Tornier Announces First Implant in U.S. Trial of Its Simpliciti Stemless Shoulder Joint Replacement System

Tornier N.V. (Amsterdam, The Netherlands), an orthopedic surgical solutions company, has announced the first implant of its Simpliciti stemless shoulder joint replacement system as part of an FDA -approved, investigational device exemption (IDE) study. The Simpliciti system is designed to allow surgeons to carry out total shoulder replacements without the complications, additional bone removal and time associated with conventional stemmed implants.

Functional reconstruction of ischemic contracture in the lower limb.

Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Tang H, Zhang SC, Tan ZY, Zhu HW, Zhang QL, Li M. Chin J Traumatol. 2011 Apr 1;14(2):96-9. PMID: 21453575

Management of Grade III Open Dislocated Ankle Fractures: Combined Internal Fixation with Bioabsorbable Screws/Rods and External Fixation.

Isolated dislocation of the ankle with grade III open fracture has been scarcely reported. These ankle injuries usually involved mortise fractures, complete dislocation of the tibial astragaloid joint, capsuloligamentous structure disruption, and severe soft-tissue damage. There is no well-recognized regimen that would result in desirable outcomes. Ye T, Chen A, Yuan W, Gou S. J Am Podiatr Med ssoc. 2011 Jul-Aug;101(4):307-15. PMID: 21816999

Mechanical Comparison of Two Types of Fixation for Ludloff Oblique First Metatarsal Osteotomy.

The use of a medially applied supplementary mini locking plate offers a simple and effective method to improve the mechanical stability of the Ludloff oblique osteotomy.  Tsilikas SP, Stamatis ED, Kourkoulis SK, Mitousoudis AS, Chatzistergos PE, Papagelopoulos PJ. J Foot Ankle Surg. 2011 Aug 1. [Epub ahead of print] PMID: 21813302

American Journal of Sports Medicine [Epub ahead of print]

1. Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis: A Randomized Controlled Clinical Trial. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813443 PDF

2. Patellar Tendon Ruptures in National Football League Players. Boublik M, Schlegel T, Koonce R, Genuario J, Lind C, Hamming D. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813442 PDF

3. Factors Affecting Rotator Cuff Healing After Arthroscopic Repair: Osteoporosis as One of the Independent Risk Factors. Chung SW, Oh JH, Gong HS, Kim JY, Kim SH. Am J Sports Med. 2011 Aug 3. [Epub ahead of print] PMID: 21813440 PDF

Stem cells in bone diseases: current clinical practice.

Introduction Bone is an obvious candidate tissue for stem cell therapy. This review provides an update of existing stem cell-based clinical treatments for bone pathologies. Sources of data A systematic computerized literature search was conducted. The following databases were accessed on 10 February 2011: NIH clinical trials database, PubMed, Ovid and Cochrane Reviews. Areas of agreement Stem cell therapy offers new options for bone conditions, both acquired and inherited. Areas of controversy There is still no agreement on the exact definition of 'mesenchymal stem cells'. Consequently, it is difficult to appreciate the effect of culture expansion and the feasibility of allogeneic transplantation. Growing points Based on the sound foundations of pre-clinical research, stem cell-based treatments and protocols have recently emerged. Areas timely for developing research Well-designed prospective clinical trials are needed in order to establish and develop stem cell therapy for bone diseases. Beyth S, Schroeder J, Liebergall M. Br Med Bull. 2011 Aug 3. [Epub ahead of print] PMID:  21813557

Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review.

Efficacy among surgical techniques varied depending on the clinical outcome measure, but all were superior to corticosteroid therapy and physical therapy according to the VAS and HHS in both comparison studies and between studies. This systematic review found that traditional nonoperative treatment helped most patients, SWT was a good alternative, and surgery was effective in refractory cases. Lustenberger DP, Ng VY, Best TM, Ellis TJ. Clin J Sport Med. 2011 Aug 2. [Epub ahead of print] PMID: 21814140

Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant.

Use of the anterolateral approach and endosteal augment of a lateral locking plate can minimize avascular necrosis following proximal humerus fracture Neviaser AS, Hettrich CM, Dines JS, Lorich DG. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814772

Intra-articular injection of hyaluronic acid (MW 1,500-2,000 kDa; HyalOne(®)) in symptomatic osteoarthritis of the hip: a prospective cohort study.

The study treatment reduced pain and improved mobility in osteoarthritis of the hip. These results in daily clinical practice demonstrate a beneficial effect and the safety of the study product and suggest adding intra-articular injections of HyalOne(®) to the armamentarium of conservative management of symptomatic hip osteoarthritis. Alberto M, Umberto M, Emanuele B, Bruno L, Valentina G, Prisco P, Mauro G, Sandro T. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814776

Recent Military Related Ortho Trauma in PubMed

1. Combat-related pelvis fractures in nonsurvivors. Bailey JR, Stinner DJ, Blackbourne LH, Hsu JR, Mazurek MT. J Trauma. 2011 Jul;71(1 Suppl):S58-61. PMID: 21795891

2. Infections complicating the care of combat casualties during operations iraqi freedom and enduring freedom. Murray CK, Wilkins K, Molter NC, Li F, Yu L, Spott MA, Eastridge B, Blackbourne LH, Hospenthal DR. J Trauma. 2011 Jul;71(1 Suppl):S62-73. PMID: 21795880

3. Infectious complications and soft tissue injury contribute to late amputation after severe lower extremity trauma. Huh J, Stinner DJ, Burns TC, Hsu JR; Late Amputation Study Team. J Trauma. 2011 Jul;71(1 Suppl):S47-51. PMID: 21795878

4. Died of wounds on the battlefield: causation and implications for improving combat casualty care.

Eastridge BJ, Hardin M, Cantrell J, Oetjen-Gerdes L, Zubko T, Mallak C, Wade CE, Simmons J, Mace J, Mabry R, Bolenbaucher R, Blackbourne LH. J Trauma. 2011 Jul;71(1 Suppl):S4-8. PMID:  21795876

5. Silver dressings augment the ability of negative pressure wound therapy to reduce bacteria in a contaminated open fracture model. Stinner DJ, Waterman SM, Masini BD, Wenke JC.

J Trauma. 2011 Jul;71(1 Suppl):S147-50. PMID: 21795872

6. Prehospital medical documentation in the joint theater trauma registry: a retrospective study.

Therien SP, Nesbitt ME, Duran-Stanton AM, Gerhardt RT. J Trauma. 2011 Jul;71(1 Suppl):S103-8. PMID: 21795867

7. The Modern "Deck-Slap" Injury-Calcaneal Blast Fractures From Vehicle Explosions.

Ramasamy A, Hill AM, Phillip R, Gibb I, Bull AM, Clasper JC. J Trauma. 2011 Jul 29. [Epub ahead of print] PMID: 21808204 

8. Posterior distal tibial fracture in a military trainee. Miller J, Gerber JP. J Orthop Sports Phys Ther. 2011;41(8):615. Epub 2011 Aug 1. PMID: 21808103

9. Multiple limb compartment syndromes in a recruit with sickle cell trait. Way A, Ganesan S, McErlain M. J R Army Med Corps. 2011 Jun;157(2):182-3. PMID: 21805771 

10. rhBMP-2 not alendronate combined with HA-TCP biomaterial and distraction osteogenesis enhance bone formation. Ni M, Li G, Tang PF, Chan KM, Wang Y. Arch Orthop Trauma Surg. 2011 Jul 31. [Epub ahead of print] PMID: 21805359

11. Use of an "Antibiotic Plate" for Infected Periprosthetic Fracture in Total Hip Arthroplasty. Liporace FA, Yoon RS, Frank MA, Gaines RJ, Maurer JP, Polishchuk DL, Choung EW. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID:  21804411

12. Surface wound mapping of battlefield occulo-facial injury. Breeze J, Allanson-Bailey LS, Hunt NC, Midwinter MJ, Hepper AE, Monaghan A, Gibbons AJ. Injury. 2011 Jul 28. [Epub ahead of print] PMID: 21802684

13. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures. Tong DK, Ji F, Cai XB. Chin J Traumatol. 2011 Aug 1;14(4):233-6. PMID: 21801668

Surgical treatment of displaced medial clavicle fractures using a small T-shaped plate and tension band sutures.

The surgical treatment of medial clavicle nonunion is associated with high complication and failure rates, particularly with regard to metal work migration. Therefore, we describe a simple surgical procedure for displaced medial clavicle fractures using a small T-shaped plate and multiple tension band sutures. After stabilizing the medial clavicle fracture using a small nonunion for the distal radius, our simple technique for preventing high complication and failure rates is performed easily and effectively, with sufficient tension band sutures. Kim KC, Shin HD, Cha SM. Arch Orthop Trauma Surg. 2011 Aug 3. [Epub ahead of print] PMID: 21811810

Proximal Sural Traction Neurectomy During Transtibial Amputations

Symptomatic neuroma formation after trauma-related transtibial amputations remains a clinical problem. The sural nerve is frequently overlooked in its vulnerable subcutaneous location in the posterior myofasciocutaneous flap and commonly leads to chronic pain and decreased prosthesis use.

Tintle SM, Donohue MA, Shawen S, Forsberg JA, Potter BK. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID: 21804416

Strategies in Trauma and Limb Reconstruction (Open Access)

1. Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface-experience in eight adult patients. Livani B, Castro G, Filho JR, Morgatho TR, Mongon ML, Belangero WD, Davitt M, Carvalho JA. Strategies Trauma Limb Reconstr. 2011 Jul 26. [Epub ahead of print] PMID: 21789589 PDF

2. Transiliac lengthening with posterior lumbar-iliac percutaneous fusion in sacral hemiagenesis.

Mesa PA. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785911 PDF

3. Guided growth for correction of knee flexion deformity: a series of four cases. Macwilliams BA, Harjinder B, Stevens PM. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785910 PDF

4. Controversial topics in the management of displaced supracondylar humerus fractures in children.

Pretell-Mazzini J, Rodriguez-Martin J, Auñon-Martin I, Zafra-Jimenez JA. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785909 PDF

5. Reconstruction nailing for ipsilateral femoral neck and shaft fractures. Tsarouhas A, Hantes ME, Karachalios T, Bargiotas K, Malizos KN. Strategies Trauma Limb Reconstr. 2011 Jul 21. [Epub ahead of print] PMID: 21779894 PDF

6. Complex elbow dislocation associated with radial and ulnar diaphyseal fractures: a rare combination.

Ramesh S, Lim YJ. Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773776 PDF

7. Distal radioulnar joint prosthesis for the treatment of giant cell tumor of the distal ulna: a case report and literature review. Gracia I, Proubasta IR, Trullols L, Peiró A, Moya E, Cortés S, Buezo O, Majó J.

Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773775 PDF

8. Subperiosteal resection of mid-clavicle in Sprengel's deformity correction. Abuhassan FO.

Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773774 PDF

Descending Geniculate Artery: The Ideal Recipient Vessel for Free Tissue Transfer Coverage of Below-the-Knee Amputation Wounds.

The descending geniculate artery has received notoriety as the source vessel of the medial femoral condyle vascularized bone flap in recent years. Its size and location enable it to serve as a useful recipient vessel in free flap reconstruction about the knee. It is particularly useful in coverage of unstable below-the-knee amputation stumps when recipient vessels are limited. It provides the ease and convenience of two-team surgery in the supine position and its distal position permits convenient and distal insetting of the transferred flap of choice. A discussion of its use in this setting and exemplary cases are provided. Higgins JP. J Reconstr Microsurg. 2011 Aug 2. [Epub ahead of print] PMID: 21811968

A meta-analysis of open versus arthroscopic Bankart repair using suture anchors

Purpose of this study is to conduct a meta-analysis comparing the results of open and arthroscopic Bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Using Medline Pubmed, Cochrane and Embase databases we performed a search of all published articles. We included only studies that compared open and arthroscopic repair using suture anchors. Database of Abstracts of Reviews of Effects ( DARE )

IT solution to improve hospital workflow and schedules (including the OR)

"The benefit of this system, over a human-run system, is that it is more accurate, efficient and quicker and is able to adapt to any changes in the availability of staff, equipment, or delays immediately.

"For example, surgical procedures can go overtime, staff can be off sick and equipment can fail, all of which can cause delays. This system is able to automatically revise the schedule of tasks in a way that maintains efficiency and assists in the decision making process." MedicalXpress

Orthopedic Reviews Vol 3, No 1 (2011) (open access)

1. Does improved instrumentation result in better component alignment in total knee arthroplasty?Hassaballa M, Budnar V, Gbejuade H, Learmonth I. Orthop Rev (Pavia). 2011 Mar 17;3(1):e3. PMID: 21808715 PDF

2. Enlarged transacromial superior approach with reverse shoulder arthroplasty for fractures. Poignard A, Bouhou M, Homma Y, Hernigou P. Orthop Rev (Pavia). 2011 Mar 17;3(1):e2. PMID: 21808714 PDF

3. Oxidative stress in secondary osteoarthritis: from cartilage destruction to clinical presentation? Ziskoven C, Jäger M, Zilkens C, Bloch W, Brixius K, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e23. PMID:  21808712 PDF

4. Additional external hinged fixator after open repositioning and internal fixation of acute elbow instability in non-compliant patients. Berendes S, Zilkens C, Anastasiadis A, Graf M, Muhr G, Kalicke T.

Orthop Rev (Pavia). 2010 Sep 23;2(2):e21. PMID: 21808711 PDF

5. Cell therapy in bone healing disorders. Jäger M, Hernigou P, Zilkens C, Herten M, Li X, Fischer J, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e20. PMID:  21808710  PDF

6. Arthroplasty of a Charcot knee. Babazadeh S, Stoney JD, Lim K, Choong PF. Orthop Rev (Pavia). 2010 Sep 23;2(2):e17. PMID: 21808708 PDF

7. Surgical management of complex humerus head fractures. El-Sayed MM. Orthop Rev (Pavia). 2010 Sep 23;2(2):e14. PMID: 21808705 PDF

Proximal humeral fractures.

This article reviews the current literature on the classification and treatment options for proximal humeral fractures, while seeking to help the reader to define the most appropriate treatment plan for each individual patient with this type of fracture.  Mauro CS. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print] PMID:  21808995

Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment.

The glenohumeral joint is inherently predisposed to instability by its bony architecture. The incidence of traumatic shoulder instability is 1.7% in the general population. Associated injuries to the capsulolabral structures of the glenohumeral joint have been described and may play a role in predicting recurrent instability. Advanced imaging, computed tomography or MRI may be necessary to adequately evaluate for associated glenohumeral pathology. Treatment algorithms have traditionally included a period of non-operative management in all patients, however young athletic patients may often benefit from early operative treatment. Various open and arthroscopic surgical options exist to address anterior glenohumeral instability. Bony injuries including bony Bankart lesions and Hills Sachs lesion have been implicated in failed surgical management using techniques that address only the soft tissues. An individualized treatment approach, based upon the patient's injury pattern and expectations, will likely lead to the most successful outcome. Dumont GD, Russell RD, Robertson WJ. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print]PMID:  21808996

Operative Management of Flatfoot and Arthritis of the Ankle

OPERATIVE MANAGEMENT OF FLATFOOT AND ARTHRITIS OF THE ANKLE
Orthopaedics
Volume 34, Issue 16
August 21, 2011Lateral column lengthening and midfoot fusion – Alastair S.E. Younger, MD
Managing valgus angle pes planus – Timothy Daniels, MD
Ankle options: fusion and replacement – Dr. Daniels
Arthroscopic ankle fusion – Kevin J. Wing, MD


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Apps for surgeons and the operating room

The explosive growth of medical applications for smartphones, launched by the  debut of the innovative Apple iTunes App store in 2008, promises to fundamentally change the physician’s tool set. While many specialties have always been heavily dependent on technology, such as radiology and cardiology, the ubiquity of these small, interconnected computers means that every physician will soon have access to a broad array of software and hardware to help them perform their daily work. iMedicalApps

New composite material may restore damaged soft tissue

Biomedical engineers at Johns Hopkins have developed a new liquid material that in early experiments in rats and humans shows promise in restoring damaged soft tissue relatively safely and durably. The material, a composite of biological and synthetic molecules, is injected under the skin, then "set" using light to form a more solid structure, like using cold to set gelatin in a mold. The researchers say the product one day could be used to reconstruct soldier's faces marred by blast injuries. Eurekalert!

Accuracy of intra-articular injections of the glenohumeral joint through an anterior approach: arthroscopic correlation.

The results of this study show that an anterior injection into the glenohumeral joint can be accurately placed without radiographic assistance using standard landmarks. The technique used is similar to making a standard rotator interval portal during shoulder arthroscopy; therefore, it is most successful in the hands of experienced shoulder arthroscopists.  Kraeutler MJ, Cohen SB, Ciccotti MG, Dodson CC. J Shoulder Elbow Surg. 2011 Jul 27. [Epub ahead of print] PMID: 21798769

Journal of Pediatric Orthopaedics. Part B [Epub ahead of print]

1.  Reconstruction and anticipatory Langenskiöld procedure in traumatic defect of tibial medial malleolus with type 6 physeal fracture. Abbo O, Accadbled F, Laffosse JM, De Gauzy JS.

J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799451 Related citations

2.

Hemivertebra resection and scoliosis correction by a unilateral posterior approach using single rod and pedicle screw instrumentation in children under 5 years of age. Peng X, Chen L, Zou X.

J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799450 Related citations

3. Risk of redisplacement after first successful reduction in paediatric distal radius fractures: sensitivity assessment of casting indices. Devalia KL, Asaad SS, Kakkar R. J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799449 Related citations

Extensor pollicis longus rupture after distal radius fracture: Results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting.

Injury of the extensor pollicis longus tendon is one of the commonest extensor tendon injuries after distal radius fracture. In 2003-2005 we performed extensor indicis transfer in 31 patients with loss of function of the EPL tendon and postoperative dynamic splinting. In 25 patients, a distal radius fracture managed surgically led to the EPL rupture (wire internal fixation in 23 patients, plate internal fixation in 2 patients). In 6 patients, the cause was a distal radius fracture treated conservatively. Out of our 25 followed-up patients, 9 (36%) had a very good and 15 (60%) a good result in the Geldmacher score. We did not identify any re-rupture. In injuries of the extensor pollicis tendon, transposition of the extensor indicis tendon is a simple and uncomplicated procedure. Considerable improvement of thumb extension can be achieved through this substitution repair. Figl M, Mayer M, Lederer S, Bogner R, Leixnering M. Wien Klin Wochenschr. 2011 Aug 3. [Epub ahead of print] PMID: 21800046

Knee Surgery, Sports Traumatology, Arthroscopy [Epub ahead of print]

1.  Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R, Saito T. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800168

2.

Predisposing factors which are relevant for the clinical outcome after revision total knee arthroplasty.

Hardeman F, Londers J, Favril A, Witvrouw E, Bellemans J, Victor J. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800167

3. The painful knee after total knee arthroplasty. Becker R, Bonnin M, Hofmann S. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] No abstract available. PMID: 21800166

4. Medium to long-term follow-up after ACL revision. Lind M, Lund B, Faunø P, Said S, Miller LL, Christiansen SE. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800165

Insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures.

Insufficiency fractures are often overlooked, particularly when associated with greater trochanteric avulsion fractures. Here, we report magnetic resonance imaging (MRI) findings of insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures treated by internal fixation.  Suzuki K, Kawachi S, Nanke H. Arch Orthop Trauma Surg. 2011 Jul 29. [Epub ahead of print] PMID: 21800198