bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distalization of the Tibial Tubercle for Patellar Stabilization Combined With Medial Patellofemoral Ligament Reconstruction: Length of Distalization or Residual Patella Alta and its Affect on Outcome
Authors: Schmiesing Andrew , Engelking Marta , Agel Julie , Arendt Elizabeth A. 
Published: April 2022

Background: Previous research supports that distal translation of the tibial tubercle osteotomy (dTTO) for patients with recurrent lateral patellar dislocation (R-LPD) and patella alta is effective for surgical patellar stabilization. Hypothesis/Purpose: The main purpose of this article is to evaluate (1) the results of modifying the surgical threshold and postoperative goal of patellar height measurements for surgical stabilization originated in the “menu à la carte” approach to patellar surgical stabilization and (2) the relationship between the distance distalized in millimeters and postoperative complications. Our hypothesis was that dTTO with medial patellofemoral ligament reconstruction (MPFL-R) will successfully stabilize the patella with improvement in outcome scores and few complications, using a modification of the original menu à la carte as our surgical algorithm. Study Design: Case series; Level of evidence, 4. Methods: A total of 68 consecutive patients with R-LPD underwent dTTO and MPFL-R for surgical patellar stabilization by a single surgeon between May 2009 and September 2015. Surgical indications were R-LPD combined with patella alta. The surgical threshold for dTTO was Caton-Deschamps index (CDI) or Insall-Salvati ratio ≥1.4 and/or a patellar trochlear index <0.15. The postoperative surgical goal for patellar height was a CDI of 1.1 to 1.2. Length of the distalization was computed by using the CDI measurement as the primary intraoperative guide and measured intraoperatively with a ruler. Clinical, radiographic, and patient outcome measures were reviewed. Results: The mean CDI preoperatively was 1.40 and postoperatively it was 1.09. The mean distalization was 9.9 mm (range, 4-15 mm). Three patients (4.4%) had frank R-LPD postoperatively. Ten patients had residual patella alta (CDI >1.2), with 1 redislocation. Mean postoperative CDI in the recurrent dislocation group was 1.13 (range, 1.06-1.25) as compared with 1.09 (range, 0.92-1.35) in the nonrecurrent group ( P = 0.65). Complications included 3 tibial fractures (4.4%) and postoperative knee arthrofibrosis in 6 patients (8.8%), with mean distalization greater in the arthrofibrosis group ( P = .04). Knee injury and Osteoarthritis Outcome Score (KOOS) values improved in all domains, including a 31–point increase in Quality of Life. Conclusion: dTTO with MPFL-R for patients with patella alta leads to a high rate of normalization of patellar height measurements (87%) and patellar stabilization (95.6%). Residual patella alta is not associated with an increased risk of recurrence. The length of dTTO up to 15 mm is not associated with an increase in postoperative complications, except for an increased prevalence of arthrofibrosis (8.8%).
A Randomized Controlled Trial Comparing a Patella-Stabilizing, Motion-Restricting Knee Brace Versus a Neoprene Nonhinged Knee Brace After a First-Time Traumatic Patellar Dislocation
Authors: Honkonen Essi E. , Sillanpää Petri J. , Reito Aleksi , Mäenpää Heikki , Mattila Ville M. 
Published: April 2022

Background: A traumatic lateral patellar dislocation is a common injury in adolescents and young adults. The majority of first–time dislocations can be treated nonoperatively. Various types of knee braces are used for nonoperative treatment, but evidence on the most preferable bracing method is lacking. Purpose: To evaluate the efficacy of a patella–stabilizing, motion-restricting knee brace versus a neoprene nonhinged knee brace for the treatment of a first–time traumatic patellar dislocation at 3 years of follow–up. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 101 skeletally mature patients with a first–time traumatic patellar dislocation were enrolled in the study. After exclusion criteria were applied, 79 patients with a first–time traumatic patellar dislocation were randomized and allocated into 2 study groups: group A, with a patella–stabilizing, motion-restricting knee brace (hinged to allow knee range of motion [ROM] of 0°-30°) and group B, with a neoprene nonhinged knee brace (not restricting any knee motion). Both groups received similar physical therapy instructions and were advised to use the brace continuously for 4 weeks. Overall, 64 patients completed the trial. Results: The redislocation rate in group A was 34.4% (11/32) and in group B it was 37.5% (12/32) (risk difference, –3.1% [95% CI, –26.6% to 20.3%]; P = .794). Patients in group A had less knee ROM than those in group B at 4 weeks (90° vs 115°, respectively; P < .001) and 3 months (125° vs 133°, respectively; P = .028). Patients in group A had more quadriceps muscle atrophy than patients in group B at 4 weeks (24/32 vs 16/32, respectively; P = .048) and 3 months. At 6 months, patients in group B reported better functional outcomes than patients in group A (Kujala score mean difference, 4.6; P = .012), although no clinically relevant difference was found at 3 years. Conclusion: The use of a patella–stabilizing, motion-restricting knee brace for 4 weeks after a first–time traumatic patellar dislocation did not result in a statistically significant reduction in redislocations versus a neoprene nonhinged knee brace, although this trial was underpowered to detect more modest differences. Knee immobilization was associated with quadriceps muscle atrophy, less knee ROM, and worse functional outcomes in the first 6 months after the injury. Registration: NCT01344915 (ClinicalTrials.gov identifier).
Effect of printing characteristics for the incorporation of hexagonal-shaped lattice structure on the PLA polymeric material
Authors: Palaniyappan Sabarinathan , Veeman Dhinakaran , Narain Kumar S , Surendhar G J , Natrayan L 
Published: April 2022

Additive manufacturing is an emerging technique for manufacturing 3-D objects from the design of the component. Lattice structures are incorporated in metal and polymeric materials and find various applications in aerospace, marine, and other engineering fields. The present research work concentrates on incorporating hexagonal-shaped lattice structures through the fused deposition modeling (FDM) technique. The optimization was carried out by varying the printing process parameters such as infill density (80%, 90%, and 100%), layer thickness (0.1 mm, 0.2 mm, and 0.3 mm), and printing temperature (195°C, 205°C, and 215°C). The impact of printing parameters with respect to the quality characteristics responses such as tensile strength/density and dimensional area error can be considered for the optimization process. The samples are prepared using an L9 orthogonal array, and the process condition was optimized using the Taguchi optimization technique. The tensile strength/density is observed to be higher at a lower infill density of about 80%, a minimum layer height of 0.1 mm, and a maximum extrusion temperature of 215°C. From the ANOVA analysis results, the influential parameters sequence for the tensile strength/density was infill density > layer thickness > printing temperature. And the sequence of effective parameters for obtaining the lowest dimensional area error was infill density > printing temperature > layer thickness. Therefore, this research has found the application for incorporating hexagonal-shaped lattice structure in the PLA material. The material is capable of structural applications in automotive and marine applications, etc.
Ursolic acid protects against anoxic injury in cardiac microvascular endothelial cells by regulating intercellular adhesion molecule-1 and toll-like receptor 4/MyD88/NF-κB pathway
Authors: Bian Zhongrui , Liu Hui , Xu Fei , Du Yimeng 
Published: April 2022

Background Cardiac microvascular endothelial cells (CMECs) are rapidly damaged after myocardial ischemia or hypoxia. In this study, we intend to explore whether ursolic acid (UA) can protect CMECs against hypoxia/reoxygenation (H/R) injury and to detect related molecular mechanism. Methods CMECs were subjected to H/R condition in the absence or presence of UA. Cell behaviors were measured by Cell Counting Kit-8, transwell, ELISA and western blot assays. siRNA was applied to reduce ICAM1 expression, then the effect of co-treatment of UA and si-ICAM1 on CMECs has been detected by biological experiments. Results Under H/R stimulation, the proliferation and migration of CMECs were inhibited, as well as the inflammation and oxidative stress were enhanced. UA treatment obviously reversed these H/R-induced injuries and reduced ICAM1 expression. Moreover, knockdown of ICAM1 could alleviate the H/R-induced injuries and strengthen the protective effect of UA on CMECs under H/R condition. Additionally, the protein levels of TLR4, MyD88 and p-P65 NF-κB were obviously increased after H/R stimulation, whereas the addition of UA could alter the phenomena by reducing TLR4, MyD88, and p-P65 NF-κB expression. Conclusions Our results insinuated that UA could alleviate H/R-induced injuries in CMECs by regulating ICAM1 and TLR4/MyD88/NF-κB pathway.
Electroacupuncture reduces weight, skinfold thickness and waist circumference and increases skin temperature of the abdominal region in women: a randomized controlled trial
Authors: Lima Isabella Gomes de , Silva Josie Resende Torres da , Silva Amanda Godoy da , Andrade Alice de Sousa , Sousa Ligia de 
Published: April 2022

Background: Acupuncture, as a complementary and alternative medical treatment, has shown some promise as a therapeutic option for obesity and weight control. The aim of the current study was to investigate the effects of electroacupuncture (EA) on body weight, body mass index (BMI), skin fold thickness, waist circumference and skin temperature of the abdominal region in non-obese women with excessive abdominal subcutaneous fat. Methods: A total of 50 women with excessive abdominal subcutaneous fat (and average BMI of 22) were randomly assigned to one of two groups: an EA group (n = 25) receiving 10 EA sessions (insertion of needles connected to an electrical stimulator at a frequency of 40 Hz for 40 min) and a control group (n = 25) that received no treatment. Outcome measures evaluated included waist circumference, supra-iliac and abdominal skinfolds, body composition and superficial skin temperature (measured by cutaneous thermography) before and after treatment. Results: Compared with the untreated group, women in the EA group exhibited decreased supra-iliac and abdominal skin folds (p < 0.001), waist circumference (p < 0.001), percentage body fat (p = 0.001) and percentage abdominal fat (p < 0.001). In addition, the EA group showed an elevated skin temperature at the site of the treatment. However, EA did not significantly impact body weight (p = 0.01) or BMI (p = 0.2). Conclusion: EA promoted a reduction in abdominal waist circumference, supra-iliac and abdominal skin folds, and percentage body and abdominal fat in women of normal BMI with excessive abdominal subcutaneous fat, as well as an increase in the superficial skin temperature of the abdominal region. Trial registration number: RBR-9tsmpp (Brazilian Registry of Clinical Trials).
Effect of Revascularization on Exercise-Induced Changes in Cardiac and Prothrombotic Biomarkers in Patients with Coronary Artery Disease
Authors: Hansen C. H. , Cwikiel J. , Bratseth V. , Arnesen H. , Flaa A. , Seljeflot I. 
Published: April 2022

We examined whether resting levels and exercise-induced changes during exercise ECG stress test (EST) of cardiac Troponin T (cTnT), NT-proBNP and prothrombotic markers were affected by revascularization in patients with coronary artery disease (CAD). EST1 was performed before coronary angiography and revascularization, and patients (n  =  20) with confirmed CAD, performed another EST (EST2) 9 weeks later. Blood samples were drawn at rest and within five min after termination of ESTs. cTnT and NT-proBNP increased during exercise at both ESTs (p < 0.001, all). Resting cTnT levels at EST2 versus EST1 were significantly higher (p  =  0.02) whereas NT-proBNP did not differ. At both visits, increased D-dimer (p  =  0.008 and <0.001), pro-thrombin fragment 1  +  2 (p  =  0.009 and 0.001) and tissue factor pathway inhibitor (TFPI) (p < 0.001 and 0.001) during exercise were demonstrated. Resting levels of endogenous thrombin potential (ETP) and TFPI were reduced at EST2 versus EST1 (p < 0.01). Revascularization did not affect exercise-induced release of cardiac and prothrombotic biomarkers and did not reduce resting levels of cTnT or NT-proBNP, suggesting revascularization per se not to prevent secretion of biomarkers. The lower resting levels of ETP and TFPI after revascularization may however, be indicative of reduced thrombin generation and endothelial activation. Clinicaltrials.gov, CADENCE, NCT01495091 https://clinicaltrials.gov/ct2/show/NCT01495091?term = 01495091&draw = 2&rank = 1 .
Two-stage strategy in end-stage hip periprosthetic joint infection: utility of industrially prefabricated custom-made antibiotic spacers
Authors: Vicente Matías , Vilar Inca , Soriano Rosa Fraile , Capó Irina , Corona Pablo S 
Published: April 2022

Purpose: Use of prefabricated mobile spacers in end-stage cases of hip periprosthetic joint infection (HPJI) is hindered when large bone defects exist. In such cases, prefabricated custom-made antibiotic spacers (P-CMAS) offer an alternative. Such spacers are individually designed according to the size and anatomical characteristics of the bone defect. The purpose of this study is to describe and evaluate the use of such patient-specific spacers in a two-stage strategy to treat end-stage HPJI cases, and to report on clinical outcomes. Methods: A retrospective study identified all patients with end-stage HPJIs from January 2015 through December 2019, treated using a P-CMAS. Primary outcome: infection eradication rate. Secondary outcomes: spacer-related complications and patient satisfaction. Minimum follow-up: 12 months after the second-stage surgery. Results: A total of 7 end-stage cases (mean of 6.7 previous surgical procedures) were included. Mean bone defect size was 191.57 (range 47–304) mm. Polymicrobial infection was detected in 42.86% of these cases. During the spacer stage there were no periprosthetic fractures, spacer dislocations or breakages, nor spacer-drug-related complications. All patients proceeded with the second stage uneventfully, with an average time between stages of 178 (range 119–326) days. In 5 cases a total femur arthroplasty was the reconstructive procedure performed. After a mean follow-up of 27.29 (range 14–49) months the infection was clinically eradicated in all patients, despite their difficult-to-treat scenarios. Conclusions: Industrially custom-made spacers offer an effective and safe option in performing 2-stage exchange arthroplasty in cases of end-stage HPJI with extensive bone defects.
The outcomes of total hip arthroplasty in patients with and without multiple sclerosis: a retrospective cohort study
Authors: Mai David H , Blackowicz Michael E , Kister Ilya , Schwarzkopf Ran 
Published: April 2022

Background: Multiple sclerosis (MS) is a neuroinflammatory disease with debilitating manifestations that may predispose patients to hip fracture and osteoarthritis, and may affect recovery from total hip arthroplasty (THA). With increased longevity of MS patients and growth in demand for arthroplasty in this population, it is important to understand outcomes of THA in patients with MS. Aim: We sought to compare outcomes of THA among persons with MS and without MS. Methods: International Classification of Diseases, Ninth Revision Procedure Coding System (ICD-9-PCS) codes for hip arthroplasty (815.1) were used to identify all patients in the New York Statewide Planning and Research Cooperative System (SPARCS) database who underwent THA between 2000 and 2014. Patients with MS, the primary exposure, were identified using ICD-9-Clinical Modification (CM) code 340. The study outcomes of length of stay (days), discharge disposition, index admission mortality, 90-day readmission, 1-year revision arthroplasty, and 1-year all-cause mortality were evaluated using multivariable regression analyses inclusive of basic demographics, admission source, disposition, payer, comorbidity, and socioeconomic status (SES). Results: Compared to patients without MS, those with MS had marginally longer lengths of stay (mean ratio [MR] 1.05; 95% confidence interval [CI], 1.01–1.10; p = 0.0142), higher risk for institutional discharge disposition (odds ratio [OR] 2.03; 95% CI, 1.54–2.70; p < 0.0001) and higher risk of readmission for revision hip arthroplasty (OR 2.60; 95% CI, 1.07–6.35; p = 0.035). However, MS patients had similar risk for 90-day readmission and one-year all-cause mortality as compared with non-MS patients. Conclusions: Although patients with MS who underwent THA had a 90-day complication risk that was similar to those without MS, the risk for requiring revision surgery was more than 2-fold higher. Additional studies are needed to understand the reasons for revision surgery and for developing strategies to mitigate the risk of complications.
Comparison of total hip arthroplasty outcomes between haemodyalisis and renal transplant patients
Authors: Ahlquist Seth , Kim Samuel T , Hsiue Peter P , Benharash Peyman , Ponzio Danielle Y , Photopoulos Christos , Zeegen Erik N , Stavrakis Alexandra I 
Published: April 2022

Introduction: Total hip arthroplasty (THA) in end-stage renal disease (ESRD) patients is associated with increased complications. Controversy exists whether elective THA should be performed while these patients are on haemodialysis (HD) or following renal transplant (RT). This study seeks to compare THA outcomes in HD versus RT patients. Methods: A national database was retrospectively reviewed using ICD codes to identify all HD and RT patients who underwent primary THA from 2010 to 2018. Demographics, comorbidities, and hospital factors were compared between cohorts using Wald and chi-square tests. The primary outcome was in-hospital mortality, while secondary outcomes included length of stay (LOS), non-home discharge, cost, readmission, and medical/surgical complications. Multivariate regression was used to determine independent associations. Significance was determined with a 2-tailed p-value of 0.05. Results: 11,133 patients underwent THA, 61.6% HD and 39.4% RT patients. RT patients were younger, had fewer comorbidities, and more likely to have private insurance. After adjusting for these differences, RT patients had a lower rate of mortality (OR 0.31, p = 0.01), complications (OR 0.54, p < 0.01), cardiopulmonary complications (OR 0.54, p = 0.04), sepsis (OR 0.43, p < 0.01), and blood transfusion (OR 0.39, p < 0.001) during the index hospitalisation. RT was associated with decreased LOS (−2.0 days, p < 0.001), non-home discharge (OR 0.35, p < 0.001), and hospital cost (−$6,000, p < 0.001). RT had a lower rate of readmission (OR 0.60, p < 0.001) and revision surgery (OR 0.24, p = 0.01) within 90 days. Conclusions: These findings suggest HD patients are a high-risk population in THA compared to RT patients and warrant stringent perioperative monitoring.
Outcomes of isolated head-liner exchange versus full acetabular component revision in aseptic revision total hip arthroplasty
Authors: Berlinberg Elyse J , Roof Mackenzie A , Meftah Morteza , Long William J , Schwarzkopf Ran 
Published: April 2022

Introduction: Isolated head and liner exchange in aseptic revision total hip arthroplasty (rTHA) is an appealing option rather than full acetabular component revision; however, early outcome reports suggest high rates of complications requiring re-revision. This study seeks to compare the outcomes of these procedures. Methods: This retrospective study assessed 124 head and liner exchanges and 59 full acetabular cup revisions conducted at a single center between 2011 and 2019 with at least 2 years of follow-up. Baseline demographics did not vary by group. Mean follow-up was 3.7 (range 2.0–8.6) years. Results: In the head and liner exchange group, re-revision-free survivorship at 2 years was 79% for all-causes and 84% for aseptic reasons. In the full acetabular revision group, it was 80% for all causes ( p > 0.99) and 83% for aseptic reasons ( p > 0.99). The 2-year survivorship of head and liner exchange was non-inferior to that of full acetabular revision, correcting for surgical indication and history of prior revision (adj-OR 0.1.39, 95% CI, 0.62–3.28, p = 0.99). A best-fit multivariable model found that revision for instability (adj-OR=3.03, 95% CI 1.40–6.66, p = 0.005), prior revision (adj-OR 2.15; 95% CI, 0.87–5.32; p = 0.10), current smoking (adj-OR 2.07; 95% CI, 0.94–4.57; p = 0.07), and obesity (adj-OR 0.58; 95% CI, 0.24–1.36; p = 0.22) were associated with failure within 2 years. Conclusions: In this analysis, 2-year outcomes for isolated head and liner exchange were non-inferior to full acetabular component revision. A future randomised prospective study should be conducted to better assess the optimal approach to revision in an aseptic failed hip arthroplasty.
Prehabilitation before major abdominal surgery: Evaluation of the impact of a perioperative clinical pathway, a pilot study
Authors: Boukili Ilies E. , Flaris Alexandros N. , Mercier Frederic , Cotte Eddy , Kepenekian Vahan , Vaudoyer Delphine , Glehen Olivier , Passot Guillaume 
Published: April 2022

Background & objective: Major abdominal surgery morbidity can reach 50%. Prehabilitation has shown promising results in decreasing complications. However, it is unknown if prehabilitation can have a positive effect specifically after major abdominal surgery. The goal of this study was to evaluate the feasibility and safety of a prehabilitation program before major abdominal surgery. Methods: All patients evaluated for major abdominal surgery between February and April 2018 were eligible. A 4-week trimodal prehabilitation program combining physical therapy, nutritional support and psychological preparation was set up. Results: Among 106 patients evaluated for major abdominal surgery during the study period, 60 were included in the prehabilitation program. No cardiovascular events occurred during prehabilitation. The 6-min walking distance increased significantly (+45 m, increase of 9.3%, p = 0.008) after prehabilitation (and before the operation). Anxiety, depression, and several quality of life (QoL) items improved. Postoperative 90-day mortality and morbidity were 3.4% and 48%, respectively. Median hospital length of stay, and intensive care unit length of stay were 14 and 6 days, respectively. For 19 patients readmitted, the treatment was medical, radiological, or surgical, for 11, 5, and 3 patients, respectively. Conclusions: Prehabilitation before major abdominal surgery is feasible, safe, and improve patients’ functional reserves, QoL, and psychological status.