Background: One of the disadvantages of the
CAN TKR is aimed to improve accuracy in realignment with balanced knee joint. Variability in the force exerted during tissue tensioning depends on the viscoelastic nature of soft tissues. Aim: To measure gap balance to assess effectiveness of CAN on ligament balance using gap balancing approach with tibia 1st cut. Methods: OrthoPilot system with 4.3 software and Statistical evaluation with Testimate Version 6.0, IDV Gaunting Germany with a two sided Wilcoxon-Pratt test (P<
0.05) used simulating errors in extension and flexion gap balance. P1, control with 16 datasets created and P2-P7 (96 case series) was propagated with ±3mm variants in extension and flexion gap both medial and lateral, only varying 1, keeping others constant. Controls fixed: distal transverse plane cut at 0° to femoral mechanical axis in frontal plane and 3°external rotation in sagittal plane. Tibia cut 90° to mechanical axis. Mechanical axis constant at 0° and gap balance at 0 mm. Deviations in gap errors using trigonometrical calculations based on E-Motion femoral implant, size/thickness; 3/7mm and 4/8.5mm with variation of insert size 10/12mm equal to sum of gap and bone cut. Results: Over tensioning (OT) distal lateral extension gap (DLEG) causes tight distal medial extension gap (DMEG). Under tensioning (UT) DLEG causes loose posterior medial flexion gap (PMFG). UT DLEG causes tight DLEG.
Aims. The evidence base within trauma and orthopaedics has traditionally favoured quantitative research methodologies. Qualitative research can provide unique insights which illuminate patient experiences and perceptions of care. Qualitative methods reveal the subjective narratives of patients that are not captured by quantitative data, providing a more comprehensive understanding of patient-centred care. The aim of this study is to quantify the level of qualitative research within the orthopaedic literature. Methods. A bibliometric search of journals’ online archives and multiple databases was undertaken in March 2024, to identify articles using qualitative research methods in the top 12 trauma and orthopaedic journals based on the 2023
Aims. Systematic reviews of randomized controlled trials (RCTs) are the highest level of evidence used to inform patient care. However, it has been suggested that the quality of randomization in RCTs in orthopaedic surgery may be low. This study aims to describe the quality of randomization in trials included in systematic reviews in orthopaedic surgery. Methods. Systematic reviews of RCTs testing orthopaedic procedures published in 2022 were extracted from PubMed, Embase, and the Cochrane Library. A random sample of 100 systematic reviews was selected, and all included RCTs were retrieved. To be eligible for inclusion, systematic reviews must have tested an orthopaedic procedure as the primary intervention, included at least one study identified as a RCT, been published in 2022 in English, and included human clinical trials. The Cochrane Risk of Bias-2 Tool was used to assess random sequence generation as ‘adequate’, ‘inadequate’, or ‘no information’; we then calculated the proportion of trials in each category. We also collected data to test the association between these categories and characteristics of the RCTs and systematic reviews. Results. We included 917 unique RCTs. We found that 374 RCTs (40.8%) reported adequate sequence generation, 61 (6.7%) were inadequate, 410 (44.7%) lacked information, and 72 (7.9%) were observational studies incorrectly included as RCTs within the systematic review. Publication year, an author with statistical or epidemiological qualifications, and journal
Hypermobility Spectrum Disorder (HSD or hEDS) is attributed to a collagen abnormality associated with excessive joint flexibility. Approximately 90% of females with hip dysplasia have hypermobility. Manifestations of hypermobility in various body systems are unique to every patient, affecting different tissues of the body with varying degrees of severity. Our purposes were to identify the manifestations of hypermobility across multiple body systems and to study the recognition of hypermobility in the medical literature of multiple specialties over multiple decades. A literature search of the major medical disciplines for key words associated with HSD was performed. These specialties included gastroenterology, gynecology, neurology, psychiatry, oral-maxillofacial surgery, cardiology, and orthopaedic surgery. A specialty-specific
Objectives. Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature. Methods. Two reviewers independently searched MEDLINE, EMBASE, and the Cochrane Library (1995 to current) using MeSH keyword headings and the ‘retracted’ filter. We also searched an independent website that reports and archives retracted scientific publications (. www.retractionwatch.com. ). Two reviewers independently extracted data including reason for retraction, study type, journal
Research is the quest for information. It is not an excuse for attending meetings in exotic places, nor is it an escape from clinical work that has become uninteresting. The early orthopaedic joumals contained reports of patients who have been treated by individual surgeons in specific, often novel, ways. There was little scientific structure, but nevertheless these papers were valuable as they disseminated knowledge to other Surgeons and also stimulated enquiry. Orthopaedic research has developed dramatically over the last two or three decades. Patient related research has been advanced as a result of the availability of new techniques for example electron microscopy, DNA sequencing and the Genome, together with the discovery of the fine details of the cytokine control of cellular processes. This has gone hand in hand with the development of surgical sophistication allowing more adventurous interventions. Joint replacement and internal fixation have led to close associations between orthopaedic surgeons and scientists from other disciplines, notably engineers and material scientists. This multi-disciplinary involvement is typical of orthopaedic surgeons and results in each discipline benefiting from the specialist knowledge of the others. The natural tendeney for orthopaedic surgeons to be interested in mechanical items is clear from a study of the distribution of interesting cars in the hospital car park!. The efficacy of different treatment methods should be challenged and this has resulted in the need for careful audit and epidemiological review. In some instances this has resulted in the conclusion that often used treatments are not effective. The assiduous application of the Cochrane principles is often very revealing, not least in that it indicates the lack of properly conducted orthopaedic trials. Academic orthopaedics is in danger. In many countries the speciality is under pressure, normally as a result of economic measures that restrict the avallability of salarles and grants. In spite of these restrictions, it is surprising that there is a steady supply of excellent papers. How much better it could be with more funding. The purpose of publícation is to share information. It should be the aim of every research worker to make a contribution to the understanding of the subject and to share his findings with his colleagues. Curiously many researchers feeI that their commitment to their project is complete as soon as they finish the trial and have the results. The preparafion of their work for dissemination through publication is often a very weak link and in some instances is absent. This is a dangerous tendency as their information may not be broadcast, wasting the scientific endeavour and endangering the status of the fundíng organisation, whose charitable status often depends on sharing the fruitg of research. The incentive to publish is very variable. In some institutions the very existenee of a research department depends on a ‘paper score’ which is normally calculated from the product of the number of papers and the
Introduction. The productivity of trainees, consultants and institutions is frequently judged by the quantity of articles published in medical journals. While personnel may change, an institution should pride itself on its publication record. The aim of the study was to assess the publication history of Irish orthopaedic units over the last 5 years, and to identify patterns of publication. Methods. Using the same criteria used to differentiate candidates applying for the specialist registrar posts, we performed an extensive Pub Med search of each consultant affiliated with each orthopaedic unit in the country for the last 5 years (2004-2008) to assess the number of publications by each respective consultant and unit. Only the most senior publishing orthopaedic consultant, and the specific institution cited received credit for each paper. Publications were classified by individuals, institutions, publication type and
Summary Statement. The mechanism of spinal cord injury varies across the human population and this may be important for the development of effective therapies. Therefore, detailed understanding of how variables such as impact velocity and depth affect cord tissue damage is important. Introduction. Studies have shown an independent effect of impact velocity and depth on injury severity, thereby suggesting importance of the interaction between the two for spinal cord injury. This work examines both the individual and interactive effects of impact velocity and impact depth on demyelination, tissue sparing, and behavioural outcomes in the rat cervical spinal cord. It also aims to understand the contribution of the energy applied during impact, not only the
Several artificial bone grafts have been developed but fail to achieve anticipated osteogenesis due to their insufficient neovascularization capacity and periosteum support. This study aimed to develop a vascularized bone-periosteum construct (VBPC) to provide better angiogenesis and osteogenesis for bone regeneration. A total of 24 male New Zealand white rabbits were divided into four groups according to the experimental materials. Allogenic adipose-derived mesenchymal stem cells (AMSCs) were cultured and seeded evenly in the collagen/chitosan sheet to form cell sheet as periosteum. Simultaneously, allogenic AMSCs were seeded onto alginate beads and were cultured to differentiate to endothelial-like cells to form vascularized bone construct (VBC). The cell sheet was wrapped onto VBC to create a vascularized bone-periosteum construct (VBPC). Four different experimental materials – acellular construct, VBC, non-vascularized bone-periosteum construct, and VBPC – were then implanted in bilateral L4-L5 intertransverse space. At 12 weeks post-surgery, the bone-forming capacities were determined by CT, biomechanical testing, histology, and immunohistochemistry staining analyses.Aims
Methods
Preprint servers allow authors to publish full-text manuscripts or interim findings prior to undergoing peer review. Several preprint servers have extended their services to biological sciences, clinical research, and medicine. The purpose of this study was to systematically identify and analyze all articles related to Trauma & Orthopaedic (T&O) surgery published in five medical preprint servers, and to investigate the factors that influence the subsequent rate of publication in a peer-reviewed journal. All preprints covering T&O surgery were systematically searched in five medical preprint servers (medRxiv, OSF Preprints, Preprints.org, PeerJ, and Research Square) and subsequently identified after a minimum of 12 months by searching for the title, keywords, and corresponding author in Google Scholar, PubMed, Scopus, Embase, Cochrane, and the Web of Science. Subsequent publication of a work was defined as publication in a peer-reviewed indexed journal. The rate of publication and time to peer-reviewed publication were assessed. Differences in definitive publication rates of preprints according to geographical origin and level of evidence were analyzed.Aims
Methods
Background. The recent emphasis on using “evidence based medicine” for decision-making in patient care has prompted many publishers to mention the level of evidence of articles in their journals. The “quality” of a journal may thus be reflected by the proportion of articles with high levels of evidence and assist it achieve citations and therefore an
The follow-up interval of a study represents an important aspect that is frequently mentioned in the title of the manuscript. Authors arbitrarily define whether the follow-up of their study is short-, mid-, or long-term. There is no clear consensus in that regard and definitions show a large range of variation. It was therefore the aim of this study to systematically identify clinical research published in high-impact orthopaedic journals in the last five years and extract follow-up information to deduce corresponding evidence-based definitions of short-, mid-, and long-term follow-up. A systematic literature search was performed to identify papers published in the six highest ranked orthopaedic journals during the years 2015 to 2019. Follow-up intervals were analyzed. Each article was assigned to a corresponding subspecialty field: sports traumatology, knee arthroplasty and reconstruction, hip-preserving surgery, hip arthroplasty, shoulder and elbow arthroplasty, hand and wrist, foot and ankle, paediatric orthopaedics, orthopaedic trauma, spine, and tumour. Mean follow-up data were tabulated for the corresponding subspecialty fields. Comparison between means was conducted using analysis of variance.Aims
Methods
Aims: To calculate one-year survival after dislocated intracapsular femoral neck fractures and to assess factors associated with increased risk of death. Patients: 2045 patients treated for dislocated intracapsular femoral neck fractures during 2005 were registered in The Norwegian Hip Fracture Registry and were included in the present study. Methods: Almost all hospitals in Norway reported proximal femoral fractures to the Registry using standard forms filled in by the operating surgeons. Survival was calculated using Kaplan Meier survival analyses, and the
Introduction: Spinal cord injury (SCI) continues to challenge the healthcare and the adjunct social welfare systems. Significant advances have been made in our understanding of the pathological cascade following the initial insult. However, this has yet to be translated into clinically significant treatments and one possible reason for this is that little is known about the actual interaction between the cord and the spinal column at the moment of
Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns.Objectives
Materials and Methods