliminary Evidence ◽  
Human Studies ◽  
In Vivo Studies ◽  
Resistant Bacteria ◽  
Keywords Probiotics

Background: Chronic wounds are commonly associated with polymicrobial biofilm infections. In the last years, the extensive use of antibiotics has generated several antibiotic-resistant variants. To overcome this issue, alternative natural treatments have been proposed, including the use of microorganisms like probiotics. The aim of this manuscript was to review current literature concerning the application of probiotics for the treatment of infected chronic wounds. Methods: Relevant articles were searched in the Medline database using PubMed and Scholar, using the keywords “probiotics” and “wound” and “injuries”, “probiotics” and “wound” and “ulcer”, “biofilm” and “probiotics” and “wound”, “biofilm” and “ulcer” and “probiotics”, “biofilm” and “ulcer” and “probiotics”, “probiotics” and “wound”. Results: The research initially included 253 articles. After removal of duplicate studies, and selection according to specific inclusion and exclusion criteria, 19 research articles were included and reviewed, accounting for 12 in vitro, 8 in vivo studies and 2 human studies (three articles dealing with animal experiments included also in vitro testing). Most of the published studies about the effects of probiotics for the treatment of infected chronic wounds reported a partial inhibition of microbial growth, biofilm formation and quorum sensing. Discussion: The application of probiotics represents an intriguing option in the treatment of infected chronic wounds with multidrug-resistant bacteria; however, current results are difficult to compare due to the heterogeneity in methodology, laboratory techniques, and applied clinical protocols. Lactobacillus plantarum currently represents the most studied strain, showing a positive application in burns compared to guideline treatments, and an additional mean in chronic wound infections. Conclusions: Although preliminary evidence supports the use of specific strains of probiotics in certain clinical settings such as infected chronic wounds, large, long-term clinical trials are still lacking, and further research is needed.

Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia

2015 ◽  
Vol 129 (5) ◽  
pp. 410-415 ◽  
Author(s):  
I Syed ◽  
V S Sunkaraneni
Keyword(s):  
Assessment Tool ◽  
Case Reports ◽  
Treatment Algorithm ◽  
Case Series ◽  
Team Approach ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Questionnaire Studies ◽  
Randomised Controlled ◽  
Specific Management

AbstractBackground:There are currently no guidelines in the UK for the specific management of hereditary haemorrhagic telangiectasia related epistaxis. The authors aimed to review the literature and provide an algorithm for the management of hereditary haemorrhagic telangiectasia related epistaxis.Method:The Medline and Embase databases were interrogated on 15 November 2013 using the search items ‘hereditary haemorrhagic telangiectasia’ (title), ‘epistaxis’ (title) and ‘treatment’ (title and abstract), and limiting the search to articles published in English.Results:A total of 46 publications were identified, comprising 1 systematic review, 2 randomised, controlled trials, 27 case series, 9 case reports, 4 questionnaire studies and 3in vitrostudies.Conclusion:There is a lack of high-level evidence for the use of many of the available treatments for the specific management of epistaxis in hereditary haemorrhagic telangiectasia. Current management should be based on a multidisciplinary team approach involving both a hereditary haemorrhagic telangiectasia physician and an ENT surgeon, especially when systemic therapy is being considered. The suggested treatment algorithm considers that the severity of epistaxis merits intervention at different levels of the treatment ladder. The patient should be assessed using a reproducible validated assessment tool, for example an epistaxis severity score, to guide treatment. More research is required, particularly in the investigation of topical agents targeting the development and fragility of telangiectasiae in hereditary haemorrhagic telangiectasia.

scholarly journals Nano-encapsulated tryptanthrin derivative for combined anticancer therapy via inhibiting indoleamine 2,3-dioxygenase and inducing immunogenic cell death

Nanomedicine ◽  
2019 ◽  
Vol 14 (18) ◽  
pp. 2423-2440 ◽  
Author(s):  
Canyu Yang ◽  
Bing He ◽  
Qiang Zheng ◽  
Dakuan Wang ◽  
Mengmeng Qin ◽  
...  
Keyword(s):  
Cell Death ◽  
Single Agent ◽  
Tumor Burden ◽  
Antitumor Efficacy ◽  
In Vivo Studies ◽  
Immunogenic Cell Death ◽  
Indoleamine 2,3 Dioxygenase ◽  
Tumor Tissues

Aim: We developed a polycaprolactone-based nanoparticle (NP) to encapsulate tryptanthrin derivative CY-1-4 and evaluated its antitumor efficacy. Materials & methods: CY-1-4 NPs were prepared and evaluated for their cytotoxicity and associated mechanisms, indoleamine 2,3-dioxygenase (IDO)-inhibitory ability, immunogenic cell death (ICD)-inducing ability and antitumor efficacy. Results: CY-1-4 NPs were 123 nm in size. In vitro experiments indicated that they could both induce ICD and inhibit IDO. In vivo studies indicated that a medium dose reduced 58% of the tumor burden in a B16-F10-bearing mouse model, decreased IDO expression in tumor tissues and regulated lymphocytes subsets in spleen and tumors. Conclusion: CY-1-4 is a potential antitumor candidate that could act as a single agent with combined functions of IDO inhibition and ICD induction.

scholarly journals Voriconazole versus Itraconazole for the Initial and Step-Down Treatment of Histoplasmosis: A Retrospective Cohort

2020 ◽  
Author(s):  
Michael Joshua Hendrix ◽  
Lindsey Larson ◽  
Adriana M Rauseo ◽  
Sasinuch Rutjanawech ◽  
Alexander D Franklin ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Histoplasma Capsulatum ◽  
Case Reports ◽  
Case Series ◽  
Clinical Information ◽  
Cox Proportional Hazards ◽  
Heaviside Function ◽  
Step Down

Abstract Background Itraconazole is the preferred azole for histoplasmosis in the current Infectious Diseases Society of America guidelines. Voriconazole is increasingly used as treatment for histoplasmosis; it has in-vitro activity against Histoplasma capsulatum and has shown success in case reports and small case series but may have a lower barrier to resistance. No comparative studies have been published. Methods We constructed a single-center retrospective cohort of adult patients diagnosed with histoplasmosis from 2002 to 2017. Individual charts were reviewed to gather clinical information including demographics, clinical features, immune status, treatments, and mortality. Patients were categorized based on initial choice of azole, either as initial treatment or as step-down therapy from amphotericin B. Initial therapies with other azoles were excluded. Mortality was compared using a multivariable Cox proportional hazards with Heaviside function at 42 days. Results We identified 261 cases of histoplasmosis from 2002 to 2017. After excluding patients not treated with itraconazole or voriconazole, 194 patients remained. 175 (90%) patients received itraconazole and 19 (10%) received voriconazole. There were no significant demographic differences between patient populations receiving either azole as their initial azole treatment. Death at 180 days occurred in 41 patients (23.4%) in the itraconazole group and 6 patients (31.6%) in the voriconazole group. Patients on voriconazole had a statistically significant increase in mortality during the first 42 days after initiation of treatment when compared to patients receiving itraconazole (HR 4.30 [95% CI 1.3-13.9, p 0.015]) when controlled for other risk factors. Conclusion Voriconazole in histoplasmosis was associated with increased mortality in the first 42 days compared to itraconazole.

scholarly journals Kratom from Head to Toe—Case Reviews of Adverse Events and Toxicities

2019 ◽  
Vol 7 (4) ◽  
pp. 141-168 ◽  
Author(s):  
Emad Alsarraf ◽  
Jamie Myers ◽  
Sarah Culbreth ◽  
John Fanikos
Keyword(s):  
Adverse Events ◽  
Case Reports ◽  
In Vivo Studies ◽  
Poison Control ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Reversible Encephalopathy ◽  
Neonatal Withdrawal

Abstract Purpose of Review This review describes case reports for patients with kratom-associated adverse events in order to assist clinicians with patient management. A stepwise approach is proposed for assessing active kratom users as well as considerations for the management of toxicities or withdrawal. Recent Findings Multiple in vitro and in vivo studies illustrate the pharmacologic and toxicologic effects of kratom extract. No randomized controlled trials in humans exist that assess the safety and efficacy of the substance. Cross-sectional surveys from active users and reports from poison control centers have shown acute and chronic physiological and psychological adverse events. Summary Reports of adverse effects associated with kratom use have demonstrated hypothyroidism, hypogonadism, hepatitis, acute respiratory distress syndrome, posterior reversible encephalopathy syndrome, seizure, and coma. Overdose toxidrome leads to respiratory failure, cardiac arrest, and fatalities. Adult and neonatal withdrawal symptoms have also occurred. Clinicians should be aware of the risks and benefits of kratom use.

Inhibition of Human Lymphoma Cell Growth by the PKC-Beta Selective Inhibitor Enzastaurin (LY317615) in Combination with Multiple Therapeutic Agents.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1595-1595
Author(s):  
Randall M Rossi ◽  
Marlene Balys ◽  
Dean Franklin ◽  
Valerie Grose ◽  
Richard I Fisher ◽  
...  
Keyword(s):  
Single Agent ◽  
Large Cell ◽  
Therapeutic Agents ◽  
In Vivo Studies ◽  
Therapeutic Drugs ◽  
Potential Synergy ◽  
Size Growth ◽  
Reduce Tumor Growth

Abstract Previous studies in our lab have shown that the PKC-beta inhibitor, enzastaurin (LY317615), when used to treat a panel of human diffuse large cell lymphoma (DLCL) lines, was able to induce cell death in vitro and substantially reduce tumor growth in xenograft assays. These findings support the hypothesis that activation of PKC contributes to tumor cell survival and proliferation, which has been implicated in the pathogenesis of human B cell lymphomas. Specifically, PKC-beta activation is increased in tumor cells from patients with poor prognosis DLCL, suggesting that PKC-beta may be a target for therapeutic intervention. In the present study, we have explored the interaction of enzastaurin with a panel of well characterized therapeutic agents to evaluate whether its anti-tumor activity can potentially be enhanced. Drugs were chosen for analysis based either on known single agent activity in lymphoma, or by preclinical evaluation indicating potential synergy with enzastaurin. For in vitro culture assays (48–72 hr treatment), the addition of gemcitabine, rapamycin, or bortezomib, increased the cytotoxicity of enzastaurin from 2 to 7 fold. This effect was evident with multiple human DLCL cell lines, (OCI-Ly3, 7, 10, 19, and SUDHL-4, and 6), as well as two independent primary DLCL cultures. For in vivo studies, subcutaneous transplantation of the DLCL cell line OCI-Ly19, (previously engineered to express luciferase which allows for real time in vivo imaging), or a primary DLCL isolate, into immune deficient NOD/SCID mice formed reproducible tumors. Recipient animals were separated into uniform cohorts when the tumors were of <=500 cubic mm in size. The animals were then simultaneously or sequentially treated with enzastaurin, (150 mg/kg b.i.d. via oral gavage) and a secondary drug, either gemcitabine, (2.5 or 5.0 mg/kg 1x/3 days IP), bortezomib, (0.4 mg/kg twice weekly IP), rapamycin, (1.0 mg/kg, daily IP), or rituxan, (5 mg/kg, weekly IP). Imaging and analysis of tumor volumes showed that addition of either rituxan or rapamycin provided no additional benefit in comparison to enzastaurin alone during the course of treatment. In contrast, the combination of either gemcitabine or bortezomib with enzastaurin demonstrated significantly reduced tumor volumes in comparison to enzastaurin alone (17% to 38% greater decrease with enzastaurin + gemcitabine, and 50% greater decrease in tumor volume with enzastaurin + bortezomib). These data suggest that the use of enzastaurin in combination with existing therapeutic drugs (gemcitabine or bortezomib) has the potential to limit tumor size/growth while lowering dose levels and thereby reducing potential side effects associated with traditional treatments.

Reactivation of Hepatitis B Virus (HBV) Associated with Rituximab Use in Lymphoma: Under Reporting and Lack of Data Quality Reported to the FDA.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1370-1370
Author(s):  
Andrew M. Evens ◽  
Bara Fintel ◽  
Brian Chiu ◽  
Leo I. Gordon ◽  
Daniel Ganger ◽  
...  
Keyword(s):  
Liver Failure ◽  
B Cell ◽  
Immunosuppressive Therapy ◽  
Active Surveillance ◽  
Medical Literature ◽  
Cell Lymphoma ◽  
Case Reports ◽  
Single Agent ◽  
Case Series ◽  
B Cell Lymphoma

Abstract Abstract 1370 Poster Board I-392 Background: HBV is a major public health problem with infection that can lead to cirrhosis, liver failure, and death. Immunosuppressive therapy, such as steroids and/or chemotherapy, is known to cause a flare or “reactivation” of HBV (HBV-react). Rituximab was approved in 1997 for the treatment of B-cell lymphoma. In 2004, based on 3 case reports, the FDA warned healthcare professionals of rituximab-associated HBV-react. Since that time, multiple cases and retrospective series of rituximab-induced HBV-react have been reported in the literature. However, the characteristics and scope of this association still remains largely unknown. We evaluated the characteristics of patients with lymphoma who developed HBV-react after exposure to rituximab, and the quality of case reports available in the medical literature and at the FDA. Methods: Data sources included 2 observations at Northwestern Memorial Hospital, 83 reports from the medical literature, and 10 reports obtained from the FDA MedWatch database (n=97). Two reports of rituximab-related HBV-react not associated with lymphoma (vasculitis and gloumerulonephritis) were excluded. HBV-react was defined as ≥ 2-fold increase in serum HBV DNA with an increase in serum ALT compared with baseline. A completeness analysis was performed comparing cases submitted to the FDA MedWatch database vs. the medical literature and active surveillance. Results: Of 83 unique cases of HBV-react associated with rituximab reported in the literature, 28 were published as case reports, while 55 were included in case series. Of these 83 cases, 46 occurred in patients (pts) with anti-HBV core antibody (HBcAb+) in the absence of HBV surface antigen (HBsAg-), while 37 cases involved pts with chronic HBV hepatitis (i.e, HBsAg+). Among the 28 case reports and 2 Northwestern cases (n=30; HBcAb+ n=16, HBsAg+ n=14), the median age at HBV-react was 55 years (23M/9F). Histology of these cases were diffuse large B-cell lymphoma (n=19), indolent lymphoma (n=8), CLL (n=2), and mantle-cell lymphoma (n=1). In terms of concomitant treatment at time of HBV-react, 25 pts were receiving concurrent immunosuppressive therapy (chemotherapy +/- steroids n=22 and steroids n=3), while only 5 cases involved single-agent rituximab treatment. Each of these 5 latter pts had received chemotherapy prior to rituximab treatment (2, 3, 12, 24, and 34 months). The median number of rituximab doses received prior to HBV-react was 6 (range 3-10). The median time from last rituximab dose to HBV-react was 5 months (0-21 months); of note, 30% of cases occurred >6 months from last rituximab dose. In terms of outcome, 60% of pts experienced fulminant liver failure, while the remaining had HBV-related hepatitis. Furthermore, 40% (12/30) of pts died due to HBV-react. Quality comparison of source data of the literature and surveillance reports vs. the FDA is contained in Table 1. Overall completeness ratio for literature and observed reports vs. the FDA was 2.18. Of rituximab-related HBV-react occurrences (n=55) reported in 8 case series, five studies included a control group; there was a suggestion of increased risk of HBV-react with rituximab-based therapy, especially with concurrent steroids, although the absolute risk was not consistent (e.g., among HBcAb+ cases, reported rate of HBV-react: 2.7% to 23.8%). Conclusions: We have found 95 total cases of rituximab-associated HBV-react. A paucity of safety reports regarding rituximab-associated HBV-react have been reported to the FDA MedWatch. Furthermore, published cases in the medical literature and through active surveillance were superior in data quality compared with FDA reports. However, the absolute risks of rituximab-related HBV-react in HBsAg+ or HBcAb+ pts are still not known. Further examination of the relationship of HBV-react with single-agent rituximab and rituximab combined with immunosuppressive therapy, with and without steroids, using an active surveillance strategy is warranted. Disclosures: No relevant conflicts of interest to declare.

Effect of short course, high-dose valproic acid on proliferation in breast adenocarcinomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13522-e13522
Author(s):  
Adam Louis Cohen ◽  
Rachel Factor ◽  
Matthias Schabel ◽  
Andrea Bild ◽  
Theresa Louise Werner
Keyword(s):  
Valproic Acid ◽  
Standard Dose ◽  
Single Agent ◽  
In Vivo Studies ◽  
Breast Adenocarcinoma ◽  
High Dose ◽  
Breast Cancers ◽  
Dce Mri ◽  
Mib 1

e13522 Background: Our in vitro and in vivo studies showed that single agent valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, is effective in a subset of breast cancers. Whether VPA is effective as a single agent and what the optimal dosing would be are unknown. Methods: In an ongoing IRB-approved, window-of-opportunity study testing a genomic predictor of sensitivity to VPA (NCT01007695), we performed biopsies and DCE-MRI on women before and after seven days of escalating doses of VPA on untreated women with breast adenocarcinoma with an intact breast tumor. Within patient dose-escalation was done with a goal dose of 50 mg/kg. Proliferation was assessed with MIB-1 immunohistochemistry. Only correlative secondary endpoints are presented here. Results: Sixteen women have completed treatment and are evaluable. Total and free VPA levels on the last day of treatment averaged 136 µg/ml (range 15-242) and 30 µg/ml (range 1-90), respectively. Proliferation rate by MIB-1 decreased by and average of -7.25% (range +4% to -45%, p=0.04). The change in proliferation did not correlated with VPA levels, although only one of four women with VPA levels less than 100 µg/ml had a decrease in proliferation, compared to five of twelve women with VPA levels greater than 100 µg/ml. Four women had MIB-1 decreases of 10% or greater. Two women have had post-treatment biopsies with fibrosis similar to that seen with chemotherapy treatment effect. DCE-MRI parameters, including ktrans, vp, and kep, did not change significantly with VPA treatment or correlate with VPA levels. Conclusions: VPA as a single agent can reduce proliferation in a subset of women with breast cancers. Higher VPA levels are needed than those achieved at standard dose levels, but VPA levels by themselves do not predict effect. Other monitoring parameters, such as peripheral blood histone acetylation changes, or other predictors of benefit are needed. Clinical trial information: NCT01007695.

scholarly journals Profile of Scientific Production on Ankyloglossia

2020 ◽  
pp. 1-13
Author(s):  
Roberta Lopes de Castro Martinelli ◽  
Reinaldo Jordão Gusmão ◽  
María Paz Moya Daza ◽  
Irene Queiroz Marchesan ◽  
Giédre Berretin-Felix
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Case Series ◽  
Scientific Production ◽  
Publication Type ◽  
Level Of Evidence ◽  
First Results ◽  
Bibliometric Review

This work aims to describe the profile of scientific production referring to ankyloglossia. For this an investigation was carried out by searching for scientific articles indexed in the electronic databases LILACS and PUBMED. For the bibliometric review, the data referring to the year of publication, type of study and level of evidence were examined and tabulated. The data were discussed on the quantitative and representative values optics. The first results allowed to analyzic 651 published studies were analyzed. Most of the research on tongue tie found correspond to descriptive studies and case series (49.31%), followed by case reports, in vitro research, in animals and literature review (24.27%), cohort and cases and controls (11.98%), specialist opinion (11.68%), randomized clinical trials (1.54%) and systematic reviews (1.22%). Few studies addressed complications during or after lingual frenulum release surgery. In conclusion Scientific production on ankyloglossia has shown an increasing increase in the last 28 years, with studies with evidence levels 1, 2 and 3 being published, whose main focus was the performance of surgery to release the lingual frenulum.

scholarly journals Iatrogenic Avascular Necrosis of the Talus Following Subchondroplasty

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0019 ◽  
Author(s):  
Andrew Hanselman ◽  
Elizabeth Cody ◽  
Mark Easley ◽  
Samuel Adams ◽  
Selene Parekh
Keyword(s):  
Avascular Necrosis ◽  
Surgical Intervention ◽  
Case Reports ◽  
Case Series ◽  
Patient Characteristics ◽  
The Other ◽  
Study Patient ◽  
Foot And Ankle ◽  
Small Case Series ◽  
Synthetic Bone Substitute

Category: Ankle, Basic Sciences/Biologics Introduction/Purpose: Subchondroplasty® (SCP®) (Zimmer Holdings, Inc, Warsaw, IN) is a relatively new procedure that was developed in 2007 for the treatment of bone-marrow lesions (BMLs). It involves the injection of flowable nanocrystalline calcium phosphate (CaP) synthetic bone substitute into the BML using fluoroscopic-guidance, in order to promote healing and reinforce the effected region. Although a newer technique, SCP has been shown promising results in the knee through several different small case-series. The foot and ankle literature is sparser, with only a few documented case-reports or case-series. As a result, we wanted to report our small case-series of patients who underwent talar SCP and went on to develop avascular necrosis (AVN). Methods: A retrospective review was conducted of patients who underwent SCP for a talar BML at our facility or were referred to our facility after undergoing SCP at an outside institution. Patients who developed iatrogenic talar AVN postoperatively were included in the study. Patient characteristics, comorbidities, imaging, and need for further surgery was analyzed. Results: Four patients were identified who had previously undergone talar SCP and went on to develop iatrogenic talar AVN. Two patients had their original SCP performed at our facility, whereas the other two patients were referred from outside institutions. All four patients were symptomatic from their AVN. Two patients have undergone revision surgical intervention, while the other two patients are pending surgical intervention. Conclusion: This case-series is the first study, to our knowledge, to report iatrogenic talar AVN after undergoing SCP for talar BMLs. Although early studies in the Foot and Ankle literature are promising for use of this technology, these studies have been small and surgeons should be aware of this potential complication.

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