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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_1 | Pages 27 - 27
1 Jan 2022
De C Kainth N Harbham P Brooks M Agarwal S
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Abstract

Background

This study aims to estimate the risk of acquiring a medical complication or death from COVID-19 infection in patients who were admitted for orthopaedic trauma surgery during the peak and plateau of pandemic. Unlike other recently published studies, where patient-cohort includes a more morbid group and cancer surgeries, we report on a group more akin to those having routine elective orthopaedic surgery.

Methods

The study included 214 patients who underwent orthopaedic trauma surgeries in the hospital between 12th March and 12th May 2020 when the COVID-19 pandemic was on the rise in the United Kingdom. Data was collected on demographic profile including comorbidities, ASA grade, COVID-19 test results, type of procedures and any readmissions, complications or mortality due to COVID-19.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_1 | Pages 13 - 13
1 Jan 2022
De C Shah S Suleiman K Chen Z Paringe V Prakash D
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Abstract

Background

During COVID-19 pandemic, there has been worldwide cancellation of elective surgeries to protect patients from nosocomial transmission and peri-operative complications. With unfolding situation, there is definite need for exit strategy to reinstate elective services. Therefore, more literature evidence supporting exit plan to elective surgical services is imperative to adopt a safe working principle. This study aims to provide evidence for safe elective surgical practice during pandemic.

Methods

This single centre, prospective, observational study included adult patients who were admitted and underwent elective surgical procedures in the trust's COVID-Free environment at Birmingham Treatment Centre between 19th May and 14th July’2020. Data collected on demographic parameters, peri-operative variables, surgical specialities, COVID-19 RT-PCR testing results, post-operative complications and mortality. The study also highlighted the protocols it followed for the elective services during pandemic.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 25 - 25
1 Dec 2019
de Vor L Van Kessel K De Haas C Aerts P Viveen M Boel E Fluit A van Dijk B Vogely C van der Wal B van Strijp J Weinans H Rooijakkers S
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Aim

“Implant associated Staphylococcus aureus or S. epidermidis infections are often difficult to treat due to the formation of biofilms on prosthetic material. Biofilms are bacterial communities adhered to a surface with a self-made extracellular polymeric substance that surrounds resident bacteria. In contrast to planktonic bacteria, bacteria in a biofilm are in an adherent, dormant state and are insensitive to most antibiotics. In addition, bacteria in a biofilm are protected from phagocytic cells of the immune system. Therefore, complete surgical removal and replacement of the prosthetic implant is often necessary to treat this type of infections. Neutrophils play a crucial role in clearing bacterial pathogens. They recognize planktonic bacteria via immunoglobulin (Ig) and complement opsonisation. In this project, we aim to evaluate the role of IgG and complement in the recognition and clearance of staphylococcal biofilms by human neutrophils. Furthermore, we evaluate if monoclonal antibodies (mAbs) targeting biofilm structures can enhance recognition and clearance of staphylococcal biofilms by the human immune system.”

Method

“We produced a set of 20 recombinant mAbs specific for staphylococcal antigens. Using flow cytometry and ELISA-based methods we determined the binding of these mAbs to planktonic staphylococci and in vitro staphylococcal biofilms. Following incubation with IgG/IgM depleted human serum we determined whether mAbs can react with the human complement system after binding to biofilm. Confocal microscopy was used to visualize the location of antibody binding in the biofilm 3D structure.”


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_4 | Pages 10 - 10
1 Apr 2019
De Biase C Fiorentino G Catellani F Ziveri G Banci L Meoli A Bloch HR
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Background

The current use of a spherical prosthetic humeral head in total shoulder arthroplasty results in an imprecise restoration of the native geometry and improper placement of the center of rotation, maintained in a constant position, in comparison to the native head and regardless of glenoid component conformity.

A radially-mismatched spherical head to allow gleno-humeral translation is a trade-off that decreases the contact area on the glenoid component, which may cause glenoid component wear. This finding suggests that the use of a non-spherical head with a more conforming glenoid component may reduce the risk of glenoid component wear by allowing gleno-humeral translation while increasing the contact area.

A non-spherical prosthetic head more accurately replicates the head shape, rotational range of motion and gleno-humeral joint kinematics than a spherical prosthetic head, compared with the native humeral head. The combination of inversion of the bearing materials with the non-spherical configuration of the humeral head may thus decrease polyethylene wear.

Aim of the present study is to evaluate in vitro wear behaviour of an all-polyethylene elliptical humeral head component against a metallic glenoid component in an anatomic configuration.

Material and methods

The prosthetic components tested are from the Mirai® Modular Shoulder System by Permedica S.p.A.. The prosthetic bearing components were tested in their anatomic configuration: the humeral head rubbing against the glenoid inlay, assembled over the glenoid base-plate.

The glenoid insert is made of Ti6Al4V alloy coated with TiNbN. The glenoid insert, as the glenoid base-plate have the same shape which reproduce the native shape of the glenoid. Moreover, the glenoid insert has a concave articular surface described by two different radii on orthogonal planes.

The vitamin E-blended UHMWPE humeral head is not spherical but elliptic-shaped with an articular surface described by two different profiles in sagittal and coronal plane.

The component sizes combination tested have the greatest radial mismatches allowed between humeral head and glenoid insert.

The test was performed up to 2.5 million of cycles applying a constant axial load of 756 N.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 27 - 27
1 Dec 2018
Bandeira R de C. Melo M Costa LR Cruz VD Mello MA de A. C. Tadeu H Silva RM Salles M
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Aim

Orthopedic implant related surgical site infection (SSI) is a severe complication which represents an important challenge concerning to its treatment. Therefore, gram-negative orthopedic infections have recently become a global concern.

Method

Retrospective study through searching of the SCIH (infection control service) database, concerning to the year 2016 and 2017. Cases selected were those of implant placement clean surgeries (osteosynthesis or prosthetic placement) which evolved with SSI and Gram-negative bacterial growth in bone tissue or periprosthetic cultures.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_1 | Pages 47 - 47
1 Jan 2016
De Biase C Delcogliano M Borroni M Marotta D Ziveri G Pittalis G Castagna A
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Introduction

Reverse shoulder prosthesis has been developed to treat the clinical and pathological condition noted as cuff tear arthropathy (CTA).

The current models of reverse shoulder arthroplasty (RSA) expose the procedure to the risk of scapular notching, possibly leading to loosening of the glenoid.

Aim

The purpose of this study was to report updated results at a minimum follow-up of four years of 25 patients underwent reverse shoulder arthroplasty between 2006 and 2010 with an eccentric 36-mm glenoid component (SMR Lima).


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 283 - 283
1 Dec 2013
De Caro F De Biase C Ziveri G Delcogliano M Borroni M Castagna A
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Introduction:

Reverse shoulder arthroplasty (RSA) is a reasonable treatment modality in patients with Cuff Tear Arthropaty and massive irreparable cuff tears. RSA has been shown to increase patient function and decrease pain. The aim of this study is to evaluate the clinical and radiographic results of a 44 polyethylene glenosphere.

Methods:

Since 2008 we treated 88 patients with cuff tear arthropaty and irreparable massive cuff tear, using an RSA. We selected 80 patients with minimum FU of 24 months in which we used an implant with polyethylene glenosphere and metal humeral insert. Size of the glenosphere used was 44. All patients were assessed with the Constant score and with VAS. The shoulder ROM was measured preoperatively and postoperatively.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 280 - 280
1 Dec 2013
De Caro F Berruto M Delcogliano M Carimati G Ziveri G Uboldi F Ferrua P De Biase C Delcogliano A
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Background:

Different surgical approaches have been proposed for the treatment of chondral lesions. However surgical management of osteochondral defects of the knee joint involving subchondral bone are still under debate.

Purpose:

The aim of this prospective non-randomized uncontrolled clinical investigation is to confirm the effectiveness of a commercially available biomimetic osteochondral scaffold in regenerating cartilage and subchondral bone of severe osteochondral lesions of the knee joint with one step surgery.