- International Consensus Statement on the Management of Glenohumeral Arthritis in Patients ≤ 50 Years Old. [Journal Article]J Shoulder Elbow Surg. 2023 Jan 31 [Online ahead of print]JS
- CONCLUSIONS: The optimal treatment of glenohumeral arthritis in patients ≤ 50 years of age remains controversial, and there are many treatment options to consider when responding to the variety of clinical presentations and anatomic pathologies. While physicians and patients engage in the shared decision-making process regarding the final choice for management, this consensus statement serves as a basis for discussion amongst colleagues and between patients and surgeons though it clearly demonstrates that the topic must be further investigated prospectively and with large cohorts.
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- Closed reduction and plaster immobilization: an alternative solution for patients with developmental dysplasia of the hip who failed Pavlik harness treatment. [Journal Article]ANZ J Surg. 2023 Feb 02 [Online ahead of print]AJ
- CONCLUSIONS: Although the success rate of closed reduction after early harness failure in DDH is only 66%, we still advocate closed reduction as a first-line treatment for children who have failed sling treatment. Even if closed reduction fails, open reduction can still achieve acceptable results.
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- Coxa Magna following treatment of developmental dysplasia of the hip: investigation for associated potential factors. [Journal Article]J Pediatr Orthop B. 2022 Dec 01 [Online ahead of print]JP
- Coxa Magna (CM) is defined as a condition in which the horizontal (transverse) diameter of the femoral head is larger on the affected side than on the intact side. CM can occur as a manifestation of avascular necrosis (AVN) following treatment for the developmental dysplasia of the hip (DDH). Alternatively, it can also be secondary to other hip disorders, such as Perthes' disease. This study aime…
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- Modernizing Our Understanding of Total Hip Arthroplasty in the Pediatric and Young Adult Patient: A Single-center Experience. [Journal Article]J Pediatr Orthop. 2023 Jan 19 [Online ahead of print]JP
- CONCLUSIONS: Modern PYA THA is dissimilar in indications and surgical techniques to historic cohorts, and conclusions from prior studies should not be generalized to modern practice. In our practice, PYA patients most commonly carry a diagnosis of AVN, and THA can be performed with modern cementless fixation with large cup and head sizes and ceramic-on-cross-linked polyethylene bearings utilizing any approach. Further study is required to better characterize middle-term and long-term results and patient-reported outcomes.
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- A Retrospective Observational Study to Compare the Outcome of Various Treatment Modalities of Idiopathic Avascular Necrosis of Hip. [Journal Article]
- CONCLUSIONS: In the early stage of disease, core decompression with and without bone grafting produced satisfactory results. In an advanced stage of AVN, THR is an excellent treatment option.
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- Anterolateral approach may be superior to posterolateral approach in controlling postoperative lower limb discrepancy in primary total hip arthroplasty: A single-center, retrospective cohort study. [Journal Article]Jt Dis Relat Surg. 2023; 34(1):32-41.JD
- CONCLUSIONS: Our study results suggest that the ALA may be superior to the PLA in controlling the postoperative LLD among some of the selective unilateral primary THA patients. Both the ALA and the PLA were comparable in terms of the restoration of offset.
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- Low complexity symmetric-coded based sphere decoding for low-rate polar codes. [Journal Article]Sci Rep. 2023 Jan 21; 13(1):1191.SR
- The sphere decoding (SD) algorithm can provide (sub)optimal solutions with reduced computational complexity of maximum likelihood (ML) detection for multi-input multi-output (MIMO) communication systems. In this paper, we propose a novel low complexity symmetric-coded based SD algorithm for short polar codes with low rate. At the encoding stage, the first N/2 sub-channels transmit the frozen bits…
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- A Deep Learning Method for Quantification of Femoral Head Necrosis Based on Routine Hip MRI for Improved Surgical Decision Making. [Journal Article]
- (1) Background: To evaluate the performance of a deep learning model to automatically segment femoral head necrosis (FHN) based on a standard 2D MRI sequence compared to manual segmentations for 3D quantification of FHN. (2) Methods: Twenty-six patients (thirty hips) with avascular necrosis underwent preoperative MR arthrography including a coronal 2D PD-w sequence and a 3D T1 VIBE sequence. Manu…
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- Avascular necrosis of the femoral head: three-dimensional measurement of drilling precision reveals high accuracy and no difference between fluoroscopically controlled core decompression and cancellous bone grafting. [Journal Article]Arch Orthop Trauma Surg. 2023 Jan 19 [Online ahead of print]AO
- CONCLUSIONS: Concerning the most important difference between the two procedures-the surgical higher demanding technique of CBG-we suggest applying the less invasive technique of CD alone.
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- Nonunion following valgus subtrochanteric osteotomy for neglected femoral neck fracture: A case report. [Case Reports]
- CONCLUSIONS: Careful selection of osteotomy site and appropriate fixation device might prevent of non-union.
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- Completely Displaced Femoral Neck Stress Fracture in a Young Male Soldier With Almost No Functional Impact: A Case Report. [Case Reports]
- Stress fracture in general is a well-known condition that can be found commonly in healthy athletes and military personnel. These fractures occur due to bone fatigue in response to the repetitive stress of exercise. Although few reports on stress fractures among military personnel and active young athletes can be found in previous literature, we present this case report of a young military soldie…
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- Avascular Necrosis and Posttraumatic Arthritis After Proximal Humerus Fracture Internal Fixation: Evaluation and Management. [Review]
- Avascular necrosis (AVN) and posttraumatic arthritis (PTA) are common complications following both conservative treatment and open reduction and internal fixation (ORIF) of proximal humerus fractures (PHFs). Despite the frequent utilization of ORIF, information regarding these leading causes of failure is limited. This review includes a discussion of incidence, risk factors, and evaluation of AVN…
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- New insights in AV nodal anatomy, physiology and immunochemistry: a comprehensive review and a proposed model of the slow-fast AVNRT circuit in agreement with direct potential recordings in the Koch's triangle area. [Review]Heart Rhythm. 2023 Jan 09 [Online ahead of print]HR
- Atrioventricular nodal re-entrant tachycardia (AVNRT) is humans' most frequent regular tachycardia. In this review, we describe the most recent discoveries regarding the anatomical, physiological and molecular biological features of the AV junction that could underlie the typical slow-fast AVNRT mechanisms, as these insights could lead to the proposal of a new theory concerning the circuit of thi…
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- The incidence and risk factors for femoral head necrosis after femoral neck fracture in pediatric patients: a systematic review and meta-analysis. [Meta-Analysis]
- CONCLUSIONS: The pooled incidence of AVN after PFNF was ~ 22%; furthermore, the available evidence demonstrates that patient age and Delbet type of fracture were important influencing factors of AVN after PFNF.
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- Case report: adipose-derived mesenchymal stem cells combined with core decompression in the treatment of early-stage avascular necrosis of the femoral head. [Case Reports]
- CONCLUSIONS: Implantation of AD-MSCs with Core decompression could be an effective modality to treat osteonecrosis of the femoral head in pre-collapse stages, however, we need bigger clinical studies to determine the actual effectiveness of this method.
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- The Importance of Monitoring and Factors That May Influence Leg Length Difference in Developmental Dysplasia of the Hip. [Journal Article]
- CONCLUSIONS: Procedures to correct LLD were performed irrespective of previous DDH surgery or AVN grades. In most patients, the affected/DDH leg was longer, mainly in the subtrochanteric segment of the femur, largely influenced by femoral osteotomy in patients with multiple operative procedures for DDH. We recommend careful monitoring of LLD in DDH.
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- Complications after talus fractures: A trauma centre experience. [Journal Article]Injury. 2022 Dec 15 [Online ahead of print]I
- CONCLUSIONS: Our study found that talar body fractures are more common than previously reported; however, talar neck fractures cause the highest rates of AVN and post-traumatic arthritis. Open fractures also carry a greater risk of complications. This information is useful during consenting and preoperatively when planning these cases to ensure adverse outcomes may be anticipated.
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- Management of Scaphoid Nonunion (SNU) With Ilizarov Ring Fixator Using Two Olive Wire Compression Without Bone Grafting: A Case Series. [Journal Article]
- CONCLUSIONS: With our technique of Ilizarov fixation and compression with two cross olive wires, SNU can be treated safely even without opening the non-union site and even without bone grafting. Since we excluded SNU patients with humpback deformity, carpal instability, carpal collapse, or avascular necrosis (AVN), our results might not be directly comparable to those of other SNU series in the literature. These would have predisposed to a poor outcome. Since we did not assign the patients at random, it is challenging to compare the Ilizarov technique to other widely used SNU treatments and determine whether it is more effective. However, the study's results are encouraging and show that the Ilizarov method using two olive wires for compression.
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- Relative frequency of avascular necrosis of the hip as indication for primary Total Hip Arthroplasty in the USA vs. India. [Journal Article]
- CONCLUSIONS: The relative frequency of AVN as an indication for THA is significantly higher in India than in the USA. It is important to recognize the differences in relative indications for THA between world populations, as outcomes after THA among Eastern populations of the world may not be equivalent to ones seen in their Western counterparts.
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- Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: A case report. [Case Reports]
- Avascular necrosis (AVN) or joint osteonecrosis is a debilitating complication of sickle cell disease, increasing the disease burden on both patients and healthcare systems. AVN can be radiologically categorized into early and late stages depending on the extent of the disease. Management of AVN is challenging and controversial. Generally, it includes conservative measures for early disease to pr…
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- Operative outcomes of a high-grade talar neck fracture - Lessons from 20 years' clinical experience in a single, tertiary hospital. [Journal Article]Foot Ankle Surg. 2022 Dec 06 [Online ahead of print]FA
- CONCLUSIONS: We recommend leaving talar body AVN untouched, unless the patient's symptoms become intolerable. In our clinical practice, postoperative AVN could be stably maintained without talar dome collapse for more than 7 years, although the sclerotic change persisted. Despite the small number of patients, our clinical experience may benefit patients with high-grade talar neck fractures and surgeons who treat such rare, serious, and challenging foot injuries.
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- Concomitant Avascular Necrosis of the Lunate and Proximal Pole of the Scaphoid in a Thalassemia Minor Patient. [Case Reports]
- Avascular necrosis (AVN) of multiple carpal bones is a very rare condition. This case report presents a patient with concomitant AVN of the lunate and proximal pole of the scaphoid that had led to severe joint space narrowing and degenerative arthritis in the radiocarpal and distal radioulnar joints (DRUJs). She was known to have thalassemia minor hemoglobinopathy. Wrist arthrodesis and distal ul…
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- Modified Smith-Petersen approach with rectus-sparing reduces severe avascular necrosis for developmental dysplasia of the hip at walking age: minimum 5-year follow-up. [Journal Article]
- CONCLUSIONS: These mid-term data suggest that the modified Smith-Petersen approach with rectus-sparing could reduce severe AVN more than the classical Smith-Peterson approach in open reduction in DDH at walking age. In addition, early open reduction can reduce the postoperative degree of AVN.
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- Outcome of surgically treated acetabular fractures: risk factors for postoperative complications and for early conversion to total hip arthroplasty. [Journal Article]Eur J Orthop Surg Traumatol. 2022 Dec 10 [Online ahead of print]EJ
- CONCLUSIONS: A high rate of patients with acetabular fractures still develop complications and require THA. Identification of predictors for poor outcome may help to inform surgical decision-making regarding options of plate osteosynthesis or 'Fix and Replace', to avoid poor outcomes and early revision surgery.
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- Mid-term results of subcapital realignment of chronic slipped capital femoral epiphysis using surgical hip dislocation: a prospective case series. [Journal Article]
- CONCLUSIONS: Subcapital realignment of chronic SCFE can achieve satisfactory clinical and radiological outcomes, but femoral head AVN remains a risk. Level of evidence Level IV.
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- 3D-Printed Total Talus Replacement After Free Vascularized Medial Femoral Condyle Osteocutaneous Flap for Avascular Necrosis of the Talus Leads to Poor Clinical Outcomes: A Case Series. [Journal Article]Foot Ankle Spec. 2022 Dec 08 [Online ahead of print]FA
- CONCLUSIONS: Patients 1 and 2 demonstrated reduced plantarflexion and ankle motion after TTR relative to the comparison group which improved in both physical assessments. The first patient needed a below knee amputation for persistent pain. Patient 2 showed less improvement in all the foot and ankle outcome scores as compared with the primary TTR group.
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- Ex vivo study of detergent-assisted intraosseous bone wash treatment of osteonecrosis. [Journal Article]J Orthop Res. 2022 Dec 01 [Online ahead of print]JO
- Avascular necrosis (AVN) involves ischemic cell death of the bone. AVN leaves an abundance of necrotic lipids and debris in the bone marrow, which instigates inflammatory bone repair. Consequently, the necrotic bone microenvironment stimulates excessive bone resorption, leading to joint deformities and osteoarthritis. Here, we performed a detergent-assisted bone wash using poloxamer 407 (P407) to…
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- Long-term response of dragon fruit (Hylocereus undatus) to transformed rooting zone of a shallow soil improving yield, storage quality and profitability in a drought prone semi-arid agro-ecosystem. [Journal Article]
- Agricultural crops especially fruit trees are constrained by edaphic stresses in shallow soils with low water retention and poor fertility. Therefore, interventions of shifting to trench planting for better root anchorage and replacing the filling soil were evaluated for 8 years in dragon fruit (Hylocereus undatus) cultivated in Deccan Plateau of peninsular India. When averaged for last 5-years, …
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- Diagnosis and Treatment of Avascular Necrosis of the Humeral Head: Current Concepts. [Journal Article]J ISAKOS. 2022 Nov 23 [Online ahead of print]JI
- Avascular necrosis (AVN) of the humeral head is an uncommon clinical entity which can result in significant morbidity for patients. Compared to femoral head AVN, the volume of literature concerning humeral head AVN is a distant second. This could be due to the relatively rarity of the condition and poorly understood nature. Despite being first described decades ago, the underlying pathophysiology…
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- Does Diabetes Mellitus Increase the Risk of Avascular Osteonecrosis? A Systematic Review and Meta-Analysis. [Review]
- Avascular osteonecrosis (AVN) is caused by the disrupted blood supply to the bone. Most AVN cases occur in the femoral head, but other sites might be affected as well, including the jaw or distal bones of the extremities. Previous studies suggested that diabetes could increase the risk of AVN of the jaw, but the relationship between diabetes and AVN in other bone sites is unclear. This systematic…
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