Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,prov...Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,provides compelling evidence of significant associations between depression,anxiety,and postoperative recovery.These findings align with an expanding body of literature that confirms the need for orthopedic rehabilitation to adopt a biopsychosocial perspective.This letter contextualizes Yang et al’s study within current evidence,highlighting the roles of sleep disturbance,catastrophizing,stress,neurobiological mechanisms,and coping strategies in shaping recovery.It further emphasizes the importance of integrating nursing-led and multidisciplinary interventions to address both physical and psychological domains,ultimately promoting holistic recovery.展开更多
BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
Introduction The global burden of orthopedic diseases has reached unprecedented levels,with recent epidemiological data revealing that musculoskeletal conditions affect over 1.71 billion people worldwide,representing ...Introduction The global burden of orthopedic diseases has reached unprecedented levels,with recent epidemiological data revealing that musculoskeletal conditions affect over 1.71 billion people worldwide,representing a 150%increase since 1990[1].By 2050,the number of individuals aged 60 and above requiring orthopedic interventions is projected to exceed 2.1 billion,with osteoporosis alone affecting 200 million people globally.展开更多
Artificial intelligence(AI)can help in diagnosing fractures and demonstrating effusions,dislocations,and focal bone lesions in both adult and pediatric aged individuals and also aid in early tumor discovery(bone osteo...Artificial intelligence(AI)can help in diagnosing fractures and demonstrating effusions,dislocations,and focal bone lesions in both adult and pediatric aged individuals and also aid in early tumor discovery(bone osteosarcoma)and in robot-assisted surgery.A recent AI model[Mask R-CNN(region-based convolutional neural network)]has shown to be dependable for detecting surgical target zones in pediatric hip and periarticular infections,offering a more convenient and quicker alternative to conventional methods.It can help inexperienced physicians in pre-treatment evaluations,diminishing the risk of missed diagnosis and misdiagnosis.AI has some very interesting applications in orthopedic surgery,which orthopedic surgeons should be aware of and if possible use.Although some interesting advances have been made recently on AI in orthopedic surgery,its usefulness in clinical practice is still very limited.Ethical concerns,such as transparency in AI decision-making,data privacy,and the potential loss of human intuition cannot be forgotten.Besides,it is paramount to explore how to gain trust from both healthcare professionals and patients in the utilization of AI.展开更多
BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is ...BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.展开更多
This narrative review evaluated the potential of nanotechnology platforms(DepoFoam bupivacaine^(R),DepoDur^(R),Exparel^(R),Zynrelef^(R),NeuroCuple™)in the control of postoperative pain following orthopedic procedures....This narrative review evaluated the potential of nanotechnology platforms(DepoFoam bupivacaine^(R),DepoDur^(R),Exparel^(R),Zynrelef^(R),NeuroCuple™)in the control of postoperative pain following orthopedic procedures.In individuals experiencing bunionectomy DepoFoam bupivacaine^(R)120 mg and placebo via wound infiltration before wound closure was compared.The area under the curve for numeric rating scale scores was substantially less in individuals treated with DepoFoam bupivacaine^(R)vs individuals receiving placebo at 24 h and 36 h.In individuals undergoing total hip arthroplasty,a single dose of 15 mg,20 mg,or 25 mg DepoDur^(R)[extended-release epidural morphine(EREM)]and placebo were compared.All EREM dosages diminished the mean fentanyl usage vs placebo and delayed the median time to first dose of fentanyl.All EREM cohorts had substantially improved pain control at rest for up to 48 h post-surgery compared with placebo.No supplementary analgesia was required in 25%of individuals treated with EREM and 2%of individuals treated with placebo at 48 h.In individuals undergoing total knee arthroplasty,iPACK(local anesthetic infiltration of the interspace between the popliteal artery and the posterior knee capsule)adductor canal block was compared to adductor canal block with Exparel^(R).Individuals in the Exparel^(R)cohort experienced an improvement in numeric rating scale pain scores at all postsurgical time points.These individuals also utilized a lower dose of inpatient opioids.In individuals undergoing bunionectomy a single intraoperative dose of Zynrelef^(R)prolonged release(PR)was compared to bupivacaine HCl 0.5%via wound infiltration before wound closure.Zynrelef^(R)PR diminished pain intensity by 18%compared with bupivacaine HCl.Opioid consumption was reduced by 37%in the Zynrelef^(R)PR cohort vs 25%in the bupivacaine HCl cohort.In individuals experiencing total knee arthroplasty and total hip arthroplasty,the use of a nanotechnology-based NeuroCuple^(TM)device diminished postoperative pain at rest by 34%and reduced pain with movement by 18%.展开更多
Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse ...Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse populations depends on rigorous processes of translation,cultural adaptation,and validation.AlMousa et al successfully validated the Arabic version of the American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire,demonstrating strong reliability and clinical applicability for Arabic-speaking patients with traumatic foot and ankle injuries.This article highlights the vital role of culturally adapted PROMs in expanding the global scope of orthopedic research,enhancing patient-centered care,and promoting international collaboration.By addressing linguistic and cultural barriers,such adaptations support a more comprehensive and inclusive approach to evidence-based medicine.Future research should aim to optimize the integration of adapted PROMs into clinical practice,evaluate their influences on treatment decision-making,and investigate their functions in largescale multicenter studies to further globally advance orthopedic research.展开更多
BACKGROUND In 2017,our institution implemented a high efficiency(HE)pathway for lower limb orthopedic surgery.The employed strategy included patient selection,surgical instrument standardization,preoperative surgical ...BACKGROUND In 2017,our institution implemented a high efficiency(HE)pathway for lower limb orthopedic surgery.The employed strategy included patient selection,surgical instrument standardization,preoperative surgical nerve blocks,avoidance of general anesthesia and bypassing phase one recovery.We conducted a historic cohort study whose primary outcome was the postoperative recovery time between the HE and traditional(T)pathway.AIM To determine whether the implementation of a HE pathway was correlated with a reduction in postoperative recovery time.METHODS Patients who had unilateral elective lower limb orthopedic procedures through the T and HE pathway were screened between 2017 to 2019.Patients were at least 18 years old,and American Society of Anesthesiologists(ASA)Physical Status I to III without major systemic comorbidities were included.Propensity score was generated using multivariable regression taking age,body mass index,sex,ASA class and surgical type as covariates using nearest neighbour methods between the two pathways.Mann Whitney U test were used to analyzed total postoperative time.RESULTS There was an associated reduction in total postoperative recovery time of 63 minutes(95%CI:-69 to-57)in the HE group.The operating room time and total length of stay also had an associated decrease of 20 minutes(95%CI:-23 to-17)and 84 minutes(95%CI:-92 to-75)respectively.CONCLUSION Utilizing multifaceted strategies to improve perioperative efficiency was associated with a reduction in the postoperative recovery time in our retrospective study.This model can be a potential strategy to deal with surgical backlog in the face of ongoing human resource challenges.展开更多
The Health Action Process Approach(HAPA),developed by German psychologist Schwarzer in the 1980s,provides a comprehensive framework for understanding and influencing health behavior change.By dividing behavior change ...The Health Action Process Approach(HAPA),developed by German psychologist Schwarzer in the 1980s,provides a comprehensive framework for understanding and influencing health behavior change.By dividing behavior change into three dynamic stages-pre-intention,intention,and action-HAPA highlights the critical role of self-efficacy as a driving force in adopting healthier behaviors.This stage-based approach addresses the limitations of continuous health behavior models by emphasizing individual differentiation and recognizing that behavior change is not linear but progresses through distinct phases.HAPA theory has demonstrated significant potential in clinical applications,particularly in orthopedic postoperative patients.Its implementation facilitates the development of positive behavioral intentions,enhances self-efficacy,and supports sustained health action,ultimately improving patients’health outcomes and quality of life.Tailored interventions based on HAPA stages ensure that patients receive appropriate guidance and support throughout their recovery journey.Despite its successes,limitations remain.Future research should focus on expanding the application of HAPA to various orthopedic conditions and developing more targeted behavioral plans and health education programs to optimize patient rehabilitation.Additionally,further exploration is needed to sustain HAPA’s effectiveness during long-term recovery.Strengthening interdisciplinary collaboration and integrating HAPA with other theoretical models could create a more comprehensive health behavior education system,providing robust support for orthopedic patients and advancing their overall recovery and well-being.展开更多
Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult t...Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult tissue repair processes.Aberrant FGF signal transduction is associated with various pathological conditions such as cartilage damage,bone loss,muscle reduction,and other core pathological changes observed in orthopedic degenerative diseases like osteoarthritis(OA),intervertebral disc degeneration(IVDD),osteoporosis(OP),and sarcopenia.In OA and IVDD pathologies specifically,FGF1,FGF2,FGF8,FGF9,FGF18,FGF21,and FGF23 regulate the synthesis,catabolism,and ossification of cartilage tissue.Additionally,the dysregulation of FGFR expression(FGFR1 and FGFR3)promotes the pathological process of cartilage degradation.In OP and sarcopenia,endocrine-derived FGFs(FGF19,FGF21,and FGF23)modulate bone mineral synthesis and decomposition as well as muscle tissues.FGF2 and other FGFs also exert regulatory roles.A growing body of research has focused on understanding the implications of FGF signaling in orthopedic degeneration.Moreover,an increasing number of potential targets within the FGF signaling have been identified,such as FGF9,FGF18,and FGF23.However,it should be noted that most of these discoveries are still in the experimental stage,and further studies are needed before clinical application can be considered.Presently,this review aims to document the association between the FGF signaling pathway and the development and progression of orthopedic diseases.Besides,current therapeutic strategies targeting the FGF signaling pathway to prevent and treat orthopedic degeneration will be evaluated.展开更多
Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 wer...Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.展开更多
BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported...BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.展开更多
Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized tre...Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized treatment.These challenges not only impact treatment outcomes but also severely impact patients’daily lives.Layer-by-Layer(LbL)serves as a simple surface coating technique,in simple terms,to functionalize implants by sequentially adsorbing oppositely charged materials onto a substrate.In orthopaedics,LbL self-assembly technology solves some of the challenges by loading various drugs or biological agents on the implant surface and controlling their release precisely to the site of bone defects in a personalized way.This review will introduce the basic principle and the development of LbL in orthopaedics,review and analyze the chemical strategy of LbL in the preparation of bone implants to ensure the stability of the implant,and introduce the use of LbL bone implants in orthopaedics in recent years.The application of LbL includes the realization of programmed drug delivery and sustained release,thereby promoting osseointegration and the formation of new blood vessels,antibacterial,antioxidant,etc.This review focuses on the LbL technology,involving the technology selection for the preparation of bone implants,the chemical strategies of the stability guarantee of LbL implants,the pharmacological properties,loading and release mechanisms of loaded drugs,and the molecular mechanisms of osteogenesis and angiogenesis.The aim of this review is to provide an overview of current research advances,and a prospect in this field was also described.展开更多
BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervisio...BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervision.It is an emerging tool in pediatric orthopedic surgery,with various promising applications.An evaluation of the current awareness and perceptions among pediatric orthopedic surgeons is necessary to facilitate AI utilization and highlight possible areas of concern.AIM To assess the awareness and perceptions of AI among pediatric orthopedic surgeons.METHODS This cross-sectional observational study was conducted using a structured questionnaire designed using QuestionPro online survey software to collect quantitative and qualitative data.One hundred and twenty-eight pediatric orthopedic surgeons affiliated with two groups:Pediatric Orthopedic Chapter of Saudi Orthopedics Association and Middle East Pediatric Orthopedic Society in Gulf Cooperation Council Countries were surveyed.RESULTS The pediatric orthopedic surgeons surveyed had a low level of familiarity with AI,with more than 60%of respondents rating themselves as being slightly familiar or not at all familiar.The most positively rated aspect of AI applications for pediatric orthopedic surgery was their ability to save time and enhance productivity,with 61.97%agreeing or strongly agreeing,and only 4.23%disagreeing or strongly disagreeing.Our participants also placed a high priority on patient privacy and data security,with over 90%rating them as quite important or highly important.Additional bivariate analyses suggested that physicians with a higher awareness of AI also have a more positive perception.CONCLUSION Our study highlights a lack of familiarity among pediatric orthopedic surgeons towards AI,and suggests a need for enhanced education and regulatory frameworks to ensure the safe adoption of AI.展开更多
The last decade has seen a significant growth in the market for alloys used for implants,especially for those intended for orthopedic implants.Research into biodegradable magnesium-based alloys has made great strides ...The last decade has seen a significant growth in the market for alloys used for implants,especially for those intended for orthopedic implants.Research into biodegradable magnesium-based alloys has made great strides in this period,so huge progress has been made in their use in the medical industry.The important factors that led to the intensification of research in this regard,were social but also economic,wanting to improve the quality of life,by reducing the use of conventionally permanent metallic implants(stainless steel,cobalt-based alloys,and titanium alloys)which involve the second implant removal surgery and other undesirable effects(stress shielding and metal ion releases),with a negative impact on the emotional and physical condition of patients,and by significantly reducing the costs for both the patient and the health system in the field of orthopedics.This paper refers to the impact and importance of biodegradable Mg alloys,reviewing the beginning of their development,the significant characteristics that make them so desirable for such applications(orthopedic implants)but also the characteristics that must be modulated(corrosion rate and mechanical properties)to arrive at the ideal product for the targeted application.It highlights,in detail,the mechanism and aspects related to the corrosion behaviour of Mg alloys,electrochemical characterization techniques/methods,as well as strategies to improve the corrosion behaviour and mechanical properties of these types of biodegradable alloys.The means of optimization,the category and the effect of the alloying elements,the design criteria,the requirements that the implants of biodegradable alloys Mg-based must meet and the aspects related to their efficiency are also presented.Finally,the potential applications in the specialized clinics,as well as the final products currently used and made by important prestigious companies in the world are approached.展开更多
Magnesium(Mg)and its alloys have been widely researched for orthopedic applications recently.Mg alloys have stupendous advantages over the commercially available stainless steel,Co-Cr-Ni alloy and titanium implants.Ti...Magnesium(Mg)and its alloys have been widely researched for orthopedic applications recently.Mg alloys have stupendous advantages over the commercially available stainless steel,Co-Cr-Ni alloy and titanium implants.Till date,extensive mechanical,in-vitro and in-vivo studies have been done to improve the biomedical performance of Mg alloys through alloying,processing conditions,surface modification etc.This review comprehensively describes the strategies for improving the mechanical and degradation performance of Mg alloys through properly tailoring the composition of alloying elements,reinforcements and processing techniques.It also highlights the status and progress of research in to(i)the selection of nutrient elements for alloying,reinforcement and its effects(ii)type of Mg alloy system(binary,ternary and quaternary)and composites(iii)grain refinement for strengthening through severe plastic deformation techniques.Furthermore it also emphasizes on the importance of Mg composites with regard to hard tissue applications.展开更多
Objective:To explore the effect of ulinastatin(UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.Methods:Forty-five patients undergoing major ort...Objective:To explore the effect of ulinastatin(UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.Methods:Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion(Uc) group,ulinastatin single injection(Us) group and control(C) group.All patients received patient-controlled intravenous analgesia(PCIA) after operation,and took Rivaroxaban 10 mg orally 12 hours after operation.Ulinastatin(5 000 U/kg)was given intravenously to both Uc and Us groups preoperatively.Group C was given isometric normal saline,group Uc was pumped UTI continuous intravenously at the end of surgery(10 000U/kg) to 48 hours through PCIA pump.The values of hematocrit(HCT),thrombomodulin(TM),Interleukin(IL-6),thrombin-antithrombin complex(TAT),D-Dimer(D-D) were normally tested before surgery(T1),at the end of the surgery(T2),12 hours(T3).24 hours(T4) and 48 hours(T5)after surgery.Results:Compared with T1,there was an upward tendency in TM,IL-6,TAT,and D-D after operation in group C group(P <0.05).The values of them were significandy increased from nearly 24-hour after surgery in Us group(P<0.05).In group Uc.there were no significant changes in these indices after operation(P>0.05).Conclusions:During the perioperative period,ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.展开更多
Mg-Ca alloys have recently attracted great attention towards the research in the field of orthopedic biodegradable implants.This study presents an in vitro degradation assessment of Mg-0.8Ca(0.8 wt.%of Ca)alloy in Han...Mg-Ca alloys have recently attracted great attention towards the research in the field of orthopedic biodegradable implants.This study presents an in vitro degradation assessment of Mg-0.8Ca(0.8 wt.%of Ca)alloy in Hank’s balanced salt solution(HBSS).Immersion,hydrogen evolution and electrochemical behavior was studied as well as the cytotoxicity of the degradation products.Morphology and phase composition of the corrosion products were studied using SEM,EDX and XRD techniques.Degradation in HBSS resulted in the formation of the needle-shaped carbonated hydroxyapatite which was similar to the biological apatite in the human bone.Degradation kinetics showed that Mg-0.8Ca alloy had approximately 3-fold faster degradation rate than the pure Mg(1.08±0.38 mm/year for Mg-0.8Ca and 0.35±0.17 mm/year for pure Mg),as observed in two independent experiments.Both,pure Mg and Mg-0.8Ca alloy were biocompatible,generating no cytotoxic degradation products against human-derived HEK 293 cells.Thus,the Mg-0.8Ca alloy was found to be a promising biodegradable implant in terms of bioactivity and compatibility with human cell lines.Depending on the application of the implant and the estimated healing time of the bone,the desired degradation rate of an implant can be controlled by the Mg-Ca composition of such alloys.展开更多
AIM: To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids.
The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy(HA) in patients with deficiency of coagulation factor Ⅷ or Ⅸ and thus this manuscript seeks to present a current perspecti...The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy(HA) in patients with deficiency of coagulation factor Ⅷ or Ⅸ and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems.Lifelong factor replacement therapy(FRT) is optimal to prevent HA,however adherence to this regerous treatment is challenging leading to breakthrough bleeding.In patients with chronic hemophilic synovitis,the prelude to HA,radiosynovectomy(RS) is the optimal to ameliorate bleeding.Surgery in people with hemophilia(PWH) is associated with a high risk of bleeding and infection,and must be performed with FRT.A coordinated effort including orthopedic surgeons,hematologists,physical medicine and rehabilitation physicians,physiotherapists and other team members is key to optimal outcomes.Ideally,orthopedic procedures should be performed in specialized hospitals with experienced teams.Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures(arthrocentesis,RS,arthroscopic synovectomy,hamstring release,arthroscopic debridement,alignment osteotomy,and total knee arthroplasty).By using the aforementioned procedures,the quality of life of PWH will be improved.展开更多
文摘Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,provides compelling evidence of significant associations between depression,anxiety,and postoperative recovery.These findings align with an expanding body of literature that confirms the need for orthopedic rehabilitation to adopt a biopsychosocial perspective.This letter contextualizes Yang et al’s study within current evidence,highlighting the roles of sleep disturbance,catastrophizing,stress,neurobiological mechanisms,and coping strategies in shaping recovery.It further emphasizes the importance of integrating nursing-led and multidisciplinary interventions to address both physical and psychological domains,ultimately promoting holistic recovery.
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金support from Qinghai Province basic research project(2024-ZJ-760)Changzhou Sci&Tech Program(CZ20240029)+1 种基金Science and Technology Project of Changzhou Health Commission(QN202356)Top Talent of Changzhou“The 14th Five-Year Plan”High-Level Health Talents Training Project(2022CZBJ059 and 2022CZBJ061).
文摘Introduction The global burden of orthopedic diseases has reached unprecedented levels,with recent epidemiological data revealing that musculoskeletal conditions affect over 1.71 billion people worldwide,representing a 150%increase since 1990[1].By 2050,the number of individuals aged 60 and above requiring orthopedic interventions is projected to exceed 2.1 billion,with osteoporosis alone affecting 200 million people globally.
文摘Artificial intelligence(AI)can help in diagnosing fractures and demonstrating effusions,dislocations,and focal bone lesions in both adult and pediatric aged individuals and also aid in early tumor discovery(bone osteosarcoma)and in robot-assisted surgery.A recent AI model[Mask R-CNN(region-based convolutional neural network)]has shown to be dependable for detecting surgical target zones in pediatric hip and periarticular infections,offering a more convenient and quicker alternative to conventional methods.It can help inexperienced physicians in pre-treatment evaluations,diminishing the risk of missed diagnosis and misdiagnosis.AI has some very interesting applications in orthopedic surgery,which orthopedic surgeons should be aware of and if possible use.Although some interesting advances have been made recently on AI in orthopedic surgery,its usefulness in clinical practice is still very limited.Ethical concerns,such as transparency in AI decision-making,data privacy,and the potential loss of human intuition cannot be forgotten.Besides,it is paramount to explore how to gain trust from both healthcare professionals and patients in the utilization of AI.
文摘BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.
文摘This narrative review evaluated the potential of nanotechnology platforms(DepoFoam bupivacaine^(R),DepoDur^(R),Exparel^(R),Zynrelef^(R),NeuroCuple™)in the control of postoperative pain following orthopedic procedures.In individuals experiencing bunionectomy DepoFoam bupivacaine^(R)120 mg and placebo via wound infiltration before wound closure was compared.The area under the curve for numeric rating scale scores was substantially less in individuals treated with DepoFoam bupivacaine^(R)vs individuals receiving placebo at 24 h and 36 h.In individuals undergoing total hip arthroplasty,a single dose of 15 mg,20 mg,or 25 mg DepoDur^(R)[extended-release epidural morphine(EREM)]and placebo were compared.All EREM dosages diminished the mean fentanyl usage vs placebo and delayed the median time to first dose of fentanyl.All EREM cohorts had substantially improved pain control at rest for up to 48 h post-surgery compared with placebo.No supplementary analgesia was required in 25%of individuals treated with EREM and 2%of individuals treated with placebo at 48 h.In individuals undergoing total knee arthroplasty,iPACK(local anesthetic infiltration of the interspace between the popliteal artery and the posterior knee capsule)adductor canal block was compared to adductor canal block with Exparel^(R).Individuals in the Exparel^(R)cohort experienced an improvement in numeric rating scale pain scores at all postsurgical time points.These individuals also utilized a lower dose of inpatient opioids.In individuals undergoing bunionectomy a single intraoperative dose of Zynrelef^(R)prolonged release(PR)was compared to bupivacaine HCl 0.5%via wound infiltration before wound closure.Zynrelef^(R)PR diminished pain intensity by 18%compared with bupivacaine HCl.Opioid consumption was reduced by 37%in the Zynrelef^(R)PR cohort vs 25%in the bupivacaine HCl cohort.In individuals experiencing total knee arthroplasty and total hip arthroplasty,the use of a nanotechnology-based NeuroCuple^(TM)device diminished postoperative pain at rest by 34%and reduced pain with movement by 18%.
基金Supported by the Hubei Provincial Natural Science Foundation,No.2025AFB845Graduate Innovation and Entrepreneurship Fund of Wuhan University of Science and Technology,No.JCX2024044.
文摘Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse populations depends on rigorous processes of translation,cultural adaptation,and validation.AlMousa et al successfully validated the Arabic version of the American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire,demonstrating strong reliability and clinical applicability for Arabic-speaking patients with traumatic foot and ankle injuries.This article highlights the vital role of culturally adapted PROMs in expanding the global scope of orthopedic research,enhancing patient-centered care,and promoting international collaboration.By addressing linguistic and cultural barriers,such adaptations support a more comprehensive and inclusive approach to evidence-based medicine.Future research should aim to optimize the integration of adapted PROMs into clinical practice,evaluate their influences on treatment decision-making,and investigate their functions in largescale multicenter studies to further globally advance orthopedic research.
文摘BACKGROUND In 2017,our institution implemented a high efficiency(HE)pathway for lower limb orthopedic surgery.The employed strategy included patient selection,surgical instrument standardization,preoperative surgical nerve blocks,avoidance of general anesthesia and bypassing phase one recovery.We conducted a historic cohort study whose primary outcome was the postoperative recovery time between the HE and traditional(T)pathway.AIM To determine whether the implementation of a HE pathway was correlated with a reduction in postoperative recovery time.METHODS Patients who had unilateral elective lower limb orthopedic procedures through the T and HE pathway were screened between 2017 to 2019.Patients were at least 18 years old,and American Society of Anesthesiologists(ASA)Physical Status I to III without major systemic comorbidities were included.Propensity score was generated using multivariable regression taking age,body mass index,sex,ASA class and surgical type as covariates using nearest neighbour methods between the two pathways.Mann Whitney U test were used to analyzed total postoperative time.RESULTS There was an associated reduction in total postoperative recovery time of 63 minutes(95%CI:-69 to-57)in the HE group.The operating room time and total length of stay also had an associated decrease of 20 minutes(95%CI:-23 to-17)and 84 minutes(95%CI:-92 to-75)respectively.CONCLUSION Utilizing multifaceted strategies to improve perioperative efficiency was associated with a reduction in the postoperative recovery time in our retrospective study.This model can be a potential strategy to deal with surgical backlog in the face of ongoing human resource challenges.
基金Youth Project of Inner Mongolia Medical University in 2022(YKD2022QN020)。
文摘The Health Action Process Approach(HAPA),developed by German psychologist Schwarzer in the 1980s,provides a comprehensive framework for understanding and influencing health behavior change.By dividing behavior change into three dynamic stages-pre-intention,intention,and action-HAPA highlights the critical role of self-efficacy as a driving force in adopting healthier behaviors.This stage-based approach addresses the limitations of continuous health behavior models by emphasizing individual differentiation and recognizing that behavior change is not linear but progresses through distinct phases.HAPA theory has demonstrated significant potential in clinical applications,particularly in orthopedic postoperative patients.Its implementation facilitates the development of positive behavioral intentions,enhances self-efficacy,and supports sustained health action,ultimately improving patients’health outcomes and quality of life.Tailored interventions based on HAPA stages ensure that patients receive appropriate guidance and support throughout their recovery journey.Despite its successes,limitations remain.Future research should focus on expanding the application of HAPA to various orthopedic conditions and developing more targeted behavioral plans and health education programs to optimize patient rehabilitation.Additionally,further exploration is needed to sustain HAPA’s effectiveness during long-term recovery.Strengthening interdisciplinary collaboration and integrating HAPA with other theoretical models could create a more comprehensive health behavior education system,providing robust support for orthopedic patients and advancing their overall recovery and well-being.
基金supported by the National Key R&D Program of China(2023YFC3603400)the National Natural Science Foundation of China(82072506,92268115)+2 种基金the Hunan Provincial Science Fund for Distinguished Young Scholars(2024JJ2089)the Science and Technology Innovation Program of Hunan Province(2021RC3025)the National Clinical Research Center for Geriatric Disorders(Xiangya Hospital,2021KF02).
文摘Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult tissue repair processes.Aberrant FGF signal transduction is associated with various pathological conditions such as cartilage damage,bone loss,muscle reduction,and other core pathological changes observed in orthopedic degenerative diseases like osteoarthritis(OA),intervertebral disc degeneration(IVDD),osteoporosis(OP),and sarcopenia.In OA and IVDD pathologies specifically,FGF1,FGF2,FGF8,FGF9,FGF18,FGF21,and FGF23 regulate the synthesis,catabolism,and ossification of cartilage tissue.Additionally,the dysregulation of FGFR expression(FGFR1 and FGFR3)promotes the pathological process of cartilage degradation.In OP and sarcopenia,endocrine-derived FGFs(FGF19,FGF21,and FGF23)modulate bone mineral synthesis and decomposition as well as muscle tissues.FGF2 and other FGFs also exert regulatory roles.A growing body of research has focused on understanding the implications of FGF signaling in orthopedic degeneration.Moreover,an increasing number of potential targets within the FGF signaling have been identified,such as FGF9,FGF18,and FGF23.However,it should be noted that most of these discoveries are still in the experimental stage,and further studies are needed before clinical application can be considered.Presently,this review aims to document the association between the FGF signaling pathway and the development and progression of orthopedic diseases.Besides,current therapeutic strategies targeting the FGF signaling pathway to prevent and treat orthopedic degeneration will be evaluated.
文摘Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.
文摘BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.
文摘Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized treatment.These challenges not only impact treatment outcomes but also severely impact patients’daily lives.Layer-by-Layer(LbL)serves as a simple surface coating technique,in simple terms,to functionalize implants by sequentially adsorbing oppositely charged materials onto a substrate.In orthopaedics,LbL self-assembly technology solves some of the challenges by loading various drugs or biological agents on the implant surface and controlling their release precisely to the site of bone defects in a personalized way.This review will introduce the basic principle and the development of LbL in orthopaedics,review and analyze the chemical strategy of LbL in the preparation of bone implants to ensure the stability of the implant,and introduce the use of LbL bone implants in orthopaedics in recent years.The application of LbL includes the realization of programmed drug delivery and sustained release,thereby promoting osseointegration and the formation of new blood vessels,antibacterial,antioxidant,etc.This review focuses on the LbL technology,involving the technology selection for the preparation of bone implants,the chemical strategies of the stability guarantee of LbL implants,the pharmacological properties,loading and release mechanisms of loaded drugs,and the molecular mechanisms of osteogenesis and angiogenesis.The aim of this review is to provide an overview of current research advances,and a prospect in this field was also described.
文摘BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervision.It is an emerging tool in pediatric orthopedic surgery,with various promising applications.An evaluation of the current awareness and perceptions among pediatric orthopedic surgeons is necessary to facilitate AI utilization and highlight possible areas of concern.AIM To assess the awareness and perceptions of AI among pediatric orthopedic surgeons.METHODS This cross-sectional observational study was conducted using a structured questionnaire designed using QuestionPro online survey software to collect quantitative and qualitative data.One hundred and twenty-eight pediatric orthopedic surgeons affiliated with two groups:Pediatric Orthopedic Chapter of Saudi Orthopedics Association and Middle East Pediatric Orthopedic Society in Gulf Cooperation Council Countries were surveyed.RESULTS The pediatric orthopedic surgeons surveyed had a low level of familiarity with AI,with more than 60%of respondents rating themselves as being slightly familiar or not at all familiar.The most positively rated aspect of AI applications for pediatric orthopedic surgery was their ability to save time and enhance productivity,with 61.97%agreeing or strongly agreeing,and only 4.23%disagreeing or strongly disagreeing.Our participants also placed a high priority on patient privacy and data security,with over 90%rating them as quite important or highly important.Additional bivariate analyses suggested that physicians with a higher awareness of AI also have a more positive perception.CONCLUSION Our study highlights a lack of familiarity among pediatric orthopedic surgeons towards AI,and suggests a need for enhanced education and regulatory frameworks to ensure the safe adoption of AI.
基金performed under contracts no.46N/2019-project no.PN19310102/2019 and 30PFE/2018 between the National Institute for Research and Development in Electrical Engineering ICPE-CA and the Romanian Ministry of Research and Innovation
文摘The last decade has seen a significant growth in the market for alloys used for implants,especially for those intended for orthopedic implants.Research into biodegradable magnesium-based alloys has made great strides in this period,so huge progress has been made in their use in the medical industry.The important factors that led to the intensification of research in this regard,were social but also economic,wanting to improve the quality of life,by reducing the use of conventionally permanent metallic implants(stainless steel,cobalt-based alloys,and titanium alloys)which involve the second implant removal surgery and other undesirable effects(stress shielding and metal ion releases),with a negative impact on the emotional and physical condition of patients,and by significantly reducing the costs for both the patient and the health system in the field of orthopedics.This paper refers to the impact and importance of biodegradable Mg alloys,reviewing the beginning of their development,the significant characteristics that make them so desirable for such applications(orthopedic implants)but also the characteristics that must be modulated(corrosion rate and mechanical properties)to arrive at the ideal product for the targeted application.It highlights,in detail,the mechanism and aspects related to the corrosion behaviour of Mg alloys,electrochemical characterization techniques/methods,as well as strategies to improve the corrosion behaviour and mechanical properties of these types of biodegradable alloys.The means of optimization,the category and the effect of the alloying elements,the design criteria,the requirements that the implants of biodegradable alloys Mg-based must meet and the aspects related to their efficiency are also presented.Finally,the potential applications in the specialized clinics,as well as the final products currently used and made by important prestigious companies in the world are approached.
文摘Magnesium(Mg)and its alloys have been widely researched for orthopedic applications recently.Mg alloys have stupendous advantages over the commercially available stainless steel,Co-Cr-Ni alloy and titanium implants.Till date,extensive mechanical,in-vitro and in-vivo studies have been done to improve the biomedical performance of Mg alloys through alloying,processing conditions,surface modification etc.This review comprehensively describes the strategies for improving the mechanical and degradation performance of Mg alloys through properly tailoring the composition of alloying elements,reinforcements and processing techniques.It also highlights the status and progress of research in to(i)the selection of nutrient elements for alloying,reinforcement and its effects(ii)type of Mg alloy system(binary,ternary and quaternary)and composites(iii)grain refinement for strengthening through severe plastic deformation techniques.Furthermore it also emphasizes on the importance of Mg composites with regard to hard tissue applications.
基金supported in part by Scientific Research Fund of Hainan Provincial Health Department(No.2010-83)
文摘Objective:To explore the effect of ulinastatin(UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.Methods:Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion(Uc) group,ulinastatin single injection(Us) group and control(C) group.All patients received patient-controlled intravenous analgesia(PCIA) after operation,and took Rivaroxaban 10 mg orally 12 hours after operation.Ulinastatin(5 000 U/kg)was given intravenously to both Uc and Us groups preoperatively.Group C was given isometric normal saline,group Uc was pumped UTI continuous intravenously at the end of surgery(10 000U/kg) to 48 hours through PCIA pump.The values of hematocrit(HCT),thrombomodulin(TM),Interleukin(IL-6),thrombin-antithrombin complex(TAT),D-Dimer(D-D) were normally tested before surgery(T1),at the end of the surgery(T2),12 hours(T3).24 hours(T4) and 48 hours(T5)after surgery.Results:Compared with T1,there was an upward tendency in TM,IL-6,TAT,and D-D after operation in group C group(P <0.05).The values of them were significandy increased from nearly 24-hour after surgery in Us group(P<0.05).In group Uc.there were no significant changes in these indices after operation(P>0.05).Conclusions:During the perioperative period,ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.
基金The authors would like to thank the Helmholtz-Zentrum Geesthacht and Fesil Company(Germany)for the alloys syn-thesis and casting.
文摘Mg-Ca alloys have recently attracted great attention towards the research in the field of orthopedic biodegradable implants.This study presents an in vitro degradation assessment of Mg-0.8Ca(0.8 wt.%of Ca)alloy in Hank’s balanced salt solution(HBSS).Immersion,hydrogen evolution and electrochemical behavior was studied as well as the cytotoxicity of the degradation products.Morphology and phase composition of the corrosion products were studied using SEM,EDX and XRD techniques.Degradation in HBSS resulted in the formation of the needle-shaped carbonated hydroxyapatite which was similar to the biological apatite in the human bone.Degradation kinetics showed that Mg-0.8Ca alloy had approximately 3-fold faster degradation rate than the pure Mg(1.08±0.38 mm/year for Mg-0.8Ca and 0.35±0.17 mm/year for pure Mg),as observed in two independent experiments.Both,pure Mg and Mg-0.8Ca alloy were biocompatible,generating no cytotoxic degradation products against human-derived HEK 293 cells.Thus,the Mg-0.8Ca alloy was found to be a promising biodegradable implant in terms of bioactivity and compatibility with human cell lines.Depending on the application of the implant and the estimated healing time of the bone,the desired degradation rate of an implant can be controlled by the Mg-Ca composition of such alloys.
基金Supported by A grant from Takeda Pharmaceuticals North America,Inc
文摘AIM: To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids.
文摘The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy(HA) in patients with deficiency of coagulation factor Ⅷ or Ⅸ and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems.Lifelong factor replacement therapy(FRT) is optimal to prevent HA,however adherence to this regerous treatment is challenging leading to breakthrough bleeding.In patients with chronic hemophilic synovitis,the prelude to HA,radiosynovectomy(RS) is the optimal to ameliorate bleeding.Surgery in people with hemophilia(PWH) is associated with a high risk of bleeding and infection,and must be performed with FRT.A coordinated effort including orthopedic surgeons,hematologists,physical medicine and rehabilitation physicians,physiotherapists and other team members is key to optimal outcomes.Ideally,orthopedic procedures should be performed in specialized hospitals with experienced teams.Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures(arthrocentesis,RS,arthroscopic synovectomy,hamstring release,arthroscopic debridement,alignment osteotomy,and total knee arthroplasty).By using the aforementioned procedures,the quality of life of PWH will be improved.
