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Saturday, September 10, 2011

Effect of a five-toed minimal protection shoe on static and dynamic ankle position sense.

The data support the assumption that with Fivefingers is more likely to get a more correct estimation of the surface slope while standing and running compared to using a standard cushioned running shoe. The finding that the cushioned shoes significantly impair foot position awareness compared to less structured shoes is consistent with the results of some previous studies on healthy and unhealthy subjects. Squadrone R, Gallozzi C. J Sports Med Phys Fitness. 2011 Sep;51(3):401-8. PMID: 21904278 

Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature.

Coronal fractures of the medial femoral condyle are very rare, and there is a highly likelihood of these fractures being missed by an average orthopaedic surgeon. A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures. Being intra-articular, the ideal management includes open reduction and internal fixation. Medial or antero-medial approach with antero-posterior screws is the preferred method for fixation.  Dhillon MS, Mootha AK, Bali K, Prabhakar S, Dhatt SS, Kumar V. Musculoskelet Surg. 2011 Sep 9. [Epub ahead of print] PMID: 21904943

Inducible Expression of Neurotrophic Factors by Mesenchymal Progenitor Cells Derived from Traumatically Injured Human Muscle.

Peripheral nerve damage frequently accompanies musculoskeletal trauma and repair of these nerves could be enhanced by the targeted application of neurotrophic factors (NTFs), which are typically expressed by endogenous cells that support nerve regeneration. Injured muscle tissues express NTFs to promote reinnervation as the tissue regenerates, but the source of these factors from within the muscles is not fully understood. We have previously identified a population of mesenchymal progenitor cells (MPCs) in traumatized muscle tissue with properties that support tissue regeneration, and our hypothesis was that MPCs also secrete the NTFs that are associated with muscle tissue reinnervation. We determined that MPCs express genes associated with neurogenic function and measured the protein-level expression of specific NTFs with known functions to support nerve regeneration. We also demonstrated the effectiveness of a neurotrophic induction protocol to enhance the expression of the NTFs, which suggests that the expression of these factors may be modulated by the cellular environment. Finally, neurotrophic induction affected the expression of cell surface markers and proliferation rate of the MPCs. Our findings indicate that traumatized muscle-derived MPCs may be useful as a therapeutic cell type to enhance peripheral nerve regeneration following musculoskeletal injury.  Bulken-Hoover JD, Jackson WM, Ji Y, Volger JA, Tuan RS, Nesti LJ. Mol Biotechnol. 2011 Sep 9. [Epub ahead of print] PMID: 21904958

Ultrasonographic evaluation of medial radial displacement of medial meniscus in knee osteoarthritis.

MRD of the medial meniscus increased with weight-bearing and during follow-up suggesting a close association between extra-articular displacement of the medial meniscus and OA progression. Kawaguchi K, Enokida M, Otsuki R, Teshima R. Arthritis Rheum. 2011 Sep 8. doi: 10.1002/art.33319. [Epub ahead of print] PMID: 21905003

Friday, September 9, 2011

Evaluation of the syndesmotic-only fixation for Weber-C ankle fractures with syndesmotic injury.

With the length of the fibula restored and the syndesmosis reduced anatomically, internal fixation using a plating device may not be necessary for supra-syndesmotic fibular fractures combined with diastasis of inferior tibio-fibular joint. A retrospective observational study was performed in patients who had this injury pattern treated with syndesmosis-only fixation. Mohammed R, Syed S, Metikala S, Ali S. Indian J Orthop. 2011 Sep;45(5):454-8. PMID: 21886929 FullText

Management of talar neck fractures.

Talar neck fractures are usually the result of high-energy trauma. It remains controversial whether talar neck fractures require emergent treatment. Most surgeons recommend the use of dual surgical approaches, anteromedial and anterolateral, to allow accurate visualization and anatomic reduction. It is important to carefully preserve any remaining talar blood supply. Obtaining satisfactory clinical results, while avoiding complications, presents a unique challenge in the treatment of talar neck fractures. Common complications include posttraumatic arthritis, avascular necrosis, malunion, and nonunion. Hak DJ, Lin S. Orthopedics. 2011 Sep 1;34(9):715-21. doi: 10.3928/01477447-20110714-16. PMID: 21899238  PDF (with free registration)

Heterotopic ossification following musculoskeletal trauma: modeling stem and progenitor cells in their microenvironment.

Heterotopic ossification (HO), characterized by the formation of mature bone in the soft tissues, is a complication that can accompany musculoskeletal injury, and it is a frequent occurrence within the military population that has experienced orthopaedic combat trauma. The etiology of this disease is largely unknown. Our laboratory has developed strategies to investigate the cellular and molecular events leading to HO using clinical specimens that were obtained during irrigation and debridement of musculoskeletal injuries. Our approach enables to study (1) the cell types that are responsible for pathological transformation and ossification, (2) the cell- and tissue-level signaling that induces the pathologic transformation, and (3) the effect of extracellular matrix topography and force transduction on HO progression. In this review, we will report on our findings in each of these aspects of HO etiology and describe our efforts to recapitulate our findings in an animal model for traumatic HO. Ji Y, Christopherson GT, Kluk MW, Amrani O, Jackson WM, Nesti LJ. Adv Exp Med Biol. 2011;720:39-50. PMID: 21901617

Biological constraints that limit compensation of a common skeletal trait variant lead to inequivalence of tibial function among healthy young adults.

Although anecdotal evidence suggests functional inequivalence is tolerated under normal loading conditions, our concern is that the functional deficit of slender tibiae may contribute to fracture susceptibility under extreme loading conditions, such as intense exercise during military training or falls in the elderly. Thus, we show the natural variation in bone robustness was associated with predictable functional deficits that were attributable to cellular constraints limiting the amount of compensation permissible in human long bone. Whether these cellular constraints can be circumvented prophylactically to better equilibrate function among individuals remains to be determined.  Jepsen KJ, Centi A, Duarte GF, Galloway K, Goldman H, Hampson N, Lappe JM, Cullen DM, Greeves J, Izard R, Nindl BC, Kraemer WJ, Negus CH, Evans RK. J Bone Miner Res. 2011 Aug 26. [Epub ahead of print] PMID: 21898595

Emergency Room Coverage of Orthopaedic Injuries: A Public Relations Problem

This study points to the fact that we as orthopaedic surgeons have a major public relations problem on our hands. The authors of this survey clearly demonstrate that there is a perception that orthopaedic surgeons are truly not interested in providing care for injured patients. Jahangir, A Alex MD; Sethi, Manish K MD. Journal of Orthopaedic Trauma: September 03, 2011 - Volume Publish Ahead of Print  PDF

How Do Emergency Department Physicians Rate Their Orthopaedic On-Call Coverage?

Throughout the United States, the lack of orthopaedic on-call coverage at many institutions has been described as a "crisis." This study sought to understand how emergency department (ED) physicians perceive their orthopaedic on-call coverage. Specifically, the study looked at availability of orthopaedic coverage, adequacy of coverage, and reasons for patient transfers. Cantu, Robert Victor MD, MS; Bell, John Erik MD, MS; Padula, William V MS; Nahikian, Kael R MS; Pober, David M PhD. Journal of Orthopaedic Trauma: POST AUTHOR CORRECTIONS, 03 September 2011 PDF

Open Clavicle Fractures: Patterns of Trauma and Associated Injuries

Open clavicle fractures are rare injuries. Patients often have associated head, thoracic, and great vessel injuries. Penetrating injuries have higher rates of great vessel injuries and that blunt force injuries have higher rates of head injuries. Gottschalk, Hilton P MD; Dumont, Guillaume MD; Khanani, Sadia BS; Browne, Richard H PhD; Starr, Adam J MD. Journal of Orthopaedic Trauma: POST AUTHOR CORRECTIONS, 03 September 2011 PDF

Randomized, Prospective Comparison of Plate versus Intramedullary Nail Fixation for Distal Tibia Shaft Fractures

High primary union rates were noted after surgical treatment of distal tibia shaft fractures with both nonlocked plates and reamed intramedullary nails. Rates of infection, nonunion, and secondary procedures were similar. Open fractures had higher rates of infection, nonunion, and malunion. Intramedullary nailing was associated with more malalignment versus plating. Fibula fixation may facilitate reduction of the tibia at the time of surgery. The effect of fibula fixation on tibia healing deserves further study. Economic assessment and functional outcomes data for this population will help to enhance our treatment decision-making. Vallier, Heather A MD; Cureton, Beth Ann BS; Patterson, Brendan M MD; Journal of Orthopaedic Trauma; Published Ahead-of-Print POST AUTHOR CORRECTIONS, 03 September 2011. PDF

Superior versus Anteroinferior Plating of the Clavicle: A Finite Element Study

Anterorinferior plating is generally preferable, because it induces deformation modes similar to the intact clavicle and is less likely to fail during normal physiological loading (cantilever bending). Superior placement of the reconstruction plate may be recommended for a patient with a high risk of shoulder impacts (axial compression). Design improvements in the bridging area of the plate and special attention to obtain a good fixation around the fracture could reduce plate failures and provide a stiffer construct. Favre, Philippe MSc; Kloen, Peter MD, PhD; Helfet, David L MD; Werner, Clément M L MD Journal of Orthopaedic Trauma: POST AUTHOR CORRECTIONS, 03 September 2011  PDF

Combination therapy rids common infection from implanted medical devices

Researchers at the University of Toronto have developed a therapy for a potentially deadly type of infection common in catheters, artificial joints and other "in-dwelling" medical devices. Their findings appear in the Open Access Journal PLoS Pathogens on September 8th. PDF  via MedicalXpress

New limits on physician training hours could prove costly for US teaching hospitals

The new UCLA study, published online in the Journal of General Internal Medicine, estimates that teaching hospitals nationwide will have to spend an aggregate $400 million to $1.3 billion each year to carry out the new hour limits and related changes. But some hospitals might have trouble coming up with the money to do it. Eurekalert!

Thursday, September 8, 2011

Some New Smartphone Apps and Info

Physician’s guide to buying a smartphone. Until recently investing in a smartphone hinged mainly on two factors: good voice reception (think Verizon versus AT&T) and prolific data options (iPhone versus cell phones).   Over the past several months, however, the field has leveled significantly. Now, if you’re one of the 81% of physicians currently in the smartphone market, you may be finding yourself reconsidering your alternatives. Herewith, Doximity’s guide to what to look for now Doximity

Papers app sets high standard for PDF mobile medical literature management.  Papers by is well renowned as one of the best, if not the best, applications for managing academic literature. We last reviewed Papers back in 2009 and concluded: “Papers for the iPhone is a must-have for any clinician who frequently searches medical literature, whether for academic or patient care purposes. Once you find an article and discover it’s useful, chances are you’ll need it again sometime in the future. Now, with this powerful iPhone app, you’ll never have to look further than your pocket.” iMedicalApps

Great medical app for staying fresh on medications and pharmacology, Davis Mobile “Pharm Phlash!” Mobile Pharm Phlash! Pharmacology flash cards, are designed by Valerie I. Leek, RNC-NIC, CMSRN and produced by the F.A. Davis Company – well known for their popular medical texts, Taber’s Cyclopedic Medical Dictionary and Davis’s Drug Guide for Nurses. This mobile flash card app colorfully highlights pertinent drug features, and lists patient counseling points for nearly four-hundred of the most frequently prescribed generic drugs. iMedicalApps

Understanding and interpretation of lab tests made exceedingly easy by Clinlab Navigator To Go. 
The ability to read and understand a wide range of laboratory test results is a crucial part of being a doctor. With the advancement of medical technology, lab tests have become more specific, accurate and often, more complicated. We recently reviewed LabDX (review here) and now we focus on one of its major competitors, Clinlab Navigator to go.  iMedicalApps

When That Shoulder Aches Too Much to Move

According to a recent literature review published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) (PDF), “patients with a painful stiff shoulder are frequently diagnosed with frozen shoulder” which is a vague diagnosis because there are many factors that contribute to motion loss in the shoulder, says Robert J. Neviaser, MD, Professor and Chairman of the Department of Orthopaedic Surgery at George Washington University Medical Center in Washington, D.C., who co-authored the review with his son, Andrew S. Neviaser, MD, Assistant Professor in the department. AAOS

Cam-type deformities linked to MRI detected hip damage in asymptomatic young men

Hip impingement (femoracetabular impingement) may be a risk factor of osteoarthritis (OA) of the hip. A new study reveals that the presence of an underlying deformity, known as cam impingement, is associated with hip damage in young men without any arthritis symptoms and detected using magnetic resonance imaging (MRI). Full findings are now published in Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR). Eurekalert!

Wednesday, September 7, 2011

Arthroscopy: [Epub ahead of print]

1. Comparisons of Femoral Tunnel Position and Length in Anterior Cruciate Ligament Reconstruction: Modified Transtibial Versus Anteromedial Portal Techniques. Chang CB, Choi JY, Koh IJ, Lee KJ, Lee KH, Kim TK. Arthroscopy. 2011 Sep 1. [Epub ahead of print] PMID: 21889869 PDF

2. Posterior Shoulder Dislocation: Systematic Review and Treatment Algorithm. Paul J, Buchmann S, Beitzel K, Solovyova O, Imhoff AB. Arthroscopy. 2011 Sep 1. [Epub ahead of print] PMID: 21889868 PDF

3. The "50% Rule" in Arthroscopic and Orthopaedic Surgery. Pedowitz RA, Higashigawa K, Nguyen V. Arthroscopy. 2011 Sep 1. [Epub ahead of print] PMID: 21889867  PDF

Injury (journal): articles in press

1. Scaphoid morphology and clinical outcomes in scaphoid reconstructions. In Press, Corrected Proof, Available online 7 September 2011; K. Megerle, P.S. Harenberg, G. Germann, S. Hellmich PDF

2. Percutaneous screw fixation for the acetabular fracture with quadrilateral plate involved by three-dimensional fluoroscopy navigation: Surgical technique. In Press, Corrected Proof, Available online 6 September 2011; Zhiyong Ruan, Cong-Feng Luo, Bing-Fang Zeng, Chang-Qing Zhang PDF

3. Anticoagulation management in hip fracture patients: A clinical conundrum. In Press, Corrected Proof, Available online 6 September 2011; Paolo Mazzola, Giuseppe Bellelli, Pamina Baccella, Giorgio Annoni PDF

4. Intramedullary nailing of trochanteric fractures—Operative technical tips. In Press, Corrected Proof, Available online 6 September 2011; Ioannis Aktselis, Dimos Papadimas, Evaggelos Fragkomichalos, Anastasios Deligeorgis, Constantine Kokoroghiannis PDF

5. Allograft bone matrix versus synthetic bone graft substitutes. In Press, Corrected Proof, Available online 1 September 2011; Gerald Zimmermann, Arash Moghaddam PDF

6. Incidence and predictors for the need for fasciotomy after extremity trauma. In Press, Corrected Proof, Available online 1 September 2011; Hoda Javadikasgari PDF

7. Stabilization of fatigue fractures of the dorsal pelvis with a trans-sacral bar. Operative technique and outcome. In Press, Corrected Proof, Available online 1 September 2011; Isabella Mehling, Martin Henry Hessmann, Pol Maria Rommens PDF

8. Disaster triage after the Haitian earthquake. In Press, Corrected Proof, Available online 24 August 2011; R.M. Smith, G.S.M. Dyer, K. Antonangeli, N. Arredondo, H. Bedlion, A. Dalal, G.M. Deveny, G. Joseph, D. Lauria, S.H. Lockhart, S. Lucien, S. Marsh, S.O. Rogers, H. Salzarulo, S. Shah, R.J. Toussaint, J. Wagoner PDF

Outcome of conjoined tendon and coracoacromial ligament transfer for the treatment of chronic type V acromioclavicular joint separation.

Despite the small study cohort, the results of LHCT and CAL transfer in chronic type V AC separation are promising. CAL transfer alone has been shown to be biomechanically insufficient for an AC reconstruction, particularly in chronic situations. The advantage of LHCT transfer is that it does not require a distant donor site or incur the costs of an allograft or implant. Kim SH, Lee YH, Shin SH, Lee YH, Baek GH. Injury. 2011 Sep 2. [Epub ahead of print] PMID: 21890137  PDF

Meniscus Repair and Transplantation: A Comprehensive Update.

Preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following repair of meniscus tears for both simple longitudinal tears located in the periphery and complex multi-planar tears that extend into the central third avascular region. This operation is usually indicated in active patients who have tibiofemoral joint line pain and are less than 50 years of age. However, not all meniscus tears are repairable, especially if considerable damage has occurred. In select patients, meniscus transplantation may restore partial load-bearing meniscus function, decrease symptoms, and provide chondroprotective effects. The initial postoperative goal after both meniscus repair and transplantation is to prevent excessive weight bearing, as high compressive and shear forces can disrupt healing meniscus repair sites and transplants. Immediate knee motion and muscle strengthening are begun the day following surgery. Variations are built into the rehabilitation protocol according to the type, location, and size of the meniscus repair; if concomitant procedures are performed; and if articular cartilage damage is present. Meniscus repairs located in the periphery heal rapidly, whereas complex multiplanar repairs tend to heal more slowly and require greater caution. We have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies. Noyes FR, Heckmann TP, Barber-Westin SD. J Orthop Sports Phys Ther. 2011 Sep 4. [Epub ahead of print] PMID: 21891878

Analysis of anatomic positioning in computer-assisted and conventional anterior cruciate ligament reconstruction.

Computer-guided navigation ensured implant positioning within the so-called anatomometric area of the native ACL attachment, avoiding impingement with the femoral notch.  Plaweski S, Rossi J, Merloz P, Julliard R. Orthop Traumatol Surg Res. 2011 Sep 2. [Epub ahead of print] PMID: 21890442

Three-dimensional in vivo motion analysis of normal knees using single-plane fluoroscopy.

Analysis of the movement of anatomically defined reference axes at the femoral condyles relative to the tibia is appropriate for evaluating knee kinematics. However, such parameters have been previously employed only in studies utilizing stop-motion techniques. The purpose of this study was to evaluate in vivo dynamic kinematics for full range of motion in normal knees using the three-dimensional to two-dimensional registration technique and to compare them with previously reported normal knee kinematics obtained via stop-motion techniques.  Tanifuji O, Sato T, Kobayashi K, Mochizuki T, Koga Y, Yamagiwa H, Omori G, Endo N. J Orthop Sci. 2011 Sep 4. [Epub ahead of print] PMID: 21892788

The Clinical Assessment Study of the Foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population.

This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and clinical examination findings, and their presentation, diagnosis and management in primary care.  Roddy E, Myers H, Thomas MJ, Marshall M, D'Cruz D, Menz HB, Belcher J, Muller S, Peat G. J Foot Ankle Res. 2011 Sep 5;4(1):22. [Epub ahead of print] PMID: 21892960 PDF

Management of the greater trochanteric pain syndrome: a systematic review.

Repetitive low-energy radial shock wave therapy and home training approach provide beneficial effect over months, with almost 80% success rate at 15 months .Poor available data extracted from small studies do not allow definitive conclusions to be drawn on the best treatment for GTPS  Del Buono A, Papalia R, Khanduja V, Denaro V, Maffulli N. Br Med Bull. 2011 Sep 4. [Epub ahead of print] PMID: 21893483

Tuesday, September 6, 2011

UC Davis neurosurgeons use adult stem cells to grow neck vertebrae

Neurosurgery researchers at UC Davis Health System have used a new, leading-edge stem cell therapy to promote the growth of bone tissue following the removal of cervical discs -- the cushions between the bones in the neck -- to relieve chronic, debilitating pain.

The procedure was performed by associate professors of neurosurgery Kee Kim and Rudolph Schrot. It used bone marrow-derived adult stem cells to promote the growth of the bone tissue essential for spinal fusion following surgery, as part of a nationwide, multicenter clinical trial of the therapy. The study is one of several clinical trials under way in the UC Davis Spine Center and led by Kim. He anticipates launching a clinical trial soon to study the safety of injecting stem cells into disc tissue to repair degenerated discs. Eurekalert!

Chondroitin sulfate improves hand function, relieves morning stiffness caused by osteoarthritis

New research shows that chondroitin sulfate significantly decreased pain and improved hand function in patients with osteoarthritis (OA) of the hand compared with those in the placebo group. Results of the clinical trial available today in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR), also report that chondroitin sulfate improves grip strength and relieves morning stiffness. Eurekalert!

Full citation:
Symptomatic Effect of Chondroitin Sulfate 4&6 in Hand Osteoarthritis: The Finger osteoArthritis Chondroitin Treatment Study (FACTS): A Randomized Double-Blind Placebo Controlled Clinical Trial." Cem Gabay, Carole Medinger-Sadowski, Danielle Gascon, Frank Kolo, Axel Finckh. Arthritis & Rheumatism; Published Online: September 6, 2011

Monday, September 5, 2011

The role of ultrasound in the diagnosis and follow-up of early inflammatory arthritis.

The inflammatory arthritides are a group of chronic, often debilitating disorders characterized by synovial inflammation and progressive joint destruction. The primary diagnostic aim is to recognize the inflammatory arthritis at an early stage, such that therapies may be implemented before irreversible joint destruction has occurred. The radiologist now plays a pivotal role both in making an accurate and early diagnosis of inflammatory arthritis as well as assessing treatment response. This article reviews the current literature and presents our approach to the sonographic assessment of early inflammatory arthritis. Spencer SP, Ganeshalingam S, Kelly S, Ahmad M. Clin Radiol. 2011 Aug 30. [Epub ahead of print] PMID: 21885046

Perilunate Dislocation and Perilunate Fracture-dislocation.

Perilunate dislocations and perilunate fracture-dislocations usually result from high-energy traumatic injuries to the wrist and are associated with a characteristic spectrum of bony and ligamentous damage. Radiographic evaluation of the wrist reveals loss of normal radiocarpal and intercarpal colinearity and bony insult, which may be overlooked at the initial presentation. Prompt recognition is important to optimize outcomes. Closed reduction is performed acutely, followed by open reduction and ligamentous and bony repair with internal fixation. Complications include posttraumatic arthrosis, median nerve dysfunction, complex regional pain syndrome, tendon problems, and carpal instability. Despite appropriate treatment, loss of wrist motion and grip strength, as well as persistent pain, is common. Medium- and long-term studies demonstrate radiographic evidence of midcarpal and radiocarpal arthrosis, although this does not correlate with functional outcomes. Stanbury SJ, Elfar JC. J Am Acad Orthop Surg. 2011 Sep;19(9):554-62. PMID: 21885701

Return to Duty After Type III Open Tibia Fracture.

Despite the severe nature of combat extremity wounds, 20% of patients with salvaged Type III open tibia fractures and 22% with isolated injuries were able to return to active duty. These rates are similar to those reported for civilian amputees. Amputees in our cohort were less likely to RTD. Cross JD, Stinner DJ, Burns TC, Wenke JC, Hsu JR; and Skeletal Trauma Research Consortium (STReC). J Orthop Trauma. 2011 Aug 27. [Epub ahead of print] PMID: 21885998

Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial.

From the Food Network
Being a Resident is a tough job.  Go eat some tuna!

These data suggest that n-3 supplementation can reduce inflammation and anxiety even among healthy young adults. The reduction in anxiety symptoms associated with n-3 supplementation provides the first evidence that n-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis.  Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Brain Behav Immun. 2011 Jul 19. [Epub ahead of print] PMID: 21784145

Omega-3 fatty acids from fish oil lower anxiety, improve cognitive functions and reduce spontaneous locomotor activity in a non-human primate. The long-term dietary ω3 PUFA supplementation positively impacts on anxiety and cognitive performances in the adult mouse lemur. The supplementation of human food with ω3 fatty acids may represent a valuable dietary strategy to improve behavioural and cognitive functions. Vinot N, Jouin M, Lhomme-Duchadeuil A, Guesnet P, Alessandri JM, Aujard F, Pifferi F. PLoS One. 2011;6(6):e20491. Epub 2011 Jun 7. PMID: 21666750  PDF

The Open Orthopaedics Journal: Special Issue Tissue Engineering in Orthopaedics and Musculoskeletal Sciences

Punwar S, Khan WS.
Open Orthop J. 2011;5 Suppl 2:296-301. Epub 2011 Jul 28.

[PubMed - in process]
Khaled EG, Saleh M, Hindocha S, Griffin M, Khan WS.
Open Orthop J. 2011;5 Suppl 2:289-95. Epub 2011 Jul 28.

[PubMed - in process]
Khashan M, Smitham PJ, Khan WS, Goddard NJ.
Open Orthop J. 2011;5 Suppl 2:283-8. Epub 2011 Jul 28.

[PubMed - in process]
Grange S.
Open Orthop J. 2011;5 Suppl 2:276-82. Epub 2011 Jul 28.

[PubMed - in process]
Kanitkar M, Tailor HD, Khan WS.
Open Orthop J. 2011;5 Suppl 2:271-5. Epub 2011 Jul 28.

[PubMed - in process]
Oragui E, Nannaparaju M, Khan WS.
Open Orthop J. 2011;5 Suppl 2:267-70. Epub 2011 Jul 28.

[PubMed - in process]
Henson F, Getgood A.
Open Orthop J. 2011;5 Suppl 2:261-6. Epub 2011 Jul 28.

[PubMed - in process]
Mafi R, Hindocha S, Mafi P, Griffin M, Khan WS.
Open Orthop J. 2011;5 Suppl 2:242-8. Epub 2011 Jul 28.

[PubMed - in process]
Mahapatra A, Khan WS.
Open Orthop J. 2011;5 Suppl 2:239-41. Epub 2011 Jul 28. No abstract available.

[PubMed - in process]
Potenza V, Caterini R, Maglione P, Bisicchia S, Farsetti P.
Open Orthop J. 2011;5:315-8. Epub 2011 Aug 10.

[PubMed - in process]
Schulze C, Lindner T, Schulz K, Finze S, Kundt G, Mittelmeier W, Bader R.
Open Orthop J. 2011;5:302-6. Epub 2011 Aug 10.

[PubMed - in process]

Experience of using local flaps to cover open lower limb injuries at an Indian trauma center.

Optimal care of open, high-velocity, lower limb injury requires surgical skills in debridement, skeletal stabilization, and in providing appropriate soft tissue cover. Timely coordination between orthopedic and plastic surgeons, though ideal, is often difficult. In our center, orthopedic surgeons undertake comprehensive treatment of open fractures including soft tissue cover. We reviewed the results of the local flaps of lower limb, done by orthopedic surgeons. Boopalan PR, Nithyananth M, Titus VT, Cherian VM, Jepegnanam TS. J Emerg Trauma Shock. 2011 Jul;4(3):325-9. PMID: 21887018

Immunomodulative Efficacy of Bone Marrow-Derived Mesenchymal Stem Cells Cultured in Human Platelet Lysate.

Human mesenchymal stem cells (hMSCs) are considered to be a promising tool for novel cell-based therapies. Clinical applications in solid organ transplantation were hampered by the dependence on animal serum for hMSCs clinical scale expansion until substitution with human platelet lysate (HPL) became a promising alternative. Therefore we focused on a direct comparison of immunomodulatory properties of hMSCs cultured in HPL or fetal calf serum (FCS). Phenotypic characterization, detection of cytokine secretion and effects on alloantigen- and mitogen-induced lymphocyte proliferation as well as degranulation of cytomegalovirus-specific cytotoxic T cells were applied in potency assays. We demonstrated that HPL-cultured MSCs have comparable immunomodulatory capacities to their FCS-cultured counterparts. The observed immunomodulatory properties include a beneficial inhibitory effect on immune cell proliferation and an unaffected viral T cell immunity. Thus, culturing hMSCs in HPL generates an efficient and safe expansion combined with intriguing immunomodulatory properties making these cells an attractive cell therapeutic tool. Flemming A, Schallmoser K, Strunk D, Stolk M, Volk HD, Seifert M. J Clin Immunol. 2011 Sep 2. [Epub ahead of print] 


As Sports Medicine Surges, Hope and Hype Outpace Proven Treatments

Steffen Dietzel via
Wikimedia Commons

 Medical experts say her tale of multiple futile treatments is all too familiar and points to growing problems in sports medicine, a medical subspecialty that has been experiencing explosive growth. Part of the field’s popularity, among patients and doctors alike, stems from the fact that celebrity athletes, desperate to get back to playing after an injury, have been trying unproven treatments, giving the procedures a sort of star appeal.

But now researchers are questioning many of the procedures, including new ones that often have no rigorous studies to back them up. “Everyone wants to get into sports medicine,” said Dr. James Andrews, a sports medicine orthopedist in Gulf Breeze, Fla., and president-elect of the American Orthopaedic Society for Sports Medicine.   New York Times

Sunday, September 4, 2011

A Prospective Comparison of Procedural Sedation and Ultrasound-guided Interscalene Nerve Block for Shoulder Reduction in the Emergency Department.

In this study, patients undergoing shoulder dislocation reduction using US-guided interscalene block spent less time in the ED and required less one-on-one health care provider time compared to those receiving procedural sedation. There was no difference in pain level or satisfaction when compared to procedural sedation patients. Blaivas M, Adhikari S, Lander L. Acad Emerg Med. 2011 Aug 30. [Epub ahead of print] PMID: 21883635