Nealejlersen2198
On average, the skin incision was slightly more than 2 cm, and 27 mL of solid graft and 16 mL of liquid phase aspirate were collected. At 6 weeks after the procedure, there was minimal to no pain at the donor site, and we did not observe any fractures or other complications.
We report the use of a novel vacuum-assisted curette device to harvest bone graft from the proximal tibial metaphysis for use in foot and ankle fusions. This device has been reliable and efficient in clinical practice.
Level IV, retrospective case series.
Level IV, retrospective case series.
Screw head prominence in the heel following fixation for calcaneal osteotomy or subtalar arthrodesis has resulted in high rates of symptomatic hardware and screw removal. A cost analysis was performed to determine the financial implications of screw removal. Furthermore, we compared the rate of nonunion following fixation.
codes were used to identify all patients who had a subtalar arthrodesis or calcaneal osteotomy (with screw fixation) performed between 2010 and 2016. The cohort was divided into 2 groups 7.0-mm headless screw or 6.7-mm headed screw. The primary outcome measure was the rate of symptomatic screw removal. Secondary outcomes included the rate of nonunion. The expense associated with symptomatic hardware removal was determined by cost analysis.
Seventy-six patients underwent headless screw fixation, and 2 patients (2.6%) required screw removal. Fifty-four patients underwent headed screw fixation and 12 patients (22.2%) required screw removal. Symptomatic hardware removal was performed more frequently in the headed screw group (
< .001). There was no difference in the rate of nonunion after subtalar arthrodesis between the 2 groups (
= .363). The calcaneal osteotomy united in 100% of patients. There was a $51 755 cost savings per 100 cases using headless screw fixation.
The rate of symptomatic screw removal was lower with headless screw fixation. The calcaneal osteotomy healed in 100% of patients, and there was no difference in the rate of subtalar nonunion between the 2 groups. Cost analysis demonstrated a significant benefit when the expense of hardware removal was considered.
Level III, retrospective cohort study.
Level III, retrospective cohort study.
The intermetatarsal joint between the fourth and fifth metatarsals (4-5 IM) is important in defining fifth metatarsal fractures. The purpose of the current study was to quantify this joint in order to determine the mean cartilage area, the percentage of the articulation that is cartilage, and to give the clinician data to help understand the joint anatomy as it relates to fifth metatarsal fracture classification.
Twenty cadaver 4-5 IM joints were dissected. Digital images were taken and the articular cartilage was quantified by calibrated digital imaging software.
For the lateral fourth proximal intermetatarsal articulation, the mean area of articulation was 188 ± 49 mm
, with 49% of the area composed of articular cartilage. The shape of the articular cartilage had 3 variations triangular, oval, and square. A triangular variant was the most common (80%, 16 of 20 specimens). For the medial fifth proximal intermetatarsal articulation, the mean area of articulation was 143 ± 30 mm
, with 48% of the joint surface being composed of articular cartilage. The shape of the articular surface was oval or triangular. An oval variant was the most common (75%, 15 of 20 specimens).
This study supports the notion that the 4-5 IM joint is not completely articular and has both fibrous and cartilaginous components.
The clinical significance of this study is that it quantifies the articular surface area and shape. This information may be useful in understanding fifth metatarsal fracture extension into the articular surface and to inform implant design and also help guide surgeons intraoperatively in order to minimize articular damage.
The clinical significance of this study is that it quantifies the articular surface area and shape. This information may be useful in understanding fifth metatarsal fracture extension into the articular surface and to inform implant design and also help guide surgeons intraoperatively in order to minimize articular damage.
For hallux rigidus, dorsal cheilectomy remains a treatment option even with advances in interposition techniques and devices. Cheilectomy aims to alleviate dorsal impingement and improve pain and function as well as range of motion. Cryopreserved umbilical cord allograft, with properties to mitigate inflammation and scar formation, has theoretical benefit for improving outcomes following cheilectomy. In this first prospective randomized and blinded cheilectomy study reported, we aimed to compare outcomes between cheilectomy alone and cheilectomy with umbilical cord allograft.
Patients were randomized to cheilectomy alone (CA) or cheilectomy with cryopreserved umbilical cord (ie, amniotic membrane-umbilical cord [AM-UC]). Patients were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS), Foot Function Index (FFI), and visual analog scale (VAS) pain outcomes collected preoperatively and at 6 months and 1 year postoperatively. In addition, radiographic range of motion data were collected usivements in functional outcome scores.
Level II, prospective comparative study.
Level II, prospective comparative study.
Patients undergoing fixation for foot and ankle fractures may experience poor outcomes despite achieving apparent anatomic reduction. Adjunct arthroscopy to identify missed concomitant injuries and subtle displacements has been proposed as a vehicle to enhance functional results for these patients. The purpose of this review is to provide an overview of the literature regarding arthroscopically assisted open reduction and internal fixation (AAORIF) methods for commonly encountered foot and ankle injuries including pilon, ankle, and calcaneus fractures published to date.
A systematic review of the literature was performed using the PubMed database to access all studies reporting on arthroscopically assisted internal fixation methods for pilon, ankle, and calcaneus fractures. Relevant publications were analyzed for details on their respective study designs, the operative technique used, clinical outcomes, outcome instruments used, and reported complications.
A total of 32 studies were included in this review. The presence of intra-articular pathology may lead to unexpectedly poor outcomes seen in some patients who undergo surgical fixation of ankle fractures with an otherwise anatomic reduction on postoperative radiographs; the ability to diagnose and address these lesions with arthroscopy, therefore, has the potential to improve patient outcomes. To date, however, available literature has not shown that significant improvements in anatomical reductions and treatment of these intra-articular injuries provide any improvement in outcomes over standard fixation methods. Few prospective randomized controlled studies have been performed comparing these 2 operative techniques, rendering any suggestion that AAORIF improves clinical outcomes over traditional open fixation difficult to justify. Further research is indicated for what may be a potentially promising surgical adjunct prior to advocating for its routine use in patients.
Monoaminergic activity modulates nociceptive transmission in the central nervous system (CNS). Although pain is the most disabling symptom of osteoarthritis (OA), limited knowledge exists regarding the CNS mechanisms that amplify pain and drive sensitization processes in humans.
The main objective of this study was to evaluate associations between cerebrospinal fluid (CSF) monoamine metabolites, pain severity, and central sensitization in patients with OA undergoing total hip arthroplasty (THA).
Patients with OA (n = 52) and pain-free controls (n = 30) provided CSF samples for measurement of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), noradrenaline (3-methoxy-4-hydroxyphenylglycol [HMPG]), and dopamine (homovanillic acid [HVA]) monoamine metabolites. Patients with OA completed longitudinal evaluation of pain using clinical measures and quantitative sensory testing.
Patients with OA had higher HMPG levels when compared with controls (
= 0.036). Within patients with OA undergoing THA, higher 5-HItral sensitization. Increased noradrenergic activity may be associated with more efficient pain inhibitory capacity.The COVID-19 virus is spread by pulmonary droplets. Its high infectivity is caused by the high-affinity binding of the viral spike protein to the ACE2 receptors on the surface of respiratory epithelial cell membranes. The proper hydration of nasal mucosa plays an essential role in defense of bacterial and viral infections. Therefore, a nasal formulation, which can moisture the nasal mucosa and contains the ACE2 receptor inhibitor, can reduce the risk of COVID-19 infection. This article presents a systematic study of the preparation of chitosan hydrogels with dicarboxylic acids (malic and glutaric acid) and their detailed characterization (Fourier transform infrared spectroscopy, determination of cross-linking efficiency, rheological studies, thermal analysis, and swelling kinetics). The results confirm that chemically cross-linked chitosan hydrogels can be synthesized using malic or glutaric acid without additives or catalysts. The adsorption capacity of hydrogels for three different ACE2 inhibitors, as APIs, has also been investigated. CompK purchase The API content of hydrogels and their mucoadhesive property can provide an excellent basis to use the hydrogels for the development of a nasal formulation in order to reduce the risk of SARS-CoV 2 infection.In the current study, a facile, rapid, and ecologically safe photosynthesis of gold nanoparticles (AuNPs) that remained stable for 3 months is reported to advocate the main aspects of green chemistry, such as safer solvents and auxiliaries, and the use of renewable feedstock. Zi-AuNPs were phytosynthesized by the aqueous extract of Ziziphus spina-christi leaves, and numerous techniques were employed for their characterization. The results demonstrated the successful phytofabrication of crystalline AuNPs with brownish-black color, spherical nanoparticles with a size between 0 and 10 nm, a plasmon peak at 540 nm, and a surface charge of -25.7 mV. Zi-AuNPs showed an effective photodegradation efficiency (81.14%) against malachite green and a good recycling capacity of 69.2% after five cycles of regeneration. The cytotoxicity test by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay signified a high anticancer efficiency for both Zi-AuNPs and Z. spina-christi extract against human breast cancer cells (MCF7 cell line) with IC50's of 48 and 40.25 μg/mL, respectively. Highly efficient antioxidant capabilities were proven with 2,2-diphenyl-1-picrylhydrazyl (DPPH) removal percentages of 67.5% for Zi-AuNPs and 92.34% for Z. spina-christi extract.There is a trend to use nanoparticles as distinct treatments for cancer treatment because they have overcome many of the limitations of traditional drug delivery systems. Gallic acid (GA) is an effective polyphenol in the treatment of tissue injuries. In this study, GA was loaded onto niosomes to produce gallic acid nanoemulsion (GANE) using a green synthesis technique. GANE's efficiency, morphology, UV absorption, release, and Fourier-transform infrared spectroscopy (FTIR) analysis were evaluated. An in vitro study was conducted on the A549 lung carcinoma cell line to determine the GANE cytotoxicity. Also, our study was extended to evaluate the protective effect of GANE against lipopolysaccharide (LPS)-induced pulmonary fibrosis in rats. GANE showed higher encapsulation efficiency and strong absorption at 280 nm. Transmission electron microscopy presented a spherical shape of the prepared nanoparticles, and FTIR demonstrated different spectra for the free gallic acid sample compared to GANE. GANE showed cytotoxicity for the A549 carcinoma lung cell line with a low IC50 value.
