Ortho News

Sunday, March 25, 2012

First sterile iPad sleeve for operating room now available, exclusive hands-on review

EchoMedical has partnered with Protek Medical devices to bring to market a disposable sterile iPad sleeve for use in the operating room. iMedicalApps

Gait analysis accuracy: Android app comparable to standard accelerometer methodology

Smartphones are becoming more ubiquitous and many have a built in tri-axial accelerometer, a sensor that measures change in speed in multiple directions. These smartphone accelerometers can be used to assess gait patterns, or walking patterns, an important evaluation in many neurologic or musculoskeletal disorders. However, the reliability and validity of using smartphones to assess gait patterns is not yet fully established evaluated. In Japan, a team of registered physical therapists and other physicians performed a study to do just that. iMedicalapps

Navy (not Medical) Related: Materials inspired by Mother Nature: A 1-pound boat that could float 1,000 pounds

Combining the secrets that enable water striders to walk on water and give wood its lightness and great strength has yielded an amazing new material so buoyant that, in everyday terms, a boat made from 1 pound of the substance could carry five kitchen refrigerators, about 1,000 pounds. PhysOrg.com

Skull resconstruction immediately following traumatic brain injury worsens brain damage

Immediate skull reconstruction following trauma that penetrates or creates an indentation in the skull can aggravate brain damage inflicted by the initial injury, a study by a University of South Florida research team reports. Using a rat model for moderate and severe traumatic brain injury, the researchers also showed that a delay of just two days in the surgical repair of skull defects resulted in significantly less brain swelling and damage.

The study was published March 16, 2012 in the online journal PloS ONE. University of South Florida

Runner's high motivated the evolution of exercise

In the last century something unexpected happened: humans became sedentary. We traded in our active lifestyles for a more immobile existence. But these were not the conditions under which we evolved. David Raichlen from the University of Arizona, USA, explains that our hunter-gatherer predecessors were long-distance endurance athletes. 'Aerobic activity has played a role in the evolution of lots of different systems in the human body, which may explain why aerobic exercise seems to be so good for us', says Raichlen. However, he points out that testing the hypothesis that we evolved for high-endurance performance is problematic, because most other mammalian endurance athletes are quadrupedal. 'So we got interested in the brain as a way to look at whether evolution generated exercise behaviours in humans through motivation pathways', says Raichlen. Eurekalert!

New MRI Technique Visualizes Phosphorus, Opens Potential for Hard Tissue Imaging

The image here shows the interior

spongy bone of a rabbit femoral head,

or the "ball" of the rabbit's hip bone.

Conventional magnetic resonance imaging (MRI) relies on aligning the magnetization of hydrogen atoms in a study sample, which makes it an excellent tool for visualizing water-rich materials like soft tissues and organs.

Yet MRI is not fundamentally limited to focusing on hydrogen atoms, and scientists at Yale have developed a new approach that allows them to visualize phosphorus, opening a way to look into hard tissues like bone. The imaging technology may take some time finding use in clinical practice though, because the process creates too much heat for live tissue to survive. We’re speculating that perhaps it may instead serve as a safer option over therapeutic radiation. MedGadget

Wednesday, March 21, 2012

Two apps you knee(d) to stay hip.

Knee Pro III app will help orthopedic surgeons with patient education

Knee Pro III contains a detailed anatomical overview of the knee region and areas slightly superior and inferior. The attention to detail is excellent and there is a huge number of pins marking anatomical structures which provide a comprehensive overview of the knee joint. iMedicalApps

Hip Pro III another impressive specialist NOVA anatomy app from 3D4Medical

Hip Pro III is primarily focused on the anatomy of the hip region and includes the superior portion of the upper leg. The anatomical detail is excellent and the 3D models really do look impressive with the inclusion of small details like subcutaneous fat adding to the overall positive impression. iMedicalApps

Possible Use for Joint Injections? AxoTrack Needle Guidance Ultrasound Probe Unveiled

Basically, AxoTrack allows traditional ultrasound imaging to be coupled with a virtual needle that points the way for the real needle during all kinds of ultrasound-guided procedures, especially central line placements. The company says that “when tested in vitro, an AxoTrack-equipped ultrasound probe resulted in successful vascular access on the first stick and first pass 99.3% of the time versus just 37.1% of the time when compared to the standard freehand method for ultrasound-guided central venous access.” MedGadget

New study shows vast geographic variation in hip fracture risk

An extensive study of country-specific risk of hip fracture and 10-year probability of a major fragility fracture has revealed a remarkably large geographic variation in fracture risk. Even accounting for possible errors or limitations in the source data, there was an astonishing 10-fold variation in hip fracture risk and fracture probability between countries.

'A systematic review of hip fracture incidence and probability of fracture worldwide', authored by the International Osteoporosis Foundation (IOF) Working Group on Epidemiology and Quality of Life, has today been published in the journal Osteoporosis International. The aim of the study was to update the available information base on the global heterogeneity in the risk of hip fracture. Age-standardised hip fracture rates from 63 countries were compiled. Additionally, the study documents variations in major fracture probability as determined from 45 FRAX models from 40 countries. Eurekalert!

The publication is freely accessible on the Springer website at http://www.springerlink.com/content/r27872850q9t772l/

BUSM study demonstrates tomosynthesis effective in diagnosing knee

A recent study done by researchers at Boston University School of Medicine (BUSM) shows that tomosynthesis may be more beneficial in diagnosing knee osteoarthritis than X-ray imaging. In the study, which is published online in the journal Radiology, tomosynthesis detected more osteophytes (abnormal bony spurs) and subchondral cysts (small collection of fluid within the bone) in the knee joint than conventional X-ray imaging. Boston University

Thromboembolic events are uncommon following ankle fracture surgery

Thromboembolic events – such as deep vein thrombosis (DVT), blood clots developing in the extremities; or pulmonary embolism (PE), a complication that causes a blood clot to move to the lungs – can occur following musculoskeletal injury and related surgery, and are potentially life threatening. In "The Incidence of Thromboembolic Events in Surgically Treated Ankle Fracture," a study appearing in the March 21, 2012 issue of the JBJS, researchers sought to determine the frequency of, and potential risk factors for, thromboembolic events following surgical treatment of an ankle fracture. Eurekalert!

Monday, March 19, 2012

Clinical Orthopedic Exam (CORE) app is a great resource for internists and specialists alike

For those of you who didn’t catch Dr. Felasfa Wodajo’s previous review, the Clinical Orthopedic Exam (CORE) app is a multimedia source of over 250 different musculoskeletal physical exam maneuvers. It is indexed by body area in picture and text format, is comprehensive and very well referenced. It’s certainly not your average app.

Each physical exam test is well described and contains a YouTube video link that demonstrates the proper way to perform the test. Of note, the app also includes a synopsis of the statistical validity of the particular test as well as links to scientific references that describe the test. iMedicalApps

Scott Summit: Beautiful artificial limbs

Prosthetics can’t replicate the look and feel of lost limbs but they can carry a lot of personality. At TEDxCambridge, Scott Summit shows 3D-printed, individually designed prosthetic legs that are unabashedly artificial and completely personal -- from macho to fabulous.

Scott Summit uses his 20 years of experience as an industrial designer to make artificial limbs that help people take personal control of these intimate objects. TED Talks

Venous Thromboembolism Prophylaxis in Orthopedic Surgery: a comparative effectiveness review from AHRQ 13 March 2012

Objectives: This is an evidence report prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center (EPC) examining the comparative efficacy and safety of prophylaxis for venous thromboembolism in major orthopedic surgery (total hip replacement [THR], total knee replacement [TKR], and hip fracture surgery [HFS]) and other nonmajor orthopedic surgeries (knee arthroscopy, injuries distal to the hip requiring surgery, and elective spine surgery).

Data Sources: Medline, the Cochrane Central Register of Controlled Trials, and Scopus from 1980 to May 2011 with no language restrictions. (PDF)

Saturday, March 17, 2012

Hip fracture surgery type impacts future fracture risk

Patients with a primary proximal femoral fracture who undergo closed reduction and percutaneous pinning have a significantly increased risk of subsequent contralateral hip fracture compared with those who undergo arthroplasty, according to a study published in the March 7 issue of The Journal of Bone & Joint Surgery. MedicalXpress

European Society of Musculoskeletal Radiology: ESSR Ultrasound Group Protocols

ESSR Ultrasound Group Protocols:

Shoulder

Elbow

Wrist

Hip

Knee

Ankle

John Theurer Cancer Center Surgeon Co-Authors the Only Guide on Orthopedic Oncology Tumor Surgery

James C. Wittig, M.D., Chief Orthopedic Oncology and Co-Chief, Skin and Sarcoma at the John Theurer Cancer Center at Hackensack University Medical Center, one of the nation’s top 50 best hospitals for cancer, joined leading experts to co-author the only step by step guide of all operative procedures in orthopedic oncology titled “Operative Techniques in Orthopaedic Surgical Oncology.” John Theurer Cancer Center

Nano rescues skin

Nanoparticles containing chitosan have been shown to have effective antimicrobial activity against Staphylococcus saprophyticus and Escherichia coli. The materials could be used as a protective wound-healing material to avoid opportunistic infection as well as working to facilitate wound healing.

Chitosan is a natural, non-toxic and biodegradable, polysaccharide readily obtained from chitin, the main component of the shells of shrimp, lobster and the beak of the octopus and squid. Its antimicrobial activity is well known and has been exploited in dentistry to prevent caries and as preservative applications in food packaging. It has even been tested as an additive for antimicrobial textiles used in clothing for healthcare and other workers.

Now, Mihaela Leonida of Fairleigh Dickinson University, in Teaneck, New Jersey and colleagues writing in the International Journal of Nano and Biomaterials describe how they have prepared nanoparticles of chitosan that could have potential in preventing infection in wounds as well as enhancing the wound-healing process itself by stimulating skin cell growth. Eurekalert!

Calculate is an essential free download for all Android users

When it comes to medical apps and mobile technology, one of the most well used resources is the medical calculator. These apps take user input information and apply defined formulae to calculate a range of useful information.

These apps allow physicians to save time and effort but more importantly reduce the chance of making a mistake. QxMD have developed a highly successful medical calculator called Calculate for iPhone which has recently been ported to Android.

Calculate by QxMD is an incredibly useful free app for Android. It contains over 150 medical calculators and clinical support tools which are all easily accessible from the home menu. iMedicalApps

Supraacetabular Fossa (Pseudodefect of Acetabular Cartilage): Frequency at MR Arthrography and Comparison of Findings at MR Arthrography and Arthroscopy.

Purpose:To evaluate the frequency of the supraacetabular fossa (SAF) (pseudodefect of acetabular cartilage) at magnetic resonance (MR) arthrography of the hip and to compare the MR findings with those from arthroscopy. Dietrich TJ, Suter A, Pfirrmann CW, Dora C, Fucentese SF, Zanetti M. Radiology. 2012 Mar 13. PMID: 22416250

Johns Hopkins: Health apps should have disclaimers

Baltimore-based Johns Hopkins University’s Global mHealth Initiative has undertaken what the Baltimore Sun calls “one of the broadest efforts to assess mHealth strategies” with 49 official studies underway by dozens of university faculty members. According to the report, the initiative is evaluating which mHealth services can help physicians, community health workers and consumers “in ways equal to other more traditional methods” like clinic visits or in-person coaching. (Maybe even in ways superior to existing and legacy methods?) Mobile Health News

Wednesday, March 14, 2012

Arc Sterile Turns Any Room into OR

Surgical theaters are not only clean inside, but the air supplied to them is delivered in laminar flow and filtered to maximize sterility. This commonly requires a proper ventilation system built into the infrastructure of the building. What if you’re a hospital administrator and a need arises for another operating room, but upgrading the ventilation system would be way too expensive? MedGadget

New England Journal of Medicine Now Available as iPad App

Massachusetts Medical Society has released an iPad version of its venerable NEJM. In addition to all the content from the print version, the iPad app also includes audio and video materials from the NEJM.org website.

The software is free to download, and includes one complete New England Journal of Medicine issue, but subscriptions are $14.99 per month and $5.99 for a single issue. MedGadget

University of Chicago study demonstrates efficiency gains from using iPads in medicine

Ever since the first iPad was released in early 2010, physicians have been adopting tablet devices in droves. According to a survey by QuantiaMD in May ’11, 80% of physicians surveyed owned a smartphone or tablet and 30% owned a tablet device. And from this individual adoption, physicians are increasingly using their mobile devices in their clinical duties, creating headaches for many IT managers out there. iMedicalApps

Clinical news alert: Journal of the American Academy of Orthopaedic Surgeons highlights

Highlights of new research articles appearing in the March 2012 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), as well as the full table of contents. Each news highlight, and listed title in the table of contents, includes a link to the study abstract. AAOS

Italian researchers found how to stop low back pain

Italian researchers at the Catholic University of Sacred Heart in Rome found an important molecular mechanism responsible for low back pain and other acute vertebral problems like cervical axial pain, all due to aging and degeneration of the vertebral column.

The team led by Dr. Luigi Aurelio Nasto and Enrico Pola also developed an experimental drug to inhibit this degenerative mechanism, by blocking its principal culprit, the molecule, "NF-kB" and tested it successfully in mice. The study was carried out in collaboration with the University of Pittsburgh research team led by Paul Robbins, James Kang and Nam Vo (e-mail: von@upmc.edu).

Researchers reported their findings in the February 16 online edition of the journal Spine. Eurekalert!

Storage time for cartilage transplant tissue doubled by MU researchers

In a study due to be published in the Journal of Knee Surgery, Cook and Aaron Stoker from MU's Comparative Orthopaedic Laboratory, Clark Hung and Eric Lima from Columbia University, and James Stannard, the J. Vernon Luck Sr. Distinguished Professor in Orthopaedic Surgery in the MU School of Medicine, tested tissue using their patented system, which includes storing the tissue at room temperature in a specially designed container and storage solution. The researchers found that their system preserved transplant-quality tissue for as long as 63 days. The collaborative team of researchers also developed a way to monitor the quality of the stored tissue simply by testing a few drops of their patented storage solution. Eurekalert!

Monday, March 12, 2012

Two new open-access Ortho related journals

Bone & Joint Research
"A new 'open access' journal set to revolutionise research communication in the field of orthopaedics and the musculoskeletal sciences."

Skeletal Muscle
Skeletal Muscle is a peer-reviewed, open access, online journal that publishes articles investigating molecular mechanisms underlying the biology of skeletal muscle. A wide range of skeletal muscle biology is included: development, metabolism, the regulation of mass and function, aging, degeneration, dystrophy and regeneration. The emphasis is on understanding adult skeletal muscle, its maintenance, and its interactions with non-muscle cell types and regulatory modulators.

Delay in surgery can cause irreparable meniscus tears in children with ACL injuries

For children aged 14 and under, delaying reconstructive surgery for anterior cruciate ligament (ACL) injuries may raise their risk of further injury, according to a new study by pediatric orthopaedic surgeons. If surgery occurs later than 12 weeks after the injury, the injury may even be irreparable.

"Treating ACL injuries in these children is controversial, because they are still growing and the surgery has a small risk of causing a growth disturbance," said study leader J. Todd Lawrence, M.D., Ph.D., an orthopaedic surgeon at The Children's Hospital of Philadelphia. "However, we found that the risk of additional injury outweighs the risk of growth disturbance in most children."

Lawrence's study appeared in a recent issue of The American Journal of Sports Medicine. Eurekalert!

A lifetime of research may be leading to a life-saving treatment for shock

A 200-patient Phase 2 clinical pilot study will be initiated this month to test the efficacy and safety of a new use, and method of administering, an enzyme inhibitor for critically ill patients developed by University of California, San Diego Bioengineering Professor Geert Schmid-Schönbein. Conditions expected to qualify for the study include new-onset sepsis and septic shock, post-operative complications, and new-onset gastrointestinal bleeding. MedicalXpress

Wednesday, March 7, 2012

Knee Replacement Outcome Data Fall Short

Long-term data on total knee replacement surgery is largely limited to revision, leaving clinicians and patients in the dark about outcomes such as residual pain and disability, researchers said.

Currently the best data come from national procedure registries, but the traditional outcome measure is subsequent revision surgery, which "can underestimate problems [because] patients can remain with pain or poor function without necessarily undergoing revision," according to Andrew J. Carr, FMedSci, of the University of Oxford in England, and colleagues.

More than 600,000 knee replacement procedures are performed in the U.S. annually, according to the Agency for Healthcare Research and Quality.

Writing online in The Lancet (PDF), Carr and colleagues outlined four directions for the future of knee replacement surgery:

More consistent patient selection for knee replacement

Long-term monitoring with patient-oriented outcomes, as well as revision, as endpoints

Approval of new designs only after large randomized trials that demonstrate cost-effectiveness as well as clinical efficacy

Better management of young people with early arthritis to avoid need for replacement surgery MedPage Today

Merck Manual app is a useful mobile resource despite one or two interface issues

The Merck Manual is well known as one of the key reference texts for internal medicine physicians.

Unbound Medicine, developers of other well known reference apps including Johns Hopkins POC-IT series, Harriet Lane Handbook, have recently released the latest edition (19th) of the popular Merck Manual of Diagnosis and Therapy.

This app review will not focus on the core content of the Merck Manual but rather examine the app itself. iMedicalApps

Exercise changes your DNA

You might think that the DNA you inherited is one thing that you absolutely can't do anything about, but in one sense you'd be wrong. Researchers reporting in the March issue of Cell Metabolism, a Cell Press publication, have found that when healthy but inactive men and women exercise for a matter of minutes, it produces a rather immediate change to their DNA. Perhaps even more tantalizing, the study suggests that the caffeine in your morning coffee might also influence muscle in essentially the same way. MedicalXpress

Some new Clinical Guidelines for Ortho via MD Consult

2012 Prevention of VTE in Orthopedic Surgery Patients

American College of Chest Physicians (ACCP)

2012 The Perioperative Management of Antithrombotic Therapy

American College of Chest Physicians (ACCP)

Antibiotics I-Pocketcards app assists healthcare providers with antimicrobial choices

Faced with innumerable micro-organisms, evolving susceptibility patterns, and patient antibiotic allergies, clinicians –especially those in training like myself—often struggle with antimicrobial regimen choices in the management of infectious diseases, in both the inpatient as well as outpatient settings.

What antibiotics should I order (or not order) for a penicillin-allergic postpartum patient with a fever, a hypotensive nursing home resident with a sacral ulcer, an otherwise healthy middle-aged man with dysuria, a diabetic with foot cellulitis, or a cystic fibrosis patient with an infiltrate on chest x-ray?

Borm Bruckmeier Publishing LLC, founded in 1992 by two German physicians, has brought us the expansive I-Pocketcards series of apps for the iPhone/iPad, including the most recently reviewed Smoking Cessation I-Pocketcards. To assist in clinical decision making, Borm Bruckmeier Publishing LLC has developed an I-Pocketcards App for Antibiotics. iMedicalApps

Surgery less than 24 hours after traumatic cervical spinal cord injury leads to improved outcomes

Researchers at the Rothman Institute at Jefferson have shown that patients who receive surgery less than 24 hours after a traumatic cervical spine injury suffer less neural tissue destruction and improved clinical outcomes. The results of their study, the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) are available in PLoS One.

"This practice-changing study is the first to show that the timing of surgery after traumatic spinal cord injury (SCI) matters," says Alexander Vaccaro, MD, PhD, professor of Orthopaedics and Neurosurgery at Jefferson Medical College of Thomas Jefferson University and attending surgeon at Thomas Jefferson University Hospital, the largest spinal cord injury center in the country. Eurekalert!

Vitamin D intake may be associated with lower stress fracture risk in girls

Vitamin D may be associated with a lower risk of developing stress fractures in preadolescent and adolescent girls, especially among those very active in high-impact activities, according to a report published Online First by Archives of Pediatrics & Adolescent Medicine. MedicalXpress

Test Would Speed Treatment of Joint Replacement Infections

Infection poses one of the most serious risks to patients getting a hip or knee replaced, and a major U.S. drugmaker is developing a test to quickly identify the pathogens responsible so doctors can treat problems sooner.

Abbott Diagnostics Group, a unit of Abbott Laboratories, is working with privately held Genetics Laboratory Inc., whose expertise is in orthopedics, to develop the test.

It will be based on Abbott's PLEX-ID system for identifying microbes, and is expected to help doctors detect infections that become rooted in the body's joints long before they become apparent through physical symptoms. NewsMax Health

Ekso Bionics Sells Its First Commercial Exoskeleton

Ekso Bionics (Berkeley, CA) has recently delivered the ready-to-wear, battery-powered Ekso exoskeleton to its first customer, the Craig Hospital in Denver, an institution dedicated to spinal cord injury and traumatic brain injury rehabilitation. The Ekso system is strapped on to the user over clothing, enabling paraplegics to stand and walk. The company will deliver more units over the next few months. MedGadget

Study reveals how anesthetic isoflurane induces Alzheimer's-like changes in mammalian brains

The association of the inhaled anesthetic isoflurane with Alzheimer's-disease-like changes in mammalian brains may by caused by the drug's effects on mitochondria, the structures in which most cellular energy is produced. In a study that will appear in Annals of Neurology and has received early online release, Massachusetts General Hospital (MGH) researchers report that administration of isoflurane impaired the performance of mice on a standard test of learning and memory – a result not seen when another anesthetic, desflurane, was administered. They also found evidence that the two drugs have significantly different effects on mitochondrial function. Eurekalert!

Sunday, March 4, 2012

AAOS Now and Ortho Supersite are two apps that provide orthopedic and musculoskeletal news and information

Many apps are small versions of their respective web site. Others carry out one distinct function that works well in the portable world. Still others augment the main web site’s functionality.

AAOS NOW and OrthoSupersite, known as reliable sources of orthopedic print and web information, have ventured out with their own respective apps. iMedicalApps

Study shows brain flexibility, gives hope for natural-feeling neuroprosthetics

Opening the door to the development of thought-controlled prosthetic devices to help people with spinal cord injuries, amputations and other impairments, neuroscientists at the University of California, Berkeley, and the Champalimaud Center for the Unknown in Portugal have demonstrated that the brain is more flexible and trainable than previously thought.

Their new study, to be published Sunday, March 4, in the advanced online publication of the journal Nature, shows that through a process called plasticity, parts of the brain can be trained to do something it normally does not do. The same brain circuits employed in the learning of motor skills, such as riding a bike or driving a car, can be used to master purely mental tasks, even arbitrary ones. Eurekalert!

Wednesday, February 29, 2012

Google set to revolutionize mHealth and medicine with Google Glasses?

News from unnamed employees at the X center, a secretive experimental Google product laboratory, indicates that Google will be releasing eyeglasses with an integrated computer and camera by year’s end. Think of it as the wearable smart phone or a heads up display…for your head. The glasses will have a 3G or 4G connection, run on an android platform, and house multiple sensors including GPS. iMedicalApps

New Journal: Bone & Joint360 from publisher of JBJS (Br)

The publishers of JBJS (Br) unveil Bone & Joint³⁶⁰ – a time-saving journal highlighting the latest developments in orthopaedic research and practice worldwide.

Bone & Joint³⁶⁰ provides a snapshot overview of the most important developments in orthopaedic research and practice, drawn from the global literature and assessed for relevance and impact by an international panel of experts. The journal is presented in an easy-to-read layout that aids fast reading and easy absorption of information. NewsWise

No workout? No worries: Scientists prevent muscle loss in mice, despite disease and inactivity

If you want big muscles without working out, there's hope. In the March 2012 print issue of the FASEB Journal, scientists from the University of Florida report that a family of protein transcription factors, called "Forkhead (Fox0)" plays a significant role in the regulation of skeletal muscle mass. Specifically, they found that interfering with the activity of these transcription factors prevents muscle wasting associated with cancer and sepsis. Eurekalert!

Researchers find safer way to use common but potentially dangerous medication

A team of global scientists, led by researchers at Intermountain Medical Center in Salt Lake City, has developed a safer and more accurate way to administer warfarin, one of the most commonly prescribed but also potentially dangerous medications in the United States.

As part of a worldwide study, the research team developed and tested a new formula that combines individual genetic data with a mathematical model to help physicians more accurately predict patient response to the popular blood-thinning drug.

Researchers found that the formula was safer and more accurate than current methods used to dose for warfarin patients. They're hopeful that the more accurate dosing will eliminate many emergency hospitalizations among warfarin users. Results of the team's study are published in the February edition of the journal, Thrombosis and Haemostasis. Eurekalert!

Foot bones allow researchers to determine sex of skeletal remains

Law enforcement officials who are tasked with identifying a body based on partial skeletal remains have a new tool at their disposal. A new paper from North Carolina State University researchers details how to determine the biological sex of skeletal remains based solely on measurements of the seven tarsal bones in the feet.

"Tarsals are fairly dense bones, and can be more durable than other bones – such as the pelvis – that are used to determine biological sex," says Dr. Troy Case, an associate professor of anthropology at NC State and co-author of a paper describing the research. "Also, the tarsal bones are often enclosed in shoes, which further protects them from damage. That's particularly useful in a forensic context." The tarsals are the seven bones that make up the ankle, heel and rear part of the arch in a human foot. Eurekalert!

Smart Partial Knee Replacement System Receives European Clearance

Blue Belt Technologies, Inc., a developer of surgical devices out of Pittsburgh, PA, has received CE Mark for the Navio PFS System. The system comprises a robotic handheld cutting tool and a camera system interfaced to planning and navigation software. The software platform provides virtual cutting guides for the surgeon by visually tracking the motion of the cutting tool in real time using the stereoscopic camera system. The system aims to improve the precision and effectiveness of orthopedic procedures. MedGadget

World’s First Biodegradable Joint Implant Targets Arthritis

Researchers at Tampere University of Technology (TUT), Finland, have developed what they believe to be the first biodegradable joint implant. The implant, called RegJoint, is used in the treatment of osteoarthritis and rheumatoid arthritis.

The RegJoint is fabricated from biodegradable polylactide copolymer and is placed inside the capsule that surrounds the joint. It is designed to stimulate growth of connective tissue and soft tissue around the joint in order to replace cartilage lost to rheumatoid arthritis and osteoarthritis. MedGadget

Muscle System Pro III is an impressive update to 3D4Medical NOVA anatomy app

The Muscle System Pro II app by 3D4Medical was one of the outstanding NOVA apps when we reviewed our Top Anatomy apps for iPad.

We have previously reviewed Muscle System Pro II and thought it was an impressive app for those purely focused on the muscular system.

Since then, the NOVA series has undergone a significant update to version III and the new Muscle System Pro III app is even more impressive. We have reviewed a number of these latest updates to Skeleton System Pro III and Heart Pro III. iMedicalApps

Sunday, February 26, 2012

Rib fractures linked to circulatory disorder often seen in athletes

Surgeons at Washington University School of Medicine in St. Louis have identified tiny fractures and other rib abnormalities in patients treated for a circulatory condition called venous thoracic outlet syndrome.

The findings come from a study of 37 patients who underwent surgery for the syndrome at Barnes-Jewish Hospital.

Also known as subclavian vein effort thrombosis or Paget-Schroetter syndrome, the disorder is often seen in elite athletes who rely on their upper extremities. The hallmark of the syndrome is blockage of the vein that carries blood from the arm to the heart. The vein passes over the first rib and under the collarbone, making it vulnerable to compression, especially under repetitive stress with the arm in an elevated position. MedicalXpress

Novel Bioactive Peptides Promote Wound Healing In Vivo

Researchers have combined bioactive peptides to successfully stimulate wound healing. The in vitro and in vivo study, published today in PLoS ONE, demonstrates that the combination of two peptides stimulates the growth of blood vessels and promotes re-growth of tissue. Further development of these peptides could lead to a new treatment for chronic and acute wounds. Newswise

Skeletal System Pro III app develops anatomical understanding through strong visuals

The popular NOVA series by 3D4Medical cover a range of systems and anatomical areas and have all recently been upgraded to version III.

This significant update has brought better quality visuals, integrated animations, and audio features among a range of other features.

Skeleton System Pro III has been updated in collaboration with Stanford University School of Medicine and features an in depth look at the skeletal system. This app will appeal to a range of medical professionals ranging from student to educator. iMedicalApps

iPads show the way forward for medical imaging

Results of the University of Sydney study, presented this month at the International Society for Optical Engineering (SPIE) Medical Imaging conference in San Diego, show tablet computers such as the iPad are as good as standard LCD computer screens when used as secondary display devices for viewing medical imaging. Secondary display devices can be used by doctors who move from patient to patient in hospital wards. MedicalXpress

Allergy Tests Needed Before New Knee or Hip (CME/CE)

Preoperative skin patch testing for metal allergy influenced treatment planning in two-thirds of a small cohort of patients scheduled to receive metal-containing prosthetic devices, a retrospective chart review showed.
All 21 patients with positive tests received allergen-free prostheses and had no complications associated with hypersensitivity.

Post-implantation patch testing led to prosthesis removal in 10 additional patients, and six had resolution of hypersensitivity-associated symptoms.

"The findings of this study support a role for patch testing in patients with a clinical history of metal hypersensitivity before prosthetic device implantation," Natasha Atanaskova Mesinkovska, MD, PhD, of the Cleveland Clinic, and co-authors wrote in an article published online in Archives of Dermatology. MedPage Today

Guideline: Monitoring Spinal Cord During Surgery May Help Prevent Paralysis

The American Academy of Neurology is issuing an updated guideline that recommends monitoring the spinal cord during spinal surgery and certain chest surgeries to help prevent paralysis, or loss of muscle function, related to the surgeries. The guideline, which was developed with the American Clinical Neurophysiology Society, is published in the February 21, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology and also in the Journal of Clinical Neurophysiology. Newswise

A step forward in effort to regenerate damaged nerves

The carnage evident in disasters like car wrecks or wartime battles is oftentimes mirrored within the bodies of the people involved. A severe wound can leave blood vessels and nerves severed, bones broken, and cellular wreckage strewn throughout the body – a debris field within the body itself.

It's scenes like this that neurosurgeon Jason Huang, M.D., confronts every day. Severe damage to nerves is one of the most challenging wounds to treat for Huang and colleagues. It's a type of wound suffered by people who are the victims of gunshots or stabbings, by those who have been involved in car accidents – or by soldiers injured on the battlefield, like those whom Huang treated in Iraq.

Now, back in his university laboratory, Huang and his team have taken a step forward toward the goal of repairing nerves in such patients more effectively. In a paper published in the journal PLoS One, Huang and colleagues at the University of Rochester Medical Center report that a surprising set of cells may hold potential for nerve transplants. Eurekalert!

'Mirror therapy' reduces chronic phantom pain

A team of researchers led by Stefan Seidel from the University Department of Neurology at the MedUni Vienna has demonstrated that – and how – mirror therapy, as it is known, can help patients reduce the symptoms of phantom pain following limb amputations. This is achieved by stimulating a "motor network” in the brain that "substitutes for" the original motor centre. MedicalXpress

Improved assessment of cartilage repair tissue using fluid-suppressed (23)Na inversion recovery MRI at 7 Tesla: preliminary results.

OBJECTIVES: To evaluate cartilage repair and native tissue using a three-dimensional (3D), radial, ultra-short echo time (UTE) (23)Na MR sequence without and with an inversion recovery (IR) preparation pulse for fluid suppression at 7 Tesla (T). Chang G, Madelin G, Sherman OH, Strauss EJ, Xia D, Recht MP, Jerschow A, Regatte RR. Eur Radiol. 2012 Feb 18. [Epub ahead of print] PMID: 22350437

Superior Labral Anterior-to-Posterior Lesions: Comparison of External Rotation and Active Supination CT Arthrography with Neutral CT Arthrography

Purpose: To compare the diagnostic performance of computed tomographic (CT) arthrography performed with external rotation and active supination (ERAS) with that of CT angiography performed in the neutral position for superior labral anterior-to-posterior (SLAP) lesions. Choi JY, Kim SH, Yoo HJ, Shin SH, Oh JH, Baek GH, Hong SH. Radiology. 2012 Feb 17. [Epub ahead of print] PMID: 22344405

Lumbar MR Imaging and Reporting Epidemiology: Do Epidemiologic Data in Reports Affect Clinical Management?

Purpose: To retrospectively examine the association between the inclusion of epidemiologic information in lumbar spine magnetic resonance (MR) imaging reports regarding findings in asymptomatic individuals and the rates of subsequent cross-sectional imaging and treatments in patients with low back pain or radiculopathy referred for imaging by primary care providers. McCullough BJ, Johnson GR, Martin BI, Jarvik JG. Radiology. 2012 Mar;262(3):941-6. PMID: 22357893

Two new Ortho lectures from Audio Digest

NEUROLOGY OF THE SPINE
Orthopaedics
Volume 35, Issue 05
March 7, 2012
Optimizing anesthesia to reduce postoperative pain – Jeremy A. Lieberman, MD
Intracranial hypotension and headache with cerebrospinal fluid leaks – John W. Engstrom, MD
Minimally invasive approaches for spinal tumors – Valli P. Mummaneni, MD
Neurologic cases with difficult differential diagnoses – Dr. Engstrom
________________________________________
SPORTS INJURIES
Orthopaedics
Volume 35, Issue 04
February 21, 2012
Update on osteochondritis dissecans – Robert E. Hunter, MD
Anterior cruciate ligament reconstruction – Robert A. Arciero, MD
Pearls and pitfalls of multiple–ligament knee surgery – Dr. Arciero

Open PubMed with NMCP LinkOut Before Accessing Articles

Monday, March 26, 2012