1,721,285 research outputs found
Complications after surgery or nonoperative treatment for acute achilles tendon rupture.
No full textLetter to the editor: Minimally invasive paratenon release for non-insertional Achilles tendinopathy.
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Role of percutaneous distal metatarsal osteotomy for the management of hallux valgus deformity.
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Genetic susceptibility to aseptic loosening following total hip arthroplasty: a systematic review.
No full textIntroduction Aseptic loosening is the most common cause of total hip arthroplasty (THA) failure and revision surgery. Genetic polymorphisms could be determinant factors for implant loosening. Source of data We performed a comprehensive search of Medline, CINAHL, Googlescholar, Embase and Cochrane databases, using various combinations of the keyword terms 'aseptic loosening', 'gene', 'hip arthoplasty', 'genetics', 'loosening'. Twelve studies detailing the genetic investigation of patients with aseptic loosening of a THA were identified. Areas of agreement SNPs of GNAS1, TNF-238 A allele, TNF-α promoter (-308G→A) transition, IL6-174 G allele, interleukin (IL)-6 (-597) and (-572), MMP-1-promoting gene, C/C genotype for the MMP1, MT1-MMP, MMP-2, transforming growth factor-beta1 signal sequence (29T→C) transitions, A/A genotype for the OPG-163, and MBL were overexpressed in patients with aseptic loosening and periprosthetic osteolysis. Areas of controversy Data from single centre studies do not allow one to compare the results of different studies. Conclusion Several gene pathways and genes contribute to the genetic susceptibility to aseptic loosening following THA. Further studies will enhance the understanding of prosthesis failure, and may inform and direct pharmaceutical interventions. Growing points Further multi-centre prospective studies are necessary to confirm the general validity of the findings reported. Single-centre findings should be replicated in other centres and populations to open new avenues for pre-surgical genetic testing and to investigate immune response modulation in THA. Areas timely for developing research Research in this field could lead to better understanding of mechanisms behind aseptic osteolysis, and improve the results of THA
Vertebroplasty and Kyphoplasty: Reasons for Concern?
No full textTwo different minimally invasive percutaneous vertebral augmentation methods for cement application into the vertebral body for the management of symptomatic compression fractures without neurologic impairment have been developed, namely, vertebroplasty and kyphoplasty. In vertebroplasty, polymethylmethacrylate cement is injected percutaneously into a collapsed vertebral body. Kyphoplasty involves placing an inflatable bone tamp percutaneously into a vertebral body. The inflation of the bone tamp with fluid allows restoration of vertebral height and correction of the kyphosis. After deflation, the cavity that has been produced is filled by injection of polymethylmethacrylate. This article provides an overview of the state of the art in vertebroplasty and kyphoplasty, discussing the indications, techniques, results, and pitfalls
Novel approaches for the management of tendinopathy.
No full textTendinopathy is a failed healing response of the tendon. Despite an abundance of therapeutic options, very few randomized prospective, placebo-controlled trials have been carried out to assist physicians in choosing the best evidence-based management. Eccentric exercises have been proposed to promote collagen fiber cross-link formation within the tendon, thereby facilitating tendon remodeling. Overall results suggest a trend for a positive effect of eccentric exercises, with no reported adverse effects. Combining eccentric training and shock wave therapy produces higher success rates compared with eccentric loading alone or shock wave therapy alone. The use of injectable substances such as platelet-rich plasma, autologous blood, polidocanol, corticosteroids, and aprotinin in and around tendons is popular, but there is minimal clinical evidence to support their use. The aim of operative treatment is to excise fibrotic adhesions, remove areas of failed healing, and make multiple longitudinal incisions in the tendon to detect intratendinous lesions and to restore vascularity and possibly stimulate the remaining viable cells to initiate cell matrix response and healing. New operative procedures include endoscopy, electrocoagulation, and minimally invasive stripping. The aim of these techniques is to disrupt the abnormal neoinnervation to interfere with the pain sensation caused by tendinopathy. Randomized controlled trials are necessary to better clarify the best therapeutic options for the management of tendinopathy
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