Orthopaedics Bulletin: Healthcare Library of Northern Ireland

BACKGROUND: Dissatisfaction occurs in nearly 20% of patients after total knee arthroplasty (TKA); however, there remains only limited understanding of the biologic mechanisms that may contribute to suboptimal postoperative outcomes requiring revision surgery. Expansion of effector T and B cells, could promote an abnormal healing response via local or peripheral immune system mechanisms and contribute to inferior outcomes necessitating revision TKA. In this pilot study we hypothesized that patients suffering from complications of arthrofibrosis or instability may exhibit differences in adaptive immune function...

OBJECTIVE: To identify subgroups of patients with magnetic resonance imaging (MRI)-confirmed degenerative meniscus tears who may benefit from arthroscopic partial meniscectomy (APM) in comparison with non-surgical or sham treatment. METHODS: Individual participant data (IPD) from four RCTs were pooled (605 patients, mean age: 55 (SD: 7.5), 52.4% female) as to investigate the effectiveness of APM in patients with MRI-confirmed degenerative meniscus tears compared to non-surgical or sham treatment...

OBJECTIVE: To compare the clinical effectiveness of three common shoulder injections mentioned in the guidelines [corticosteroid, sodium hyaluronate (SH) and platelet-rich plasma (PRP)] on rotator cuff tears. MATERIAL AND METHODS: The PubMed, Embase and Cochrane Library databases were systematically searched up to June 1, 2022, for randomized controlled trials (RCTs) and prospective studies on the three injection therapies for rotator cuff tears. The main results were pain relief and functional improvement at 1-5 months and over 6 months, pooled using a network meta-analysis and ranked by SUCRA score...

In tissue engineering, the fate of a particular organ/tissue regeneration and repair mainly depends on three pillars - 3D architecture, cells used, and stimulus provided. 3D cell supportive structure development is one of the crucial pillars necessary for defining organ/tissue geometry and shape. In recent years, the advancements in 3D bio-printing (additive manufacturing) made it possible to develop very precise 3D architectures with the help of industrial software like Computer-Aided Design (CAD). The main requirement for the 3D printing process is the bio-ink, which can act as a source for cell support, proliferation, drug (growth factors, stimulators) delivery, and organ/tissue shape...

Due to the higher birth rate of preterm infants and improvements in their management, metabolic bone disease of prematurity (MBDP) has a high incidence and is attracting attention. However, clear indicators for the early diagnosis of MBDP are lacking. We aimed to explore simple and feasible early warning indicators for diagnosing MBDP. Our study collected case data of premature infants from two medical centers in Chongqing from January 2020 to February 2022. According to the inclusion and exclusion criteria, data from 136 cases were collected...

BACKGROUND: The intent of this meta-analysis was to examine the efficacy of thoracolumbar interfascial plane block (TLIP) for pain control after lumbar spinal surgery. METHODS: Randomized controlled trials (RCTs) published on PubMed, CENTRAL, Scopus, Embase, and Web of Science databases up to February 10, 2023, comparing TLIP with no or sham block or wound infiltration for lumbar spinal surgeries were included. Pain scores, total analgesic consumption, and postoperative nausea and vomiting (PONV) were analyzed...

Pelvic incidence (PI) is often quantified in patients undergoing total hip arthroplasty. Errors in radiographic PI measurements can affect clinical outcomes. The purposes of this study were 1) to evaluate the error in radiographic PI measurement in patients with hip osteoarthritis (OA) and 2) to analyze the factors related to the error. Radiographs and computer tomography (CT) images of 100 patients (24 men and 76 women; mean age 63.7 years) with unilateral OA were reviewed. The error in radiographic PI measurement was defined as the difference between the radiographic measurement of the PI (rPI) and the accurate value of PI measured using CT images (cPI)...

OBJECTIVE: To review current knowledge surrounding the role of mast cells in joint inflammation and arthritis. METHOD: Narrative review. RESULTS: Mast cells (MCs) are commonly observed in the synovium of the joint, particularly surrounding blood vessels and nerve endings. Some studies have reported increased MC number and degranulation in patients with osteoarthritis (OA). In two studies, MCs were the only immune cell type found in higher concentrations in synovium of OA patients compared to rheumatoid arthritis patients...

OBJECTIVE: The objective of this meta-analysis was to illustrate the clinical outcomes and safety of two different management options for Song stage 2-4 lateral condyle humeral fractures in children. METHOD: In January 2023, a systematic computer-based search was conducted. Data were retrieved for patients with two different management options for lateral condyle humeral fractures in children. The primary endpoints were clinical outcomes based on infection, avascular necrosis, and nonunion...

Discovery in 1904 of the disorder initially called "marble bones", then in 1926 more appropriately referred to as "osteopetrosis", is attributed to Heinrich E. Albers-Schönberg (1865-1921), the first radiologist. He used the new technique of Röntgenography to report in a young man the radiographic hallmarks of this osteopathy. Clinical descriptions of lethal forms of osteopetrosis had apparently been published earlier by others. Here, I review the discovery and early understanding of osteopetrosis...

Despite the relatively high frequency of Achilles ruptures, there is no general consensus on the optimal treatment method. A general trend toward more patients being treated nonoperatively has emerged recently with the advent of functional rehabilitation. However, much of the recent data on this subject has been highly variable. This systematic review focused on Achilles tendon rupture (ATR) treatment outcomes, with a focus on rerupture and complication rates. This systematic review specifically focused on articles regarding ATR treatment that also included rerupture and complication rates...

This study aimed to evaluate the performance of a deep-learning model to evaluate knee osteoarthritis using Kellgren-Lawrence grading in real-life knee radiographs. A deep convolutional neural network model was trained using 8,964 knee radiographs from the Osteoarthritis Initiative, including 962 testing set images. Another 246 knee radiographs from the Far Eastern Memorial Hospital were used for external validation. The Osteoarthritis Initiative testing set and external validation images were evaluated by experienced specialists, two orthopedic surgeons, and a musculoskeletal radiologist...

BACKGROUND: Patient reviews provide an important referral source for physicians and an opportunity to improve practice performance. This study's objective was to characterize the online reviews of hip and knee arthroplasty surgeons published by three of the industry's leading platforms. METHODS: A random sample of 1000 hip and knee arthroplasty surgeons across all 50 US states (10 hip and 10 knee surgeons per state) was generated using Google Search. A total of 7842 online reviews posted for those surgeons on Healthgrades, Vitals, and Google were analyzed...

Although osteoblasts and osteocytes are descended from the same lineage, they each have unique and essential roles in bone. Targeting gene deletion to osteoblasts and osteocytes using the Cre/loxP system has greatly increased our current understanding of how these cells function. Additionally, the use of the Cre/loxP system in conjunction with cell-specific reporters has enabled lineage tracing of these bone cells both in vivo and ex vivo. However, concerns have been raised regarding the specificity of the promoters used and the resulting off-target effects on cells within and outside of the bone...

Historically, opioids have played a major role in the treatment of postoperative pain in orthopedic surgery. A multitude of adverse events have been associated with opioid use and alternative approaches to pain relief are being investigated, with particular focus on multimodal pain management regimens. Liposomal bupivacaine (EXPAREL) is a component of some multimodal regimens. This formulation of bupivacaine encapsulates the local anesthetic into a multivesicular liposome to theoretically deliver a consistent amount of drug for up to 72 hours...