Platelet-rich plasma for regeneration of neural feedback pathways around dental implants: a concise review and outlook on future possibilities

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The Future of Rheumatoid Arthritis and Hand Surgery - Combining Evolutionary Pharmacology and Surgical Technique

Rheumatoid arthritis is a systemic autoimmune disease of uncertain aetiology, which is characterized primarily by synovial inflammation with secondary skeletal destructions

Principles of Hand Fracture Management

The hand is essential in humans for physical manipulation of their surrounding environment. Allowing the ability to grasp, and differentiated from other animals by an opposing thumb, the main functions include both fine and gross motor skills as well as being a key tool for sensing and understanding the immediate surroundings of their owner

The clinical outcome of the different hemiCAP and uniCAP knee implants: A systematic and comprehensive review

The focal metallic cartilage resurfacing is a surgical method that offers an appropriate step between the biological techniques and arthroplasty in middle-aged patients with full-thickness cartilage defects. The advantages of this technique are that it addresses the defect, respects healthy tissues and provides stability and contoured surface similar to a full arthroplasty. A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (MM and DC) independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews (CDSR). These databases were searched for the terms hemicap knee implant and unicap knee implant and knee focal metallic implant. From the initial 21 studies that were evaluated, 10 were eligible for analysis. Considering both the HemiCAP focal implant and the HemiCap® Wave patellofemoral prosthesis, we found a lack of mid- to long-term clinical outcomes in well-designed prospective clinical studies. No Level I or II studies were found, while the limited number of patients who were included undermines the overall clinical results of these studies. The progression of osteoarthritis, the persisting pain and the subsequent high revision or failure rates in the limited available studies with long-term follow-up, seem to be the major drawbacks of these partial resurfacing techniques. Utilization of partial resurfacing for femoral or patellofemoral compartments results in good short-term outcome for middle-aged patients as a step between biological technique and total knee arthroplasty. The surgeon should be cognizant and also notify the patient of the high failure rates that are reported in the literature in mid- to longterm follow-up and ultimately, the decision to perform partial resurfacing should be taken by both the patient and the orthopedic surgeon. © M-A. Malahias et al., 2018

The clinical outcome of one-stage high tibial osteotomy and anterior cruciate ligament reconstruction. A current concept systematic and comprehensive review

Background: Patients with an anterior cruciate ligament-deficient varus-angulated knee may need not only an isolated high tibial osteotomy (HTO), but also an additional anterior cruciate ligament reconstruction (ACLR). A number of prospective clinical trials have been published considering the combination of HTO and ACL reconstruction. Our aim was to investigate whether one-stage combined HTO and ACL reconstruction is an effective, well-established technique with long-term results in the treatment of varus-angu lated knees with ACL deficiency. Methods: A systematic review was conducted by two independent reviewers by searching the MEDLINE/PubMed and the Cochrane Database of Systematic Reviews. These databases were queried with the term 'combined high tibial osteotomy anterior cruciate ligament reconstruction' and 'simultaneous high tibial osteotomy anterior cruciate ligament reconstruction'. Results: From the initial 41 studies we finally chose and assessed 6 studies were eligible according to our inclusionexclusion criteria. The vast majority of the patients were treated with hamstrings autograft (85.6% of the patients), whereas a small minority had a patellar Bone-to-Bone autograft (12.8% of the patients) and 3 patients received a patellar allograft. High tibial open wedge osteotomy was performed in 116 patients (57.4%) and closed wedge in 86 patients (42.6%). The mean pre-operative angle of the patients included in our review was 6.6° varus, while the mean final post-operative angle was found to be 1.3° valgus. All 6 studies illustrated improved post-operative IKDC with the use of one-stage HTO and ACLR, whereas the reoperation rate was very low. Conclusion: Despite the lack of high quality studies, it seems that one-stage HTO and ACLR is a safe and effective procedure for treatment of patients suffering from symptomatic varus osteoarthritis in combination with anterior knee instability. © By The Archives of Bone and Joint Surgery

Augmented reality in orthopedics: Current state and future directions

Augmented reality (AR) comprises special hardware and software, which is used in order to offer computer-processed imaging data to the surgeon in real time, so that real-life objects are combined with computer-generated images. AR technology has recently gained increasing interest in the surgical practice. Preclinical research has provided substantial evidence that AR might be a useful tool for intra-operative guidance and decision-making. AR has been applied to a wide spectrum of orthopedic procedures, such as tumor resection, fracture fixation, arthroscopy, and component’s alignment in total joint arthroplasty. The present study aimed to summarize the current state of the application of AR in orthopedics, in preclinical and clinical level, providing future directions and perspectives concerning potential further benefits from this technology. © 2019 Chytas, Malahias and Nikolaou

Platelet-Rich Plasma Guided Injections: Clinical Application in Peripheral Neuropathies

Platelet-rich plasma (PRP) is defined as an autologous concentrated preparation of platelets and their associated growth factors in a small volume of plasma. The presence of these growth factors has stimulated the scientific community to search about possible benefits of the use of PRP in tissue regeneration. Provided that previously in vitro and animal research demonstrated that PRP could probably play an important role in the treatment of neural tissue disorders, we aimed to review the current literature, regarding the clinical studies that have been conducted to confirm this hypothesis. More specifically, we have reviewed the literature concerning the clinical application of PRP in peripheral neuropathies and investigated if there is strong evidence to establish the use of PRP in clinical practice as a therapeutic option. In contrast with animal studies, we have been able to identify only few clinical data concerning the use of PRP in peripheral neuropathies. We found five trials matched to our research that yields positive and promising results for the future for the application of PRP for the therapy of disorders of the peripheral nervous system. It is obvious that this interesting field of research gives to the scientists the ability to expand it extensively, in terms of both quality and quantity. © Copyright © 2014 Malahias, Chytas, Babis and Nikolaou

Nontraumatic fracture of a custom-made wagner cone prosthesis hip stem: A case report

Fractures of modern cementless stems are almost extinct. However, extra small stems used for cases of developmental dysplasia of the hip (DDH) are still at risk for this complication. We review the fracture of a small size 11, custom-made Wagner cone prosthesis in a 70 year old female patient. The patient had a body-mass index (BMI) of 22.2, 7 yrs after undergoing a total hip arthroplasty. The procedure was undertaken to correct extreme high-riding congenital hip dysplasia. She presented with sudden pain due to a nontraumatic fracture of the stem, just below the proximal third region. At revision, it was apparent that the stem had a concrete distal fixation, whereas the proximal part was loose and probably failed due to cantilever bending fatigue, although the patient had small stature and a low BMI. We trephined out the distal portion, and the patient was successfully revised with a cemented DDH Co-Cr stem. It is our belief that care should be taken when choosing extra small, cementless implants with distal fixation. Cemented prostheses may offer a safe alternative in such cases. © 2017 Begell House, Inc