Wilhelmsenhaahr3411

, UK). Animals were euthanized 12 weeks post surgery. The ICBG group had a 45% (5/11) manual palpation fusion rate and correlated with motion analysis fusion results of 36% (4/11). The Actifuse ABX group had a 33% (4/12) manual palpation fusion rate and a motion analysis fusion rate of 25% (3/12). No motion segments in the Vitoss BA group (0/11) showed any signs of fusion. The SiCaP-30 group demonstrated a statistically higher manual palpation and motion analysis fusion rate of 82% (9/11; p less then 0.05) and produced superior bone formation compared with Actifuse ABX and βTCP-BG.

Few references are available describing the epidemiology of pediatric spine injuries. The purpose of this study is to examine the prevalence, risk factors and trends during the period from 1997 to 2009 of pediatric spine injuries in the United States using a large national database.

Data was obtained from the Kid's Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP), for the years 1997-2009. This data includes >3 million discharges from 44 states and 4121 hospitals on children younger than 20 years. Weighted variables are provided which allow for the calculation of national prevalence rates. The Nationwide Emergency Department Sample (NEDS), HCUP. net, and National Highway Traffic Safety Administration (NHTSA) data were used for verification and comparison.

A prevalence of 107.96 pmp (per million population) spine injuries in children and adolescents was found in 2009, which is increased from the 77.07 pmp observed in 1997. The group 15 to 19 years old had the highest prevalence of all age groups in (345.44 pmp). Neurological injury was present in 14.6% of the cases, for a prevalence of 15.82 pmp. The majority (86.7%) of these injuries occurred in children >15 years. Motor vehicle collisions accounted for 52.9% of all spine injuries, particularly in children >15 years. Between 1997 and 2009 the hospital length of stay decreased, but hospital charges demonstrated a significant increase.

Pediatric Spine Injuries continue to be a relevant problem, with rates exceeding those of other industrialized nations. Teenagers >15 years of age were at greatest risk, and motor vehicle collisions accounted for the most common mechanism. An increase in prevalence was observed between 1997 and 2009, and this was matched by a similar increase in hospital charges.

III.

III.

Perioperative blood loss is a frequent concern in spine surgery and often necessitates the use of allogeneic transfusion. Minimally invasive technique (MIS) is an option that minimizes surgical trauma and therefore intra-operative bleeding. The purpose of this study is to evaluate the blood loss, surgical complications, and duration of inpatient hospitalization in patients undergoing open posterolateral lumbar fusion (PLF), open posterior lumbar interbody fusion (PLIF) with PLF, or MIS transforaminal lumbar interbody fusion (MIS TLIF).

Operative reports and perioperative data of patients undergoing single-level, primary open PLF (n=41), open PLIF/PLF (n=42), and MIS TLIF (n=71) were retrospectively evaluated. Patient demographics, operative blood loss, use of transfusion products, complications, and length of stay were tabulated. Patient data was controlled for age, BMI, and gender for statistical analysis.

Patients undergoing open PLF and open PLIF/PLF respectively experienced a significantly higher blood loss (p<0.001), higher volume of blood transfusion (p<0.001), higher volume of cell saver transfusion (p<0.001), and more surgical complications (dural injury, wound infections, screw malposition) (p=0.02) than those undergoing MIS TLIF. There was no statistically significant difference in duration of hospital stay (p=0.11).

MIS TLIF provides interbody fusion with less intraoperative blood loss and subsequently a lower transfusion rate compared to open techniques, but this did not influence length of hospital stay. Crenolanib chemical structure MIS TLIF is at least as safe as open techniques with respect to dural tear, wound infection, and screw placement.

Level III, Therapeutic.

Level III, Therapeutic.

Total elbow arthroplasty for posttraumatic arthritis or nonunion has been associated with a high rate of complications. Bushing wear is a known complication, although the actual incidence is unknown because stress views of the elbow are not routinely performed. We evaluate incidence of bushing wear in total elbow arthroplasty using stress radiographs.

Eighteen patients underwent total elbow arthroplasty from 1997-2009 for posttraumatic arthritis or distal humerus nonunion using the third generation Coonrad-Moorey design. Eight patients met inclusion criteria and had an average age of 67 years and mean follow-up of 105 months. Radiographs were analyzed for bushing wear and implant loosening on standard and stress radiographs. Clinical outcome measures included the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, Mayo Elbow Performance Score (MEPS), overall patient satisfaction, range of motion, and complications.

Rate of bushing wear was high, and stress views were five times more sensitive in detecting bushing wear (63%) compared to non-stress views (12%). Seventy-five percent of patients had a good or excellent MEPS. Range of motion slightly improved from pre- to post-operatively. Minor complications were common, but there were no revisions and no cases with radiographic loosening. There was no correlation between bushing wear and the DASH or MEPS.

Incidence of bushing wear in total elbow arthroplasty is high, and under-diagnosed without stress views. Although minor complications are common, frequent loosening and revision do not occur as previously reported for other implants. Despite bushing wear, mid-term functional outcomes are good.

Therapeutic IV.

Therapeutic IV.

Fracture of the scaphoid bone can be treated with cast immobilization or surgery. Historically, surgery was reserved for displaced fractures. However, because weeks of cast immobilization may result in stiffness, loss of strength, loss of bone density and an inability to work or participate in recreational activities for a prolonged period, operative treatment of non-displaced fractures has become increasingly common. Several surgical techniques for fixation have been described, but their risks and benefits have not yet been clearly elucidated. In a study in cadavers, we investigated whether one approach--volar percutaneous fixation--might pose a risk of injury to surrounding structures.

In 15 cadaver upper limbs with the wrist structures intact, a K-wire was inserted in a volar percutaneous manner under fluoroscopic guidance, distal to proximal and through the scaphoid waist into the center-center position. The volar aspect of the wrist and hand were then dissected around the K-wire, with isolation of sute that modification of the volar percutaneous approach to scaphoid fixation may be advisable to avoid damage to adjacent structures. We suggest use of a "mini-open" percutaneous procedure.

Although lateral epicondylitis (LE) is a very common tendinopathy, we understand little about the etiology of the disease. Tobacco use has been associated with other tendinopathies, and the purpose of this study is to determine if there is an association between the incidence of lateral epicondylitis and tobacco use.

We performed a retrospective cohort study of adult patients diagnosed with lateral epicondylitis. Patients from a single orthopaedic surgeon's practice with LE were matched to control patients with other common upper extremity conditions based on age, gender, and occupation. A total of 65 case patients and 217 control patients were included in the study. The incidence of smoking in patients with lateral epicondylitis was compared to the incidence of smoking in the control group.

Of the LE patients, 30/65 (46.2%) were non-smokers, 23/65 (35.4%) were former smokers, and 12/65 (18.5%) were current smokers. Of the control patients, 121/217 (55.8%) were non-smokers, 45/217 (20.7%) were former smokers, and 51/217 (23.5%) were current smokers. The odds of LE patients being former or current smokers compared to control patients were 1.45 times higher, but this was not statistically significant. Among people who did not smoke at the time of presentation, the odds of being a former smoker were 2.28 times higher in LE patients than in controls, which was statistically significant.

The odds of being a former smoker were significantly higher in patients with lateral epicondylitis compared to patients with other upper extremity conditions. Although it did not reach statistical significance, the odds of being former or current smokers were also higher in the LE group. These results suggest a relationship between smoking history and incidence of lateral epicondylitis, though more research is needed to determine the exact nature of the relationship.

Prognostic, Level III.

Prognostic, Level III.

The purpose of this study was to determine the early outcomes of 599 cases of revision THA performed using a porous tantalum cup.

Clinical and radiographic data was sought in all patients at a minimum two years follow-up, after acetabular revision performed with a porous tantalum cup.

Of the 599 cases identified, there were 51 re-operations in 47 patients (7.8 percent). Cup removal was required in 14 of these cases (2.3 percent). The most common cause for cup removal was a septic joint (12). No cups were revised for aseptic loosening during the study period. There was one case of early cup migration. There were 17 incomplete lucencies not initially seen on post-operative films, but identified later, all were non-progressive on subsequent x-rays.

Early results of porous tantalum acetabular components in the revision setting demonstrate good initial stability and low re-operation rates at two years follow-up.

Level 4 Case series.

Level 4 Case series.

Medial protrusio is a recognized complication of total hip arthroplasty, but it is not known if a medial wall breach during cup implantation increases the risk. We thus investigated the effect of up to a 2 cm defect in the medial acetabular wall in a cadaveric model. Separately, we investigated the ability of acetabular screws to rescue the construct.

Nine human fresh-frozen hemipelves were reamed medially to create the defect, implanted with acetabular cups, and then loaded to failure. The nine contralateral hemipelves were reamed in a standard fashion and served as controls. Separately, nine hemipelves with a medial defect were augmented with two acetabular screws each, then loaded to failure, with the contralateral side as a control. Load-to-failure, stiffness, and energy were recorded.

The presence of a medial wall defect decreased the load-to-failure by a mean of 26% (5710 v. 4221 N, p=0.024). The addition of two acetabular screws did not rescue the construct (mean 27% decrease, 4082 v. 2985 N, p=0.024). The majority of specimens failed in a supra-physiologic range of force. Bone density correlated with failure loads (R(2) range of 0.54-0.78), and osteoporotic specimens were more likely to fail at a physiologic range, consistent with forces experienced during minor stumbles or falls.

Osteoporotic patients with a medial wall defect after hip arthroplasty may be susceptible to fracture during activities of daily living. Protected weight bearing with an assistive device may be reasonable in order to minimize fall risk until cup ingrowth is achieved.

Osteoporotic patients with a medial wall defect after hip arthroplasty may be susceptible to fracture during activities of daily living. Protected weight bearing with an assistive device may be reasonable in order to minimize fall risk until cup ingrowth is achieved.