Osseous manipulations

BACKGROUND: Static palpation of vertebral spinous process deviations from the midline are often utilized by manual therapists as a means to determine area for treatment of manipulable lesions. Previous research has discussed the diagnostic validity of this technique, but no correlation to vertebral morphology has been presented. AIM: To evaluate the frequency and presentation of vertebral spinous process deviations and their relationship with articular morphology, and the impact this may have in terms of static palpation techniques in the upper thoracic spine...

An aspiration biopsy is a commonly performed procedure for diagnostic sampling, particularly for sampling of cystic soft tissue lesions and bone marrow. The method is also useful for diagnostic sampling of bone lesions, particularly cystic and lytic osseous lesions where traditional methods of core biopsy may yield little to no material. Performing a successful aspiration biopsy involves aspiration of the lesion's contents and curettage of the walls. This requires maintaining a constant negative pressure on the syringe, which can be challenging with bone biopsies, as it requires one hand to maintain significant pressure on the plunger while the other hand manipulates the needle within the lesion...

OBJECTIVE: The International Consortium on Manual Therapies (ICMT) is a grassroots interprofessional association open to any formally trained practitioner of manual therapy (MT) and basic scientists promoting research related to the practice of MT. Currently, MT research is impeded by professions' lack of communication with other MT professions, biases, and vernacular. Current ICMT goals are to minimize these barriers, compare MT techniques, and establish an interprofessional MT glossary...

Diabetes is a chronic metabolic disorder that can lead to diabetic myopathy and bone diseases. The etiology of musculoskeletal complications in such metabolic disorders and the interplay between the muscular and osseous systems are not well understood. Exercise training promises to prevent diabetic myopathy and bone disease and offer protection. Although the muscle-bone interaction is largely biomechanical, the muscle secretome has significant implications for bone biology. Uncoupling effects of biophysical and biochemical stimuli on the adaptive response of bone during exercise training may offer therapeutic targets for diabetic bone disease...

BACKGROUND: Sacral dysmorphism is not uncommon and complicates S1 iliosacral screw placement partially because of the difficulty of determining the starting point accurately on the sacral lateral view. We propose a method of specifying the starting point. METHODS: The starting point for the S1 iliosacral screw into the dysmorphic sacrum was specifically set at a point where the ossification of the S1/S2 intervertebral disc (OSID) intersected the posterior vertebral cortical line (PVCL) on the sacral lateral view, followed by guidewire manipulation and screw placement on the pelvic outlet and inlet views...

BACKGROUND: Severe idiopathic arthrofibrosis after total knee arthroplasty (TKA) is a challenging problem to treat. Low-dose irradiation may decrease fibro-osseous proliferation, while rotating-hinge (RH) revision allows for distal femur shortening and collateral ligament sacrifice. This study reports the clinical outcomes and implant survivorship in patients treated with low-dose irradiation and RH revision for severe idiopathic arthrofibrosis following TKA. METHODS: A retrospective review was performed on 60 consecutive patients...

Defects characterized as large osseous voids in bone, in certain circumstances, are difficult to treat, requiring extensive treatments which lead to an increased financial burden, pain, and prolonged hospital stays. Grafts exist to aid in bone tissue regeneration (BTR), among which ceramic-based grafts have become increasingly popular due to their biocompatibility and resorbability. BTR using bioceramic materials such as β-tricalcium phosphate has seen tremendous progress and has been extensively used in the fabrication of biomimetic scaffolds through the three-dimensional printing (3DP) workflow...

The intracranial vertebrobasilar artery system has a unique hemodynamic pattern (vessel trunk converged bilateral flow with three groups of perforators directly arising from it), is embedded within intense osseous constraints, and is located far from conventional donor vessels. Two major traditional modalities of posterior circulation revascularization encompass the superficial temporal artery to the superior cerebellar artery and the occipital artery to the posteroinferior cerebellar artery anastomosis, which are extracranial-intracranial low-flow bypass with donor arteries belonging to the anterior circulation and mainly supply focal perforators and distal vascular territories...

BACKGROUND: Pedicle screw fixation provides one of the most stable spinal constructs. Their designs together with osseous characteristics have been known to influence the screw-bone interplay during surgical maneuvers and thereafter the fusion process. Various technical modifications to enhance screw performance have been suggested. This study evaluated the pull-out strength and axial stiffness of a novel pedicle screw design with variable thread geometry and pitch. METHODS: The newly designed triple threaded pedicle screw is tapered, and has unique out-turned flanges to hold the cancellous bone and a finer pitch at its distal and proximal end to engage the cortical bone...

Five canine cadaveric pelvic limbs with intact cranial cruciate ligaments were used to quantify the effect of variation in limb positioning on the radiographic measurement of the tibial plateau angle (TPA) with reference to the degree of femoral condyle superimposition. Intra-osseous pin placement and a custom jig design allowed the controlled three-dimensional manipulation of limbs. Medio-lateral digital radiographic projections were taken with perfect femoral hemicondylar superimposition to establish a "reference" TPA (difference in position = 0 mm), and subsequently in varying degrees of supination/pronation and abduction/adduction...

Stiffness following total knee arthroplasty is a challenging complication for both the patient and surgeon, with an incidence that ranges from 1% to 13%1 . There are several correctable mechanical causes for stiffness including malposition, malalignment, overstuffing, aseptic loosening, patella baja, and heterotopic ossification2 . Idiopathic stiffness is often termed arthrofibrosis and is more difficult to treat1 . Once patients have exhausted nonoperative options, including physical therapy and manipulation under anesthesia, revision surgery may be considered...

PURPOSE: Bony anatomy in patients with immature spines has been previously characterized. Alterations in lumbosacral morphology in patients with myelodysplasia, demonstrating increasing medial pedicle angulation (MPA) from L1-S1, have been examined; however, MPA related to size of the defect in myelomeningocele patients has not been defined. We aimed to establish that magnitude of posterior vertebral arch defects determines the extent of MPA in the lumbar spine, with larger posterior defects associated with increased MPA...

Medical phantoms are commonly used for training and skill demonstration of surgical procedures without exposing a patient to unnecessary risk. The discrimination of these tissues is critical to the ability of young orthopedic surgical trainees to identify patient injuries and properly manipulate surrounding tissues into healing-compliant positions. Most commercial phantoms lack anatomical specificity and use materials that inadequately attempt to mimic human tissue characteristics. This paper covers the manufacturing methods used to create novel, higher fidelity surgical training phantoms...

Our knowledge of the recolonization of north-west Europe at the end of the Last Glacial Maximum depends to a large extent on finds from Gough's Cave (Somerset, UK). Ultra-high resolution radiocarbon determinations suggest that the cave was occupied seasonally by Magdalenian hunters for perhaps no more than two or three human generations, centred on 12,600 BP (~14,950-14,750 cal BP). They left behind a rich and diverse assemblage of Magdalenian lithic and osseous artefacts, butchered animal bones, and cannibalised human remains...

CASE: A 2.5-year-old male child presented to the clinic for evaluation of left wrist popping. Ten months earlier, he sustained a closed left both-bone forearm fracture (BBFF) treated with reduction and casting. His clinical course was complicated by redisplacement requiring secondary manipulation and casting before osseous union. His parents reported wrist popping with active motion in the setting of a 20° apex volar malunion of the midshaft radius. He has been treated with observation and monitoring of deformity remodeling...

The aim is to present a single-center case series of patients with symptomatic hyperpronated feet treated with arthroereisis by using a second generation extra-osseous talo-tarsal stabilization device. This case series enrolled 123 feet in 87 patients (20 [6-75] years) treated with arthroereisis, either isolated (76 cases) or combined procedure (47 cases). At their final follow-up, a patient reported questionnaire (overall satisfaction, foot stability and shape, activities of daily living, pain level, and analgesics usage) was distributed...

For the past three decades, laser use has been investigated, mainly on implant applications, as well as hard and soft tissue processing on orthopedics. However, despite significant technological advances and achievements in Biophotonics, lasers have yet to emerge as a successful tool for hard-tissue manipulation (e.g., osseous tissue). Indeed, a careful search in relevant literature reveals a limited number of laser-based clinical applications in orthopedics, except for the low-level laser therapy applications...

HYPOTHESIS: Virtual fixtures can be enforced in cooperative-control robotic mastoidectomies with submillimeter accuracy. BACKGROUND: Otologic procedures are well-suited for robotic assistance due to consistent osseous landmarks. We have previously demonstrated the feasibility of cooperative-control robots (CCRs) for mastoidectomy. CCRs manipulate instruments simultaneously with the surgeon, allowing the surgeon to control instruments with robotic augmentation of motion...

Critical-sized defects remain a significant challenge in orthopaedics. 3D printed scaffolds are a promising treatment but are still limited due to inconsistent osseous integration. The goal of the study is to understand how changing the surface roughness of 3D printed titanium either by surface treatment or artificially printing rough topography impacts the mechanical and biological properties of 3D printed titanium. Titanium tensile samples and discs were printed via laser powder bed fusion. Roughness was manipulated by post-processing printed samples or by directly printing rough features...

BACKGROUND: Cervical arthroplasty has established itself as a safe and efficacious alternative to fusion in management of symptomatic cervical degenerative disease. Recent literature has indicated a trend toward decreased risk of reoperation with cervical arthroplasty, and reoperation in this subset commonly occurs secondary to recurrent pain and device-related complications. The instance of cervical arthroplasty migration, particularly in the setting of trauma, is particularly rare. Here, we report the first case of implant migration secondary to iatrogenic trauma following neck manipulation during direct laryngoscopy for mechanical intubation...