Yusufabel3437

DOI 10.1302/2058-5241.6.200071.Medical progress, including in the orthopaedic surgery field, depends on the interaction and collaboration between physicians, with their expertise on the clinical setting; scientists, with their expertise on the research setting; and professionals who are skilled in both settings (clinical scientists). This leads to the need to develop research approaches which involves people who are committed and support the process, strategic planning, and a cohesive team that can execute the tasks. All these interactions must be supported financially in order to maintain the long-term viability of such team.Time management is crucial for the clinical research team. To ensure success, the research team must be flexible in order to adapt to dynamic clinical and surgical schedules. It is especially important that surgeons have regular, dedicated quality research time to maintain a consistent interaction with the team.Building a successful and productive orthopaedic clinical research programme involves many challenges in creating proper leadership, obtaining funding, setting proper resources, establishing necessary training, and providing guidance and insight around the importance of each role that every member plays on the team. Cite this article EFORT Open Rev 2021;6245-251. DOI 10.1302/2058-5241.6.200058.Periprosthetic joint infections (PJI) represent one of the most catastrophic complications following total joint arthroplasty (TJA). The lack of standardized diagnostic tests and protocols for PJI is a challenge for arthroplasty surgeons.Next generation sequencing (NGS) is an innovative diagnostic tool that can sequence microbial deoxyribonucleic acids (DNA) from a synovial fluid sample all DNA present in a specimen is sequenced in parallel, generating millions of reads. It has been shown to be extremely useful in a culture-negative PJI setting.Metagenomic NGS (mNGS) allows for universal pathogen detection, regardless of microbe type, in a 24-48-hour timeframe in its nanopore-base variation, mNGS also allows for antimicrobial resistance characterization.Cell-free DNA (cfDNA) NGS, characterized by lack of the cell lysis step, has a fast run-time (hours) and, together with a high sensitivity and specificity in microorganism isolation, may provide information on the presence of antimicrobial resistance genes.Metagenomics and cfDNA testing have reduced the time needed to detect infecting bacteria and represent very promising technologies for fast PJI diagnosis.NGS technologies are revolutionary methods that could disrupt the diagnostic paradigm of PJI, but a comprehensive collection of clinical evidence is still needed before they become widely used diagnostic tools. MM-102 mouse Cite this article EFORT Open Rev 2021;6236-244. DOI 10.1302/2058-5241.6.200099.The aim of this article was to synopsize platelet-rich plasma (PRP) use in musculoskeletal pathologies through evidence-based assessment of the preparation, classification, mechanism of action and applications of PRP, thereby answering which PRP type is best for each clinical indication.The literature search was performed using Medline, EMBASE and Cochrane Reviews databases for papers containing the key terms "platelet-rich plasma" AND "orthopaedics" AND ("classification" OR "mechanism of action" OR "preparation" OR "clinical application"). Generated papers were evaluated for pertinence in following areas preparation, classification, mechanism of action, clinical application within orthopaedics. Non-English papers were excluded. Included studies were evaluated for quality.Sixty studies were included in our review. There are many commercial PRP preparation kits with differing component concentrations. There is no consensus on optimal component concentrations. Multiple PRP classifications exist but none have been validated. Platelet-rich plasma acts via growth factors (GFs) released from α-granules within platelets. Growth factors have been shown to be beneficial in healing. Grossly elevated concentrations of GFs may have inhibitory effects on healing. Multiple systematic reviews show efficacy of PRP in tendinopathies, early osteoarthritis, acute muscle injuries and in combination with rotator cuff repair and anterior cruciate ligament reconstruction.The literature suggests leukocyte-rich PRP (L-PRP) is more beneficial in tendinopathies and pure PRP (P-PRP) is more beneficial in cartilage pathology. However, different PRP preparations have not been directly compared in any pathology. Classification of PRP type is frequently not stated in research. Standardization of PRP research parameters is needed to streamline findings and generate clear indications for PRP types to yield maximum clinical benefit. Cite this article EFORT Open Rev 2021;6225-235. DOI 10.1302/2058-5241.6.200017.Low intensity pulsed ultrasound (LIPUS) therapy has demonstrated clinical effectiveness in achieving union in a variety of fracture situations.Few studies have investigated the effectiveness of LIPUS therapy in foot and ankle surgery.The overall rate of union in all published studies relating to the use of LIPUS in a variety of foot and ankle fracture and fusion situations is 95%.Some studies suggest lower healing rates (~ 67%) when LIPUS therapy is used to treat hindfoot fusion nonunion.A well-powered, high-quality, randomized controlled trial is needed to demonstrate the clinical and cost effectiveness of LIPUS therapy in foot and ankle surgery. Cite this article EFORT Open Rev 2021;6217-224. DOI 10.1302/2058-5241.6.200045.Range uncertainty remains a big concern in particle therapy, as it may cause target dose degradation and normal tissue overdosing. Positron emission tomography (PET) and prompt gamma imaging (PGI) are two promising modalities for range verification. However, the relatively long acquisition time of PET and the relatively low yield of PGI pose challenges for real-time range verification. In this paper, we explore using the primary Carbon-11 (C-11) ion beams to enhance the gamma yield compared to the primary C-12 ion beams to improve PET and PGI by using Monte Carlo simulations of water and PMMA phantoms at four incident energies (95, 200, 300, and 430 MeV u-1). Prompt gammas (PGs) and annihilation gammas (AGs) were recorded for post-processing to mimic PGI and PET imaging, respectively. We used both time-of-flight (TOF) and energy selections for PGI, which boosted the ratio of PGs to background neutrons to 2.44, up from 0.87 without the selections. At the lowest incident energy (100 MeVu-1), PG yield from C-11 was 0.