Archives of Orthopaedics

Research Article Open Access

The Incidence and Risk Factors of Pelvic Stress Fracture, Delayed-healing and Non-union Following Periacetabular Osteotomy in Adolescents

Daniel Lazar, Daniel Bomark, Ole Ovesen, Morten Bøgehøj, Søren Overgaard

Background: Periacetabular Osteotomy (PAO) is a well-established procedure, however more prospective cohort studies are required to assess all clinical factors related to this invasive intervention. The aims of this study are as follows 1) quantifying stress fractures, delayed-healing and non-union post PAO and 2) to correlate possible risk factors for developing symptomatic stress fracture, delayed-healing or non-union.

Research Article Open Access

Doctor, Can We Reuse this Brace; Patient Attitudes towards Reuse of Orthopedic Braces

Raja Jambulingam, Yusuf Mirza, Mark Kemp

Introduction: Climate change presents an important threat to human health and wellbeing. Paradoxically, many facets of healthcare provision contribute significantly to greenhouse gas emissions. An important example of this is the use of single use, disposable orthopedic orthotics, widely dispensed in emergency departments and fracture clinics. This study aimed to understand patients’ attitudes towards climate change, single use plastics, and recycling of orthotics.

Case Report Open Access

Atypical Presentation of Tibia and Fibula Fracture in an Old Woman - Case Report

Esam Lawand, Michael Krasheninnikoff, Jacob Fyhring Mortensen

This case report presents the clinical details, diagnostic findings, and management of a 64-year-old female patient who suffered a tibia and fibula fracture, presented in an atypical manner, after twisting her ankle during daily activities. The medical background, physical examination, radiological results, and course of treatment of the patient are detailed.

Review Article Open Access

Surgical Fixation of Severe Rib Fractures: A Systematic Literature Review and Meta-Analysis

Adam M. Shiroff, Simone Wolf, Alex Wu, Mollie Vanderkarr, Raymark Salonga, Thibaut Galvain, Chantal E Holy

Rib fractures are a commonly encountered traumatic injury and are associated with significant morbidity and mortality. They are a marker of severe injury and can lead to defects in the chest wall and severe pain which may hinder breathing.

Research Article Open Access

The Natural History of Developmental Patellar Dislocation in Dogs

Michael Farrell

Developmental dislocation of the patella (DDP) is rare in humans but common in dogs. The canine syndrome, termed patellar luxation (PL), is an inherited condition related to genetic selection of dogs with conformational defects. Breeds with short, bowed legs, including chihuahuas, toy poodles, and bull terriers are predisposed to medial patellar luxation (MPL).

Short Communication Open Access

L-shaped Corrective Osteotomy for Distal Radius Malunion

Nicolás Gabriel Cuestas, Ana Laura Douglas Price, María Candelaria Torre, Hernán Esteban Blanchetiere

For many years it was widely believed that the functional outcome of distal radius fractures (RDF) was usually satisfactory, even in the absence of treatment or when treatment had failed to achieve acceptable anatomic reduction.

Mini Review Open Access

Surgical Management of Patella Fractures: A Review

Andrew D. Posner, Joseph P. Zimmerman

Patella fractures account for 1% of fractures in adults and are seen in all age groups. The treatment options for fractures requiring surgery have evolved over time in response to postoperative complications and with the advent of new technologies which optimize fixation.

Research Article Open Access

Evaluation of Specific Cementation Criteria on Total Elbow Arthroplasty – A Mono-Center Analysis of 31 Cases, with Minimum Follow-up of 4 Years

Arnaldo Sousa, Joao Rosa, Diogo Sousa, Alexandre Pereira, Cesar Silva

Total elbow arthroplasty (TEA) has gained popularity in recent years and the indications for performing this surgery have been expanding. Initially this arthroplasty was used predominantly in patients with severe rheumatoid arthritis of the elbow, however, nowadays, TEA has been performed also in other situations like osteoarthritis, comminuted intraarticular fractures or tumors.

Research Article Open Access

Study of the Element Concentrations in Synovial Fluids of Patients with Arthritis and Rheumatic Diseases

Pawel Konieczynski, Grzegorz Szreder, Marek Wesolowski

Rheumatic diseases are one of the most common problems in modern societies. The majority of rheumatic diseases occur when the human immune system attacks its own tissues, including the joints. There is no single cause of rheumatic diseases. Sometimes it may be a genetic factor, but in other cases cigarette smoking is responsible for the disease, or pollution, or other factors such as an infection. Seidman and Limaiem claim that “synovial fluid aspiration and analysis is a necessary therapeutic and diagnostic procedure useful in alleviating pain from a joint effusion and in the diagnosis of potentially serious joint pathologies.”

Research Article Open Access

Evaluation of Patellofemoral Complications by Comparing the Medial Parapatellar and Subvastus Approaches

Mehmet Menken, Raif Özden, Mehmet Karadag, Ibrahim Gökhan Duman, Aydiner Kalaci, Yunus Dogramaci

Total knee arthroplasty (TKA) is considered to be the best method for treating advanced knee osteoarthritis in terms of reducing pain, improving joint functions, and increasing the patient’s quality of life. The most commonly used approach in TKA is the standard medial parapatellar (MPP) approach described by Insall. The MPP approach provides a good view of the operating field.

Research Article Open Access

Performance Validation of An Upper Limb Exoskeleton Using Joint ROM Signal

Yousef Alshahrani, Yang Zhou, Chaoyang Chen, Hannah Joines, Tangfei Tao, Guanghua Xu, Stephen Lemos

Upper extremity (UE) exoskeletons were developed for industrial applications where assistive force enhancement was needed, but there have also been developments for use in telemanipulation and virtual reality, clinical applications such as assistance in orthopedic surgery, and orthopedic rehabilitation. 

Research Article Open Access

Improve the Efficiency of the Yaskawa Motoman MH5 Robot for Utilization in Robot-Assisted Orthopedic Surgery

Arshia Eskandari, Arash Sherafati, Samir Zein

Using robots in surgeries dates back to the mid-1980s. The robotic was applied in a wide range of biological and medical sciences such as clinical medicine, neuroscience, cardiovascular, dentofacial, and cellular and molecular life sciences. Orthopedic robots are much more widely used and complex in medical engineering sciences. 

Review Article Open Access

Efficacy of a Virtual Fracture Clinic Model Created During Covid-19 Pandemic

Anne-Marie Hutchison, Paul Williams, Andrew Bebbington, Mark Mullins, Andrew Lewis, David Beard

The COVID-19 pandemic has caused delivery of orthopaedic services to require extra consideration and substantial revision. Alternative ways to manage patients with urgent injuries have been instigated to minimize patient’s exposure to the disease, spread within the hospital system and reduce the overall impact on stretched resources.

Research Article Open Access

A Pilot Study for Assessing a Novel Method of Measuring Shoulder Activation in Healthy Volunteers Using Surface Electromyography

Sreten Franovic, Yang Zhou, Emily Lau, Alexander D Pietroski, Noah A Kuhlmann, Vishwajeet Singh, Chaoyang Chen, Stephanie J Muh

Over the years, healthcare providers have used a host of physical examinations and clinical tools to assess a patient’s physical functioning and health, but many of these assessment tools lack generalizability among physicians or the specificity and sensitivity to accurately diagnose a patient. Range of motion measures are one-way physicians assess many physical deficiencies in the upper and lower extremity.

Research Article Open Access

The Use of a New Type of Heart Rate-controlled Training System HeartGo® for Patients with Chronic Heart Failure on the Pedelec

Erik B. Friedrich, Herbert Löllgen, Helmut Röder, Wolfgang Baltes, Oliver Adam, Martin Schlickel, Günter Hennersdorf

Secondary prevention of cardiovascular disease such as heart failure includes regular physical activity with endurance and strength training, which is used for this purpose with high prevalence. Early rehabilitation should begin in hospital (phase I), be continued in a rehabilitation clinic or as an outpatient close to home (phase II), and then (phase III) preferably in outpatient heart groups (AHG).

Research Article Open Access

Submuscular Anterior Transposition for Treatment of Ulnar Nerve Syndrome: Outcomes and Final Satisfaction

Alvaro Martínez-Ayora, Julio Morán, Antonio Benjumea-Carrasco, Eudaldo José Gallodel Valle, Javier Vaquero

Ulnar neuropathy is the second most common peripheral neuropathy in the upper limb after carpal tunnel syndrome, with an incidence of 30 cases per 100,000 persons/year. It is characterized by the appearance of sensory symptoms such as pain, dysesthesia, and paresthesia, initially intermittent and then continuous, in the ulnar territory of the forearm and hand.

Mini Review Open Access

Bacterial Biofilms and Implant Infections: A Perspective

T. Subba Rao

Human body implants are rapidly covered by a conditioning film (which contains the biochemical moieties) when they interact with human body fluids and its components. This surface-bound biochemical blend elicits a chemotactic response to attract bacteria that are transmitted through infection or by contamination. 

Research Article Open Access

Hamstrings Injuries with MRI Findings in a Major League Soccer Team

Gabriella Bucci, Nicolas Galante, Ryan P. McGovern, Skylar Richards, John J.Christoforetti, Steven B. Singleton

Hamstring injuries are the most common pathology reported in professional soccer players and represent about 10-30% of all injuries. The hamstring complex is comprised of three muscles located in the posterior compartment of the thigh including the semimembranosus (SM), semitendinosus (ST), and biceps femoris (BF), which is comprised of the long head (BFLH) and short head (BFSH).

Review Article Open Access

The use of Percutaneous Achilles’ Tendon Lengthening as an Adjunct Procedure in Foot and Ankle Surgery: A Review

Gabriel Santamarina, George Zislis

The goal of reconstructive foot and surgery for diabetic foot pathologies is to create a plantigrade foot that is braceable and has low risk of ulcer formation or recurrence. Experienced surgeons are cognizant that foot pathologies are defined in three planes: frontal, transverse and sagittal. The Achilles’ tendon is the chief deforming force in the foot along the sagittal plane.

Research Article Open Access

Incidental Spinal Durotomies Noted During Spinal Surgery: Incidence and Management

Ishvinder Singh Grewal, Urpinder Singh Grewal, Tom Eadsforth, Robin Pillay

An incidental durotomy or dural tear is defined by ICD- 10 as an accidental puncture or laceration of dura during a procedure. These procedures include spinal surgery and interventional procedures such as epidural injection. The published incidence of incidental durotomy varies in the literature and is dependent on the procedure being performed, the experience of the surgeon, and patient factors but can range from 1% to 17%.

Commentary Open Access

Pain in Patients undergoing Total Knee Arthroplasty

Ramlall Y, Cameron HU, Sawhney M

Pain continues to be reported by patients waiting for total knee arthroplasty (TKA) and after undergoing this surgery despite advances in the delivery of pain management. The motivation for carrying out this initial work was due to the concerns of the surgeons based on patients reports of pain, at their 6-week return to clinic appointments. Concerns of addiction, overdosing, multi-modal analgesia and lack of pain education were the factors.

Research Article Open Access

Epidemiology of Displaced Supracondylar Fractures

Nicholas I. Pilla, John M. Rinaldi, Mark D. Hatch, William L. Hennrikus

Supracondylar fractures of the humerus are the most common elbow fracture in the pediatric population and comprise nearly 60% of all elbow fractures. Supracondylar fractures most commonly occur in children aged five to seven. Historically, males had a higher incidence of supracondylar humeral fractures. More recent studies support a more equal distribution amongst males and females.

Commentary Open Access

Clinical and Histological Proof that Surgical Incisions along Skin Folding Lines Result in Optimal Scars

Gottfried Lemperle

In an early publication, we could show that striae distensae always develop perpendicular to the skin tension lines. In another article, we demonstrated that virtual skin tension lines are identical to the obvious Main Folding Lines; we recommended their use as optimal directions for orthopedic incisions, when inconspicuous scar formation is a prerequisite, as in children, younger adults, and women.

Review Open Access

The Role of the Sciatic Nerve Ultrasound Elastography in the Clinical Pathway: A Meta-analysis

Stajic Sava, Misic Miroslav

Ultrasound elastography is a diagnostic method, to measure elasticity and strain in tissues and organs. The aim of this review was to highlight the usefulness of sciatic nerve ultrasound elastography in clinical practice. Different changes affect the sciatic nerves through various diseases and conditions. 

Research Article Open Access

The Role of the MPFL and MPTL in Patellar Stability – A Biomechanical Study

James P. Halloran, Amanda O. Esquivel, Allison M. Cracchiolo, Chaoyang Chen, Stephen E. Lemos

The medial patellofemoral ligament (MPFL) is a thickened band of tissue that originates from the adductor tubercle and inserts on the proximal medial patella. It is expected that the MPFL, under patellar lateral subluxation, will fail at approximately 12-18 mm of displacement  due to the failing of collagen based structures at 20% to 30% elongation.

Research Article Open Access

Relationship between Plate Length and Fracture Height as a Predictor of Non-Union in Distal Femur Fractures. A Restrospective Study

Alvaro Martínez-Ayora, Marina Diaz-Jumain, Eudaldo José Gallo-del Valle, Manuel Cuervas-Mons Cantón, Juan Arnal-Burró, Javier Vaquero

The distal femur constitutes the region between the metaphyseal-diaphyseal junction and the femoral condyles. Fractures of this segment, which includes supracondylar and intercondylar fractures, represent between 4 and 7% of all the femur fractures, with an incidence of 37 cases per 100,000 habitants/year. These fractures present a bimodal distribution depending on the injury mechanism. 

Research Article Open Access

Physiotherapy Exercise Program for Managing Adhesive Capsulitis in Patients with and without Diabetes: A Pilot Randomized Trial

Sana’a A. Alsubheen, Joy C. MacDermid, Tom J. Overend, Kenneth J. Faber, Rochelle Furtado

Adhesive capsulitis (AC), also known as ‘frozen shoulder’, is characterized by the development of dense adhesions and capsular thickening leading to a progressive and painful restriction of shoulder range of motion (ROM) and functional disability [1]. The onset is gradual, usually occurs between the ages of 40 and 60 years and is more common in females and diabetics.

Research Article Open Access

EMG Signal Processing for Hand Motion Pattern Recognition Using Machine Learning Algorithms

Yang Zhou, Chaoyang Chen, Juan Ni, Guoxin Ni, Min Li, Guanghua Xu, John Cavanaugh, Mark Cheng, Stephen Lemos

Stroke is a major cause of death and disability in the world. There were approximately 25.7 million stroke survivors and 6.5 million deaths from stroke [1]. Stroke can result in arm disability and reduce daily life activity via weak arm muscle activity [2]. Studies have been performed to discover therapeutic and assistive approaches to compensate for disabilities and restore functions. 

Commentary Open Access

Editorial Commentary for In Throwers with Posterior Instability, Rotator Cuff Tears are Common but Do Not Affect Surgical Outcomes

Andrew J. Sheean, James P. Bradley

Superior labral pathology is an exceedingly common entity among throwers, and in recent years, a number of reports have elucidated the prevalence of posterior glenohumeral instability among overhead athletes (baseball, softball, volleyball.) However, within this unique patient population, these conditions should not be viewed as separate clinical entities, but, rather as findings that exist on a single pathomechanic spectrum.

Commentary Open Access

Viscosupplementation in Horses: What do We Really Know?

Anderson Fernando de Souza, André Luis do Valle De Zoppa

The importance of osteoarthritis (OA) is undeniable in equine medicine, with a high occurrence in the routine, several studies have been carried out to understand the pathophysiology of the disease and to seek more efficient methods of prevention and treatment.

Mini Review Open Access

Rearfoot and Ankle Reconstruction for Charcot Joint Disease: A Review

Gabriel Santamarina

Charcot joint disease refers to the structural breakdown of the joints in the presence of neuropathy [1]. It has multiple pseudonyms but one of the most descriptive names of this condition is “Diabetic Neuroarthropathy.” The first cases studied by Jean-Marie Charcot however were not due to diabetic peripheral neuropathy but syphilis-related peripheral neuropathy.

Commentary Open Access

Ultrasound-Guided Bone Surgery: A New Perspective

Alvaro Martínez-Ayora, Manuel Cuervas-Mons, Javier Vaquero

Metatarsalgia is a frequent cause of forefoot pain. Surgical treatment is based on the performance of osteotomies at the level of the minor radii to restore a normal distribution of pressure within the forefoot and improve the biomechanics during gait.