- Dynamic Compressive Loading Improves Cartilage Repair in an In Vitro Model of Microfracture: Comparison of 2 Mechanical Loading Regimens on Simulated Microfracture Based on Fibrin Gel Scaffolds Encapsulating Connective Tissue Progenitor Cells. [Journal Article]
- AJAm J Sports Med 2019; 47(9):2188-2199
- CONCLUSIONS: Dynamic compressive loading enhanced neotissue chondrogenesis and maturation in a simulated in vitro model of microfracture, with generation of more hyaline-like cartilage and improved integration with the surrounding tissue.
- Is the incidence of paediatric stress fractures on the rise? Trends in New York State from 2000 to 2015. [Journal Article]
- JPJ Pediatr Orthop B 2019 Jul 11
- The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress frac…
The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress fractures in children between the ages of 6 and 18 years. After checking for monotonicity of the data, Spearman's correlation coefficient was calculated. Multivariate regressions were used to test for associations between demographic variables and risk of stress fracture. Analysis of 11 475 386 outpatient visits between 2000 and 2015 showed that the annual incidence of paediatric stress fractures increased from 1.37 cases per 100 000 outpatient visits in 2006 to 5.32 per 100 000 visits in 2015 (ρ = 0.876, P < 0.01). The mean age at the time of injury was 14.4 ± 2.8 years. Children younger than 14 years accounted for 33.6% of the cohort. Age, male sex, white ethnicity, and private insurance were statistically significant predictors of stress fractures in a multivariate model. This study is the first to document an increase in the annual incidence of paediatric stress fractures.
- Part II: presentation, diagnosis, classification, treatment, and prevention of stress fractures in female athletes. [Journal Article]
- PSPhys Sportsmed 2019 Jul 11; :1-8
- CONCLUSIONS: The ability to screen for at-risk athletes is paramount in preventing SFx. Recognition and prompt treatment of the female athlete triad requires a multidisciplinary approach in order to restore energy balance, correct menstrual irregularities, and improve bone health. This review provides a basis for understanding how to identify and treat stress fractures, which may allow treating physicians to diagnose this condition earlier and minimize any associated morbidity.
- Effects of short- and long-term administration of nonsteroidal anti-inflammatory drugs on osteotomy healing in dogs. [Journal Article]
- VSVet Surg 2019 Jul 10
- CONCLUSIONS: Long-term administration of carprofen had a negative effect on bone healing compared with short-term or no administration of carprofen.Nonsteroidal anti-inflammatory drugs should be used cautiously in dogs at risk for delayed bone healing, and administration should be discontinued beyond the perioperative period in dogs with fractures or osteotomies.
- Osteosynthesis Technique for Periprosthetic Femoral Fractures: A Case of Interprosthetic Fracture Between a Total Knee Arthroplasty and a Dynamic Hip Screw. [Journal Article]
- JOJ Orthop Trauma 2019; 33 Suppl 1:S28-S29
- Periprosthetic fractures remain a challenging component of every trauma practice. Total joints have become common in very elderly patients, creating a variety of implanted stress risers that make sub…
Periprosthetic fractures remain a challenging component of every trauma practice. Total joints have become common in very elderly patients, creating a variety of implanted stress risers that make subsequent fractures unique challenges to address. This creates the need to build a construct that will allow for early weight bearing while trying to reduce the potential for further fractures in the same bone. A minimally invasive submuscular approach with long periprosthetic locking plates can be used for a periprosthetic femoral fracture.
- Examination Under Anesthesia for Evaluation of Hip Stability in Posterior Wall Acetabulum Fractures. [Journal Article]
- JOJ Orthop Trauma 2019; 33 Suppl 1:S19-S21
- Posterior wall fractures of the acetabulum are the most common acetabular fracture pattern. Stable, congruous hips are amenable to nonoperative management, whereas any instability in the hip is an in…
Posterior wall fractures of the acetabulum are the most common acetabular fracture pattern. Stable, congruous hips are amenable to nonoperative management, whereas any instability in the hip is an indication for operative management of the posterior wall fracture. Stability cannot adequately be predicted by static imaging alone. Therefore, the dynamic stress examination under anesthesia remains the gold standard in determining hip stability to guide treatment. This case-based video demonstrates a systematic technique for performing an examination under anesthesia and explains how to interpret the fluoroscopic imaging to differentiate stable and unstable hips.
- Nonoperative Management of Proximal Tibiofibular Joint Synostosis after Tibial Intramedullary Nailing. [Case Reports]
- CRCase Rep Orthop 2019; 2019:2423010
- We report the case of a 28-year-old male semiprofessional basketball player who presented to an outside hospital with nonhealing stress fractures for which he underwent tibial intramedullary nailing …
We report the case of a 28-year-old male semiprofessional basketball player who presented to an outside hospital with nonhealing stress fractures for which he underwent tibial intramedullary nailing (IMN). Two weeks after surgery, he developed pain proximal and lateral to the knee. As he returned to play, the pain worsened with jumping and lateral movement and improved with rest. He presented to our hospital one year after the operation with the same unresolved pain. Imaging one year after the surgery revealed proximal tibiofibular joint (TFJ) synostosis aligned with the drill path. Literature review showed that rare noncongenital cases of proximal TFJ synostosis cases were most often treated nonoperatively. However, two cases involved the removal of excessively protruding screws and two cases involved bone resection that resolved painful disruption of other joints, such as the ankle. The current patient had proper implant positioning and no other impacted joints, so he was managed without operative intervention. By the final 16-month postoperative follow-up, his symptoms had resolved completely. Although an unusual occurrence with limited data, we recommend nonoperative management for proximal TFJ synostosis caused by tibial nailing if implants are properly positioned and no other joints are affected.
- Prayer's fracture: rare cases of knee insufficiency fracture in non-weight-bearing femoral condyle. [Journal Article]
- CIClin Imaging 2019 Jun 22; 58:80-83
- Insufficiency fractures are a relatively common sub-type of stress fractures and occur as a result of decreased bone resistance due to underlying conditions such as osteoporosis. Insufficiency fractu…
Insufficiency fractures are a relatively common sub-type of stress fractures and occur as a result of decreased bone resistance due to underlying conditions such as osteoporosis. Insufficiency fractures of the knee most commonly occur at the central weight-bearing zone of the medial femoral condyle. We present five unusual cases of insufficiency fractures occurring at the posterior non-weight-bearing zone of condyles. After investigating commonalities between these patients, we discovered that all of these patients performed the daily practice of prayer rituals that include high knee flexion. We have chosen to coin this type of fracture a "Prayer's fracture". Considering the mechanics of high knee flexion, transient changes in the weight-bearing zone of knee explain the unusual location of this fracture. We describe these cases, the characteristic imaging appearance, and the probable biomechanics that we believe predispose patients to this type of injury.
- [Comparison of curative effect between osteochondral mosaic transplantation and micro-fracture in the treatment of knee joint articular cartilage injury]. [Journal Article]
- ZGZhongguo Gu Shang 2019 Jun 25; 32(6):539-543
- CONCLUSIONS: Autogenous osteochondral mosaicplasty and microfracture are proved to be safe and effective procedures for knee articular cartilage defects. However, the mosaicplasty has better clinical outcome than the microfracture.
New Search Next
- Editorial Commentary: Haven't We Seen This Somewhere Before? Laying the Foundation for Cartilage Restoration in Hip Preservation. [Editorial]
- AArthroscopy 2019; 35(7):2048-2050
- Since its inception in the early 1980s, the microfracture procedure has been successfully used throughout the body to treat isolated full-thickness cartilage lesions. Although treatment of such injur…
Since its inception in the early 1980s, the microfracture procedure has been successfully used throughout the body to treat isolated full-thickness cartilage lesions. Although treatment of such injuries can be challenging, and outcomes variable, microfracture has afforded surgeons the ability to treat cartilage lesions in a single-stage fashion at the time of treatment for concomitant injuries. Whereas most research relating to the use of microfracture has focused on managing lesions in the knee, there continues to be interest in applying the same principles in other regions of the body. With the recent enthusiasm and procedural increase in hip arthroscopy and hip preservation procedures, evaluating the use of microfracture in the femoroacetabular joint is the next logical step in establishing treatment principles for cartilage defects in this location. Although we continue to innovate as orthopedic surgeons, and there have been recent declines in ardor for the use of microfracture, this sentiment has arisen only after decades of research and clinical advances. Because of this, continued work will be necessary to understand the limits of the microfracture procedure in hip preservation surgery. Early outcome studies are encouraging and continue to be an important platform on which to lay the foundation for further research and refinement of techniques and indications.