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Sample records for manipulation orthopedic

  1. Orthopedic services

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007455.htm Orthopedic services To use the sharing features on this page, please enable JavaScript. Orthopedics, or orthopedic services, is the medical specialty that involves the treatment ...

  2. Orthopedic surgery.

    PubMed

    Gehrig, Laura M B

    2011-09-01

    Orthopedic surgery is a specialty of surgery dedicated to the prevention, diagnosis, and treatment of diseases and injuries of the musculoskeletal system in all age groups. Careers in orthopedic surgery span the spectrum from general orthopedics to those of subspecialty expertise in orthopedic trauma, hand, pediatrics, total joint, foot and ankle, sports medicine, and oncology to name a few. PMID:21871990

  3. Orthopedic services

    MedlinePlus

    ... foot: Bunions Fasciitis Foot and ankle deformities Fractures Hammer toe Heel pain Heel spurs Joint pain and ... of orthopedics include: Amputation Arthroscopic surgeries Bunionectomy and hammer toe repair Cartilage repair or resurfacing procedures Cartilage ...

  4. Orthopedic evaluation

    NASA Technical Reports Server (NTRS)

    Walden, T.

    1978-01-01

    The clinical performance of the Lixiscope in orthopedics was compared with routine radiography. Portability and size were the major advantages of the Lixiscope. The main disadvantage at this point in time was the Lixiscope's inability to study large areas.

  5. Medical Issues: Orthopedics

    MedlinePlus

    ... support & care > living with sma > medical issues > orthopedics Orthopedics In SMA, muscle weakness can cause several complications. ... difficulty sitting, standing, or performing normal daily activities. Orthopedic Considerations Doctors and therapists classify individuals with SMA ...

  6. Orthopedic aspects of separation.

    PubMed

    Jones, David

    2015-10-01

    In the management of conjoined twins the orthopedic surgeon may be involved directly, as part of the surgical team at operation or indirectly, in dealing with associated anomalies or the sequelae of surgery. The overwhelming indication for orthopedic involvement is ischiopagus, either tripus or tetrapus. The main role of the orthopedic surgeon is to facilitate midline closure through the use of pelvic osteotomies, which allow the symphysis pubis to be approximated. PMID:26382266

  7. Orthopedic Prosthetic Infections: Diagnosis and Orthopedic Salvage.

    PubMed

    Kaufman, Matthew G; Meaike, Jesse D; Izaddoost, Shayan A

    2016-05-01

    Orthopedic hardware infections are much feared and costly complications that can occur when these devices are implemented both in traumatic cases as well as in joint replacement surgery. Because these infections can lead to great morbidity, it is important to understand their pathophysiology as well as the principles behind their diagnosis and initial treatment. Plastic surgeons are frequently consulted as part of a multidisciplinary team to provide stable soft tissue coverage of the associated defects that result from these infections. A review of the existing literature was performed to identify the potential causes of these infections, to provide established diagnostic criteria guidelines, and to explain how these prosthetic infections are managed from an orthopedic surgery perspective prior to consulting the plastic surgery team. PMID:27152098

  8. [Orthopedic shoe treatment : Inserts].

    PubMed

    Schuh, R; Windhager, R

    2016-03-01

    The use of inserts and orthopedic shoe adjustment represents an essential component of the conservative therapy of degenerative diseases and deformities of the musculoskeletal system. Inserts can have supportive, bedding and corrective effects and are used in particular for complaints of the feet and ankles. The combination of diverse materials allows a high level of cushioning and supporting features and corresponding longevity to be accomplished. The production is carried out on an individual basis and if necessary computer-assisted in order to achieve an optimal fit. For severe and rigid deformities the formation of pressure ulcers can be prevented by orthopedic shoe adjustment and by the use of orthopedic tailor-made shoes. PMID:26861757

  9. Lasers in orthopedics

    NASA Astrophysics Data System (ADS)

    Sherk, Henry H.; Rhodes, Anthony L.; Meller, Menachem M.

    1990-06-01

    Orthopedic Surgery is that surgical discipline which deals with the musculoskeletal system. Orthopedists therefore operate on joints, the spine and long bones and engage in such subsecialities as sports medicine, hand surgery, trauma surgery, and joint replacements. Since they must cut and shape bone, cartilage, tendon, and ligament, orthopedists have developed a number of mechanical techniques to achieve these ends and surgical lasers have found few applications in orthopedics because until now they have not been useful for cutting bone. In the past several years, however, there has been considerable interest in several areas within the field of orthopedic surgery that do not entail actual bone surgery and it is expected that as newer and more powerful lasers become available laser osteotomy may become feasible and even routine.

  10. Sarcopenia in Orthopedic Surgery.

    PubMed

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients. PMID:26913764

  11. Tissue bioengineering in orthopedics.

    PubMed

    Hernigou, Philippe; Homma, Yasuhiro

    2012-01-01

    The use of cells for the purpose of orthopedic tissue engineering started more than 300 years ago. The first attempt of bone grafting was reported in 1668 by the Dutch surgeon Job-Van Meek'ren. In 1867, Ollier performed a series of experiments using transplanted periosteum and concluded that transplanted periosteum and bone remained alive and formed new bone. The osteogenic potential of transplanted bone marrow was later documented by Goujon in 1869, then by Macewen in 1881. Efforts of Albee and Phemister highlighted further the utility of bone transplantation for the healing of fractures and bone defects. The techniques for autografting pioneered by these individuals remained largely unchanged until today. Advances in understanding of the biology of osteogenic cells, the availability of many highly purified peptide growth factors, and the capacity to create highly specialized implantable materials have launched an explosion of new advances in bone grafting and bone regeneration, all under the banner of tissue engineering. This new field is rapidly expanding the armamentarium of orthopedic surgeons in every setting in which bone healing is required. Composites of cells and matrices are at the core of this revolution. PMID:22783330

  12. Orthopedic Injury in Pregnancy.

    PubMed

    Gross, Gilad A; George, James W

    2016-09-01

    There are many reasons why a woman's pregnancy can put her at risk for orthopedic pain and injury. Given the high percentage of pregnant patients experiencing some degree of musculoskeletal pain, it is surprising that this is not an area of wider study. This chapter takes an evidence based approach to help the reader understand the implications of the numerous anatomic and physiologic changes associated with the gravid state, and how they act to promote both discomfort and injury. One-third of pregnant women in America are obese, further increasing risk. Exercise in most pregnancies is recommended and regarded as safe and thus obstetric care providers need to understand risk, diagnostic techniques and treatments. PMID:27403586

  13. Orthopedic prosthesis fixation.

    PubMed

    Park, J B

    1992-01-01

    The fixation of orthopedic implants has been one of the most difficult and challenging problems. The fixation can be achieved via: (a) direct mechanical fixation using screws, pins, wires, etc.; (b) passive or interference mechanical fixation where the implants are allowed to move or merely positioned onto the tissue surfaces; (c) bone cement fixation which is actually a grouting material; (d) biological fixation by allowing tissues to grow into the interstices of pores or textured surfaces of implants; (e) direct chemical bonding between implant and tissues; or (f) any combination of the above techniques. This article is concerned with various fixation techniques including the potential use of electrical, pulsed electromagnetic field, chemical stimulation using calcium phosphates for the enhancement of tissue ingrowth, direct bonding with bone by glass-ceramics and resorbable particle impregnated bone cement to take advantages of both the immediate fixation offered by the bone cement and long term fixation due to tissue ingrowth. PMID:1449228

  14. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  15. Commonly missed orthopedic problems.

    PubMed

    Ballas, M T; Tytko, J; Mannarino, F

    1998-01-15

    When not diagnosed early and managed appropriately, common musculoskeletal injuries may result in long-term disabling conditions. Anterior cruciate ligament tears are some of the most common knee ligament injuries. Slipped capital femoral epiphysis may present with little or no hip pain, and subtle or absent physical and radiographic findings. Femoral neck stress fractures, if left untreated, may result in avascular necrosis, refractures and pseudoarthrosis. A delay in diagnosis of scaphoid fractures may cause early wrist arthrosis if nonunion results. Ulnar collateral ligament tears are a frequently overlooked injury in skiers. The diagnosis of Achilles tendon rupture is missed as often as 25 percent of the time. Posterior tibial tendon tears may result in fixed bony planus if diagnosis is delayed, necessitating hindfoot fusion rather than simple soft tissue repair. Family physicians should be familiar with the initial assessment of these conditions and, when appropriate, refer patients promptly to an orthopedic surgeon. PMID:9456991

  16. Roentgen Stereophotogrammetry In Orthopedics

    NASA Astrophysics Data System (ADS)

    Selvik, Goran

    1983-07-01

    A system for roentgen stereophotogrammetry has been used in Lund, Sweden, since August 1972 and by August 1982 ten thousand stereo films have been evaluated using this method. Patient investigations started March 1973 and of the more than 500 patients investigated 300 have been referred by orthopedic surgeons. The skeletal parts investigated had been permanently marked with tantalum balls 0.5 or 0.8 mm in diameter. The causes for the investigation have been bone growth disorders in the Lower extremity (134 patients), spinal fusions (35 patients), high tibial osteotomies for gonarthrosis (21 patients) and endoprosthetic replacement of the knee (68 patients) or hip (42 patients) joint. By the roentgen stereophotogrammetric analysis (RSA), information on for instance the development of angular deformities and staple loosening in the leg, the healing process of the intended fusion in the spine or at the knee, and on the migration and stability of prosthetic components have been obtained. RSA is of value both for prognostic and followup purposes, and is versatile enough in proper setting to be used as a routine clinical investigation.

  17. Plasma Biomedicine in Orthopedics

    NASA Astrophysics Data System (ADS)

    Hamaguchi, Satsohi

    2012-10-01

    Various effects of plasmas irradiation on cells, tissues, and biomaterials relevant for orthopedic applications have been examined. For direct application of plasmas to living cells or tissues, dielectric barrier discharges (DBDs) with helium flows into ambient air were used. For biomaterial processing, on the other hand, either helium DBDs mentioned above or low-pressure discharges generated in a chamber were used. In this presentation, plasma effects on cell proliferation and plasma treatment for artificial bones will be discussed. First, the conditions for enhanced cell proliferation in vitro by plasma applications have been examined. The discharge conditions for cell proliferation depend sensitively on cell types. Since cell proliferation can be enhanced even when the cells are cultured in a plasma pre-treated medium, long-life reactive species generated in the medium by plasma application or large molecules (such as proteins) in the medium modified by the plasma are likely to be the cause of cell proliferation. It has been found that there is strong correlation between (organic) hydroperoxide generation and cell proliferation. Second, effects of plasma-treated artificial bones made of porous hydroxyapatite (HA) have been examined in vitro and vivo. It has been found that plasma treatment increases hydrophilicity of the surfaces of microscopic inner pores, which directly or indirectly promotes differentiation of mesenchymal stem cells introduced into the pores and therefore causes faster bone growth. The work has been performed in collaboration with Prof. H. Yoshikawa and his group members at the School of Medicine, Osaka University.

  18. Medical photography: principles for orthopedics

    PubMed Central

    2014-01-01

    Background Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. Results In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Conclusions Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established. PMID:24708703

  19. Moral Dilemmas in Pediatric Orthopedics.

    PubMed

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. PMID:26652336

  20. [The beginnings of orthopedic surgery in Israel].

    PubMed

    Tauber, Chanan

    2013-08-01

    In early mandatory Israel, orthopedics was mainly conservative, The first modern orthopedic surgeon was Ernst Spira from Czechoslovakia who established an orthopedic service at the Beilinson Hospital in Petah Tikva and left in 1948 to establish the Orthopedic Department and the Rehabilitation Center in Tel Hashomer, which treated the War of Independence casualties including amputees and victims of spinal cord injuries. A second orthopedic department was opened in Tel Hashomer by Shmuel Weissman who left in 1961 to open the Orthopedic Department at the Ichilov hospital in Tel Aviv. Shmuel Weissman became the first Chairman of Orthopedic Surgery at the Tel Aviv University medical school. In 1955, Myer Makin opened a modern orthopedic department in the Hadassah Hospital in Jerusalem and the Alyn Hospital for crippled children. In 1951, Assaf Harofeh Hospital opened the Department of Orthopedic Surgery headed by Anatol Axer who specialized in the treatment and rehabilitation of polio patients. The majority of the second generation of orthopedic department directors was trained by these four surgeons. Major developments in the 1960s and 1970s were the introduction of the AO system revolutionizing fracture treatment from conservative to operative treatment, the advent of total hip and knee replacements, Harrington instrumentation in spinal surgery and arthroscopy were major advances in orthopedic patient care brought to Israel by the aforementioned second generation of orthopedic surgeons. Hand surgery became an independent subspecialty of orthopedics and was lead by the internationally renowned hand surgeon, Isidore Kessler. PMID:24167938

  1. Growth factors in orthopedic surgery

    PubMed Central

    Zaharia, C; Despa, N; Simionescu, M; Jinga, V; Fleseriu, I

    2010-01-01

    Growth factors have represented an essential issue of interest for the researchers and clinicians in orthopedics and trauma over the last 40 years. In the last 10 to 15 years, the advances registered in this field have permitted the identification of the most active cellular and humoral factors as well as the improvement of their use in the orthopedic and trauma surgery. Their domain of application has been continuously enlarged and the results have been visible from the beginning. The authors present their appreciation on the actual state of this subject as well as their experience with results and related conclusions. PMID:20302195

  2. A robot-assisted orthopedic telesurgery system.

    PubMed

    Kong, M; Du, Z; Sun, L; Fu, L; Jia, Z; Wu, D

    2005-01-01

    A robot-assisted orthopedic telesurgery system, named HIT-RAOTS, has been developed according to Chinese conventional operation method. Its main function includes obtaining images with information of position and orientation of fracture, providing fracture information for doctors, assisting the doctors to complete the reposition of fracture and locking operation of intramedullary nail. In this system, a 6-dof force-reflecting master device, with a pantographic parallelogram mechanisms driven by harmonic DC servomotors, is used to control the slave manipulator movement and to translate the force from the operating room to the surgeon console; A slave robot system integrated a 6-dof force sensor, with a parallel manipulator actuated by six AC servomotors, is applied for the accurate repositioning; A virtual simulation system and human-machine interface are also developed. PI controller based on local network is used to realize the teleoperation. Only little irradiation is issued during the reposition. It can assist surgeons to perform bone-setting more safely by reducing irradiation damage to both surgeries and patients, more easily by releasing the surgeons from the heavy operation and more perfect by improving accuracy of reposition. PMID:17282120

  3. Orthopedic Management of Spina Bifida

    ERIC Educational Resources Information Center

    Thomson, Jeffrey D.; Segal, Lee S.

    2010-01-01

    The management of orthopedic problems in spina bifida has seen a dramatic change over the past 10 years. The negative effects of spasticity, poor balance, and the tethered cord syndrome on ambulatory function are better appreciated. There is less emphasis on the hip radiograph and more emphasis on the function of the knee and the prevention of…

  4. Porous metal for orthopedics implants

    PubMed Central

    Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

    2013-01-01

    Summary Porous metal has been introduced to obtain biological fixation and improve longevity of orthopedic implants. The new generation of porous metal has intriguing characteristics that allows bone healing and high osteointegration of the metallic implants. This article gives an overview about biomaterials properties of the contemporary class of highly porous metals and about the clinical use in orthopaedic surgery. PMID:24133527

  5. FLUOROSCOPY DURATION IN ORTHOPEDIC SURGERY

    PubMed Central

    Salvia, Joao Caron La; de Moraes, Pablo Reis; Ammar, Tiago Yossef; Schwartsmann, Carlos Roberto

    2015-01-01

    Objective: To ascertain the mean length of radiation emission from fluoroscopic devices during several types of orthopedic surgery and which of these required greater use of radiation. Methods: The times taken to perform sixteen different types of surgery (total of 80 procedures) were measured. At the end of each procedure, the length of time for which fluoroscopy was used directly from the image intensifier was ascertained. Results: The mean time required for fluoroscopy per operation was 61 seconds. The procedures that demanded greatest mean duration of radiation use were bilateral proximal femoral epiphysiodesis (5.1 minutes) and femoral shaft osteosynthesis using a locked intramedullary nail (3.33 min). Conclusion: The mean duration of fluoroscopy use in orthopedic operations was 61 seconds. The procedures using an intramedullary device were the ones that required greatest radiation emission. PMID:27027000

  6. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.]. PMID:27322172

  7. Locking mechanism for orthopedic braces

    NASA Technical Reports Server (NTRS)

    Chao, J. I.; Epps, C. H., Jr.

    1981-01-01

    An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

  8. Locking mechanism for orthopedic braces

    NASA Technical Reports Server (NTRS)

    I-Lechao, J.; Epps, C. H., Jr. (Inventor)

    1976-01-01

    A locking mechanism for orthopedic braces is described which automatically prevents or permits the relative pivotable movement between a lower brace member and an upper brace member. The upper and lower brace members are provided with drilled bores within which a slidable pin is disposed, and depending upon the inclination of the brace members with respect to a vertical plane, the slidable pin will be interposed between both brace members. The secondary or auxiliary latching device includes a spring biased, manually operable lever bar arrangement which is manually unlatched and automatically latched under the influence of the spring.

  9. Thromboembolic Disease After Orthopedic Trauma.

    PubMed

    Whiting, Paul S; Jahangir, A Alex

    2016-04-01

    Orthopedic trauma results in systemic physiologic changes that predispose patients to venous thromboembolism (VTE). In the absence of prophylaxis, VTE incidence may be as high as 60%. Mechanical and pharmacologic thromboprophylaxis are effective in decreasing rates of VTE. Combined mechanical and pharmacologic thromboprophylaxis is more efficacious for decreasing VTE incidence than either regimen independently. If pharmacologic thromboprophylaxis is contraindicated, mechanical prophylaxis should be used. Patients with isolated lower extremity fractures who are ambulatory, or those with isolated upper extremity trauma, do not require pharmacologic prophylaxis in the absence of other VTE risk factors. PMID:26772942

  10. Orthopedics

    SciTech Connect

    Stoker, D.J.; Tilley, E.A.

    1988-01-01

    This book presents a method of assessing a variety of entities with pathologic impact on the skeleton. The book covers 97 skeletal abnormalities or diseases. Each case is presented as a question (consisting of a radiography followed by a short clinical history and a query such as What is the abnormality '') followed by an answer (consisting of additional radiographs, an explanation of the radiographic abnormality and causative disease process, and one or two references).

  11. Orthopedic surgery in ancient Egypt

    PubMed Central

    Blomstedt, Patric

    2014-01-01

    Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentrating especially on orthopedic surgery. Results — As is well known, both literary sources and the archaeological/osteological material bear witness to treatment of various fractures. The Egyptian painting, often claimed to depict the reduction of a dislocated shoulder according to Kocher’s method, is, however, open to interpretation. Therapeutic amputations are never depicted or mentioned in the literary sources, while the specimens suggested to demonstrate such amputations are not convincing. Interpretation — The ancient Egyptians certainly treated fractures of various kinds, and with varying degrees of success. Concerning the reductions of dislocated joints and therapeutic amputations, there is no clear evidence for the existence of such procedures. It would, however, be surprising if dislocations were not treated, even though they have not left traces in the surviving sources. Concerning amputations, the general level of Egyptian surgery makes it unlikely that limb amputations were done, even if they may possibly have been performed under extraordinary circumstances. PMID:25140982

  12. Strategies for achieving orthopedic service line success.

    PubMed

    Lang, Stacey; Powers, Kristi

    2013-12-01

    Healthcare finance leaders can work with orthopedic surgeons to support better outcomes, clinically and financially, by: Establishing innovative partnerships among hospital leaders, orthopedic surgeons, and implant vendors. Developing and enforcing expectations around contracting and vendor behavior. Establishing a forum for open communication. Building a bundled payment structure. Finding ways to differentiate from the competition. PMID:24380256

  13. Using Aerospace Technology To Design Orthopedic Implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  14. Sawbones laboratory in orthopedic surgical training

    PubMed Central

    Hetaimish, Bandar M.

    2016-01-01

    Sawbones are artificial bones designed to simulate the bone architecture, as well as the bone’s physical properties. The incorporation of sawbones simulation laboratories in many orthopedic training programs has provided the residents with flexibility in learning and scheduling that align with their working hour limitations. This review paper deliberates the organization of sawbones simulation in orthopedic surgical training to enhance trainee’s future learning. In addition, it explores the implications of sawbones simulation in orthopedic surgical teaching and evaluation. It scrutinizes the suitability of practicing on sawbones at the simulation laboratory to improve orthopedic trainee’s learning. This will be followed with recommendations for future enhancement of sawbones simulation-based learning in orthopedic surgical training. PMID:27052276

  15. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction. PMID:16875525

  16. [Tranexamic acid in orthopedic surgery].

    PubMed

    Aguilera-Roig, X; Jordán-Sales, M; Natera-Cisneros, L; Monllau-García, J C; Martínez-Zapata, M J

    2014-01-01

    Perioperative bleeding may require blood transfusions, which are sometimes not without complications and risks, with the subsequent increase in health care costs. Among other prevention methods, treatment with tranexamic acid (ATX) has shown to be effective in reducing surgical blood loss, especially in the immediate postoperative period. In this regard, studies evaluating ATX in orthopedic surgery show that it is effective and safe when administered intravenously or intra-articularly. The usual evaluated intravenous doses range between 10mg/Kg and 20mg/kg or a fixed dose of 1g to 2g; while intra-articularly, it varies between 250 mg and 3g. ATX, as an anti-fibrinolytic has a potential thrombotic effect, thus it is contraindicated in those patients at risk or with a history of thrombosis. Its topical administration may be safer, but studies are needed to confirm this. PMID:24126146

  17. Orthopedic Prosthetic Infections: Plastic Surgery Management.

    PubMed

    Meaike, Jesse D; Kaufman, Matthew G; Izaddoost, Shayan A

    2016-05-01

    Orthopedic prosthetic infections are potentially devastating complications. Plastic surgeons are frequently consulted to aid in the management of the soft tissue defects that are created by these infections. A review of the existing literature was performed to identify established treatment methods for soft tissue coverage of orthopedic hardware infections for a variety of anatomic locations. The following treatment guidelines and soft tissue reconstructive options were identified as viable options for the management of exposed or infected orthopedic hardware. This review provides descriptions of the various soft tissue reconstructive options available as well as adjunctive treatment methods. PMID:27152099

  18. Physical modification of polyetheretherketone for orthopedic implants

    NASA Astrophysics Data System (ADS)

    Du, Ya-Wei; Zhang, Li-Nan; Hou, Zeng-Tao; Ye, Xin; Gu, Hong-Sheng; Yan, Guo-Ping; Shang, Peng

    2014-12-01

    Polyetheretherketone (PEEK) is regarded as one of the most potential candidates for replacing current implant applications. To obtain good bone-implant interfaces, many modification methods have been developed to enable PEEK and PEEK-based composites from bio-inert to bioactive. Among them, physical methods have aroused significant attention and been widely used to modify PEEK for orthopedic implants. This review summarizes current physical modification techniques of PEEK for orthopedic applications, which include composite strategies, surface coating methods and irradiation treatments. The positive consequences of those modification methods will encourage continuing investigations and stimulate the wide range of applications of PEEK-based implants in orthopedics.

  19. 21 CFR 888.4540 - Orthopedic manual surgical instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Orthopedic manual surgical instrument. 888.4540... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4540 Orthopedic manual surgical instrument. (a) Identification. An orthopedic manual surgical instrument is a nonpowered hand-held...

  20. Antimicrobial technology in orthopedic and spinal implants

    PubMed Central

    Eltorai, Adam EM; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-01-01

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  1. Antimicrobial technology in orthopedic and spinal implants.

    PubMed

    Eltorai, Adam Em; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-06-18

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  2. Core Concepts: Orthopedic Intern Curriculum Boot Camp.

    PubMed

    Seeley, Mark A; Kazarian, Erick; King, Brandon; Biermann, Janet S; Carpenter, James E; Caird, Michelle S; Irwin, Todd A

    2016-01-01

    Orthopedic surgical interns must gain a broad array of clinical skills in a short time. However, recent changes in health care have limited resident-patient exposures. With the reported success of simulation training in the surgical literature, the American Board of Orthopaedic Surgery (ABOS) and Residency Review Committee for Orthopaedic Surgery have required that surgical simulation training be a component of the intern curricula in orthopedic surgical residencies. This study examined the short-term effectiveness of an orthopedic "intern boot camp" covering 7 of 17 simulation training concept modules published by the ABOS. Eight orthopedic post-graduate year 1 (PGY-1) residents (study group) completed a structured 3-month curriculum and were compared with 7 post-graduate year 2 (PGY-2) residents (comparison group) who had just completed their orthopedic surgical internship. Seven core skills were assessed using both task-specific and global rating scales. The PGY-1 residents demonstrated a statistically significant improvement in all 7 modules with respect to their task-specific pre-test scores: sterile technique (P=.001), wound closure (P<.001), knot tying (P=.017), casting and splinting (P<.001), arthrocentesis (P=.01), basics of internal fixation (P<.001), and compartment syndrome evaluation (P=.004). After the camp, PGY-1 and -2 scores in task-specific measures were not significantly different. A 3-month simulation-based boot camp instituted early in orthopedic internship elevated a variety of clinical skills to levels exhibited by PGY-2 residents. PMID:26730688

  3. Orthopedic issues in vascular anomalies.

    PubMed

    Spencer, Samantha A; Sorger, Joel

    2014-08-01

    Vascular malformations impact the musculoskeletal system depending on the tissue involved (skin, subcutis, muscle, cartilage, or bone), the extent of involvement, and the type of anomalous vessels (arteries, capillaries, veins, or lymphatics). These malformations can cause a multitude of musculoskeletal problems for the patient and their Orthopedic Surgeon to manage. Leg-length discrepancy, intra-articular involvement, muscular lesions, and primary or secondary scoliosis are just to name a few. All of these problems can cause pain, deformity, and a range of functional limitations. Surgical and nonsurgical treatment plans both have a role in the care of these patients. Patients with vascular malformations may also suffer from life-threatening cardiovascular and hematologic abnormalities. For those patients who undergo surgery, thromboembolic risk is elevated, wound breakdown and infection are much more common, and bleeding risk continues well into the postoperative course. Because of the complex nature of these disorders, the clinician must have a full understanding of the types of lesions, their natural history, appropriate diagnostic studies, associated medical problems, indications for treatment, and all the treatment options. For severe malformations, especially syndromes such as CLOVES and Klippel-Trenaunay syndrome, interdisciplinary team management is essential for the best outcomes. PMID:25241103

  4. Robot Manipulators

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Space Shuttle's Remote Manipulator System (Canadarm) is a 50 foot robot arm used to deploy, retrieve or repair satellites in orbit. Initial spinoff version is designed to remove, inspect and replace large components of Ontario Hydro's CANDU nuclear reactors, which supply 50 percent of Ontario Hydro's total power reduction. CANDU robot is the first of SPAR's Remote Manipulator Systems intended for remote materials handling operations in nuclear servicing, chemical processing, smelting and manufacturing. Inco Limited used remote manipulator for remote control mining equipment to enhance safety and productivity of Inco's hardrock mining operations. System not only improves safety in a hazardous operation that costs more than a score of lives annually, it also increases productivity fourfold. Remote Manipulator System Division is also manufacturing a line of industrial robots and developing additional system for nuclear servicing, mining, defense and space operations.

  5. Nanosurfaces and nanostructures for artificial orthopedic implants.

    PubMed

    Streicher, Robert M; Schmidt, Martin; Fiorito, Silvana

    2007-12-01

    Nanomaterials and structures, such as nanoparticles, nanofibers, nanosurfaces, nanocoatings, nanoscaffolds and nanocomposites, are considered for various applications in orthopedics and traumatology. This review looks at proposed nanotechnology inspired applications for implants from the perspective of the orthopedic industry. Investigations support consistently the theory that most nanomaterials in various physical forms are able to enhance the cell response selectively for biological tissue integration or increase the strength and wear resistance of current orthopedic materials. At this stage, most of the studies are at the laboratory scale or in early in vivo testing. Significant basic and applied research and development is needed to realize their full clinical potential and biological, manufacturing, economic and regulatory issues have to be addressed. Nevertheless, a crucial factor for success is well-coordinated multimethod and multidiscipline teamwork with profound industrial and medical expertise. PMID:18095851

  6. ORTHOPEDIC SURGERY AMONG THE ELDERLY: CLINICAL CHARACTERISTICS

    PubMed Central

    Leme, Luiz Eugênio Garcez; Sitta, Maria do Carmo; Toledo, Manuella; da Silva Henriques, Simone

    2015-01-01

    Care for elderly patients undergoing orthopedic surgery, particularly for those requiring emergency surgery, needs to take into account an analysis of physical capacity and risks specific to elderly individuals, in an attempt to reduce the risks. Nevertheless, these remain high in this group. Despite the risks, procedures developed promptly have a positive effect on these patients’ evolution. Coordinated care, composed of teams of specialists within clinical medicine, geriatrics, orthopedics, anesthesiology and critical care, along with other healthcare professionals, may be highly beneficial for this group of patients. PMID:27027017

  7. Concepts of orthopedic disorders in Avicenna's Canon of Medicine.

    PubMed

    Afshar, Ahmadreza

    2011-03-01

    This manuscript offers a brief review of the orthopedic subjects in the Canon of Medicine. Highlights include, but are not limited to, the anatomy of the musculoskeletal system, fractures and dislocations, nerve and tendon injuries, different types of wounds and ulcers, and bone infections. Some of the concepts regarding musculoskeletal disorders remain relevant to current orthopedic knowledge. Reviewing the orthopedic subjects in the Canon of Medicine reveals that Avicenna has made a significant contribution to the evolution of orthopedic knowledge. PMID:21361728

  8. Billing and coding knowledge: a comparative survey of professional coders, practicing orthopedic surgeons, and orthopedic residents.

    PubMed

    Wiley, Kevin F; Yousuf, Tariq; Pasque, Charles B; Yousuf, Khalid

    2014-06-01

    Medical knowledge and surgical skills are necessary to become an effective orthopedic surgeon. To run an efficient practice, the surgeon must also possess a basic understanding of medical business practices, including billing and coding. In this study, we surveyed and compared the level of billing and coding knowledge among current orthopedic residents PGY3 and higher, academic and private practice attending orthopedic surgeons, and orthopedic coding professionals. According to the survey results, residents and fellows have a similar knowledge of coding and billing, regardless of their level of training or type of business education received in residency. Most residents would like formal training in coding, billing, and practice management didactics; this is consistent with data from previous studies. PMID:24945481

  9. Acne mechanica due to an orthopedic crutch.

    PubMed

    Kang, Y C; Choi, E H; Hwang, S M; Lee, W S; Lee, S H; Ahn, S K

    1999-08-01

    Acne mechanica describes local irritation due to the skin being pressured, occluded, rubbed, squeezed, stretched, or heated. Examples of various physical traumas that provoke lesions in acne patients are given. Users of orthopedic crutches are at particular risk for such conditions. A crutch is another extrinsic factor to be added to the list of causes of acne mechanica. PMID:10467500

  10. Molecular imaging promotes progress in orthopedic research.

    PubMed

    Mayer-Kuckuk, Philipp; Boskey, Adele L

    2006-11-01

    Modern orthopedic research is directed towards the understanding of molecular mechanisms that determine development, maintenance and health of musculoskeletal tissues. In recent years, many genetic and proteomic discoveries have been made which necessitate investigation under physiological conditions in intact, living tissues. Molecular imaging can meet this demand and is, in fact, the only strategy currently available for noninvasive, quantitative, real-time biology studies in living subjects. In this review, techniques of molecular imaging are summarized, and applications to bone and joint biology are presented. The imaging modality most frequently used in the past was optical imaging, particularly bioluminescence and near-infrared fluorescence imaging. Alternate technologies including nuclear and magnetic resonance imaging were also employed. Orthopedic researchers have applied molecular imaging to murine models including transgenic mice to monitor gene expression, protein degradation, cell migration and cell death. Within the bone compartment, osteoblasts and their stem cells have been investigated, and the organic and mineral bone phases have been assessed. These studies addressed malignancy and injury as well as repair, including fracture healing and cell/gene therapy for skeletal defects. In the joints, molecular imaging has focused on the inflammatory and tissue destructive processes that cause arthritis. As described in this review, the feasibility of applying molecular imaging to numerous areas of orthopedic research has been demonstrated and will likely result in an increase in research dedicated to this powerful strategy. Molecular imaging holds great promise in the future for preclinical orthopedic research as well as next-generation clinical musculoskeletal diagnostics. PMID:16843078

  11. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1986-01-01

    This book discusses imaging of orthopedia trauma and surgery. A review of the pertinent anatomy, mechanism of injury, and radiology and orthopedic classification is provided for each topic discussed. The book employs recent advances in technique and focuses on adult skeletal trauma, and joint replacement.

  12. Orthopedically Handicapped Children in Ohio Public Schools.

    ERIC Educational Resources Information Center

    Naples, Victor J.; Todd, Joseph H.

    The historical development of programs for orthopedically handicapped children, class units and hospital classes approved during 1967-68, and the number of therapy units established are presented. Tables give data on program population: enrollment for years 1962-68, percent of handicaps enrolled, and IQ distributions. Aspects of occupational…

  13. Underwater manipulator

    SciTech Connect

    Schrum, P.B.; Cohen, G.H.

    1993-04-20

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is described for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer [plus minus]45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer [plus minus]10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  14. Underwater manipulator

    SciTech Connect

    Schrum, P.B.; Cohen, G.H.

    1992-12-31

    This invention is comprised of a self-contained, waterproof, water-submersible, remote-controlled apparatus provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer {plus_minus} 45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer {plus_minus} 10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  15. Underwater manipulator

    DOEpatents

    Schrum, Phillip B.; Cohen, George H.

    1993-01-01

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer .+-.45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer .+-.10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  16. Characteristics of highly successful orthopedic surgeons: a survey of orthopedic chairs and editors

    PubMed Central

    Klein, Guy; Hussain, Nasir; Sprague, Sheila; Mehlman, Charles T.; Dogbey, Godwin; Bhandari, Mohit

    2013-01-01

    Background Highly successful orthopedic surgeons are a small group of individuals who exert a large influence on the orthopedic field. However, the characteristics of these leaders have not been well-described or studied. Methods Orthopedic surgeons who are departmental chairs, journal editors, editorial board members of the Journal of Bone and Joint Surgery (British edition), or current or past presidents of major orthopedic associations were invited to complete a survey designed to provide insight into their motivations, academic backgrounds and accomplishments, emotional and physical health, and job satisfaction. Results In all, 152 surgeons completed the questionnaire. We identified several characteristics of highly successful surgeons. Many have contributed prolific numbers of publications and book chapters and obtained considerable funding for research. They were often motivated by a “desire for personal development (interesting challenge, new opportunities),” whereas “relocating to a new institution, financial gain, or lack of alternative candidates” played little to no role in their decisions to take positions of leadership. Most respondents were happy with their specialty choice despite long hours and high levels of stress. Despite challenges to their time, successful orthopedic surgeons made a strong effort to maintain their health; compared with other physicians, they exercise more, are more likely to have a primary care physician and feel better physically. Conclusion Departmental chairs, journal editors and presidents of orthopedic associations cope with considerable demands of clinical, administrative, educational and research duties while maintaining a high level of health, happiness and job satisfaction. PMID:23706848

  17. Between psychology and pedagogy: "moral orthopedics" and case studies of children in fin-de-siècle French medicine.

    PubMed

    Rose, Anna Christina

    2011-02-01

    In the latter decades of the 19th century, European physicians debated a controversial practice that mixed placebos with suggestion therapy to treat children diagnosed with neurotic disorders and behavioral problems. Designed to optimize suggestibility in juvenile patients, this "moral orthopedics" offered parents and therapists the message that children could be saved from becoming victims of their own personalities, of familial neuroses, or even of public health problems. Case studies, published in medical journals and books, circulated accounts of innovative strategies to treat childhood hysteria and to change habits that were considered destructive. Moral orthopedics actualized the insight that suggestibility could be therapeutically productive for juvenile subjects. However, because its adherents sought to manipulate patients' behavior and health by influencing unconscious thought, moral orthopedics provoked questions of expertise and disciplinary propriety among domains of medicine, law, and philosophy. This article reconstructs the controversy surrounding moral orthopedics by examining case studies. I argue that adherents of moral orthopedics did overcome philosophical objections raised against the method, and that they did so through what physician Edgar B6rillon referred to as "education of the will." PMID:21688751

  18. Remote Manipulator

    NASA Technical Reports Server (NTRS)

    1986-01-01

    SPAR Aerospace Limited's "Canadarm," Canada's contribution to the space shuttle. It is a crane which can operate as a 50 foot extension of an astronaut's arm. It can lift 65,000 pounds in space and retrieve satellites for repair, etc. Redesigned versions have energy and mining applications. Some of its hardware has been redeveloped for use as a Hydro manipulator in a nuclear reactor where it is expected to be extremely cost effective.

  19. Redefining the Economics of Geriatric Orthopedics

    PubMed Central

    Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-01-01

    Introduction: The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. Materials and Methods: A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. Results: In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. Conclusion: The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios. PMID:26246943

  20. The orthopedic management of Rett syndrome.

    PubMed

    Hennessy, M J; Haas, R H

    1988-01-01

    Musculoskeletal deformity sufficiently severe to require orthopedic surgery is a significant problem in Rett syndrome. Preliminary results from the study of 16 patients suggest deformity in nearly all patients. Eight patients in stage III and seven patients in stage IV showed clinical evidence of scoliosis. Radiographic studies confirmed a structural curve in nine of ten patients studied. Heel cord tightening was seen in nine of 16 patients. Hip instability was identified as an area of potential concern in the Rett patient. PMID:3198902

  1. Proximal spinal muscular atrophy: current orthopedic perspective

    PubMed Central

    Haaker, Gerrit; Fujak, Albert

    2013-01-01

    Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective “survival motor neuron” (SMN) protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. PMID:24399883

  2. Prevention of VTE in Orthopedic Surgery Patients

    PubMed Central

    Francis, Charles W.; Johanson, Norman A.; Curley, Catherine; Dahl, Ola E.; Schulman, Sam; Ortel, Thomas L.; Pauker, Stephen G.; Colwell, Clifford W.

    2012-01-01

    Background: VTE is a serious, but decreasing complication following major orthopedic surgery. This guideline focuses on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: In patients undergoing major orthopedic surgery, we recommend the use of one of the following rather than no antithrombotic prophylaxis: low-molecular-weight heparin; fondaparinux; dabigatran, apixaban, rivaroxaban (total hip arthroplasty or total knee arthroplasty but not hip fracture surgery); low-dose unfractionated heparin; adjusted-dose vitamin K antagonist; aspirin (all Grade 1B); or an intermittent pneumatic compression device (IPCD) (Grade 1C) for a minimum of 10 to 14 days. We suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives (Grade 2C/2B), and in patients receiving pharmacologic prophylaxis, we suggest adding an IPCD during the hospital stay (Grade 2C). We suggest extending thromboprophylaxis for up to 35 days (Grade 2B). In patients at increased bleeding risk, we suggest an IPCD or no prophylaxis (Grade 2C). In patients who decline injections, we recommend using apixaban or dabigatran (all Grade 1B). We suggest against using inferior vena cava filter placement for primary prevention in patients with contraindications to both pharmacologic and mechanical thromboprophylaxis (Grade 2C). We recommend against Doppler (or duplex) ultrasonography screening before hospital discharge (Grade 1B). For patients with isolated lower-extremity injuries requiring leg immobilization, we suggest no thromboprophylaxis (Grade 2B). For patients undergoing knee arthroscopy without a history

  3. Orthopedic Resident Anatomy Review Course: A Collaboration between Anatomists and Orthopedic Surgeons

    ERIC Educational Resources Information Center

    DeFriez, Curtis B.; Morton, David A.; Horwitz, Daniel S.; Eckel, Christine M.; Foreman, K. Bo; Albertine, Kurt H.

    2011-01-01

    A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months…

  4. Legal issues affecting ancillaries and orthopedic practice.

    PubMed

    Glaser, David M

    2008-01-01

    The federal and state governments have imposed significant regulations on health care generally and on ancillary services in particular. This article focuses on how state and federal laws shape the ability of an orthopedic physician to offer ancillary services, whether as an individual, through a group practice, or as part of a joint venture. It focuses on how the Stark law, the Medicare anti-kickback statute, state anti-kickback, fee-splitting provisions, certificate of need laws, and various Medicare billing and supervision requirements impact the provision of ancillary services. It also briefly discusses how physicians should prepare for and respond to government investigations. PMID:18061773

  5. Three-Dimensional Printing in Orthopedic Surgery.

    PubMed

    Eltorai, Adam E M; Nguyen, Eric; Daniels, Alan H

    2015-11-01

    Three-dimensional (3D) printing is emerging as a clinically promising technology for rapid prototyping of surgically implantable products. With this commercially available technology, computed tomography or magnetic resonance images can be used to create graspable objects from 3D reconstructed images. Models can enhance patients' understanding of their pathology and surgeon preoperative planning. Customized implants and casts can be made to match an individual's anatomy. This review outlines 3D printing, its current applications in orthopedics, and promising future directions. PMID:26558661

  6. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1985-01-01

    This book presents papers on imaging techniques for diagnosis of trauma of bones. A comparative evaluation is presented for planning of proper diagnosis and treatment. Various techniques discussed are routine radiography; computerized tomography, NMR imaging, angiography, ultrasonography; and use of radioisotopes. The mechanism of injury of bone joints of upper and lower limbs and spine is discussed after discussing the anatomy of each in the beginning of each paper. Topics titled are healing of fractures; fractures of pelvis; knee; shoulder; foot and ankle; fractures of humerus; stress fractures; and orthopedic radiology. Prosthesis use and plastic surgery of joints is also discussed.

  7. Hunting stand-related injuries in orthopedics.

    PubMed

    Lebus, George F; Krueger, Chad A; Stinner, Daniel J; Mir, Hassan R

    2014-09-01

    Hunting remains an extremely popular recreational activity, with nearly 15 million Americans receiving a hunting license annually. Precautions have helped decrease accidents, but hunting-related injuries remain relatively common. The majority of severe, hunting-related accidents involve either a fall from a hunting platform or an accidental shooting. Both of these mechanisms frequently result in orthopedic injuries, many of which require operative care. Although firearms-associated injury has seemingly decreased, hunting platform falls and their sequelae are increasing. Understanding the mechanisms of these injuries and increasing awareness of them may minimize their morbidity and mortality or help prevent them altogether. PMID:25188622

  8. Computer assisted 3D pre-operative planning tool for femur fracture orthopedic surgery

    NASA Astrophysics Data System (ADS)

    Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

    2010-02-01

    Femur shaft fractures are caused by high impact injuries and can affect gait functionality if not treated correctly. Until recently, the pre-operative planning for femur fractures has relied on two-dimensional (2D) radiographs, light boxes, tracing paper, and transparent bone templates. The recent availability of digital radiographic equipment has to some extent improved the workflow for preoperative planning. Nevertheless, imaging is still in 2D X-rays and planning/simulation tools to support fragment manipulation and implant selection are still not available. Direct three-dimensional (3D) imaging modalities such as Computed Tomography (CT) are also still restricted to a minority of complex orthopedic procedures. This paper proposes a software tool which allows orthopedic surgeons to visualize, diagnose, plan and simulate femur shaft fracture reduction procedures in 3D. The tool utilizes frontal and lateral 2D radiographs to model the fracture surface, separate a generic bone into the two fractured fragments, identify the pose of each fragment, and automatically customize the shape of the bone. The use of 3D imaging allows full spatial inspection of the fracture providing different views through the manipulation of the interactively reconstructed 3D model, and ultimately better pre-operative planning.

  9. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS

    PubMed Central

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2015-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time. PMID:27004181

  10. Osteoanabolic Implant Materials for Orthopedic Treatment.

    PubMed

    Ding, Yun-Fei; Li, Rachel W; Nakai, Masaaki; Majumdar, Trina; Zhang, Dong-Hai; Niinomi, Mitsuo; Birbilis, Nick; Smith, Paul N; Chen, Xiao-Bo

    2016-07-01

    Osteoporosis is becoming more prevalent due to the aging demographics of many populations. Osteoporotic bone is more prone to fracture than normal bone, and current orthopedic implant materials are not ideal for the osteoporotic cases. A newly developed strontium phosphate (SrPO4 ) coating is reported herein, and applied to Ti-29Nb-13Ta-4.6Zr (wt%), TNTZ, an implant material with a comparative Young's modulus to that of natural bone. The SrPO4 coating is anticipated to modulate the activity of osteoblast (OB) and osteoclast (OC) cells, in order to promote bone formation. TNTZ, a material with excellent biocompatibility and high bioinertness is pretreated in a concentrated alkaline solution under hydrothermal conditions, followed by a hydrothermal coating growth process to achieve complete SrPO4 surface coverage with high bonding strength. Owing to the release of Sr ions from the SrPO4 coating and its unique surface topography, OB cells demonstrate increased proliferation and differentiation, while the cellular responses of OC are suppressed, compared to the control case, i.e., bare TNTZ. This TNTZ implant with a near physiologic Young's modulus and a functional SrPO4 coating provides a new direction in the design and manufacture of implantable devices used in the management of orthopedic conditions in osteoporotic individuals. PMID:27113724

  11. The orthopedic characterization of Goltz syndrome.

    PubMed

    Smith, Amanda; Hunt, Thomas R

    2016-03-01

    Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare condition in which congenital anomalies result in a multitude of defects that affect many systems of the body. These defects can involve the eyes, skin, teeth, and cardiovascular, skeletal, and gastrointestinal systems. There have been many associated abnormalities reported in the literature. An appreciation of the clinical presentation of Goltz syndrome is important because physicians rely heavily on recognition of key physical characteristics in order to help make a diagnosis. In this report, we summarize the clinical findings observed when we were afforded the unique opportunity to interview and physically examine 19 patients, the largest group of individuals with Goltz syndrome brought together in one place to date. The findings are intended to characterize the orthopedic phenotypic manifestations of Goltz syndrome. This collection of data revealed that the most common orthopedic findings were syndactyly (68%), ectrodactyly (68%), leg length discrepancy (57%), and reduction defects of long bones (52%). Nail irregularities were present in 89% of the patients seen. PMID:26867035

  12. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS.

    PubMed

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2009-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time. PMID:27004181

  13. Delay to orthopedic consultation for isolated limb injury

    PubMed Central

    Rouleau, Dominique M.; Feldman, Debbie Ehrmann; Parent, Stefan

    2009-01-01

    ABSTRACT OBJECTIVE To describe referral mechanisms for referral to orthopedic surgery for isolated limb injuries in a public health care system and to identify factors affecting access. DESIGN Cross-sectional survey. SETTING Orthopedic surgery service in a level 1 trauma centre in Montreal, Que. PARTICIPANTS We conducted a prospective study of 166 consecutive adults (mean age 48 years) referred to orthopedic surgery for isolated limb injuries during a 4-month period. MAIN OUTCOME MEASURES Self-reported data on the nature of the trauma, the elapsed time between injury and orthopedic consultation, the number and type of previous primary care consultations, sociodemographic characteristics, and the level of satisfaction with care. RESULTS Average time between the injury and orthopedic consultation was 89 hours (range 3 to 642), with an average of 68 hours (range 0 to 642) for delay between primary care consultation and orthopedic consultation. A total of 36% of patients with time-sensitive diagnoses had unacceptable delays to orthopedic consultation according to the Quebec Orthopaedic Association guidelines. Lower limb injury, consulting first at another hospital, living far from the trauma centre, patient perception of low severity, and having a soft tissue injury were associated with longer delays. CONCLUSION Identifying gaps and risk factors for slower access might help improve referral mechanisms for orthopedic consultation. PMID:19826162

  14. Young Children's Attitudes toward Orthopedic and Sensory Disabilities.

    ERIC Educational Resources Information Center

    DeGrella, Lanier H.; Green, Virginia P.

    1984-01-01

    Attitudes of 64 nondisabled children (three to seven years old) toward orthopedic and sensory disabilities were examined via the Test of Early Attitudes toward Disability. Responses indicated that bias against orthopedic and sensory disabilities increases with age but is not present among three-year-olds. (Author/CL)

  15. Improving Response Rates among Students with Orthopedic and Multiple Disabilities

    ERIC Educational Resources Information Center

    Wilkens, Christian P.; Kuntzler, Patrice M.; Cardenas, Shaun; O'Malley, Eileen; Phillips, Carolyn; Singer, Jacqueline; Stoeger, Alex; Kindler, Keith

    2014-01-01

    One challenge teachers of students with orthopedic and multiple disabilities face is providing sufficient time and opportunity to communicate. This challenge is universal across countries, schools, and settings: teachers want students to communicate because communication lies at the core of what makes us human. Yet students with orthopedic and…

  16. Manipulating Representations.

    PubMed

    Recchia-Luciani, Angelo N M

    2012-04-01

    The present paper proposes a definition for the complex polysemic concepts of consciousness and awareness (in humans as well as in other species), and puts forward the idea of a progressive ontological development of consciousness from a state of 'childhood' awareness, in order to explain that humans are not only able to manipulate objects, but also their mental representations. The paper builds on the idea of qualia intended as entities posing regular invariant requests to neural processes, trough the permanence of different properties. The concept of semantic differential introduces the properties of metaphorical qualia as an exclusively human ability. Furthermore this paper proposes a classification of qualia, according to the models-with different levels of abstraction-they are implied in, in a taxonomic perspective. This, in turn, becomes a source of categorization of divergent representations, sign systems, and forms of intentionality, relying always on biological criteria. New emerging image-of-the-world-devices are proposed, whose qualia are likely to be only accessible to humans: emotional qualia, where emotion accounts for the invariant and dominant property; and the qualic self where continuity, combined with the oneness of the self, accounts for the invariant and dominant property. The concept of congruence between different domains in a metaphor introduces the possibility of a general evaluation of truth and falsity of all kinds of metaphorical constructs, while the work of Matte Blanco enables us to classify conscious versus unconscious metaphors, both in individuals and in social organizations. PMID:22347988

  17. Biomaterial systems for orthopedic tissue engineering

    NASA Astrophysics Data System (ADS)

    Spoerke, Erik David

    2003-06-01

    The World Health Organization has estimated that one out of seven Americans suffers from a musculoskeletal impairment, annually incurring 28.6 million musculoskeletal injuries---more than half of all injuries. Bone tissue engineering has evolved rapidly to address this continued health concern. In the last decade, the focus of orthopedic biomaterials design has shifted from the use of common engineering metals and plastics to smart materials designed to mimic nature and elicit favorable bioresponse. Working within this new paradigm, this thesis explores unique chemical and materials systems for orthopedic tissue engineering. Improving on current titanium implant technologies, porous titanium scaffolds were utilized to better approximate the mechanical and structural properties of natural bone. These foam scaffolds were enhanced with bioactive coatings, designed to enhance osteoblastic implant colonization. The biopolymer poly(L-lysine) was incorporated into both hydroxypatite and octacalcium phosphate mineral phases to create modified organoapatite and pLys-CP coatings respectively. These coatings were synthesized and characterized on titanium surfaces, including porous structures such as titanium mesh and titanium foam. In addition, in vitro osteoblastic cell culture experiments probed the biological influences of these coatings. Organoapatite (OA) accelerated preosteoblastic colonization of titanium mesh and improved cellular ingrowth into titanium foam. Alternatively, the thin, uniform pLys-CP coating demonstrated significant potential as a substrate for chemically binding biological molecules and supramolecular assemblies. Biologically, pLys-CP demonstrated enhanced cellular attachment over titanium and inorganic calcium phosphate controls. Supramolecular self-assembled nanofiber assemblies were also explored both as stand-alone tissue engineering gels and as titanium coatings. Self-supporting nanofiber gels induced accelerated, biomimetic mineralization

  18. Bioactive glass coatings for orthopedic metallic implants

    SciTech Connect

    Lopez-Esteban, Sonia; Saiz, Eduardo; Fujino, Sigheru; Oku, Takeo; Suganuma, Katsuaki; Tomsia, Antoni P.

    2003-06-30

    The objective of this work is to develop bioactive glass coatings for metallic orthopedic implants. A new family of glasses in the SiO2-Na2O-K2O-CaO-MgO-P2O5 system has been synthesized and characterized. The glass properties (thermal expansion, softening and transformation temperatures, density and hardness) are in line with the predictions of established empirical models. The optimized firing conditions to fabricate coatings on Ti-based and Co-Cr alloys have been determined and related to the glass properties and the interfacial reactions. Excellent adhesion to alloys has been achieved through the formation of 100-200 nm thick interfacial layers (Ti5Si3 on Ti-based alloys and CrOx on Co-Cr). Finally, glass coatings, approximately 100 mu m thick, have been fabricated onto commercial Ti alloy-based dental implants.

  19. Orthopedic applications of silicon nitride ceramics.

    PubMed

    Bal, B S; Rahaman, M N

    2012-08-01

    Silicon nitride (Si(3)N(4)) is a ceramic material developed for industrial applications that demand high strength and fracture resistance under extreme operating conditions. Recently, Si(3)N(4) has been used as an orthopedic biomaterial, to promote bone fusion in spinal surgery and to develop bearings that can improve the wear and longevity of prosthetic hip and knee joints. Si(3)N(4) has been implanted in human patients for over 3 years now, and clinical trials with Si(3)N(4) femoral heads in prosthetic hip replacement are contemplated. This review will provide background information and data relating to Si(3)N(4) ceramics that will be of interest to engineering and medical professionals. PMID:22542731

  20. Co-Management Arrangements in Orthopedic Surgery.

    PubMed

    Bushnell, Brandon D

    2015-06-01

    A co-management arrangement (CMA) is a contractual relationship between physicians and a hospital that results in a shared-responsibility management structure for a specific service line. In orthopedic surgery, CMAs are becoming increasingly popular as stakeholders in the health care market seek increased value (ie, higher-quality care at lower costs). A CMA can significantly improve the efficiency and the outcomes of a musculoskeletal service line if it adheres to the basic principles of a focus on the patient, evidence-based decision-making, physician leadership, appropriate physician compensation, transparency, reasonable and modifiable goals, and accountability. While the specifics of each CMA will vary, all CMAs have common operational elements that include the arrangement's legal structure, legal compliance, leadership and reporting structure, facilities management, personnel management, clinical data management, financial data management, and quality and effectiveness reporting. PMID:26047000

  1. Caring for the incarcerated: an orthopedic perspective.

    PubMed

    Munns, Justin; Samora, Julie Balch; Granger, Jeffrey F; Ng, Vincent Y

    2013-12-01

    According to the 1976 Supreme Court case of Estelle v Gamble, the government is required to provide prisoners access to the necessary care for known, serious medical needs. Failure to do so violates the Eighth Amendment prohibiting the imposition of "cruel and unusual punishment." Currently, more than 2.5 million Americans are imprisoned, the highest per capita rate in the world. In the current fiscal climate and with burgeoning health care costs for society as a whole, providing care for prisoners poses both moral and logistical challenges. From an orthopedic standpoint, caring for the incarcerated raises uniquely challenging issues due to the nature of this patient population and their types of musculoskeletal conditions. PMID:24309118

  2. Regenerative treatments to enhance orthopedic surgical outcome.

    PubMed

    Murrell, William D; Anz, Adam W; Badsha, Humeira; Bennett, William F; Boykin, Robert E; Caplan, Arnold I

    2015-04-01

    In orthopedic surgery there has been a never-ending quest to improve surgical outcome and the patient's experience. Progression has been marked by the refinement of surgical techniques and instruments and later by enhanced diagnostic imaging capability, specifically magnetic resonance. Over time implant optimization was achieved, along with the development of innovative minimally invasive arthroscopic technical skills to leverage new versions of classic procedures and implants to improve short-term patient morbidity and initial, mid-term, and long-term patient outcomes. The use of regenerative and/or biological adjuncts to aid the healing process has followed in the drive for continual improvement, and major breakthroughs in basic science have significantly unraveled the mechanisms of key healing and regenerative pathways. A wide spectrum of primary and complementary regenerative treatments is becoming increasingly available, including blood-derived preparations, growth factors, bone marrow preparations, and stem cells. This is a new era in the application of biologically active material, and it is transforming clinical practice by providing effective supportive treatments either at the time of the index procedure or during the postoperative period. Regenerative treatments are currently in active use to enhance many areas of orthopedic surgery in an attempt to improve success and outcome. In this review we provide a comprehensive overview of the peer-reviewed evidence-based literature, highlighting the clinical outcomes in humans both with preclinical data and human clinical trials involving regenerative preparations within the areas of rotator cuff, meniscus, ligament, and articular cartilage surgical repair. PMID:25864660

  3. Orthopedic surgical analyzer for percutaneous vertebroplasty

    NASA Astrophysics Data System (ADS)

    Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

    2001-05-01

    Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically

  4. Insights into Avicenna's knowledge of the science of orthopedics.

    PubMed

    Dalfardi, Behnam; Yarmohammadi, Hassan; Meibodi, Mohammad Kalantari

    2014-01-18

    The art of orthopedics traces its history back to ancient civilizations like those of the Egyptians. The evolution of this branch of medicine is indebted to investigations of many scientists, including Greek, Roman and Persian scholars. The Persian physician Avicenna (980-1037 AD) is one such scientist who investigated different aspects of orthopedics. It is possible to analyze Avicenna's knowledge of orthopedics and his contributions to this branch of medicine by an examination of his epic encyclopedia of medicine, Al-Qanun fi al-Tibb (The Canon of Medicine). PMID:24649417

  5. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    MedlinePlus

    ... Orthopedic Health Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment Past Issues / Spring 2009 Table of Contents ... or the sound of bone rubbing on bone Diagnosis No single test can diagnose osteoarthritis. It is ...

  6. Orthopedic Health: Osteoarthritis— What You Should Know (quiz)

    MedlinePlus

    ... Bar Home Current Issue Past Issues Orthopedic Health Osteoarthritis— What You Should Know Past Issues / Spring 2009 ... Javascript on. How much do you know about osteoarthritis, its causes, and its therapies? Take this quiz ...

  7. The Effects of Standardized Feedback on Orthopedic Patient Evaluation Skills.

    ERIC Educational Resources Information Center

    DaRosa, Debra A.; And Others

    1984-01-01

    A study examined whether there are performance differences between surgery clerks provided corrective reinforcement on orthopedic history and physical examination write-ups and those assessed by traditional feedback means when both groups are exposed to the feedback instrument. (MLW)

  8. Clostridial orthopedic infections: case reports and review of the literature.

    PubMed

    Lazzarini, L; Conti, E; Ditri, L; Turi, G; de Lalla, F

    2004-02-01

    Clostridia are anaerobic Gram-positive bacilli that can be isolated from the soil and the intestinal tract of humans. These microorganisms are recognized as the cause of devastating soft tissue infections, such as cellulitis, myositis, and gas gangrene. However, such bacteria may also be involved in various postoperative orthopedic infections, including prosthetic joint infection. We present three clinical cases of clostridial orthopedic infection and review the related medical literature. PMID:15078006

  9. Modern Orthopedic Inpatient Care of the Orthopedic Patient With Diabetic Foot Disease.

    PubMed

    Bateman, Antony H; Bradford, Sara; Hester, Thomas W; Kubelka, Igor; Tremlett, Jennifer; Morris, Victoria; Pendry, Elizabeth; Kavarthapu, Venu; Edmonds, Michael E

    2015-12-01

    In this article, we describe emergency and elective pathways within our orthopedic multidisciplinary inpatient care of patients with diabetic foot problems. We performed a retrospective cohort review of 19 complex patients requiring orthopedic surgical treatment of infected ulceration or Charcot feet or deformity at our institution. A total of 30 admissions (19 emergency, 11 elective) were included. The pathways were coordinated by a multidisciplinary team and comprised initial assessment and investigation and a series of key events, which consisted of emergency and elective surgery together with the introduction, and change of intravenous antibiotics when indicated. Patients had rigorous microbiological assessment, in the form of deep ulcer swabs, operative tissue specimens, joint aspirates, and blood cultures according to their clinical presentation as well as close clinical and biochemical surveillance, which expedited the prompt institution of key events. Outcomes were assessed using amputation rates and patient satisfaction. In the emergency group, there were 5.6 ± 3.0 (mean ± SD) key events per admission, including 4.2 ± 2.1 antibiotic changes. In the elective group, there were 4.8 ± 1.4 key events per inpatient episode, with 3.7 ± 1.3 antibiotic changes. Overall, there were 3 minor amputations, and no major amputations. The podiatric and surgical tissue specimens showed a wide array of Gram-positive, Gram-negative, aerobic and anaerobic isolates and 15% of blood cultures showed bacteremia. When 9 podiatric specimens were compared with 9 contemporaneous surgical samples, there was concordance in 2 out of 9 pairs. We have described the successful modern care of the orthopedic diabetic foot patient, which involves close clinical, microbiological, and biochemical surveillance by the multidisciplinary team directing patients through emergency and elective pathways. This has enabled successful surgical intervention involving debridement, pressure relief, and

  10. Orthopedic surgery and its complication in systemic lupus erythematosus

    PubMed Central

    Mak, Anselm

    2014-01-01

    Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedic-related conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care. PMID:24653977

  11. Are academic orthopedic surgeons interested in global health?

    PubMed

    Makhni, Melvin C; Miao, Diana; Zurakowski, David; Day, Charles S

    2014-03-01

    Two thirds of the world's population lack orthopedic services. Natural disasters such as the 2010 Haiti earthquake temporarily increased volunteering, but the decision to volunteer regularly is likely multifactorial. In the study reported here, we investigated whether academic orthopedic surgeons are interested in volunteering abroad and identified factors that influence participation. Academic orthopedic surgeons were identified through the faculty listings of all 154 orthopedic residency programs listed by the Association of American Medical Colleges (AAMC) Electronic Residency Application Service and were sent surveys by e-mail. Of the 3,697 eligible academic orthopedic surgeons, 600 were randomly selected, and 109 completed the survey. Of the 109 respondents, 52% had volunteered abroad previously, and 62% said they were highly likely to volunteer abroad in the future. The most common barriers were scheduling, and family and social commitments (65% and 66%, respectively), followed by lack of specialty-specific opportunities (40%). In a multivariate model, the only barrier significantly decreasing likelihood to volunteer abroad was concern for medical safety (P = .015). Altruistic motivations (P = .005), religious sentiments (P = .006), international networking (P = .004), and fulfilling the true medical creed (P = .015) significantly increased likelihood. Academic orthopedic surgeons are interested in volunteering abroad. Addressing common motivations and barriers may help improve care in the developing world. PMID:24660182

  12. Physician-Hospital Alignment in Orthopedic Surgery.

    PubMed

    Bushnell, Brandon D

    2015-09-01

    The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery. PMID:26375539

  13. Plasma engineered surfaces for orthopedic devices.

    PubMed

    Farhat, Susan; Gilliam, Mary; Samaniego, Cheryl; Dwarshuis, Nate; Carson, Julia; Peterson, Benjamin; Zand, Ali

    2016-06-01

    Atmospheric pressure plasma was used to graft various biocompatible polymers to the surface of ultra-high molecular weight polyethylene (UHMWPE). Polymers used as grafts in this study were poly(2-hydroxyethylmethacrylate) (PHEMA) and polyethylene glycol (PEG). A significant decrease in contact angle was noted for grafted surfaces, indicating increased hydrophilicity. Surface functionalities were verified using Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The wear properties of the coatings were determined by weight loss under conditions of a random motion pin-on-plate apparatus with the coated polyethylene plaques immersed in DI water. Based on these tests, the grafted surfaces exhibited an improved resistance to wear, compared to UHMWPE. Cell viability studies were used to confirm that the plasma treatment had no negative effects on the surface bio-toxicity. Based on the results, it is anticipated that the incorporation of these biocompatible polymer-grafted UHMWPE surfaces in metal-on-plastic orthopedic implants should improve their performance and longevity. PMID:26999407

  14. The white blood cell scan in orthopedics

    SciTech Connect

    Propst-Proctor, S.L.; Dillingham, M.F.; McDougall, I.R.; Goodwin, D.

    1982-08-01

    A new nuclear scanning technique was found more specific for bone, joint, and soft tissue infections than any previously described scanning technique. The leukocyte scan, whereby a patient's own cells are labeled with a radioactive tagging agent (/sup 111/In oxine), can distinguish an active infectious process from other pain-inducing conditions. Ninety-seven /sup 111/In labeled autologous leukocyte scans were performed in 88 patients. The findings in 17 of 40 patients scanned for possible acute osteomyelitis, six of nine for suspected septic arthritis, and six for possible soft tissue infections, were positive. Subsequent clinical courses verified the infectious nature of these processes in all patients. Patients who had chronic osteomyelitis (14), bony metastases (four patients), heterotopic ossification (three), and degenerative arthritis (two) demonstrated negative findings. Of the seven patients scanned for acute long-bone fractures, one demonstrated positive findings. Nine scans demonstrated positive findings without determined causes. The leukocyte scan is a useful addition to the diagnostic tools of the orthopedic surgeon.

  15. Managing orthopedics and neurosciences costs through standard treatment protocols.

    PubMed

    McGinnity, E S; Pluth, T E

    1994-06-01

    High-cost, high-volume specialty programs such as orthopedics and neurosciences find themselves in a position of evaluating the costs and in some cases the appropriateness of medical practices in response to payer scrutiny and provider selection processes. Orthopedics and neurosciences programs are at a stage of development analogous to that of cardiovascular care several years ago. Many of the same trends have come into play, such as payer "carve-outs" for orthopedic services, payer selection of centers of excellence based on cost and quality, reduction of Medicare reimbursement, greater use of high-cost technology, the decline of profitability due to "older, sicker, and tougher" patients, and the recent emergence of national orthopedic specialty networks oriented to national contracts for care. In an era in which payers demand value on both sides of the cost-plus-quality equation, programs are challenged to maximize the return on a patient population rife with "no-win" situations. In the orthopedic service line these include a high proportion of Medicare patients and chronic conditions such as workers' compensation medical back cases or repetitive motion injuries, which can be elusive to diagnose and expensive to treat. Many hospitals continue to lose money on joint replacement surgeries, the largest-volume orthopedic inpatient service, primarily because of the high Medicare population and the cost of implants. Neuroservices, while still relatively well reimbursed, face a rising proportion of Medicare payments as patients live longer and develop chronic, degenerative conditions. Inpatient days are decreasing due to payer pressures to limit hospital stays and to shift inpatient care to outpatient services. Some hospitals "have lost interest in (the orthopedic) service line during the last five years because of recent trends in orthopedic-related inpatient volume and payment." But by managing costs strategically, both the neurosciences and orthopedics service lines

  16. Orthostetrics: Management of Orthopedic Conditions in the Pregnant Patient.

    PubMed

    Matthews, Leslie J; McConda, David B; Lalli, Trapper A J; Daffner, Scott D

    2015-10-01

    Managing orthopedic conditions in pregnant patients leads to challenges that must be carefully considered so that the safety of both the mother and the fetus is maintained. Both perioperative and intraoperative considerations must be made based on physiologic changes during pregnancy, risks of radiation, and recommendations for monitoring. Operative timing, imaging, and medication selection are also factors that may vary based on trimester and clinical scenario. Pregnancy introduces unique parameters that can result in undesirable outcomes for both mother and fetus if not handled appropriately. Ultimately, pregnant patients offer a distinct challenge to the orthopedic surgeon in that the well-being of 2 patients must be considered in all aspects of care. In addition, not only does pregnancy affect the management of orthopedic conditions but the pregnant state also causes physiologic changes that may actually induce various pathologies. These pregnancy-related orthopedic conditions can interfere with an otherwise healthy pregnancy and should be recognized as possible complications. Although the management of orthopedic conditions in pregnancy is often conservative, pregnancy does not necessarily preclude safely treating pathologies operatively. When surgery is considered, regional anesthesia provides less overall drug exposure to the fetus and less variability in fetal heart rate. Intraoperative fluoroscopy can be used when appropriate, with 360° fetal shielding if possible. Lateral decubitus positioning is ideal to prevent hypotension associated with compression of the inferior vena cava. PMID:26488781

  17. The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants

    PubMed Central

    Fogel, Harold A.; Finkler, Elissa S.; Wu, Karen; Schiff, Adam P.; Nystrom, Lukas M.

    2016-01-01

    Background The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. Methods We distributed surveys to 48 nonrotating applicants at our institution’s residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. Results The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. Conclusions The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population. PMID:27528831

  18. Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?*,**

    PubMed Central

    Akpinar, Evrim Eylem; Hosgün, Derya; Akan, Burak; Ates, Can; Gülhan, Meral

    2013-01-01

    OBJECTIVE: Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age). PMID:23857692

  19. Mobile Remote Manipulator

    NASA Technical Reports Server (NTRS)

    Coryell, S.; Olsen, R. E.

    1986-01-01

    Turret, roll arm, and trolley enhance manipulator dexterity. Remote manipulator moves on trolley base along structure. Roll-axis arm positions manipulator arm so it can extend end effector under structure. Yaw-axis rotation gives added reach to arm above structure. Designed for handling, inspecting, and maintaining modules of space station. Manipulators having such capabilities useful on Earth; robots in manufacturing, erection of large structures, or performing complicated tasks in hazardous locations.

  20. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study

    PubMed Central

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  1. Evidence-based orthopedic surgery: is it possible?

    PubMed

    Suk, Michael; Hanson, Beate; Helfet, David L

    2010-04-01

    The promise of evidence-based medicine is to integrate the highest levels of clinical data with patient outcomes. After framing the question and identifying appropriate studies, evaluating their relevance to clinical practice is highly dependent on the instruments and measures selected to demonstrate outcomes. Currently, there are hundreds of outcomes measures available in the orthopedic literature evaluating these treatments, and it is not uncommon for different measures to produce conflicting results. Consequently, the ability to evaluate an outcomes measure is critical in determining the value of a specific treatment intervention. Similarly, selecting the appropriate outcomes measure for research or clinical purposes is an important decision that may have far reaching implications on reimbursement, surgeon reputation, and patient treatment success. Evidence-based orthopedic surgery is indeed possible, but demands a detailed understanding of why appropriate outcomes selection is important, the difference between clinician-based and patient-reported outcomes (PROs), and potential future directions in orthopedics outcomes research. PMID:20399353

  2. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study.

    PubMed

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  3. Progress in nonprehensile manipulation

    SciTech Connect

    Mason, M.T.

    1999-11-01

    This paper reviews my recent research in robotic manipulation and speculates on potentially fruitful directions for future work. My recent work is focused on nonprehensile manipulation: manipulating objects without grasping them. In particular, the paper surveys work on a single joint robot that orients parts on a conveyor belt; a robot that uses dynamics to snatch, roll, or throw objects; hitting things to position them; manipulating things whose shapes are not completely known; and integration of manipulation with locomotion. In the future, a broad view of robotics will allow us to focus on fundamental principles and at the same time address a variety of new applications.

  4. [Technical orthopedics. Importance in an increasingly operatively oriented faculty].

    PubMed

    Greitemann, B; Maronna, U

    2013-10-01

    The foundation of the German Society for Orthopedics in 1901 was due to a separation from the faculty of surgery because a surgical approach alone did not adequately deal with the symptoms. Orthopedists were initially considered as a fringe group. The conservative treatment approach was initially at the forefront and operative measures were a side line. The main aim was the rehabilitation of patients into a normal life as best as possible. In the conservative area treatment with orthopedic technical aids and appliances rapidly came to play an important role and a great multitude of technical appliances were developed with sometimes very different possible applications. Despite the clearly improved operative treatment approaches in orthopedics and trauma surgery, technical orthopedics still plays a substantial role even today. Healing and supportive aids and appliances are of decisive importance for the treatment of a multitude of diseases and handicaps. They stabilize and improve operative treatment results and often result in new approaches. This depends on cooperation between technicians, therapists and physicians in a team, even in the scientific field. Evidence-based studies on the effectiveness of technical aids are currently still uncommon but recently some clear evidence for effectiveness could be shown. Scientifically this is a very varied field of work. The demographic development presents new requirements which must be dealt with. Technical solutions are often very promising especially in this field. Technical orthopedics remains an important component of the specialty of orthopedics and trauma surgery and with an increasing tendency due to more recent research and development. PMID:23955523

  5. Computer-assisted diagnosis of orthopedic gait disorders.

    PubMed

    Tracy, K B; Montague, E C; Gabriel, R P; Kent, B E

    1979-03-01

    A computer program was developed to help diagnose orthopedic gait disorders. Designing and implementing the program, as well as the program's method of operation are described. The main features of the program include: a knowledge base of facts about orthopedic gait, organized into premise-conclusion pairs; a goal-directed reasoning chain that causally relates the facts; and a symbolic structure that allows limited English discourse between the user and the computer. Results of the project indicate that the complex area of gait analysis does lend itself to diagnosis by computer and that this prototype has potential as an aid to physical therapists in the classroom and in the clinic. PMID:84393

  6. Nanomedicine applications in orthopedic medicine: state of the art

    PubMed Central

    Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

    2015-01-01

    The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges. PMID:26451110

  7. Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery

    NASA Astrophysics Data System (ADS)

    Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

    2015-03-01

    Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

  8. Use of lasers in orthopedic surgery: current concepts.

    PubMed

    Abelow, S P

    1993-05-01

    A surgical laser is a new, multipurpose tool that can cut, coagulate, and vaporize tissues. It utilizes a low profile handpiece that allows easy access to tight places and small joints. The holmium laser at 2.1 microns wavelength is gaining wide acceptance among orthopedic surgeons as a useful arthroscopic surgical tool. It has a minimal amount of thermal necrosis and is able to cut and ablate tissues with great ease. Current investigation with laser tissue--agglutination and tissue welding--may make it possible to repair torn tissues with laser energy. The future will bring minimally invasive and minimally damaging laser orthopedic surgery. PMID:8327382

  9. [Orthopedic aspects in interdisciplinary multimodal therapy of chronic back pain].

    PubMed

    Weh, L; Marnitz, U

    2011-06-01

    The effect of interdisciplinary multimodal therapy of chronic back pain is well documented. With elapsing time changing diagnostic focuses, therapeutic strategies and objectives have to be considered. The chronicity leads to a modification of the relevance of structure-related diagnosis and therapy and changes the significance of the classic orthopedic instruments. The requirement of a rational causal therapy in chronic back pain still remains but the focal points shift to the consideration of somatic, psychological and social disposing and supporting factors.The aim of this paper is to reflect the necessary orthopedic expertise in the context of the pathomechanics of chronic back pain and the interdisciplinary teamwork. PMID:21523420

  10. [Means of developing personnel potentials of dental orthopedic service in southern regions of Tiumen' oblast].

    PubMed

    Voznyĭ, A V; Dolgintsev, V I; Semeniuk, V M; Ivanova, L A

    2005-01-01

    The article exposes overall analysis and objective evaluation of personnel potential of orthopedic dental service in southern region of Tyumen oblast. Actual issues of enhancement of orthopedic dental service in this region are discussed. PMID:16821315

  11. Orthopedic Health: Healthy Joints for a Lifetime / Keep Your Moving Parts Moving

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Orthopedic Health Healthy Joints for a Lifetime Past Issues / ... being made every day in the world of orthopedic health and disease treatment —our bones, muscles, tendons, ...

  12. Telediagnosis system for orthopedic deformity analysis based on 3D medical imaging

    NASA Astrophysics Data System (ADS)

    Kim, Myoung-Hee; Hong, Helen; Kim, Min-A.

    2000-04-01

    Due to the structural complexity of the bone, it is difficult to diagnose and make a treatment plan for injuries and diseases in bones. In this paper, we designed and implemented a telediagnosis system for orthopedic deformity analysis based on 3D medical imaging. In order to define the intersseous relationships in each bone and to evaluate a deformity without invasions, the system produces volumetric images by reconstructing the planar images spatially and provides deformity analysis by measuring distance, area, volume and angle among the bones. The reconstructed volumetric images are freely manipulated to simulate surgical operations such as translation, scaling, rotation and so on. Our system integrates three main components: server, clients and communication subsystem. It is also composed of three main functions including the information control manager for event and message process used between client and server, and surgical simulation manager for object visualization and manipulation in individual bones, and the medical database manager for patient information. The system also supports user-friendly graphical user interface and simultaneous use by multiple users.

  13. 21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonpowered orthopedic traction apparatus and accessories. 888.5850 Section 888.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.5850 Nonpowered orthopedic traction apparatus and...

  14. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  15. The Special Orthopedic Hospital—Past and Present

    PubMed Central

    Platt, Harry

    1964-01-01

    Pioneer orthopedic institutions established in Europe in the late 18th and early 19th centuries, and in the U.S.A. in the second half of the 19th and the first decade of the 20th century, can trace their ancestry in ideas back to the practice and teachings of Hippocrates. Experience in treatment of great numbers of injured soldiers in the First World War opened a new era in reconstructive surgery of the locomotor system. After the Second World War, in advanced nations the pattern of crippling diseases showed a spectacular change. Problems that justify the existence of large special orthopedic hospitals are, in children, the more complex congenital deformities, cerebral palsies, and the increasing number of injuries due to hazards of modern life; in the adult, the reconstructive surgery of trauma and of arthritis. In modern orthopedic hospitals physicians have joined orthopedic surgeons in the study of the natural history of the various forms of arthritis. These centres provide facilities for biomechanical research and postgraduate training which acute general hospitals cannot offer. PMID:14228224

  16. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  17. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  18. Left-Handed Preschool Children with Orthopedic Disabilities.

    ERIC Educational Resources Information Center

    Banham, Katharine M.

    1983-01-01

    The mental development of 332 preschool-age children with orthopedic disabilities was assessed at a children's hospital over a 10-year period, and comparisons were made for right-handed and left-handed. The left-handed children were slower than right-handed children in learning speech and language skills (Author/SEW)

  19. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  20. 76 FR 20690 - International Consortium of Orthopedic Registries; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... be on a first- come, first-served basis. Non-U.S. citizens are subject to additional security... the performance of orthopedic devices. II. Who is the target audience for this public workshop? Who should attend this public workshop? This workshop is open to all interested parties. The target...

  1. Office orthopedics: thumb spica casting for scaphoid fractures.

    PubMed

    Richard, J R

    1995-09-15

    Fracture of the scaphoid bone of the wrist is a common orthopedic problem and is accurately diagnosed by determining the mechanism of injury based on the history, performing a specific physical examination maneuvers and interpreting radiographic findings. Skill in the application of the thumb spica cast enables the family physician to provide appropriate and definitive care for many of these patients. PMID:7668203

  2. Higher Education and Students with Orthopedic Disabilities: A Survey Instrument.

    ERIC Educational Resources Information Center

    Singh, Delar K.

    A survey instrument is presented that was used in a national survey of 160 colleges and universities to explore facilities and services to students with orthopedic disabilities. The survey contains 33 items that focus on the following areas: structural accessibility, academic accessibility, dorm-living, and recreational opportunities. The total…

  3. Supporting the Educational Needs of Students with Orthopedic Impairments.

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Swinehart-Jones, Dawn

    2003-01-01

    This article provides information on orthopedic impairments and the unique knowledge and skills required to provide these students with an appropriate education. Information on current practice is provided, as well as training and technical assistance models that can be used to help provide teachers with the necessary training. (Contains…

  4. Looking at the Social Activity for Adolescents with Orthopedic Impairments

    ERIC Educational Resources Information Center

    Biastro, Leslie; Frank, Heather; Larwin, Karen H.

    2015-01-01

    Adolescents with identified orthopedic impairments are often less likely to participate in social activities outside of the school setting. However, the adolescents who are able to participate in activities have higher social skills, more academic successes, and show more satisfaction in their roles as family member or friend. The aim of this…

  5. Outpatient parenteral antimicrobial therapy for orthopedic infections - a successful public healthcare experience in Brazil.

    PubMed

    Oliveira, Priscila Rosalba; Felix, Cassia da Silva; Carvalho, Vladimir Cordeiro de; Giovani, Arlete Mazzini; Reis, Rosangela Suarti Dos; Beraldo, Marisa; Albuquerque, Edmir Peralta; Ferreira, Walter Cintra; Silva, Jorge Dos Santos; Lima, Ana Lucia Lei

    2016-01-01

    Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions

  6. Mainstreaming Preschoolers: Children with Orthopedic Handicaps. A Guide for Teachers, Parents, and Others Who Work with Orthopedically Handicapped Preschoolers.

    ERIC Educational Resources Information Center

    Kieran, Shari Stokes; And Others

    This guide to mainstreaming preschoolers with orthopedic handicaps is one of a series of eight manuals on mainstreaming preschoolers developed by Project Head Start. The guide is addressed to parents, teachers, and other professionals and paraprofessionals. Chapter I presents information on the meaning, benefits and implementation of…

  7. Revisiting Mathematics Manipulative Materials

    ERIC Educational Resources Information Center

    Swan, Paul; Marshall, Linda

    2010-01-01

    It is over 12 years since "APMC" published Bob Perry and Peter Howard's research on the use of mathematics manipulative materials in primary mathematics classrooms. Since then the availability of virtual manipulatives and associated access to computers and interactive whiteboards have caused educators to rethink the use of mathematics manipulative…

  8. Direct Manipulation Interfaces.

    ERIC Educational Resources Information Center

    Hutchins, Edwin L.; And Others

    This paper presents a cognitive account of both the advantages and disadvantages of direct manipulation interfaces, i.e., the use of icons to manipulate and interact directly with data rather than writing programs or calling on a set of statistical subroutines. Two underlying phenomena that give rise to the sensation of directness are identified.…

  9. Osteopathic Manipulative Treatment

    PubMed Central

    Campbell, Shannon M.; Walkowski, Stevan

    2012-01-01

    Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

  10. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maeda, M.

    1986-01-01

    The Manipulator Comparative Testing Program examined differences among manipulator systems from the United States and Japan. The manipulator systems included the Meidensha BILARM 83A, the Model M-2 of Central Research Laboratories Division of Sargent Industries (CRL), and the GCA Corporation PaR Systems Model 6000. The site of testing was the Remote Operations Maintenance Demonstration (ROMD) facility, operated by the Fuel Recycle Division in the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL). In all stages of testing, operators using the CRL Model M-2 manipulator had consistently lower times to completion and error rates than they did using other machines. Performance was second best with the Meidensha BILARM 83A in master-slave mode. Performance with the BILARM in switchbox mode and the PaR 6000 manipulator was approximately equivalent in terms of criteria recorded in testing. These data show no impact of force reflection on task performance.

  11. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective

    PubMed Central

    Zheng, Guoyan; Nolte, Lutz P.

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined. PMID:26779486

  12. Radiation exposure from fluoroscopy during orthopedic surgical procedures

    SciTech Connect

    Riley, S.A. )

    1989-11-01

    The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of this study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.

  13. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective.

    PubMed

    Zheng, Guoyan; Nolte, Lutz P

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined. PMID:26779486

  14. Pediatric orthopedic surgical simulation at Boston Children's Hospital.

    PubMed

    Bae, Donald S; Waters, Peter M

    2016-07-01

    Orthopedic surgical simulation has become an increasing valuable means for optimizing patient care, promoting patient safety, improving education, and fostering clinical research. The purpose of this review was to discuss the rationale for simulation training, describe current simulation efforts within the Department of Orthopaedic Surgery at Boston Children's Hospital, and provide an example of how these simulation efforts touch both patient care and clinical research. PMID:27058820

  15. Online reviews of orthopedic surgeons: an emerging trend.

    PubMed

    Frost, Chelsea; Mesfin, Addisu

    2015-04-01

    Various websites are dedicated to rating physicians. The goals of this study were to: (1) evaluate the prevalence of orthopedic surgeon ratings on physician rating websites in the United States and (2) evaluate factors that may affect ratings, such as sex, practice sector (academic or private), years of practice, and geographic location. A total of 557 orthopedic surgeons selected from the 30 most populated US cities were enrolled. The study period was June 1 to July 31, 2013. Practice type (academic vs private), sex, geographic location, and years since completion of training were evaluated. For each orthopedic surgeon, numeric ratings from 7 physician rating websites were collected. The ratings were standardized on a scale of 0 to 100. Written reviews were also collected and categorized as positive or negative. Of the 557 orthopedic surgeons, 525 (94.3%) were rated at least once on 1 of the physician rating websites. The average rating was 71.4. The study included 39 female physicians (7.4%) and 486 male physicians (92.6%). There were 204 (38.9%) physicians in academic practice and 321 (61.1%) in private practice. The greatest number of physicians, 281 (50.4%), practiced in the South and Southeast, whereas 276 (49.6%) practiced in the West, Midwest, and Northeast. Those in academic practice had significantly higher ratings (74.4 vs 71.1; P<.007). No significant difference based on sex (72.5 male physicians vs 70.2 female physicians; P=.17) or geographic location (P=.11) were noted. Most comments (64.6%) were positive or extremely positive. Physicians who were in practice for 6 to 10 years had significantly higher ratings (76.9, P<.01) than those in practice for 0 to 5 years (70.5) or for 21 or more years (70.7). PMID:25901617

  16. Blood conservation strategies in orthopedic surgeries: A review

    PubMed Central

    Sambandam, Balaji; Batra, Sahil; Gupta, Rajat; Agrawal, Nidhi

    2013-01-01

    In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits. PMID:26403876

  17. Orthopedic cellular therapy: An overview with focus on clinical trials

    PubMed Central

    Noh, Moon Jong; Lee, Kwan Hee

    2015-01-01

    In this editorial, the authors tried to evaluate the present state of cellular therapy in orthopedic field. The topics the authors try to cover include not only the clinical trials but the various research areas as well. Both the target diseases for cellular therapy and the target cells were reviewed. New methods to activate the cells were interesting to review. Most advanced clinical trials were also included because several of them have advanced to phase III clinical trials. In the orthopedic field, there are many diseases with a definite treatment gap at this time. Because cellular therapies can regenerate damaged tissues, there is a possibility for cellular therapies to become disease modifying drugs. It is not clear whether cellular therapies will become the standard of care in any of the orthopedic disorders, however the amount of research being performed and the number of clinical trials that are on-going make the authors believe that cellular therapies will become important treatment modalities within several years. PMID:26601056

  18. Student opinions on orthopedic residency selection, education, and work hours.

    PubMed

    Hussain, Waqas; Hussain, Haroon; Manning, David W

    2013-08-01

    Other articles have been written about resident selection, musculoskeletal education, work hours, and call coverage, but none has described orthopedic applicants' opinions on these issues. We conducted a study to gain insight into applicants' attitudes about issues relevant to the specialty. We distributed a survey to 53 applicants interviewing for an orthopedic residency. The survey used both a multiple-choice format and a Likert scale ranging from 1 (strongly disagree or least important) to 5 (strongly agree or most important). Respondents rated the adequacy of musculoskeletal education in medical school a mean standard deviation (SD) of 2.00 (0.8) on the Likert scale. Ranking the factors most valuable to an orthopedic surgery application, they rated United States Medical Licensing Examination (USMLE) Step 1 board examination scores a mean (SD) of 4.26 (0.9). In addition, of the 53 respondents, 46 (87%) anticipated working as a resident more than 80 hours per week, and 36 (68%) anticipated working as an attending 60 to 70 hours per week or less. Respondents also agreed that they should receive compensation for call coverage. Therefore, students agreed that medical school education is insufficient, rated USMLE scores the most important application factor, anticipated working more than 80 hours per week, and agreed that call coverage should be compensated. PMID:24078953

  19. Clinical conundrums and challenges during geriatric orthopedic emergency surgeries

    PubMed Central

    Bajwa, Sukhminder Jit Singh

    2015-01-01

    Despite so many advancements and innovations in anesthetic techniques, expectations and challenges have also grown in plenty. Cardiac, pediatric, obstetric and neuro-anesthesia have perfectly developed to fulfill the desired needs of respective patient population. However, geriatric anesthesia has been shown a lesser interest in teaching and clinical practices over the years as compared with other anesthetic sub-specialties. The large growing geriatric population globally is also associated with an increase number of elderly patients presenting for orthopedic emergency surgeries. Orthopedic emergency surgery in geriatric population is not only a daunting clinical challenge but also has numerous socio-behavioral and economic ramifications. Decision making in anesthesia is largely influenced by the presence of co-morbidities, neuro-cognitive functions and the current socio-behavioral status. Pre-anesthetic evaluation and optimization are extremely important for a better surgical outcome but is limited by time constraints during emergency surgery. The current review aims to highlight comprehensively the various clinical, social, behavioral and psychological aspects during pre-anesthetic evaluation associated with emergency orthopedic surgery in geriatric population. PMID:25810963

  20. Anesthetic considerations in orthopedic patients with or without trauma.

    PubMed

    Chohan, Amandeep S

    2010-05-01

    Anesthetic management of orthopedic patients could vary from normal routine management to more challenging critical management depending on the state in which the patient is presented. Multimodal pain management strategies incorporating opioids, which are the mainstay drugs for pain management, along with adjunctive drugs like local anesthetics (eg, lidocaine), dissociative anesthetics (eg, ketamine), and alpha-2 agonists (eg, dexmedetomidine), could improve overall patient comfort and help prevent establishment of chronic pain pathways. Also, use of local nerve blocks can prevent nociception right at the point of origin. Orthopedic patients with multiple organ traumas like head injuries, spinal injuries, pulmonary fat embolism, compartment syndrome, or thoracic injuries are high-risk patients in which any life-threatening organ pathology should be addressed before the patient is put under general anesthesia. Interactions of various drugs like antibiotics and neuromuscular blocking agents used in the perioperative period in orthopedic patients should warrant a careful consideration with respect to their interactions with each other and other anesthetic drugs used. PMID:20515674

  1. Update: Biochemistry of Genetic Manipulation.

    ERIC Educational Resources Information Center

    Barker, G. R.

    1983-01-01

    Various topics on the biochemistry of genetic manipulation are discussed. These include genetic transformation and DNA; genetic expression; DNA replication, repair, and mutation; technology of genetic manipulation; and applications of genetic manipulation. Other techniques employed are also considered. (JN)

  2. Classifying human manipulation behavior.

    PubMed

    Bullock, Ian M; Dollar, Aaron M

    2011-01-01

    This paper presents a taxonomy for detailed classification of human and anthropomorphic manipulation behavior. This hand-centric, motion-centric taxonomy differentiates tasks based on criteria such as object contact, prehension, and the nature of object motion relative to a hand frame. A sub-classification of the most dexterous categories, within-hand manipulation, is also presented, based on the principal axis of object rotation or translation in the hand frame. Principles for categorizing complex, multi-faceted tasks are also presented, along with illustrative examples. We hope that the proposed taxonomy will both establish a standard language around human and anthropomorphic manipulation as well as enable improved understanding of the differences in hand use for a wide variety of behavior. Although designed for human and anthropomorphic hands, the taxonomy might easily be extended to a wide range of robot manipulators and end-effectors. PMID:22275611

  3. Osteopathic Manipulative Treatment

    MedlinePlus

    ... what patients really need is a healing touch. Osteopathic physicians haven't forgotten. Osteopathic manipulative treatment, or OMT, ... and prevent illness or injury. Using OMT, your osteopathic physician will move your muscles and joints using techniques ...

  4. Dielectrophoresis for bioparticle manipulation.

    PubMed

    Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

    2014-01-01

    As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

  5. Dielectrophoresis for Bioparticle Manipulation

    PubMed Central

    Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

    2014-01-01

    As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

  6. Dexterous manipulator flight demonstration

    NASA Technical Reports Server (NTRS)

    Carter, Edward L.

    1989-01-01

    The Dexterous Manipulator Flight Experiment, an outgrowth of the Dexterous End Effector project, is an experiment to demonstrate newly developed equipment and methods that make for a dexterous manipulator which can be used on the Space Shuttle or other space missions. The goals of the project, the objectives of the flight experiment, the experiment equipment, and the tasks to be performed during the demonstration are discussed.

  7. Remote manipulator dynamic simulation

    NASA Technical Reports Server (NTRS)

    Wild, E. C.; Donges, P. K.; Garand, W. A.

    1972-01-01

    A simulator to generate the real time visual scenes required to perform man in the loop investigations of remote manipulator application and design concepts for the space shuttle is described. The simulated remote manipulator consists of a computed display system that uses a digital computer, the electronic scene generator, an operator's station, and associated interface hardware. A description of the capabilities of the implemented simulation is presented. The mathematical models and programs developed for the simulation are included.

  8. Micro manipulator motion control to counteract macro manipulator structural vibrations

    SciTech Connect

    Lew, J.Y.; Trudnowski, D.J.; Evans, M.S.; Bennett, D.W.

    1995-02-01

    Inertial force damping control by micro manipulator modulation is proposed to suppress the vibrations of a micro/macro manipulator system. The proposed controller, developed using classical control theory, is added to the existing control system. The proposed controller uses real-time measurements of macro manipulator flexibility to adjust the motion of the micro manipulator to counteract structural vibrations. Experimental studies using an existing micro/macro flexible link manipulator testbed demonstrate the effectiveness of the proposed approach to suppression of vibrations in the macro/micro manipulator system using micro-manipulator-based inertial active damping control.

  9. Trends in the orthopedic job market and the importance of fellowship subspecialty training.

    PubMed

    Morrell, Nathan T; Mercer, Deana M; Moneim, Moheb S

    2012-04-01

    Previous studies have examined possible incentives for pursuing orthopedic fellowship training, but we are unaware of previously published studies reporting the trends in the orthopedic job market since the acceptance of certain criteria for fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) in 1985. We hypothesized that, since the initiation of accredited postresidency fellowship programs, job opportunities for fellowship-trained orthopedic surgeons have increased and job opportunities for nonfellowship-trained orthopedic surgeons have decreased. We reviewed the job advertisements printed in the Journal of Bone and Joint Surgery, American Volume, for the years 1984, 1994, 2004, and 2009. We categorized the job opportunities as available for either a general (nonfellowship-trained) orthopedic surgeon or a fellowship-trained orthopedic surgeon. Based on the advertisements posted in the Journal of Bone and Joint Surgery, American Volume, a trend exists in the orthopedic job market toward seeking fellowship-trained orthopedic surgeons. In the years 1984, 1994, 2004, and 2009, the percentage of job opportunities seeking fellowship-trained orthopedic surgeons was 16.7% (95% confidence interval [CI], 13.1%-20.3%), 40.6% (95% CI, 38.1%-43.1%), 52.2% (95% CI, 48.5%-55.9%), and 68.2% (95% CI, 65.0%-71.4%), respectively. These differences were statistically significant (analysis of variance, P<.05). Fellowship training is thus a worthwhile endeavor. PMID:22495859

  10. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maida, M.

    1986-01-01

    The Manipulator Comparative Testing Program compared performance of selected manipulator systems under typical remote handling conditions. The site of testing was the Remote Operations and Maintenance Demonstration Facility operated by the Consolidated Fuel Reprocessing Program of the Oak Ridge National Laboratory. Three experiment examined differences among manipulator systems from the US and Japan. The manipulator systems included the Meidensha BILARM 83A, Central Research Laboratories' (CRL's) Model M-2, and GCA PaR systems Model 6000. Six manipulator and control mode combinations were evaluated: (a) the BILARM in master-slave mode without force reflection; (b) the BILARM in master-slave mode with force reflection; (c) the Model M-2 in master-slave mode without force reflection; (d) the Model M-2 in master-slave mode with force reflection; (e) the BILARM with switchbox controls; and (f) the PaR 6000 with switchbox controls. The experiments also examined differences between master-slave systems with and without force reflections, and differences between master-slave systems and switchbox-controlled systems.

  11. Simulation of robot manipulators

    SciTech Connect

    Kress, R.L.; Babcock, S.M.; Bills, K.C.; Kwon, D.S.; Schoenwald, D.A.

    1995-03-01

    This paper describes Oak Ridge National Laboratory`s development of an environment for the simulation of robotic manipulators. Simulation includes the modeling of kinematics, dynamics, sensors, actuators, control systems, operators, and environments. Models will be used for manipulator design, proposal evaluation, control system design and analysis, graphical preview of proposed motions, safety system development, and training. Of particular interest is the development of models for robotic manipulators having at least one flexible link. As a first application, models have been developed for the Pacific Northwest Laboratories` Flexible Beam Testbed which is a one-Degree-Of-Freedom, flexible arm with a hydraulic base actuator. Initial results show good agreement between model and experiment.

  12. Minocycline-Induced Cutaneous Hyperpigmentation in an Orthopedic Patient Population

    PubMed Central

    Hanada, Yuri; Berbari, Elie F.; Steckelberg, James M.

    2016-01-01

    Background. The objectives of this study were to estimate the incidence and evaluate risk factors for development of minocycline-induced cutaneous hyperpigmentation in patients with orthopedic infections. Methods. Patients with orthopedic infections evaluated at Mayo Clinic (Rochester, MN) and treated with minocycline from 1 January 2002 to 31 December 2011 were retrospectively identified. Long-term minocycline suppression was defined as daily minocycline use for at least 3 months. A proportional hazards model was used to evaluate potential risk factors. Results. Of 291 patients receiving long-term minocycline suppression, 54% (156 of 291) developed hyperpigmentation after a mean follow-up of 4.8 years (range, 0.3–13.2 years); 88% involved blue-gray pigmentation of normal skin that appeared most commonly in the lower (75%) and upper extremities (44%). The mean duration of minocycline therapy before hyperpigmentation was 1.5 years (range, 0.1–9 years) with a mean cumulative dosage of 107.3 g (range, 8.6–657 g). Notable risk factors include a history of vitamin D deficiency (relative risk [RR], 6.29; 95% confidence interval [CI], 1.91–15.27; P = .0052), presence of a shoulder prosthesis (RR, 3.2; 95% CI, 1.23–6.56; P = .0062), noncirrhotic liver pathology (RR, 3.63; 95% CI, 1.11–8.75; P = .0359), and use of a concurrent medication also known to cause hyperpigmentation (RR, 4.75; 95% CI, 1.83–10.1; P = .0029). Conclusions. Hyperpigmentation associated with the use of long-term minocycline suppression in patients with orthopedic infections is common. PMID:26835479

  13. Venting during prophylactic nailing for femoral metastases: current orthopedic practice

    PubMed Central

    Dalgorf, Dustin; Borkhoff, Cornelia M.; Stephen, David J.G.; Finkelstein, Joel; Kreder, Hans J.

    2003-01-01

    Introduction Reamed intramedullary nailing, recommended for impending fracture of a femur weakened by bone metastases, causes a rise in intramedullary pressure and increases the risk of a fat embolism syndrome. The pressure can be equalized by the technique of venting — drilling a hole into the distal cortex of the femur. Our objective was to study the current practice of orthopedic surgeons in Ontario with respect to venting during prophylactic intramedullary nailing for an impending femoral fracture due to bone metastases. Methods We mailed a questionnaire to all orthopedic surgeons from the Province of Ontario listed in the 1999 Canadian Medical Directory or on the Canadian Orthopaedic Association membership list, asking if they vent when prophylactically nailing an impending pathologic femoral fracture. The responses were modelled as a function of surgeon volume and year of graduation. Results Of the 415 surveys mailed, 223 (54%) surgeons responded. Of these, 81% reported having prophylactically treated a femoral metastatic lesion during the previous year; 67% treated 1 to 3 metastatic lesions and 14% treated more than 3; 19% did not treat a metastatic femoral lesion prophylactically. Over two-thirds of surgeons had never considered venting, whereas one-third always or sometimes vented the femoral canal. More recent graduates were 3 times more likely to vent than earlier (before 1980) graduates (odds ratio [OR] = 3.2, 95% confidence interval [CI] 1.6–6.5) as were those who treat a greater number of impending fractures (OR = 1.4, 95% CI 1.1–1.7). Conclusions Although there is a theoretical rationale for routine venting, there is disagreement among Ontario orthopedic surgeons regarding the use of this technique during prophylactic nailing for femoral metastatic lesions. Prospective evidence will be required to warrant a change in the standard of care. PMID:14680349

  14. ELECTRONIC MASTER SLAVE MANIPULATOR

    DOEpatents

    Goertz, R.C.; Thompson, Wm.M.; Olsen, R.A.

    1958-08-01

    A remote control manipulator is described in which the master and slave arms are electrically connected to produce the desired motions. A response signal is provided in the master unit in order that the operator may sense a feel of the object and may not thereby exert such pressures that would ordinarily damage delicate objects. This apparatus will permit the manipulation of objects at a great distance, that may be viewed over a closed TV circuit, thereby permitting a remote operator to carry out operations in an extremely dangerous area with complete safety.

  15. Model based manipulator control

    NASA Technical Reports Server (NTRS)

    Petrosky, Lyman J.; Oppenheim, Irving J.

    1989-01-01

    The feasibility of using model based control (MBC) for robotic manipulators was investigated. A double inverted pendulum system was constructed as the experimental system for a general study of dynamically stable manipulation. The original interest in dynamically stable systems was driven by the objective of high vertical reach (balancing), and the planning of inertially favorable trajectories for force and payload demands. The model-based control approach is described and the results of experimental tests are summarized. Results directly demonstrate that MBC can provide stable control at all speeds of operation and support operations requiring dynamic stability such as balancing. The application of MBC to systems with flexible links is also discussed.

  16. Surface evaluation of orthopedic hip implants marketed in Brazil

    NASA Astrophysics Data System (ADS)

    Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

    2016-07-01

    One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

  17. Presurgical Dentofacial Orthopedic Management of the Cleft Patient.

    PubMed

    Smith, Kevin S; Henry, Byron T; Scott, Michelle A

    2016-05-01

    Over the last decade, presurgical orthopedic molding for the patient with cleft lip and palate has become much more common; it is even reasonable to assume it may be the standard of care for those wide unilateral and bilateral clefts with substantial dentofacial deformities. In 2013, there was a comparative study of nasoalveolar molding methods, comparing the Grayson-NAM device and DynaCleft. The results showed the 2 to be equivocal with both methods significantly reducing the cleft width and improving the nasal asymmetry. PMID:27150304

  18. Endoscopic Management of Free Lying Migratory Orthopedic Screw in Bladder.

    PubMed

    P, Puvai Murugan; M, Ramalingam

    2016-09-01

    75-year old gentleman presented with acute urinary retention. He had met with road traffic accident 15 years back and sustained pelvic fracture and bladder rupture, underwent bladder repair and open reduction and internal fixation of pubic symphsis. Imaging studies showed the free lying encrusted orthopedic screw in the bladder, which was removed per urethra using nephroscope. Migratory foreign bodies in the urinary bladder are rare. However there is a possibility of longstanding foreign bodies in adjacent structures to erode and perforate into the bladder. Inside the bladder these foreign bodies act as nidus for stone formation. PMID:27500087

  19. [Orthokin as new therapeutic option for orthopedic diseases].

    PubMed

    Heyll, U

    2004-03-01

    The synthesis and introduction of interleukin-1 receptor antagonists established a promising strategy in the treatment of inflammatory diseases. This kind of therapy is claimed now to be available for osteoarthritis and other orthopedic disorders also. In the case of "orthokin", the interleukin-1 receptor antagonist is produced by stimulation of own blood-cells. It is not possible, to evaluate the practicability of this therapeutic approach because there are no published experimental data. We also found no results of clinical studies, which would allow an estimation of the effectiveness and the risks of this method. Therefore treatment with "orthokin" cannot be recommended at present. PMID:15049471

  20. RANDOMIZED CONTROLLED CLINICAL TRIALS IN ORTHOPEDICS: DIFFICULTIES AND LIMITATIONS

    PubMed Central

    Malavolta, Eduardo Angeli; Demange, Marco Kawamura; Gobbi, Riccardo Gomes; Imamura, Marta; Fregni, Felipe

    2015-01-01

    Randomized controlled clinical trials (RCTs) are considered to be the gold standard for evidence-based medicine nowadays, and are important for directing medical practice through consistent scientific observations. Steps such as patient selection, randomization and blinding are fundamental for conducting a RCT, but some additional difficulties are presented in trials that involve surgical procedures, as is common in orthopedics. The aim of this article was to highlight and discuss some difficulties and possible limitations on RCTs within the field of surgery. PMID:27027037

  1. Manipulating the Gradient

    ERIC Educational Resources Information Center

    Gaze, Eric C.

    2005-01-01

    We introduce a cooperative learning, group lab for a Calculus III course to facilitate comprehension of the gradient vector and directional derivative concepts. The lab is a hands-on experience allowing students to manipulate a tangent plane and empirically measure the effect of partial derivatives on the direction of optimal ascent. (Contains 7…

  2. Manipulating Combinatorial Structures.

    ERIC Educational Resources Information Center

    Labelle, Gilbert

    This set of transparencies shows how the manipulation of combinatorial structures in the context of modern combinatorics can easily lead to interesting teaching and learning activities at every level of education from elementary school to university. The transparencies describe: (1) the importance and relations of combinatorics to science and…

  3. Trust versus Manipulation

    ERIC Educational Resources Information Center

    Lewis, Anne C.

    2005-01-01

    This article discusses the issue of trust in the education system. What is different about the issue of trust in the education system is the assault upon it, sometimes overt but most often subtle. There is a difference between strong criticism and willful manipulation. The nation's schools are responding to the former--perhaps too slowly for…

  4. Kinematically redundant robot manipulators

    NASA Technical Reports Server (NTRS)

    Baillieul, J.; Hollerbach, J.; Brockett, R.; Martin, D.; Percy, R.; Thomas, R.

    1987-01-01

    Research on control, design and programming of kinematically redundant robot manipulators (KRRM) is discussed. These are devices in which there are more joint space degrees of freedom than are required to achieve every position and orientation of the end-effector necessary for a given task in a given workspace. The technological developments described here deal with: kinematic programming techniques for automatically generating joint-space trajectories to execute prescribed tasks; control of redundant manipulators to optimize dynamic criteria (e.g., applications of forces and moments at the end-effector that optimally distribute the loading of actuators); and design of KRRMs to optimize functionality in congested work environments or to achieve other goals unattainable with non-redundant manipulators. Kinematic programming techniques are discussed, which show that some pseudo-inverse techniques that have been proposed for redundant manipulator control fail to achieve the goals of avoiding kinematic singularities and also generating closed joint-space paths corresponding to close paths of the end effector in the workspace. The extended Jacobian is proposed as an alternative to pseudo-inverse techniques.

  5. Computer Algebra versus Manipulation

    ERIC Educational Resources Information Center

    Zand, Hossein; Crowe, David

    2004-01-01

    In the UK there is increasing concern about the lack of skill in algebraic manipulation that is evident in students entering mathematics courses at university level. In this note we discuss how the computer can be used to ameliorate some of the problems. We take as an example the calculations needed in three dimensional vector analysis in polar…

  6. Door breaching robotic manipulator

    NASA Astrophysics Data System (ADS)

    Schoenfeld, Erik; Parrington, Lawrence; von Muehlen, Stephan

    2008-04-01

    As unmanned systems become more commonplace in military, police, and other security forces, they are tasked to perform missions that the original hardware was not designed for. Current military robots are built for rough outdoor conditions and have strong inflexible manipulators designed to handle a wide range of operations. However, these manipulators are not well suited for some essential indoor tasks, including opening doors. This is a complicated kinematic task that places prohibitively difficult control challenges on the robot and the operator. Honeybee and iRobot have designed a modular door-breaching manipulator that mechanically simplifies the demands upon operator and robot. The manipulator connects to the existing robotic arm of the iRobot PackBot EOD. The gripper is optimized for grasping a variety of door knobs, levers, and car-door handles. It works in conjunction with a compliant wrist and magnetic lock-out mechanism that allows the wrist to remain rigid until the gripper has a firm grasp of the handle and then bend with its rotation and the swing of the door. Once the door is unlatched, the operator simply drives the robot through the doorway while the wrist compensates for the complex, multiple degree-of-freedom motion of the door. Once in the doorway the operator releases the handle, the wrist pops back into place, and the robot is ready for the next door. The new manipulator dramatically improves a robot's ability to non-destructively breach doors and perform an inspection of a room's content, a capability that was previously out of reach of unmanned systems.

  7. An orthopedic tissue adhesive for targeted delivery of intraoperative biologics.

    PubMed

    Simson, Jacob; Crist, Joshua; Strehin, Iossif; Lu, Qiaozhi; Elisseeff, Jennifer H

    2013-03-01

    Tissue adhesives can bind together damaged tissues and serve as tools to deliver and localize therapeutics to facilitate regeneration. One emerging therapeutic trend in orthopedics is the use of intraoperative biologics (IOB), such as bone marrow (BM) and platelet-rich plasma (PRP), to stimulate healing. Here, we introduce the application of the biomaterial chondroitin sulfate succinimidyl succinate (CS-NHS) to deliver IOB in a hydrogel adhesive. We demonstrate the biomaterial's ability to bind various tissue types and its cellular biocompatibility with encapsulated human mesenchymal stem cells (hMSCs). Further, we examine in detail the CS-NHS adhesive combined with BM aspirate for use in bone applications. hMSCs were encapsulated in CS-BM and cultured for 5 weeks in osteogenic medium. Quantitative RT-PCR demonstrated osteogenesis via upregulation of the osteogenic transcription factor Runx2 and bone markers alkaline phosphatase and osteocalcin. Significant deposition of calcium and osteocalcin was detected using biochemical, histological, and immunohistochemical techniques. Shear testing demonstrated that the CS-BM adhesive exhibited an adhesive strength approximately an order of magnitude stronger than fibrin glue and approaching that of a cyanoacrylate adhesive. These results indicate that CS-NHS is a promising delivery tool for IOB in orthopedic applications requiring a strong, degradable, and biocompatible adhesive that supports bone growth. PMID:23097279

  8. Angiogenesis and osteogenesis in an orthopedically expanded suture

    NASA Technical Reports Server (NTRS)

    Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.

    1997-01-01

    The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.

  9. Experimental and clinical performance of porous tantalum in orthopedic surgery.

    PubMed

    Levine, Brett Russell; Sporer, Scott; Poggie, Robert A; Della Valle, Craig J; Jacobs, Joshua J

    2006-09-01

    Porous tantalum, a new low modulus metal with a characteristic appearance similar to cancellous bone, is currently available for use in several orthopedic applications (hip and knee arthroplasty, spine surgery, and bone graft substitute). The open-cell structure of repeating dodecahedrons is produced via carbon vapor deposition/infiltration of commercially pure tantalum onto a vitreous carbon scaffolding. This transition metal maintains several interesting biomaterial properties, including: a high volumetric porosity (70-80%), low modulus of elasticity (3MPa), and high frictional characteristics. Tantalum has excellent biocompatibility and is safe to use in vivo as evidenced by its historical and current use in pacemaker electrodes, cranioplasty plates and as radiopaque markers. The bioactivity and biocompatibility of porous tantalum stems from its ability to form a self-passivating surface oxide layer. This surface layer leads to the formation of a bone-like apatite coating in vivo and affords excellent bone and fibrous in-growth properties allowing for rapid and substantial bone and soft tissue attachment. Tantalum-chondrocyte composites have yielded successful early results in vitro and may afford an option for joint resurfacing in the future. The development of porous tantalum is in its early stages of evolution and the following represents a review of its biomaterial properties and applications in orthopedic surgery. PMID:16737737

  10. Inferior vena cava filter placement in orthopedic surgery.

    PubMed

    Bass, Anne R; Mattern, Christopher J; Voos, James E; Peterson, Margaret G E; Trost, David W

    2010-09-01

    Inferior vena cava (IVC) filters were developed for the treatment of venous thromboembolism but in high-risk patients are often used for prophylaxis instead. In the study reported here, we reviewed all the orthopedic surgery cases in which IVC filters were used at our institution in 2005. Charts were analyzed and patients contacted by telephone for long-term follow-up. IVC filters were used in 90 (0.96%) of the 9,348 inpatient orthopedic surgeries. Sixty-one percent of filters were placed for prophylaxis, though only 42% of patients with prophylactic filters had a contraindication to anticoagulation. Eighty-one percent of patients with prophylactic filters who received anticoagulation received warfarin. Ratios of prophylactic-to-treatment filters were 3.25 for fracture surgeries, 2.1 for arthroplasties, and 0.89 for spine surgeries. Five percent of patients with prophylactic filters developed deep vein thrombosis. Fifty-two percent of filters were retrievable, but only 40% of those were removed a mean of 5.1 months (SD, 3.9 months) after placement. Filter removal was associated with complications in 11% of patients, and in another 10% the filter could not be removed. Forty-one patients were contacted a mean of 21 months (SD, 3 months) after filter placement. Only 32% of those who still had filters were on anticoagulation at follow-up. PMID:21290021

  11. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis

    PubMed Central

    Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts’ process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts’ scanning is simultaneously both structured (i.e. deterministic) and unpredictable. PMID:27414794

  12. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis.

    PubMed

    Assaf, Dan; Amar, Eyal; Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts' process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts' scanning is simultaneously both structured (i.e. deterministic) and unpredictable. PMID:27414794

  13. Guidelines for the Implementation of Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    Black, Robert S.; Fusco, Carol B.

    Guidelines are provided for the development of programs in South Carolina for orthopedically handicapped (OH) pupils. Basic information is given concerning the definition of orthopedic handicap, the legal mandates on the education of OH pupils, funding sources, authorized programs (whether self-contained programs, resource rooms, or itinerant…

  14. The Orthopedically Disabled Child: Psychological Implications with an Individual Basis. July 1984 Revision.

    ERIC Educational Resources Information Center

    Sigmon, Scott B.

    This study describes the implications of the Individual Psychology of Alfred Adler and field theory associated with Kurt Lewin in understanding orthopedically disabled children and points out that orthopedically disabled youngsters have a remarkable range of individual differences both in type of disability as well as level of adjustment.…

  15. Dance for Students with Orthopedic Conditions--Popular, Square, Folk, Modern, [and] Ballet.

    ERIC Educational Resources Information Center

    Harris, Cordelia Graves

    1979-01-01

    Preparation for teaching dance to orthopedically handicapped students is discussed in addition to specific suggestions for teaching popular dance, square dance, folk dance, modern dance, and ballet. Dancing is seen as a way to give orthopedically handicapped students physical education success without competition. Recommended music for each type…

  16. Military Curricula for Vocational & Technical Education. Orthopedic Specialist, Classroom Course 10-13.

    ERIC Educational Resources Information Center

    Brooke Army Medical Center, Fort Sam Houston, TX. Health Care Research Div.

    These military-developed curriculum materials for a course for orthopedic specialists are targeted for students from grades 11 through the adult level. The course is designed to provide a working knowledge of the application of casts, traction, and splints to orthopedic patients and the removal of these devices; a working knowledge of assisting in…

  17. Age, Physical Activity, Physical Fitness, Body Composition, and Incidence of Orthopedic Problems.

    ERIC Educational Resources Information Center

    Research Quarterly for Exercise and Sport, 1989

    1989-01-01

    Effects of age, physical activity, physical fitness, and body mass index (BMI) on the occurrence of orthopedic problems were examined. For men, physical fitness, BMI, and physical activity were associated with orthopedic problems; for women, physical activity was the main predictor. Age was not a factor for either gender. (JD)

  18. Factors affecting interest in orthopedics among female medical students: a prospective analysis.

    PubMed

    Baldwin, Keith; Namdari, Surena; Bowers, Andrea; Keenan, Mary Ann; Levin, L Scott; Ahn, Jaimo

    2011-12-01

    The field of orthopedics has a limited ability to recruit high-quality female applicants. The purpose of this study was to determine whether early exposure to the field affects a woman's decision to pursue orthopedics. We performed a prospective, nonrandomized cohort study between academic years 2005 and 2009 and compared interest in orthopedic surgery among female (n=271) and male (n=71) medical students at 2 urban teaching institutions. Elective lectures and orthopedic literature were distributed via e-mail to the study participants. These materials included articles published in the medical literature, materials produced and distributed by the American Academy of Orthopaedic Surgeons, and Web sites providing educational materials. The primary outcome was the likelihood of application for orthopedic residency. We studied the influence of demographics, exposure, and attitudes on interest in pursuing an orthopedic career. Men had a significantly higher baseline level of interest in orthopedic surgery than women (P=.005). Younger age (P<.001) and personal (P<.001), independent (P<.001), and school (P=.023) exposures to orthopedics were significantly related to interest among women. At final follow-up, total personal exposures (P=.003) and total independent exposures (P<.001) in the form of our literature and lectures were correlated with final interest in women. Female interest was decreased by the long hours, physical demands, and predominantly male nature of the field. Early exposure to orthopedic educational resources may be useful in generating female interest. Perceptions and attitudes regarding orthopedic surgery must to be changed to attract the best and brightest minds, regardless of sex. PMID:22146211

  19. Level of billing as a function of resident documentation and orthopedic subspecialty at an academic multispecialty orthopedic surgery practice.

    PubMed

    Dezfuli, Bobby; Smith, Jordan L

    2012-11-01

    Documentation, coding, and billing for physician-patient encounters have evolved over time and have significant variability. Appropriate and complete documentation of these encounters can contribute to the financial viability of private and academic medical centers. The objectives of this study were to assess the financial effect of documentation on billing and to compare the authors' institution's distribution of billing level compared with Medicare normative data. Four orthopedic surgery subspecialty clinics were evaluated at a university outpatient clinic over a 1-year period. A single full-day clinic per week was used for each subspecialty. Residents dictated the majority of the reports. All reports were transcribed by medical transcriptionists and coded by certified professional coders. The sports medicine subspecialty generated the highest volume of patient clinic visits, followed by foot and ankle, trauma, and spine (P<.01). The majority of the reports were billed at level 3 (P<.05). Significant differences existed between subspecialty and percentage distribution of billing level (P<.05). Compared with Medicare normative data, a significantly greater percentage of level 3 reports and a lower percentage of level 2 and 4 reports existed in the orthopedic practice (P<.01). The estimated loss of revenue from the fewer level 4 reports was $81,281.11 for 1 year. These findings highlight the need for greater educational interventions to improve provider documentation, coding, and billing. The effect of new electronic medical record systems that prompt providers to include key evaluation and management components will likely affect practices and warrant further analysis. PMID:23127460

  20. REMOTELY OPERATED MANIPULATOR

    DOEpatents

    Hutto, E.L.

    1961-08-15

    A manipulator is described for performing, within an entirely enclosed cell containling radioactive materials, various mechanical operations. A rod with flexible fingers is encompassed by a tubular sleeve shorter than the rod. Relative movement between the rod and sleeve causes the fingers to open and close. This relative movement is effected by relative movement of permanent magnets in magnetic coupling relation to magnetic followers affixed to the ends of the rod and sleeve. The rod and its sleeve may be moved as a unit axially or may be rotated by means of the magnetic couplings. The manipulator is enclosed within a tubular member which is flexibly sealed to an opening in the cell. (AEC)

  1. Computer aided manipulator control

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.; Zawacki, R. L.

    1980-01-01

    This paper describes the hardware and software system of a dedicated mini- and microcomputer network developed at the JPL teleoperator project to aid the operator in real-time control of remote manipulators. The operator can be in series or in parallel with the control computer during operation. The purpose of the project is to develop, demonstrate and evaluate advanced supervisory control concepts and techniques for space applications. The paper concludes with a brief outline of future development plans and issues.

  2. Manipulation of quantum evolution

    NASA Technical Reports Server (NTRS)

    Cabera, David Jose Fernandez; Mielnik, Bogdan

    1994-01-01

    The free evolution of a non-relativistic charged particle is manipulated using time-dependent magnetic fields. It is shown that the application of a programmed sequence of magnetic pulses can invert the free evolution process, forcing an arbitrary wave packet to 'go back in time' to recover its past shape. The possibility of more general operations upon the Schrodinger wave packet is discussed.

  3. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, Russell M.

    1980-01-01

    A method and apparatus for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated to relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  4. MANIPULATOR FOR SLAVE ROBOT

    DOEpatents

    Goertz, R.C.; Grimson, J.H.; Kohut, F.A.

    1961-04-01

    A remote-control manipulator comprising two stationary master units, two slave units on a movable vehicle, and electrical connections between the master and slave units is reported. The slave units are side by side with a minimum over-all width, which is made feasible by an arrangement of transducers producing most movements of each slave unit to one side of the support of said slave unit.

  5. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, R.M.

    A method and apparatus is disclosed for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  6. Endocavity Ultrasound Probe Manipulators

    PubMed Central

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2014-01-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

  7. Endocavity Ultrasound Probe Manipulators.

    PubMed

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2013-06-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

  8. Welding nozzle position manipulator

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L. (Inventor); Gutow, David A. (Inventor)

    1994-01-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  9. Validity of subjective smoking status in orthopedic patients

    PubMed Central

    Bender, Daniel; Haubruck, Patrick; Boxriker, Sonja; Korff, Sebastian; Schmidmaier, Gerhard; Moghaddam, Arash

    2015-01-01

    Purpose In this level 1 diagnostic study, we analyzed the validity of subjective smoking status and, as secondary research question, the smoking cessation adherence in orthopedic patients during a routine hospital stay of nonunion patients by measuring serum cotinine. Methods We included patients undergoing revision surgery due to nonunion of long bones. Patients were interviewed about their smoking status. Blood samples were taken from all the patients prior to surgery and for an additional 6 weeks following surgery. Serum levels of cotinine were measured, and coherence between subjective smoking status and objective cotinine analysis was evaluated. Results Between March 2012 and August 2014, we enrolled 136 patients. Six of the 26 “previous smokers” (23%) and four of the 65 “nonsmokers” (6%) had serum cotinine above cutoff levels. In self-labeled smokers, serum cotinine levels averaged at 2,367.4±14,885.9 ng/mL (with a median of 100 ng/mL), whereas in previous smokers the levels averaged at 4,270±19,619.4 ng/mL (with a median of 0 ng/mL) and in the nonsmokers group the levels averaged at 12±53.9 ng/mL (with a median of 0.03 ng/mL). Overall, the subjective smoking status matched serum cotinine testing in 88% of the cases. Sensitivity was 79.6% and specificity was 93.1%. Ninety-one percent of the patients with preoperative positive serum values were still positive at follow-up. Conclusion In this study, we could show that subjective smoking status in orthopedic patients is predominantly reliable as validated by objective cotinine measurements; however, patients who declare themselves as “previous smokers” are at elevated risk for underreporting continued smoking and patients who smoked preoperatively are at high risk for continuing their habit. In the future, caregivers should consider introducing effective treatments for smoking cessation to smokers and furthermore offer effective treatments to maintain smoking cessation in previous smokers during

  10. Direct Manipulation and Procedural Reasoning.

    ERIC Educational Resources Information Center

    Owen, David

    Arguing that understanding what lies behind the apparent usability of direct manipulation style interfaces might not only help in building better interfaces, but can also draw attention to possible side effects, this paper uses examples from a prototype data manipulation system to pursue a characterization of direct manipulation interfaces as…

  11. Barriers to the clinical translation of orthopedic tissue engineering.

    PubMed

    Evans, Christopher H

    2011-12-01

    Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested. PMID:21682607

  12. Regulatory perspective on characterization and testing of orthopedic bone cements.

    PubMed

    Demian, H W; McDermott, K

    1998-09-01

    This paper provides a general regulatory background of acrylic bone cements, chemical composition information on several commercially available bone cements, physical and chemical methods of analyses, mechanical test methods, and risks and failure mechanisms of acrylic bone cements. Suggestions and recommendations presented in Tables 2 and 3 are not mandatory requirements but reflect data and methodologies which the FDA's Orthopedic Devices Branch (ORDB) believes to be acceptable to evaluate most pre-clinical data. FDA may require information in addition to that contained in this paper. In some instances, a sponsor may be able to sufficiently justify the omission of some tests. Although this paper describes certain administrative requirements, it does not take the place of the requirements contained in Title 21 of the Code of Federal Regulations (21 CFR) Parts 801, 807, 812, and 814 or those found in the statute. PMID:9830987

  13. ADVANCES IN THE USE OF STEM CELLS IN ORTHOPEDICS

    PubMed Central

    Cristante, Alexandre Fogaça; Narazaki, Douglas Kenji

    2015-01-01

    Primordial cells or stem cells are multipotent undifferentiated cells with the capacity to originate any type of cell in the organism. They may have their origins in the blastocyst and thus are classified as embryonic, or tissues developed in fetuses, newborns or adults and thus are known as somatic stem cells. Bone marrow is one of the main locations for isolating primordial cells, and there are two lineages: hematopoietic and mesenchymal progenitor cells. There are several uses for these undifferentiated cells in orthopedics, going from cartilaginous lesions in osteoarthrosis, osteochondritis dissecans and patellar chondromalacia, to bone lesions like in pseudarthrosis or bone losses, or nerve lesions like in spinal cord trauma. Studying stem cells is probably the most promising field of study of all within medicine, and this is shortly going to revolutionize all medical specialties (both clinical and surgical) and thus provide solutions for diseases that today are difficult to deal with. PMID:27027022

  14. Cultural Nuance in Orthopedic Foreign Aid: Differences in Patient Concerns.

    PubMed

    Kavolus, Joseph J; Ritter, Merrill A; Claverie, J Guillermo; Salas, Marcos D; Kavolus, Christopher H; Trousdale, Robert T

    2016-01-01

    Orthopedic aid to developing nations is expanding and becoming a unique facet of the specialty. This investigation seeks to compare patient impressions and concerns regarding the care patients receive as part of an itinerant surgical aid trip in 2 nations. In 2013 and 2014, patients from 2 separate nations completed a Likert scale survey assessing impressions of the care they received at the hands of a surgical team from abroad. Mean response scores were calculated and compared using a t test. This is the first investigation to compare patient concerns across 2 nations in a surgical aid trip setting. The results highlight the importance of culture in understanding patients and the impressions of the care they receive. PMID:26350258

  15. Barriers to the Clinical Translation of Orthopedic Tissue Engineering

    PubMed Central

    2011-01-01

    Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested. PMID:21682607

  16. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele.

    PubMed

    Westcott, M A; Dynes, M C; Remer, E M; Donaldson, J S; Dias, L S

    1992-11-01

    This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy. PMID:1439018

  17. Power harvesting using PZT ceramics embedded in orthopedic implants.

    PubMed

    Chen, Hong; Liu, Ming; Jia, Chen; Wang, Zihua

    2009-09-01

    Battery lifetime has been the stumbling block for many power-critical or maintenance-free real-time embedded applications, such as wireless sensors and orthopedic implants. Thus a piezoelectric material that could convert human motion into electrical energy provides a very attractive solution for clinical implants. In this work, we analyze the power generation characteristics of stiff lead zirconate titanate (PZT) ceramics and the equivalent circuit through extensive experiments. Our experimental framework allows us to explore many important design considerations of such a PZT-based power generator. Overall we can achieve a PZT element volume of 0.5 x 0.5 x 1.8 cm, which is considerably smaller than the results reported so far. Finally, we outline the application of our PZT elements in a total knee replacement (TKR) implant. PMID:19812004

  18. Perioperative coagulation assessment of patients undergoing major elective orthopedic surgery.

    PubMed

    Spiezia, Luca; Vasques, Francesco; Behr, Astrid; Campello, Elena; Maggiolo, Sara; Berizzi, Antonio; Gavasso, Sabrina; Woodhams, Barry; Biancari, Fausto; Simioni, Paolo

    2016-09-01

    Traditional coagulative parameters are of limited use in identifying perioperative coagulopathy occurring in patients undergoing major elective orthopedic surgery (MEOS). The aim of our study was to evaluate the coagulation changes in patients undergoing MEOS and to facilitate an early detection of perioperative coagulopathy in patients experiencing major intraoperative bleeding. We enrolled 40 consecutive patients (M/F 10/30, age range 34-90 years) who underwent MEOS at the Orthopedic Unit of the Padua University Hospital, Italy, between January 2014 and January 2015. Blood samples were obtained at the following time points: T0-pre: 30 min before surgery; T0-post: 30 min after the end of the procedure; T1: morning of the first postoperative day; T2: 7 ± 2 days after surgery. Patients who experienced an intraoperative blood loss ≥250 mL/h were considered as cases. Routine coagulative parameters, thromboelastometry and thrombin generation (TG) profiles were evaluated. At baseline, a significantly lower platelet count and FIBTEM MCF/AUC were observed in patents with excessive bleeding (p < 0.05 and 0.02/0.01, respectively). At T0-post and T1 intervals, cases showed hypocoagulation characterized by a significantly low platelet count (p = 0.001), prolonged CFT INTEM/EXTEM, reduction of alpha-angle and MaxV INTEM/EXTEM, MCF and AUC INTEM/EXTEM/FIBTEM (p < 0.05 in all comparisons). The only TG parameter standing out between study groups was time to peak at T0-pre. A low platelet count and fibrinogen activity were associated with significant intraoperative bleeding in patients undergoing MEOS. Thromboelastometry performed by ROTEM(®) identifies patients with coagulopathy. PMID:26951189

  19. Orthopedic Correction of Growing Hyperdivergent, Retrognathic, Patients with Miniscrew Implants

    PubMed Central

    Buschang, Peter H.; Carrillo, Roberto; Rossouw, P. Emile

    2010-01-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do require long-term patient compliance. This paper introduces a novel approach using miniscrew implants (MSIa) and growth to treat retrognathic hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (13.2 ±1.1 years of age) and again at the end of the orthopedic phase (after 1.9 ±0.3 years). Each patient had two MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a RPE, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Prior to treatment, the patients exhibited substantial and significant mandibular retrusion (Z-score=−1.0), facial convexity (Z-score=0.7), and hyperdivergence (Z-score=1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced an average of 2.4 mm, the SNB angle increased by 2.1°, the mandibular plane angle decreased 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individuals’ growth potential. PMID:21236539

  20. Orthopedic specialty hospitals: centers of excellence or greed machines?

    PubMed

    Badlani, Neil; Boden, Scott; Phillips, Frank

    2012-03-01

    Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. PMID:22385456

  1. Orthopedic correction of growing hyperdivergent, retrognathic patients with miniscrew implants.

    PubMed

    Buschang, Peter H; Carrillo, Roberto; Rossouw, P Emile

    2011-03-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do address them require long-term patient compliance. This article introduces a novel approach using miniscrew implants (MSIs) and growth to treat retrognathic, hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (aged 13.2 ± 1.1 years) and again at the end of the orthopedic phase (after 1.9 ± 0.3 years). Each patient had 2 MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a rapid palatal expander, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Before treatment, the patients exhibited substantial and significant mandibular retrusion (Z score = -1.0), facial convexity (Z score = 0.7), and hyperdivergence (Z score = 1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced by a mean of 2.4 mm, the sella-nasion-basion (SNB) angle increased by 2.1°, the mandibular plane angle decreased by 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individual's growth potential. PMID:21236539

  2. Prevalence of Internet and Social Media Usage in Orthopedic Surgery

    PubMed Central

    Curry, Emily; Nguyen, Joseph; Matzkin, Elizabeth

    2014-01-01

    Prior studies in other specialties have shown that social networking and Internet usage has become an increasingly important means of patient communication and referral. The purpose of this study is to evaluate the prevalence of Internet or social media usage in new patients referred to a major academic orthopedics center and to identify new avenues to optimize patient recruitment and communication. New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed. Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (P<0.0001). Younger age was the biggest indicator predicting the use of social media. Patients that travelled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment. We conclude that orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day’s travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals. PMID:25317312

  3. Applications of finite element simulation in orthopedic and trauma surgery.

    PubMed

    Herrera, Antonio; Ibarz, Elena; Cegoñino, José; Lobo-Escolar, Antonio; Puértolas, Sergio; López, Enrique; Mateo, Jesús; Gracia, Luis

    2012-04-18

    Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography (CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element (FE) simulation lets us know the biomechanical changes that take place after hip prostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints

  4. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein

    PubMed Central

    Ritz, Ulrike; Ackermann, Angelika; Anthonissen, Joris; Kaufmann, Kerstin B.; Brendel, Christian; Götz, Hermann; Rommens, Pol M.; Hofmann, Alexander

    2016-01-01

    Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both

  5. Hydroxyapatite-nanotube composites and coatings for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Lahiri, Debrupa

    Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. The aim of the current research is to explore the potential of nanotubes as reinforcement to HA for orthopedic implants. HA- 4 wt.% carbon nanotube (CNT) composites and coatings are synthesized by spark plasma sintering and plasma spraying respectively, and investigated for their mechanical, tribological and biological behavior. CNT reinforcement improves the fracture toughness (>90%) and wear resistance (>66%) of HA for coating and free standing composites. CNTs have demonstrated a positive influence on the proliferation, differentiation and matrix mineralization activities of osteoblasts, during in-vitro biocompatibility studies. In-vivo exposure of HA-CNT coated titanium implant in animal model (rat) shows excellent histocompatibility and neobone integration on the implant surface. The improved osseointegration due to presence of CNTs in HA is quantified by the adhesion strength measurement of single osteoblast using nano-scratch technique. Considering the ongoing debate about cytotoxicity of CNTs in the literature, the present study also suggests boron nitride nanotube (BNNT) as an alternative reinforcement. BNNT with the similar elastic modulus and strength as CNT, were added to HA. The resulting composite having 4 wt.% BNNTs improved the fracture toughness (˜85%) and wear resistance (˜75%) of HA in the similar range as HA-CNT composites. BNNTs were found to be non-cytotoxic for osteoblasts and macrophages. In-vitro evaluation shows positive role of BNNT in osteoblast proliferation and viability. Apatite formability of BNNT surface in ˜4 days establishes its osseointegration

  6. Value Added: the Case for Point-of-View Camera use in Orthopedic Surgical Education

    PubMed Central

    Thomas, Geb W.; Taylor, Leah; Liu, Xiaoxing; Anthony, Chris A.; Anderson, Donald D.

    2016-01-01

    Abstract Background Orthopedic surgical education is evolving as educators search for new ways to enhance surgical skills training. Orthopedic educators should seek new methods and technologies to augment and add value to real-time orthopedic surgical experience. This paper describes a protocol whereby we have started to capture and evaluate specific orthopedic milestone procedures with a GoPro® point-of-view video camera and a dedicated video reviewing website as a way of supplementing the current paradigm in surgical skills training. We report our experience regarding the details and feasibility of this protocol. Methods Upon identification of a patient undergoing surgical fixation of a hip or ankle fracture, an orthopedic resident places a GoPro® point-of-view camera on his or her forehead. All fluoroscopic images acquired during the case are saved and later incorporated into a video on the reviewing website. Surgical videos are uploaded to a secure server and are accessible for later review and assessment via a custom-built website. An electronic survey of resident participants was performed utilizing Qualtrics software. Results are reported using descriptive statistics. Results A total of 51 surgical videos involving 23 different residents have been captured to date. This includes 20 intertrochanteric hip fracture cases and 31 ankle fracture cases. The average duration of each surgical video was 1 hour and 16 minutes (range 40 minutes to 2 hours and 19 minutes). Of 24 orthopedic resident surgeons surveyed, 88% thought capturing a video portfolio of orthopedic milestones would benefit their education Conclusions There is a growing demand in orthopedic surgical education to extract more value from each surgical experience. While further work in development and refinement of such assessments is necessary, we feel that intraoperative video, particularly when captured and presented in a non-threatening, user friendly manner, can add significant value to the

  7. Spatial manipulation with microfluidics.

    PubMed

    Lin, Benjamin; Levchenko, Andre

    2015-01-01

    Biochemical gradients convey information through space, time, and concentration, and are ultimately capable of spatially resolving distinct cellular phenotypes, such as differentiation, proliferation, and migration. How these gradients develop, evolve, and function during development, homeostasis, and various disease states is a subject of intense interest across a variety of disciplines. Microfluidic technologies have become essential tools for investigating gradient sensing in vitro due to their ability to precisely manipulate fluids on demand in well-controlled environments at cellular length scales. This review will highlight their utility for studying gradient sensing along with relevant applications to biology. PMID:25905100

  8. Manipulation of thermal phonons

    NASA Astrophysics Data System (ADS)

    Hsu, Chung-Hao

    Developing materials that can conduct electricity easily, but block the motion of phonons is necessary in the applications of thermoelectric devices, which can generate electricity from temperature differences. In converse, a key requirement as chips get faster is to obtain better ways to dissipate heat. Controlling heat transfer in these crystalline materials devices --- such as silicon --- is important. The heat is actually the motion or vibration of atoms known as phonons. Finding ways to manipulate the behavior of phonons is crucial for both energy applications and the cooling of integrated circuits. A novel class of artificially periodic structured materials --- phononic crystals --- might make manipulation of thermal phonons possible. In many fields of physical sciences and engineering, acoustic wave propagation in solids attracts many researchers. Wave propagation phenomena can be analyzed by mathematically solving the acoustic wave equation. However, wave propagation in inhomogeneous media with various geometric structures is too complex to find an exact solution. Hence, the Finite Difference Time Domain method is developed to investigate these complicated problems. In this work, the Finite-Difference Time-Domain formula is derived from acoustic wave equations based on the Taylor's expansion. The numerical dispersion and stability problems are analyzed. In addition, the convergence conditions of numerical acoustic wave are stated. Based on the periodicity of phononic crystal, the Bloch's theorem is applied to fulfill the periodic boundary condition of the FDTD method. Then a wide-band input signal is used to excite various acoustic waves with different frequencies. In the beginning of the calculation process, the wave vector is chosen and fixed. By means of recording the displacement field and taking the Fourier transformation, we can obtain the eigenmodes from the resonance peaks of the spectrum and draw the dispersion relation curve of acoustic waves

  9. Spatial Manipulation with Microfluidics

    PubMed Central

    Lin, Benjamin; Levchenko, Andre

    2015-01-01

    Biochemical gradients convey information through space, time, and concentration, and are ultimately capable of spatially resolving distinct cellular phenotypes, such as differentiation, proliferation, and migration. How these gradients develop, evolve, and function during development, homeostasis, and various disease states is a subject of intense interest across a variety of disciplines. Microfluidic technologies have become essential tools for investigating gradient sensing in vitro due to their ability to precisely manipulate fluids on demand in well-controlled environments at cellular length scales. This review will highlight their utility for studying gradient sensing along with relevant applications to biology. PMID:25905100

  10. Performance measurement of mobile manipulators

    NASA Astrophysics Data System (ADS)

    Bostelman, Roger; Hong, Tsai; Marvel, Jeremy

    2015-05-01

    This paper describes a concept for measuring the reproducible performance of mobile manipulators to be used for assembly or other similar tasks. An automatic guided vehicle with an onboard robot arm was programmed to repeatedly move to and stop at a novel, reconfigurable mobile manipulator artifact (RMMA), sense the RMMA, and detect targets on the RMMA. The manipulator moved a laser retroreflective sensor to detect small reflectors that can be reconfigured to measure various manipulator positions and orientations (poses). This paper describes calibration of a multi-camera, motion capture system using a 6 degree-of-freedom metrology bar and then using the camera system as a ground truth measurement device for validation of the reproducible mobile manipulator's experiments and test method. Static performance measurement of a mobile manipulator using the RMMA has proved useful for relatively high tolerance pose estimation and other metrics that support standard test method development for indexed and dynamic mobile manipulator applications.

  11. The beginnings of Orthopedic Surgery at the Mayo Clinic: A Review of the First Orthopedic Patients who Presented Over 100 Years Ago

    PubMed Central

    Camp, Christopher L.; Morrey, Bernard F; Trousdale, Robert T

    2016-01-01

    Background Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907. Methods The first 400 sequential medical charts of the Mayo Clinic’s patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases. Results Of the first 400 patients reviewed, 15 (4%) received specific orthopedic diagnoses. All presented during a three week period in 1907, and they traveled from all over the region for evaluation. The diagnoses included skeletal tuberculosis (n=6), traumatic fracture (n=3), osteomyelitis (n=2), syphilitic pathologic fracture (n=1), syphilitic ostitis of the tibia and radius (n=1), painful flat foot (n=1), and Morton’s toe (n=1). Included with the records are patient demographics, diagnoses, symptoms, physical examination findings, radiograph reports, operative reports, and detailed drawings of symptomatology. Conclusion Although the technology and science has advanced since the early practice of orthopedic surgery that took place over a century ago, we consider ourselves to be merely an extension of those who established the field before us. Just as the past relies on the future for the continuation of what it began so many years ago, we rely on our founders for the groundwork that they laid in creating this field of surgical medicine PMID:27528834

  12. Parasites and supernormal manipulation.

    PubMed

    Holen, Ø H; Saetre, G P; Slagsvold, T; Stenseth, N C

    2001-12-22

    Social parasites may exploit their hosts by mimicking other organisms that the hosts normally benefit from investing in or responding to in some other way. Some parasites exaggerate key characters of the organisms they mimic, possibly in order to increase the response from the hosts. The huge gape and extreme begging intensity of the parasitic common cuckoo chick (Cuculus canorus) may be an example. In this paper, the evolutionary stability of manipulating hosts through exaggerated signals is analysed using game theory. Our model indicates that a parasite's signal intensity must be below a certain threshold in order to ensure acceptance and that this threshold depends directly on the rate of parasitism. The only evolutionarily stable strategy (ESS) combination is when hosts accept all signallers and parasites signal at their optimal signal intensity, which must be below the threshold. Supernormal manipulation by parasites is only evolutionarily stable under sufficiently low rates of parasitism. If the conditions for the ESS combination are not satisfied, rejector hosts can invade using signal intensity as a cue for identifying parasites. These qualitative predictions are discussed with respect to empirical evidence from parasitic mimicry systems that have been suggested to involve supernormal signalling, including evicting avian brood parasites and insect-mimicking Ophrys orchids. PMID:11749709

  13. Hydraulic manipulator research at ORNL

    SciTech Connect

    Kress, R.L.; Jansen, J.F.; Love, L.J.

    1997-03-01

    Recently, task requirements have dictated that manipulator payload capacity increase to accommodate greater payloads, greater manipulator length, and larger environmental interaction forces. General tasks such as waste storage tank cleanup and facility dismantlement and decommissioning require manipulator life capacities in the range of hundreds of pounds rather than tens of pounds. To meet the increased payload capacities demanded by present-day tasks, manipulator designers have turned once again to hydraulics as a means of actuation. In order to successfully design, build, and deploy a new hydraulic manipulator (or subsystem), sophisticated modeling, analysis, and control experiments are usually needed. Oak Ridge National Laboratory (ORNL) has a history of projects that incorporate hydraulics technology, including mobile robots, teleoperated manipulators, and full-scale construction equipment. In addition, to support the development and deployment of new hydraulic manipulators, ORNL has outfitted a significant experimental laboratory and has developed the software capability for research into hydraulic manipulators, hydraulic actuators, hydraulic systems, modeling of hydraulic systems, and hydraulic controls. The purpose of this article is to describe the past hydraulic manipulator developments and current hydraulic manipulator research capabilities at ORNL. Included are example experimental results from ORNL`s flexible/prismatic test stand.

  14. Rational design of nanofiber scaffolds for orthopedic tissue repair and regeneration

    PubMed Central

    Ma, Bing; Xie, Jingwei; Jiang, Jiang; Shuler, Franklin D; Bartlett, David E

    2013-01-01

    This article reviews recent significant advances in the design of nanofiber scaffolds for orthopedic tissue repair and regeneration. It begins with a brief introduction on the limitations of current approaches for orthopedic tissue repair and regeneration. It then illustrates that rationally designed scaffolds made up of electrospun nanofibers could be a promising solution to overcome the problems that current approaches encounter. The article also discusses the intriguing properties of electrospun nanofibers, including control of composition, structures, orders, alignments and mechanical properties, use as carriers for topical drug and/or gene sustained delivery, and serving as substrates for the regulation of cell behaviors, which could benefit musculoskeletal tissue repair and regeneration. It further highlights a few of the many recent applications of electrospun nanofiber scaffolds in repairing and regenerating various orthopedic tissues. Finally, the article concludes with perspectives on the challenges and future directions for better design, fabrication and utilization of nanofiber scaffolds for orthopedic tissue engineering. PMID:23987110

  15. [Progresses in the orthopedic-reconstructive surgery by microsurgery (author's transl)].

    PubMed

    Friedebold, G; Zilch, H; Gaudin, B

    1979-04-01

    After a short description of the microsurgical technique for operations of periphere nerves and small vessels, the possibilities for reconstructive operations in orthopedic surgery are demonstrated. The actual experiences allow a critical but also cautious prospective statement. PMID:463213

  16. 78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... COMMISSION Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof..., Software, Implants, and Components Thereof, DN 2945; the Commission is soliciting comments on any public... devices, software, implants, and components thereof. The complaint names as respondents Stanmore...

  17. Nanophase hydroxyapatite coatings for dental and orthopedic applications

    NASA Astrophysics Data System (ADS)

    Sato, Michiko

    In order to improve dental and orthopedic implant performance, the objective of this study was to synthesize nanocrystalline hydroxyapatite (HA) powders to coat metals (specifically, titanium and tantalum). Precipitated HA powders were either sintered in order to produce UltraCaP HA (or microcrystalline size HA) or were treated hydrothermally to produce nanocrystalline HA. Some of the UltraCaP and nanocrystalline HA powders were doped with yttrium (Y) since previous in vitro studies demonstrated that Y-doped HA in bulk improved osteoblast (or bone-forming cell) function over undoped HA. The nanocrystalline HA powders were also mixed with nanophase titania powders because previous studies demonstrated that titania/HA composite coatings increased coating adhesive strength and HA nucleation. These powders were then deposited onto titanium by a novel room-temperature process, called IonTiteT(TM). The results demonstrated that the chemical properties and crystallite size of the original HA powders were maintained in the coatings. More importantly, in vitro studies showed increased osteoblast (bone-forming cell) adhesion on the single phase nanocrystalline HA and nano-titania/HA coatings compared to traditionally used plasma-sprayed HA coatings and uncoated metals. Results further demonstrated greater amounts of calcium deposition by osteoblasts cultured on nanocrystalline HA coatings compared to UltraCaP coatings and conventionally used plasma-sprayed HA coatings. To elucidate mechanisms that influenced osteoblast functions on the HA coatings, the amount of proteins (fibronectin and vitronectin) onto the HA powders and the adsorbed fibronectin conformation were investigated. Exposure of cell integrin binding domains (in fibronectin III10 segments) was greater in fibronectin adsorbed onto 1.2 mole% Y-doped UltraCaP HA coatings compared to nanocrystalline HA coatings tested. However, 1.2 mole% Y-doped UltraCaP HA coatings did not increase mineralization by osteoblasts

  18. A History of Manipulative Therapy

    PubMed Central

    Pettman, Erland

    2007-01-01

    Manipulative therapy has known a parallel development throughout many parts of the world. The earliest historical reference to the practice of manipulative therapy in Europe dates back to 400 BCE. Over the centuries, manipulative interventions have fallen in and out of favor with the medical profession. Manipulative therapy also was initially the mainstay of the two leading alternative health care systems, osteopathy and chiropractic, both founded in the latter part of the 19th century in response to shortcomings in allopathic medicine. With medical and osteopathic physicians initially instrumental in introducing manipulative therapy to the profession of physical therapy, physical therapists have since then provided strong contributions to the field, thereby solidifying the profession's claim to have manipulative therapy within in its legally regulated scope of practice. PMID:19066664

  19. Adaptive control of robotic manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, H.

    1987-01-01

    The author presents a novel approach to adaptive control of manipulators to achieve trajectory tracking by the joint angles. The central concept in this approach is the utilization of the manipulator inverse as a feedforward controller. The desired trajectory is applied as an input to the feedforward controller which behaves as the inverse of the manipulator at any operating point; the controller output is used as the driving torque for the manipulator. The controller gains are then updated by an adaptation algorithm derived from MRAC (model reference adaptive control) theory to cope with variations in the manipulator inverse due to changes of the operating point. An adaptive feedback controller and an auxiliary signal are also used to enhance closed-loop stability and to achieve faster adaptation. The proposed control scheme is computationally fast and does not require a priori knowledge of the complex dynamic model or the parameter values of the manipulator or the payload.

  20. Simple, efficient UHV manipulator

    SciTech Connect

    Thiel, P.A.; Anderegg, J.W.

    1984-10-01

    A simple manipulator is described for use in ultrahigh vacuum. Unhindered rotation within vacuum is provided by a commercial differentially pumped adapter to which the entire XYZ stage is attached. The combination of movements provided by the XYZ stage, the rotating vacuum flange, and a gimbal permits alignment of the sample with any of the peripheral view ports. The resistively heated sample support, mounted through a cold finger, permits rapid variation of sample temperature from several hundred degrees Kelvin to near cryogenic. It is anticipated that this design could be easily used with many existing types of commercial vacuum systems, with the consequent advantage of increased ease and simplicity of both mechanical motion and cryogenic cooling.

  1. Ion manipulation device

    DOEpatents

    Anderson, Gordon A; Smith, Richard D; Ibrahim, Yehia M; Baker, Erin M

    2014-09-16

    An ion manipulation method and device is disclosed. The device includes a pair of substantially parallel surfaces. An array of inner electrodes is contained within, and extends substantially along the length of, each parallel surface. The device includes a first outer array of electrodes and a second outer array of electrodes. Each outer array of electrodes is positioned on either side of the inner electrodes, and is contained within and extends substantially along the length of each parallel surface. A DC voltage is applied to the first and second outer array of electrodes. A RF voltage, with a superimposed electric field, is applied to the inner electrodes by applying the DC voltages to each electrode. Ions either move between the parallel surfaces within an ion confinement area or along paths in the direction of the electric field, or can be trapped in the ion confinement area.

  2. Interactive protein manipulation

    SciTech Connect

    SNCrivelli@lbl.gov

    2003-07-01

    We describe an interactive visualization and modeling program for the creation of protein structures ''from scratch''. The input to our program is an amino acid sequence -decoded from a gene- and a sequence of predicted secondary structure types for each amino acid-provided by external structure prediction programs. Our program can be used in the set-up phase of a protein structure prediction process; the structures created with it serve as input for a subsequent global internal energy minimization, or another method of protein structure prediction. Our program supports basic visualization methods for protein structures, interactive manipulation based on inverse kinematics, and visualization guides to aid a user in creating ''good'' initial structures.

  3. Vacuum tool manipulator

    DOEpatents

    Zollinger, William T.

    1993-01-01

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm.

  4. Vacuum tool manipulator

    DOEpatents

    Zollinger, W.T.

    1993-11-23

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm. 6 figures.

  5. Advanced servo manipulator

    DOEpatents

    Holt, W.E.; Kuban, D.P.; Martin, H.L.

    1988-10-25

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.

  6. Advanced servo manipulator

    DOEpatents

    Holt, William E.; Kuban, Daniel P.; Martin, H. Lee

    1988-01-01

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.

  7. Do Astronauts Havbe a Higher Rate of Orthopedic Shoulder Conditions Than a Cohort of Working Professionals

    NASA Technical Reports Server (NTRS)

    Laughlin, M. S.; Murray, J. D.; Young, M.; Wear, M. L.; Van Baalen, M.; Tarver, W. J.

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. Orthopedic shoulder injury and surgery rates were calculated [1], but classifying the rates as normal, high or low was highly dependent on the comparison group. Thus, the purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  8. Manipulation hardware for microgravity research

    SciTech Connect

    Herndon, J.N.; Glassell, R.L.; Butler, P.L.; Williams, D.M. ); Rohn, D.A. . Lewis Research Center); Miller, J.H. )

    1990-01-01

    The establishment of permanent low earth orbit occupation on the Space Station Freedom will present new opportunities for the introduction of productive flexible automation systems into the microgravity environment of space. The need for robust and reliable robotic systems to support experimental activities normally intended by astronauts will assume great importance. Many experimental modules on the space station are expected to require robotic systems for ongoing experimental operations. When implementing these systems, care must be taken not to introduce deleterious effects on the experiments or on the space station itself. It is important to minimize the acceleration effects on the experimental items being handled while also minimizing manipulator base reaction effects on adjacent experiments and on the space station structure. NASA Lewis Research Center has been performing research on these manipulator applications, focusing on improving the basic manipulator hardware, as well as developing improved manipulator control algorithms. By utilizing the modular manipulator concepts developed during the Laboratory Telerobotic Manipulator program, Oak Ridge National Laboratory has developed an experimental testbed system called the Microgravity Manipulator, incorporating two pitch-yaw modular positioners to provide a 4 dof experimental manipulator arm. A key feature in the design for microgravity manipulation research was the use of traction drives for torque transmission in the modular pitch-yaw differentials.

  9. Torque-Limiting Manipulation Device

    NASA Technical Reports Server (NTRS)

    Moetteli, John B. (Inventor)

    1999-01-01

    A device for manipulating a workpiece in space includes a fixture, a stanchion assembly, a manipulation mechanism, an actuation mechanism, and a reaction mechanism. The fixture has an end onto which the workpiece affixes. The stanchion assembly has an upper and a lower end. The manipulation mechanism connects the fixture and the upper end of the stanchion assembly. The lower end of the stanchion assembly mounts, via probe and a socket, to a structure. The actuation mechanism operably connects to the manipulation mechanism, and moves the fixture in space. The reaction mechanism provides a point through which force inputs into the actuation mechanism may react.

  10. Orthopedic disorders of the knee in hemophilia: A current concept review.

    PubMed

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-06-18

    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. PMID:27335812

  11. Orthopedic disorders of the knee in hemophilia: A current concept review

    PubMed Central

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-01-01

    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. PMID:27335812

  12. Biofilm Disrupting Technology for Orthopedic Implants: What’s on the Horizon?

    PubMed Central

    Connaughton, Alexander; Childs, Abby; Dylewski, Stefan; Sabesan, Vani J.

    2014-01-01

    The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future. PMID:25705632

  13. Academic characteristics of orthopedic team physicians affiliated with high school, collegiate, and professional teams.

    PubMed

    Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S

    2015-11-01

    We conducted a study to determine the academic involvement and research productivity of orthopedic team physicians at high school, college, and professional levels of sport. Through Internet and telephone queries, we identified 1054 team physicians from 362 institutions, including 120 randomly selected high schools and colleges and 122 professional teams (baseball, basketball, football, hockey). For all physicians included in the study, we performed a comprehensive search of the Internet and of a citation database to determine academic affiliations, number of publications, and h-index values. Of the 1054 physicians, 678 (64%) were orthopedic surgeons. Percentage of orthopedic team physicians affiliated with an academic medical center was highest in professional sports (64%; 173/270) followed by collegiate sports (36%; 98/275) and high school sports (20%; 27/133). Median number of publications per orthopedic team physician was significantly higher in professional sports (30.6) than in collegiate sports (10.7) or high school sports (6). Median number of publications by orthopedic physicians also varied by sport, with the highest number in Major League Baseball (37.9; range, 0-225) followed by the National Basketball Association (32.0; range, 0-227) and the National Football League (30.4; range, 0-460), with the lowest number within the National Hockey League (20.7; range, 0-144). Academic affiliation and research productivity of orthopedic team physicians vary by competition level and professional sporting league. PMID:26566551

  14. Greater osteoblast functions on multiwalled carbon nanotubes grown from anodized nanotubular titanium for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Sirivisoot, Sirinrath; Yao, Chang; Xiao, Xingcheng; Sheldon, Brian W.; Webster, Thomas J.

    2007-09-01

    Titanium (Ti) is the most widely implanted orthopedic material. However, current formulations of Ti have an average orthopedic implant functional lifetime of only 10-15 years. While there are many reasons why orthopedic implants fail, one is a lack of initial and sustained integration into juxtaposed bone. To improve the cytocompatibility properties of Ti for orthopedic applications, parallel multiwalled carbon nanotubes (CNTs) were grown from the pores of anodized nanotubular Ti by a chemical vapor deposition process in the present study. The results of this study provided evidence, for the first time, that osteoblast (bone forming cell) functions (specifically, alkaline phosphatase activity and calcium deposition) were significantly greater on CNTs grown from anodized Ti than on anodized Ti without CNTs and currently-used Ti in orthopedics for up to 21 days. In summary, this study showed that bone growth could possibly be enhanced on currently-used Ti implants with protruding CNTs and, thus, they should be further studied for orthopedic applications.

  15. Substance P and Acute Pain in Patients Undergoing Orthopedic Surgery

    PubMed Central

    Lisowska, Barbara; Siewruk, Katarzyna; Lisowski, Aleksander

    2016-01-01

    Objective There is a limited information about the role of Substance P (SP) in acute pain nociception following surgical stimulation in patients with a chronic inflammatory state not to mention the link between this neuropeptide level changes and intensity of pain. The goal of the research was to find the correlation between SP level changes and acute pain intensity in patients with rheumatoid arthritis undergoing elective orthopedic surgery. Material and Methods Patients with rheumatoid arthritis (RA) were enrolled in the study. The correlation between acute pain intensity and concentration of SP in serum as well as in drainage fluid from postoperative wound was assessed in patients with RA who underwent Total Knee Replacement (TKA) under spinal anesthesia. Results In patients with RA a correlation between intensity of acute pain and serum SP was found postoperatively, whereas there was no correlation between intensity of acute pain and concentration of SP in drainage fluid. Conclusions 1. The correlation between acute pain intensity and SP serum concentration was found postoperatively in patients with RA. 2. The correlation between acute pain intensity and SP concentration in drainage fluid was not found postoperatively in patients with RA. PMID:26731421

  16. Parametric analysis of orthopedic screws in relation to bone density.

    PubMed

    Zanetti, Elisabetta M; Salaorno, Massimiliano; Grasso, Giovanni; Audenino, Alberto L

    2009-01-01

    A global study of geometry and material properties of orthopedic screws was performed, considering not only the effect of each single factor (screw pitch, number of threads, fillet angle, etc.) but also their interactions with respect to bone density.The stress patterns resulting from different screw geometries and bone densities were analyzed using finite element techniques, taking into account different levels of osseointegration between the screw and the bone. These numerical models where validated through experimental pull-out tests, where a pull out force of 120 N produced localized failure of the last thread (stresses above 0.42 MPa). The results of the numerical simulations were then summarised using a multi-factorial parametric analysis. This demonstrated the great relevance of the interaction between bone density and screw pitch, showing that the optimal screw pitch can vary by more than 25% for different densities (0.35 g/cm(3) and 0.47 g/cm(3), respectively).The parameters calculated by means of the multi-factorial analysis allow the pull out force to be estimated for different osseointegration levels, different screw geometries and material properties, and for different bone densities. The final objective is to determine the best choice of implant for each individual patient. PMID:19587807

  17. PEEK Biomaterials in Trauma, Orthopedic, and Spinal Implants

    PubMed Central

    Kurtz, S. M.; Devine, J. N.

    2007-01-01

    Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

  18. Preoperative Planning of Orthopedic Procedures using Digitalized Software Systems.

    PubMed

    Steinberg, Ely L; Segev, Eitan; Drexler, Michael; Ben-Tov, Tomer; Nimrod, Snir

    2016-06-01

    The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English. Digitalized software programs are enabled to import and export all picture archiving communication system (PACS) files (i.e., X-rays, computerized tomograms, magnetic resonance images) from either the local working station or from any remote PACS. Two-dimension (2D) and 3D CT scans were found to be reliable tools with a high preoperative predicting accuracy for implants. The short learning curve, user-friendly features, accurate prediction of implant size, decreased implant stocks and low-cost maintenance makes digitalized software programs an attractive tool in preoperative planning of total joint replacement, fracture fixation, limb deformity repair and pediatric skeletal disorders. PMID:27468530

  19. Why medical students choose orthopedic surgery as a specialty?

    PubMed Central

    Erraji, Moncef; Kharraji, Abdessamad; Abbasi, Najib; Najib, Abdeljawad; Yacoubi, Hicham

    2015-01-01

    Before the crisis announced the Moroccan surgery, the objectives of this study were to analyze the choice of specialties newly appointed to the internal review and the guidance of medical students and to determine the factors influencing this choice. Data on specialty choice students were analyzed and a questionnaire was offered to students of Morocco at the beginning of academic year 2013-20014 The form consisted of questions on the year of study. sex, professional guidelines and reasons for choice. candidates were male, the average age of our residents was 28 years. We also noted the importance of the passage as well as external service trauma. Care provided to patients, lifestyle and income reported by 85% of respondents to be the most important factors to pursue orthopedics as a career. The TR-Orth is now a specialty that responds to a positive choice. The choice of TR-Orth by students at the end of medical school curriculum is reinforced by teaching and practicing the specialty during the internship. The overall training is unsatisfactory overall. Students would deepen in some areas. This study confirms that there is currently a shift in trauma surgery, mostly induced by an a priori negative for particular workloads. PMID:26185556

  20. Infection Mitigation Efficacy of Photoactive Titania on Orthopedic Implant Materials

    PubMed Central

    Azad, Abdul-Majeed; Hershey, Ryan; Aboelzahab, Asem; Goel, Vijay

    2011-01-01

    In order to impede infection and achieve accelerated wound healing in the postorthopaedic surgery patients, a simple and benign procedure for creating nanotubular or nanofibrillar structure of photoactive TiO2 on the surface of Ti plates and wires is described. The nanoscale TiO2 films on titanium were grown by hydrothermal processing in one case and by anodization in the presence of dilute mineral acids under mild and benign conditions in the other. Confocal microscopy results demonstrated at least 50% reduction in the population of E. coli colonies (concentration 2.15 × 107 cells/mL) on TiO2-coated implants upon an IR exposure of up to 30 s; it required ∼20 min of exposure to UV beam for the same effect. These findings suggest the probability of eliminating wound infection during and after orthopedic surgical procedures by brief illumination of photoactive titania films on the implants with an IR beam. PMID:21994891

  1. Hydroxyapatite electrodeposition on anodized titanium nanotubes for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Parcharoen, Yardnapar; Kajitvichyanukul, Puangrat; Sirivisoot, Sirinrath; Termsuksawad, Preecha

    2014-08-01

    Nanotubes modification for orthopedic implants has shown interesting biological performances (such as improving cell adhesion, cell differentiation, and enhancing osseointegration). The purpose of this study is to investigate effect of titanium dioxide (TiO2) nanotube feature on performance of hydroxyapatite-coated titanium (Ti) bone implants. TiO2 nanotubes were prepared by anodization using ammonium fluoride electrolyte (NH4F) with and without modifiers (PEG400 and Glycerol) at various potential forms, and times. After anodization, the nanotubes were subsequently annealed. TiO2 nanotubes were characterized by scanning electron microscope and X-ray diffractometer. The amorphous to anatase transformation due to annealing was observed. Smooth and highly organized TiO2 nanotubes were found when high viscous electrolyte, NH4F in glycerol, was used. Negative voltage (-4 V) during anodization was confirmed to increase nanotube thickness. Length of the TiO2 nanotubes was significantly increased by times. The TiO2 nanotube was electrodeposited with hydroxyapatite (HA) and its adhesion was estimated by adhesive tape test. The result showed that nanotubes with the tube length of 560 nm showed excellent adhesion. The coated HA were tested for biological test by live/dead cell straining. HA coated on TiO2 nanotubes showed higher cells density, higher live cells, and more spreading of MC3T3-E1 cells than that growing on titanium plate surface.

  2. EARLY COMPLICATIONS IN THE ORTHOPEDIC TREATMENT OF BONE METASTASES

    PubMed Central

    Teixeira, Luiz Eduardo Moreira; Miranda, Ricardo Horta; Ghedini, Daniel Ferreira; Aguilar, Rafael Bazílio; Novais, Eduardo Nilo Vasconcelos; de Abreu e Silva, Guilherme Moreira; Araújo, Ivana Duval; de Andrade, Marco Antônio Percope

    2015-01-01

    Objective: To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. Method: There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. Results: Early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. Regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. There was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. The tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. Conclusion: The complications occurred in 26.6%. The complications are not related to the kind of treatment performed or to the region affected. The renal origin tumors showed a higher risk of hemorrhage. PMID:27077063

  3. Biomaterials for orthopedics: a roughness analysis by atomic force microscopy.

    PubMed

    Covani, Ugo; Giacomelli, Luca; Krajewski, Adriano; Ravaglioli, Antonio; Spotorno, Lorenza; Loria, Patrizia; Das, Saradindu; Nicolini, Claudio

    2007-09-01

    We conducted an AFM analysis of roughness on 7 materials widely used in bone reconstruction. Roughness was evaluated by measuring Root Mean Square (RMS) values and RMS/average height (AH) ratio, in different dimensional ranges, varying from 100 microns square to a few hundreds of nanometers. The results showed that Titanium presented a lower roughness than the other materials analyzed, frequently reaching statistical significance. On the contrary, bioactive materials, such as hydroxyapatite (HA) and bioactive glasses, demonstrated an overall higher roughness. In particular, this study focuses attention on AP40 and especially RKKP, which proved to have a significant higher roughness at low dimensional ranges. This determines a large increase in surface area, which is strongly connected with osteoblast adhesion and growth and to protein absorption. Therefore, the biointegration properties of bioactive glasses can also be given as answer in terms of surface structures in which chemical composition can influence directly the biological system (e.g. with chemical exchanges and development of specific surface electrical charge) and indirectly, via the properties induced on tribological behavior that expresses itself during the smoothing of the surfaces. We also test two new bioactive glasses, RBP1 and RBP2, with a chemical composition similar to AP40, but with some significant small additions and substitutions of components, in order to make preliminary considerations on their potential role in orthopedics. PMID:17326227

  4. Amino acid containing glass-ionomer cement for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Wu, Wei

    Amino acid containing glass-ionomer cements were synthesized, formulated, and evaluated for orthopedic application. The formulation of different amino acid containing glass-ionomer bone cements was optimized, and conventional and resin-modified glass-ionomer bone cements were compared. Properties of interest included handling characteristics, physical and chemical properties, and mechanical strength of the bone cement. The study was based on the synthesis of different vinyl containing amino acids, different polyelectrolytes containing these amino acid residues, and different resin-modified polyelectrolytes, as well as formulation and evaluation of conventional and resin-modified glass-ionomer bone cements using these polyelectrolytes. Systematic preparation of polyelectrolytes and formulation of glass-ionomer bone cements were essential features of this work, since we anticipated that the mechanical properties of the glass-ionomer bone cements could be strongly affected by the nature of the polyelectrolytes and formulation. Mechanical properties were evaluated in a screw driven mechanical testing machine, and structure-property relationships were determined by scanning electron microscopic (SEM) observation of the fracture surface of the specimens. How the structure of polyelectrolytes, such as different amino acid residues, molecular weight, different modifying resin, and formulation of glass-ionomer bone cement, affected the mechanical properties was also studied.

  5. Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know.

    PubMed

    Wieschhoff, Ged G; Sheehan, Scott E; Wortman, Jeremy R; Dyer, George S M; Sodickson, Aaron D; Patel, Ketan I; Khurana, Bharti

    2016-01-01

    Traumatic finger injuries account for a substantial number of emergency visits every year. Imaging plays an important role in diagnosis and in directing management of these injuries. Although many injuries can be managed conservatively, some require more invasive interventions to prevent complications and loss of function. Accurate diagnosis of finger injuries can often be difficult, given the complicated soft-tissue anatomy of the hand and the diverse spectrum of injuries that can occur. To best serve the patient and the treating physician, radiologists must have a working knowledge of finger anatomy, the wide array of injury patterns that can occur, the characteristic imaging findings of different finger injuries, and the most appropriate treatment options for each type of injury. This article details the intricate anatomy of the hand as it relates to common finger injuries, illustrates the imaging findings of a range of injuries, presents optimal imaging modalities and imaging parameters for the diagnosis of different injury types, and addresses which findings have important management implications for the patient and the orthopedic surgeon. With this fund of knowledge, radiologists will be able to recommend the most appropriate imaging studies, make accurate diagnoses, convey clinically relevant imaging findings to the referring physician, and suggest appropriate follow-up examinations. In this way, the radiologist will help improve patient care and outcomes. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27399238

  6. Manipulating and Visualizing Proteins

    SciTech Connect

    Simon, Horst D.

    2003-12-05

    ProteinShop Gives Researchers a Hands-On Tool for Manipulating, Visualizing Protein Structures. The Human Genome Project and other biological research efforts are creating an avalanche of new data about the chemical makeup and genetic codes of living organisms. But in order to make sense of this raw data, researchers need software tools which let them explore and model data in a more intuitive fashion. With this in mind, researchers at Lawrence Berkeley National Laboratory and the University of California, Davis, have developed ProteinShop, a visualization and modeling program which allows researchers to manipulate protein structures with pinpoint control, guided in large part by their own biological and experimental instincts. Biologists have spent the last half century trying to unravel the ''protein folding problem,'' which refers to the way chains of amino acids physically fold themselves into three-dimensional proteins. This final shape, which resembles a crumpled ribbon or piece of origami, is what determines how the protein functions and translates genetic information. Understanding and modeling this geometrically complex formation is no easy matter. ProteinShop takes a given sequence of amino acids and uses visualization guides to help generate predictions about the secondary structures, identifying alpha helices and flat beta strands, and the coil regions that bind them. Once secondary structures are in place, researchers can twist and turn these pre-configurations until they come up with a number of possible tertiary structure conformations. In turn, these are fed into a computationally intensive optimization procedure that tries to find the final, three-dimensional protein structure. Most importantly, ProteinShop allows users to add human knowledge and intuition to the protein structure prediction process, thus bypassing bad configurations that would otherwise be fruitless for optimization. This saves compute cycles and accelerates the entire process, so

  7. Image Manipulation: Then and Now.

    ERIC Educational Resources Information Center

    Sutton, Ronald E.

    The images of photography have been manipulated almost from the moment of their discovery. The blending together in the studio and darkroom of images not found in actual scenes from life has been a regular feature of modern photography in both art and advertising. Techniques of photograph manipulation include retouching; blocking out figures or…

  8. Modeling Manipulation in Medical Education

    ERIC Educational Resources Information Center

    Dailey, Jason I.

    2010-01-01

    As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…

  9. Stereoscopically Observing Manipulative Actions

    PubMed Central

    Ferri, S.; Pauwels, K.; Rizzolatti, G.; Orban, G. A.

    2016-01-01

    The purpose of this study was to investigate the contribution of stereopsis to the processing of observed manipulative actions. To this end, we first combined the factors “stimulus type” (action, static control, and dynamic control), “stereopsis” (present, absent) and “viewpoint” (frontal, lateral) into a single design. Four sites in premotor, retro-insular (2) and parietal cortex operated specifically when actions were viewed stereoscopically and frontally. A second experiment clarified that the stereo-action-specific regions were driven by actions moving out of the frontoparallel plane, an effect amplified by frontal viewing in premotor cortex. Analysis of single voxels and their discriminatory power showed that the representation of action in the stereo-action-specific areas was more accurate when stereopsis was active. Further analyses showed that the 4 stereo-action-specific sites form a closed network converging onto the premotor node, which connects to parietal and occipitotemporal regions outside the network. Several of the specific sites are known to process vestibular signals, suggesting that the network combines observed actions in peripersonal space with gravitational signals. These findings have wider implications for the function of premotor cortex and the role of stereopsis in human behavior. PMID:27252350

  10. Smart Hand For Manipulators

    NASA Astrophysics Data System (ADS)

    Fiorini, Paolo

    1987-10-01

    Sensor based, computer controlled end effectors for mechanical arms are receiving more and more attention in the robotics industry, because commonly available grippers are only adequate for simple pick and place tasks. This paper describes the current status of the research at JPL on a smart hand for a Puma 560 robot arm. The hand is a self contained, autonomous system, capable of executing high level commands from a supervisory computer. The mechanism consists of parallel fingers, powered by a DC motor, and controlled by a microprocessor embedded in the hand housing. Special sensors are integrated in the hand for measuring the grasp force of the fingers, and for measuring forces and torques applied between the arm and the surrounding environment. Fingers can be exercised under position, velocity and force control modes. The single-chip microcomputer in the hand executes the tasks of communication, data acquisition and sensor based motor control, with a sample cycle of 2 ms and a transmission rate of 9600 baud. The smart hand described in this paper represents a new development in the area of end effector design because of its multi-functionality and autonomy. It will also be a versatile test bed for experimenting with advanced control schemes for dexterous manipulation.