bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Ropivacaine with or without Tramadol for Femoral Nerve Block in Total Knee Arthroplasty
Authors: Tang Qi-Feng , Li Xiao-Lin , Yu Li-Xin , Hao Yue-Feng , Lu Guo-Hai 
Published: January 2017

Purpose To compare the analgesic effect of preoperative ropivacaine with or without tramadol for femoral nerve block in total knee arthroplasty (TKA). Methods 14 men and 46 women aged 59 to 80 years who were American Society of Anesthesiologists (ASA) grade I or II and were scheduled for TKA were randomised to receive preoperative femoral nerve block with 20 ml of 0.375% ropivacaine plus tramadol 0 mg (n=15), 50 mg (n=15), or 100 mg (n=15), or no preoperative femoral nerve block (control) [n=15]. Femoral nerve block was performed by a single anaesthesiologist before the standardised combined spinal epidural anaesthesia. Postoperatively, patient-controlled analgesia was given. The visual analogue score (VAS) for pain at rest and on movement was recorded at 8, 12, 24, 48, and 72 hours. Passive knee range of motion (ROM) was measured at 24, 48, and 72 hours. Results The 4 groups were comparable in terms of age, gender, weight, ASA grade, and operating time. Compared with patients who received no femoral nerve block or ropivacaine alone, those who received femoral nerve block with 20 ml of 0.375% ropivacaine plus tramadol 50 mg or 100 mg recorded a lower VAS for pain at rest and on movement at 8 to 72 hours, longer sensory and motor block time, and lower demand, delivery, and total amount of patient-controlled analgesia. The passive knee ROM at 24 to 72 hours was greater in patients with femoral nerve block than in those without. Conclusion Preoperative femoral nerve block with 20 ml of 0.375% ropivacaine and 100 mg tramadol resulted in the best analgesic effect.
Microfracture Technique versus Carbon Fibre Rod Implantation for Treatment of Knee Articular Cartilage Lesions
Authors: Dasar Uygar , Gursoy Safa , Akkaya Mustafa , Algin Oktay , Isik Cetin , Bozkurt Murat 
Published: January 2017

Purpose To compare the microfracture technique with carbon fibre rod implantation for treatment of knee articular cartilage lesions. Methods 10 men and 30 women aged 22 to 56 (mean, 37.4) years underwent microfracture (n=20) or carbon fibre rod implantation (n=20) for International Cartilage Repair Society grade 3 to 4 knee articular cartilage lesions after a mean of 12.2 months of viscosupplementation and physiotherapy. Clinical outcome at 6 and 12 months was assessed using the Tegner-Lysholm score and modified Cincinnati score. Magnetic resonance imaging (MRI) outcome at 12 months was assessed by a radiologist. The modified magnetic resonance observation of cartilage repair tissue (MOCART) score was evaluated. Results The 2 groups were comparable in terms of age, body mass index, lesion location, lesion size, duration of symptoms, and coexisting pathology. The microfracture group had a higher preoperative Tegner-Lysholm score (39.4±7.3 vs. 34.4±4.9, p=0.015) and modified Cincinnati score (36.4±7.2 vs. 30.4±4.0, p=0.002) than the carbon fibre rod group. At 12 months, change in both scores was significant within each group (p<0.001) and was higher in the microfracture than carbon fibre rod group (p<0.001). MRI showed minimal regenerative tissue. Lobulation, oedema, and hypertrophy were more commonly found in the regeneration tissue after carbon fibre rod implantation than microfracture. At 12 months, the MOCART score was higher in the microfracture than carbon fibre rod group (59 vs. 47, p<0.001). Conclusion Microfracture is superior to carbon fibre rod implantation in terms of clinical and radiological outcome.
Relationship between Pull-Out Strength and Oscillation Angle in Bipolar Cups: An in vitro Study
Authors: Kaku Nobuhiro , Tabata Tomonori , Tsumura Hiroshi 
Published: January 2017

Purpose To compare the past and present bipolar hip arthroplasty (BHA) models in terms of balance between pull-out strength and oscillation angle (OA). Methods The pull-out strength and OA of 8 BHA models were compared: UPF-II, IBC, and Tandem XLPE (Smith & Nephew); Ringloc x (Biomet); J-FX (DePuy); Bipolar (Nakashima Medical); Multipolar (Zimmer); and Centrax (Stryker). Results Respectively for the UPF-II, IBC, Tandem, Ringloc, J-FX, Nakashima Bipolar, Multipolar, and Centrax, the mean pull-out strength was 2219 N, 3303 N, 1503 N, 951 N, 1453 N, 1856 N, 1536 N, and 753 N, whereas the mean OA was 54.2°, 53.8°, 64.0°, 73.2°, 63.0°, 65.4°, 55.6°, and 75.4°. The OA was lower in the integrated types. For pull-out strength of the locking mechanism, the integrated type (IBC and Nakashima) was stronger than the metal or polyethylene ring-lock type (all others). The pull-out strength and OA were negatively correlated ( r= −0.881, p=0.007), and the balance between the 2 varied for different models. Conclusion There is a trade-off between the pull-out strength and OA; optimal balance between the 2 should be based on each patient's need.
Proximal versus Distal Screw Placement for Biceps Tenodesis: A Biomechanical Study
Authors: De Villiers Daniel Johannes , Loh Brian , Tacey Mark , Keith Prue 
Published: January 2017

Purpose To assess the maximum and end torque of a fourth-generation composite humerus model with no screw inserted or with a screw inserted in the distal (subpectoral) position or proximal (suprapectoral) position. Methods 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7times25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively. The maximum and end torque of each humerus was assessed. Results Respectively for the control, proximal, and distal groups, the maximum torque was 81.8, 78.7, and 74.3 Nm, and the end torque was 80.7, 78.6, and 71.8 Nm; only the difference between control and distal groups was significant (p=0.005 for maximum torque and p=0.033 for end torque). All fractures in both control and proximal groups involved the distal 1/3 humerus. In the distal group, the fractures involved either the distal 1/3 humerus (n=6) or the screw-hole (n=2); the difference between the 2 types of fracture was not significant in terms of maximum torque (75.7 vs. 70.0, p=0.086) or end torque (75.3 vs. 61.4, p=0.40). Conclusion Compared with proximal placement of an interference screw, distal placement decreased the maximum torque (though not significantly) and may increase the risk of proximal humeral fracture.
The Use of a 3-Dimensional Computed Tomography Bone Database to Evaluate the Risk of Distal Contact between the Rasp Tip and the Endosteal Cortical Bone
Authors: Connor Emmalynn , Cowie Jonathan G , Wuestemann Thies , Howell Jonathan R , Whitehouse Sarah L , Crawford Ross W 
Published: January 2017

Purpose To use a 3-dimensional computed tomography (CT) bone database to evaluate the risk of distal contact between the rasp tip and the endosteal cortical bone. Methods Using a 3-dimensional CT bone database, the rasps for Exeter stems of 125 mm in length and body size 1, with a femoral offset of 37.5, 44, or 50 mm were compared with those for Exeter stems of 150 mm in length and same body size with the corresponding femoral offset. Rasp geometry was determined using an engineering drawing software. Results Of the 631 femurs in the database, 238 (187 Caucasian and 51 Asian) were of appropriate femoral offset and proximal body size to receive a stem with an offset of 37.5, 44, or 50 mm. Of these, 145 (115 Caucasian and 30 Asian) femurs were of champagne-flute type; the prevalence was comparable between the 2 populations (61% vs. 59%, p=0.729). When using the 150-mm rasp, 70 (55 Caucasian and 15 Asian) of the 238 femurs had distal contact between the rasp and femoral cortex; the prevalence was comparable between the 2 populations (29% vs. 29%, relative risk=1.0, p=1.0). Distal contact between the rasp and femoral cortex occurred more commonly in champagne-flute-type femurs than other femurs in the anteroposterior plane (28% [41/145] vs. 2% [2/93], relative risk=13.1, p<0.001) and in the mediolateral plane (27% [39/145] vs. 14% [13/93], relative risk=1.92, p=0.019). When using the 125-mm rasp, only one femur (with a canal flare index of 4.52) had distal contact in the mediolateral plane with an offset of 37.5 mm. Distal contact between the rasp and femoral cortex occurred more often with the 150-mm rasp than the 125-mm rasp in both planes (p<0.001). Conclusion The use of a shorter stem may enhance anatomic fit in patients with a narrow femoral canal and prevent distal contact between the rasp and femoral cortex.
Acetabular Revision with Bone Grafting and Cementation for Aseptic Loosening after Primary Charnley Low-Friction Hip Arthroplasty with Structural Bulk Autografts
Authors: Mohammed Riazuddin , Drampalos Efstathios , Siney Paul , Purbach Bodo , Kay Peter 
Published: January 2017

Purpose To review the outcome of acetabular revision with bone grafting and cementation for aseptic loosening after primary Charnley low-friction hip arthroplasty with structural bulk autografts in 15 patients. Methods Records were reviewed for 3 men and 12 women aged 31 to 72 (mean, 53) years who underwent acetabular revision with bone grafting and cementation for aseptic loosening at a mean of 12.4 (range, 6.6–20.3) years after primary Charnley low-friction hip arthroplasty with superolateral structural bulk autografts from the femoral head for dysplastic hip (n=14) or bone loss secondary to acetabular fracture (n=1). Results After a mean follow-up of 6.7 (range, 1.1–14.5) years, the mean Merle d'Aubigné and Postel score improved from 8.55 to 16.5. Bridging trabeculae was noted in 10 hips and graft remodelling in 5 hips. Five hips had ectopic ossification of Brooker grade 1 to 2. The mean hip centre of rotation was 21.6 (range, 16.2–30.6) mm. Two women required re-revision for aseptic loosening of the acetabulum after 8.5 and 6.6 years. The first one underwent re-revision with solid allograft for superolateral deficiency of the acetabulum. The second one underwent re-revision with solid and morselised bone allografts for loosened acetabulum. One patient had superior migration of the acetabulum for 9 mm at year 2, but it was asymptomatic. One patient had a dislocation that was reduced with manipulation under anaesthesia. Three patients had trochanteric non-union and presented with lateral thigh pain and tenderness, but no further surgery was performed. Conclusion The medium-term outcome of acetabular revision with bone grafting and cementation is satisfactory. Repeat bone grafting is required to restore the anatomic acetabular position and bone loss secondary to acetabular loosening.
Four-Level Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy
Authors: Wang Shan-Jin , Ma Bin , Huang Yu-Feng , Pan Fu-Min , Zhao Wei-Dong , Wu De-Sheng 
Published: January 2017

Purpose To review the outcome of 32 consecutive patients who underwent 4-level anterior cervical discectomy and fusion (ACDF) with cages and plates and were followed up for at least 5 years. Methods Records of 19 men and 13 women aged 48 to 69 years who underwent 4-level ACDF with cages and plates for myelopathy (n=11) or myeloradiculopathy (n=21) at C3 to C7 by a single surgeon and were followed up for a minimum of 5 years were reviewed. Clinical outcome was assessed using the visual analogue scale (VAS), Neck Disability Index (NDI), and modified Japanese Orthopaedic Association (JOA) score for pain or myelopathic symptoms. Radiographic evaluation included fusion rate, range of motion, cervical lordosis (C2-to-C7 Cobb angle), and disc height. Results The mean follow-up was 66 months. All patients had good recovery of muscle strength and resolution of limb sensory disturbance, except for 4 who still had some numbness. The mean VAS for neck and arm pain improved from 14.2 to 6.84 (p=0.012); the mean NDI improved from 31.62 to 12.17 (p<0.01); and the mean JOA score improved from 10.1 to 13.9 (p=0.027). The mean percentage of recovery was 62.9. The mean Cobb angle improved from 10.24° to 1.28° (p=0.019); the mean disc height improved from 4.12 to 6.58 mm (p<0.01). 30 (94%) patients achieved solid fusion. Conclusion Multilevel ACDF using PEEK cages and plates is safe and effective for multilevel cervical spondylotic myelopathy and achieves satisfactory mid-term outcome.
Comparison of Early Outcome of Weil Osteotomy and Distal Metatarsal Mini-Invasive Osteotomy for Lesser Toe Metatarsalgia
Authors: Yeo Nicholas Eng Meng , Loh Bryan , Chen Jerry YongQiang , Yew Andy Khye Soon , Ng Sean YC 
Published: January 2017

Purpose To compare the 6-month outcome of Weil osteotomy with distal metatarsal mini-invasive osteotomy (DMMO) in 33 patients with lesser toe metatarsalgia. Methods Records of 33 patients who underwent Weil osteotomy (n=20, 41 toes) or DMMO (n=13, 22 toes) for lesser toe metatarsalgia by a single surgeon were reviewed. 25 of them had a concurrent procedure on the 1st toe. Outcome at 6 months was assessed using the visual analogue score (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) lesser toe metatarsophalangeal-interphalangeal (MTP-IP) score, and the RAND-36 score. Results The 2 groups were comparable in terms of age, gender, and preoperative MTP joint range of motion (ROM), VAS for pain, AOFAS lesser toe MTP-IP score, and RAND-36 scores. At 6 months, the Weil osteotomy group had a higher RAND-36 (mental) score (92 vs. 78, p=0.026), and the DMMO group had a higher percentage of toes with greater MTP joint ROM (p=0.043). All patients achieved bone union within 6 months. Two patients in the DMMO group had prolonged oedema until 3 months post-surgery. Conclusion DMMO is a safe and reliable alternative to Weil osteotomy for metatarsalgia and can preserve ROM of the MTP joints.
Z-Plasty of the Flexor Hallucis Longus Tendon at Tarsal Tunnel for Checkrein Deformity
Authors: Lee Jae Hoon , Kim Young Jun , Baek Jong Hun , Kim Dong Hee 
Published: January 2017

Purposes To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients. Methods Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. All patients had undergone 3 months of conservative treatment. The mean time from injury to surgical treatment was 8.4 (range, 5–12) months. All patients had associated injuries including distal tibiofibular fracture (n=6), distal fibular fracture (n=1), and crush injury around the ankle (n=1); they were treated with intramedullary nailing (n=6), long leg splinting (n=1), and short leg splinting (n=1). Results After a mean follow-up of 3.4 (range, 1–7) years, the FHL tendon was lengthened by a mean of 1.7 (range, 1.6–1.8) cm, and the mean American Orthopedic Foot and Ankle Society hallux score increased from 59 (range, 52–67) to 89 (range, 80–90). No patient had recurrence, nerve injury, or tarsal tunnel syndrome, although one patient had sensory disturbance of the posterior tibial nerve in the forefoot, which resolved spontaneously at week 2. Conclusion Z-plasty of the FHL tendon at the tarsal tunnel is a viable option for correction of checkrein deformity.
Intramedullary and Intra-Osseous Arthrodesis of the Hallux Metatarsophalangeal Joint
Authors: Drampalos Efstathios , Vun Shen Hwa , Fayyaz Irfan 
Published: January 2017

Purpose To review the outcome of arthrodesis of the hallux metatarsophalangeal (MTP) joint in 23 patients. Methods Records of 9 men and 14 women aged 27 to 88 (mean, 57) years who underwent arthrodesis of the hallux MTP joint using an intramedullary device and an intra-osseous device were reviewed. Indications for surgery were severe hallux valgus (n=15), hallux rigidus (n=6) and rheumatoid arthritis (n=2). Outcome measures included visual analogue score (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, bone union, hallux valgus angle (HVA), dorsiflexion angle (DA), complications, revision, and patient satisfaction. Results The mean follow-up was 19 (range, 6–38) months. The mean AOFAS score improved from 29 to 75.4 (p<0.0001) and the mean VAS for pain improved from 8.1 to 2.4 (p<0.0001). 20 (86%) of the patients were satisfied with the outcome. The mean HVA was 14° and the mean DA was 22°. 19 (83%) of the toes had a well-aligned hallux. 21 (91%) of the patients achieved arthrodesis of the hallux MTP joint. The remaining 2 patients underwent revision surgery for failed fusion or infected non-union; they continued to have transfer metatarsalgia despite bone union. Conclusion The intramedullary and intra-osseous devices for arthrodesis of the hallux MTP joint achieved good outcome in terms of AOFAS score, VAS for pain, HVA, DA, bone union, and patient satisfaction.
Combined Use of Ibandronate and Eldecalcitol in Postmenopausal Japanese Women with Osteoporosis
Authors: Takada Junichi , Wada Hiroshi , Iba Kousuke , Sasaki Kouichi , Dohke Takayuki , Kanaya Kumiko , Yoshizaki Takashi , Yamashita Toshihiko 
Published: January 2017

Purpose To evaluate the effect of combined use of ibandronate and eldecalcitol for 6 to 12 months on bone mineral density (BMD) and bone strength of the proximal femur in postmenopausal Japanese women with osteoporosis. Methods BMD and bone strength of the proximal femur were evaluated in 78 postmenopausal women (mean age, 73.6 years) who underwent treatment for osteoporosis with combined use of ibandronate and eldecalcitol for at least 6 months. BMD was measured at the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry (DXA) at baseline and every 6 months thereafter. Hip structure analysis of the narrow neck and intertrochanter was performed by a radiologist using DXA images. Results Respectively for the lumbar spine, femoral neck, and total hip, BMD significantly increased (from baseline) by 4.54%, 2.31%, and 1.56% at 6 months and by 5.92%, 3.02%, and 2.70% at 12 months. In hip structure analysis, most parameters improved significantly. Respectively for the narrow neck and intertrochanter, BMD significantly increased (from baseline) by 2.37% and 2.71% at 6 months and by 3.46% and 3.52% at 12 months; cross-sectional area significantly increased by 1.83% and 3.39% at 6 months and by 2.91% and 3.46% at 12 months; section modulus significantly increased by 2.42% and 4.11% at 6 months and by 4.84% and 3.26% at 12 months; cortical thickness significantly increased by 2.49% and 3.33% at 6 months and by 3.73% and 3.37% at 12 months; and buckling ratio significantly decreased by 2.97% and 2.57% at 6 months and by 3.86% and 2.99% at 12 months. Conclusion Combined use of ibandronate and eldecalcitol for 6 months significantly improved bone strength of the proximal femur in postmenopausal Japanese women with osteoporosis.
Glial activation in the collagenase model of nociception associated with osteoarthritis
Authors: Adães Sara , Almeida Lígia , Potes Catarina S , Ferreira Ana Rita , Castro-Lopes José M , Ferreira-Gomes Joana , Neto Fani L 
Published: January 2017

Background Experimental osteoarthritis entails neuropathic-like changes in dorsal root ganglia (DRG) neurons. Since glial activation has emerged as a key player in nociception, being reported in numerous models of neuropathic pain, we aimed at evaluating if glial cell activation may also occur in the DRG and spinal cord of rats with osteoarthritis induced by intra-articular injection of collagenase. Methods Osteoarthritis was induced by two injections, separated by three days, of 500 U of type II collagenase into the knee joint of rats. Movement-induced nociception was evaluated by the Knee-Bend and CatWalk tests during the following six weeks. Glial fibrillary acidic protein (GFAP) expression in satellite glial cells of the DRG was assessed by immunofluorescence and Western Blot analysis; the pattern of GFAP and activating transcription factor-3 (ATF-3) expression was also compared through double immunofluorescence analysis. GFAP expression in astrocytes and IBA-1 expression in microglia of the L3–L5 spinal cord segments was assessed by immunohistochemistry and Western Blot analysis. The effect of the intrathecal administration of fluorocitrate, an inhibitor of glial activation, on movement-induced nociception was evaluated six weeks after the first collagenase injection. Results GFAP expression in satellite glial cells of collagenase-injected animals was significantly increased six weeks after osteoarthritis induction. Double immunofluorescence showed GFAP upregulation in satellite glial cells surrounding ATF-3-positive neurons. In the spinal cord of collagenase-injected animals, an ipsilateral upregulation of GFAP and IBA-1 was also observed. The inhibition of glial activation with fluorocitrate decreased movement- and loading-induced nociception. Conclusion Collagenase-induced knee osteoarthritis leads to the development of nociception associated with movement of the affected joint and to the activation of glial cells in both the DRG and the spinal cord. Inhibition of glial cell activation by fluorocitrate decreases these osteoarthritis-associated nociceptive behaviours. These results suggest that glial cell activation may play a role in the development of chronic pain in this experimental model of osteoarthritis.
Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study
Authors: Nordenskjöld J. , Englund M. , Zhou C. , Atroshi I. 
Published: January 2017

The prevalence and incidence of doctor-diagnosed Dupuytren’s disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren’s disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren’s disease; the prevalence among men was 1.35% and among women 0.5%. Of all people diagnosed, 56% had received treatment (87% fasciectomy). In 2013, the incidence of first-time doctor-diagnosed Dupuytren’s disease among men was 14 and among women five per 10,000. The annual incidence among men aged ⩾50 years was 27 per 10,000. Clinically important Dupuytren’s disease is common in the general population. Level of evidence: III
Failure of an uncemented thumb carpometacarpal joint ceramic prosthesis
Authors: Kollig E. , Weber W. , Bieler D. , Franke A. 
Published: January 2017

Thumb carpometacarpal joint replacement is associated with high rates of loosening and failure. We present our results for an uncemented ceramic–ceramic total joint prosthesis with a reverse ball-and-socket design and bioactive coating. Between 2008 and 2012, 29 prostheses were inserted into 28 patients (mean age 63 years) with advanced osteoarthritis. After a mean period of 33 months (range 9–62), 26 patients (27 implants) were available for follow-up. Six months postoperatively, 50% of the patients had radiological evidence of early loosening. Fifteen implants had been removed in 14 patients for aseptic loosening (13) or trapezium fracture (2). The 12 patients whose prosthesis was still in place had a mean visual analogue scale pain score of 1.9 (range 0–6) and a mean Disabilities of the Arm, Shoulder and Hand score of 23 (range 0–73.3). Eleven patients were satisfied with the procedure. The rate of early aseptic failure was unacceptably high. Level of evidence: IV