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Applications of finite element simulation in orthopedic and trauma surgery

World Journal of Orthopedics 2012年第4期3卷 25-41页

作者： Antonio Herrera Elena Ibarz José Cego?ino Antonio Lobo-Escolar Sergio Puértolas Enrique López Jesús Mateo Luis Gracia Department of Orthopaedic and trauma surgery Miguel Servet University HospitalMedicine SchoolUniversity of Zaragoza Department of Mechanical Engineering University of Zaragoza

Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography(CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element(FE) simulation lets us know the biomechanical changes that take place after hipprostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints applied

关键词： Finite element simulation Hip prosthesis Lumbar spine Lumbar fixations Osteoporotic fractures Splints

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Critical adjustments and trauma surgery trends in adaptation to COVID-19 pandemic in Malaysia

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Chinese Journal of traumatology 2020年第4期23卷 207-210页

作者： Henry Tan Chor Lip Tan Jih Huei Yuzaidi Mohamad Rizal Imran Alwi Tuan Nut'Azmah Tuan Mat Department of General surgery Hospital Sultanah AminahMalaysia Ministry of HealthJohor BahruMalaysia trauma surgery Unit Department of General SurgeryHospital Sultanah AminahMalaysia Ministry of HealthJohor BahruMalaysia Department of General surgery Faculty of MedicineNational University of Malaysia Medical CentreKuala LumpurMalaysia

Malaysia has one of the highest total numbers of COVID-19 infections amongst the Southeast Asian nations,which led to the enforcements of the Malaysian"Movement Control Order"to prohibit disease *** overwhelming increasing amount of infections has led to a major strain on major healthcare *** leads to shortages in hospital beds,ventilators and critical personnel protective *** article focuses on the critical adaptations from a general surgery department in Malaysia which is part of a Malaysian tertiary hospital that treats COVID-19 *** core highlights of these strategies enforced during this pandemic are:(1)surgery ward and clinic decongestions;(2)deferment of elective surgeries;(3)restructuring of medical personnel work force;(4)utilization of online appli cations for tele-communication;(5)operating room(OR)adjustments and patient screening;and(6)continuing medical education and updating practices in context to *** adaptations were important for the continuation of emergency surgery services,preventing transmission of COVID-19 amongst healthcare workers and optimization of medical personnel work force in times of a global *** addition,an early analysis on the impact of COVID-19 pandemic and lockdown measures in Malaysia towards the reduction in total number of elective/emergent/trauma surgeries performed is described in this article.

关键词： Pandemics COVID-19 General surgery Malaysia

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Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis

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World Journal of Orthopedics 2020年第1期11卷 57-67页

作者： Catrin Morgan Chetan Khatri Sammy A Hanna Hutan Ashrafian Khaled M Sarraf trauma and Orthopaedics Imperial College NHS TrustLondon W21NYUnited Kingdom The Royal London Hospital Barts Health NHS TrustLondon E11BBUnited Kingdom Department of surgery and Cancer Imperial College LondonLondon W21NYUnited Kingdom

BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in the *** has been shown that 3D models allow surgeons to better visualise anatomy,aid in planning and performing complex *** is however not clear how best to utilise the technique and whether this results in better *** To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical *** We performed a comprehensive systematic review of the literature and a ***,Ovid and Embase were searched from inception to February 8,*** controlled trials,case-control studies,cohort studies and case series of five patients or more were included across any area of orthopaedic *** primary outcomes were operation time,intra-operative blood loss and fluoroscopy *** Seventeen studies(922 patients)met our inclusion criteria and were *** use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85%[95%confidence intervals(CI):(-22.99,-16.71)],intra-operative blood loss of 25.73%[95%CI:(-31.07,-20.40)],and number of times fluoroscopy was used by 23.80%[95%CI:(-38.49,-9.10)].CONCLUSION Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time,intraoperative blood loss and the number of times fluoroscopy is used.

关键词： Orthopaedic surgery trauma Three-dimensional printing

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Bibliometric analysis of research on the effects of human immunodeficiency virus in orthopaedic and trauma surgery

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World Journal of Orthopedics 2021年第3期12卷 169-177页

作者： Ciaran Brennan Maritz Laubscher Sithombo Maqungo Simon Matthew Graham Orthopaedic Research Unit University of Cape TownCape Town 7925South Africa Division of Orthopaedic surgery Groote Schuur HospitalCape Town 7925South Africa Institute of Population Health Sciences University of LiverpoolLiverpool L97ALUnited Kingdom Department of Orthopaedic and trauma surgery Liverpool University Teaching Hospitals TrustLiverpool L97ALUnited Kingdom Department of Clinical Sciences Liverpool School of Tropical MedicineLiverpool L97ALUnited Kingdom

BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic *** advances in treatment,HIV has become a chronic health problem and the chance of orthopaedic surgeons encountering it in clinical practice is *** To ascertain the quantity and quality of peer-reviewed publications in orthopaedic journals about *** A search of the Web of Science database was carried out,identifying any articles relating to HIV published in orthopaedic *** were assessed for geographic origin and level of *** Of 48.7%of orthopaedic journals listed on the Web of Science database had published articles relating to *** were 168 articles about HIV in orthopaedic journals with only 40.5%(n=68)published in the time frame we analysed(January 2007 to September 2017).Very few articles came from lowincome countries and any articles published from that setting were *** of the articles were low level of *** There is a need for more high level orthopaedic and trauma research investigating the effects of HIV,particularly research from low-income countries,where higher level research will help to guide improvements in their treatment of its musculoskeletal manifestations and complications.

关键词： Human immunodeficiency virus Research Bibliometric analysis Analysis Orthopaedic

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Investigation of litigation in trauma orthopaedic surgery

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World Journal of Clinical Cases 2023年第5期11卷 1000-1008页

作者： Maryam Salimi Mohammad Bagher Heidari Zohre Ravandi Seyedarad Mosalamiaghili Peyman Mirghaderi Meisam Jafari Kafiabadi Farsad Biglari Amirhossein Salimi Amir Sabaghzadeh Irani Seyyed Saeed Khabiri Department of Orthopaedic surgery Shiraz University of Medical SciencesShiraz ***Iran Department of General surgery Kermanshah University of Medical SciencesKermanshah ***Iran Student Research Committee Kermanshah University of Medical SciencesShiraz ***Iran Student Research Committee Shiraz University of Medical SciencesShiraz 716549834Iran Students’Scientific Research Center(SSRC) Tehran University of Medical SciencesTehran 714356743Iran Clinical Research Development Unit of Shohada-e Tajrish Hospital Shahid Beheshti University of Medical SciencesTehran 715643498Iran Student Research Committee Shahid Sadoughi University of Medical SciencesYazd 719167534Iran

BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further *** To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic *** A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were *** A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, ***, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff *** Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.

关键词： Clinical negligence Litigation Medicolegal claims Mismanagement Patient satisfaction

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The emerging role of tranexamic acid and its principal target,plasminogen,in skeletal health

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Acta Pharmaceutica Sinica B 2024年第7期14卷 2869-2884页

作者： Weixin Xie Antonia Donat Shan Jiang Anke Baranowsky Johannes Keller Department of trauma and Orthopedic surgery University Medical Center Hamburg-EppendorfHamburg 20246Germany

The worldwide burden of skeletal diseases such as osteoporosis,degenerative joint disease and impaired fracture healing is steadily *** acid(TXA),a plasminogen inhibitor and anti-fibrinolytic agent,is used to reduce bleeding with high effectiveness and safety in major surgical *** its widespread clinical application,the effects of TXA beyond anti-fibrinolysis have been noticed and prompted renewed interest in its *** clinical trials have characterized the effects of TXA on reducing postoperative infection rates and regulating immune responses in patients undergoing ***,several animal studies suggest potential therapeutic effects of TXA on skeletal diseases such as osteoporosis and fracture *** a direct effect of TXA on the differentiation and function of bone cells in vitro was shown,few mechanisms of action have been ***,we summarize recent findings of the effects of TXA on skeletal diseases and discuss the underlying plasminogen-dependent and-independent mechanisms related to bone metabolism and the immune *** furthermore discuss potential novel indications for TXA application as a treatment strategy for skeletal diseases.

关键词： Tranexamic acid Osteoporosis Osteoarthritis Fracture healing Bone metabolism Inflammation Plasminogen Fibrinolysis

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Adipose-derived regenerative therapies for the treatment of knee osteoarthritis

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World Journal of Stem Cells 2024年第4期16卷 324-333页

作者： Ilias E Epanomeritakis Wasim S Khan Division of trauma and Orthopaedic surgery Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation TrustCambridge CB20QQUnited Kingdom Division of trauma and Orthopaedic surgery Department of SurgeryUniversity of CambridgeCambridge CB20QQUnited Kingdom

Knee osteoarthritis is a degenerative condition with a significant disease burden and no disease-modifying *** treatment ultimately requires joint *** capable of regenerating cartilage could significantly reduce financial and clinical *** regenerative potential of mesenchymal stromal cells(MSCs)has been extensively studied in the context of knee *** has yielded promising results in human studies,and is likely a product of immunomodulatory and chondroprotective biomolecules produced by MSCs in response to ***-derived MSCs(ASCs)are becoming increasingly popular owing to their relative ease of isolation and high proliferative *** vascular fraction(SVF)and micro-fragmented adipose tissue(MFAT)are produced by the enzymatic and mechanical disruption of adipose tissue,*** avoids expansion of isolated ASCs ex vivo and their composition of heterogeneous cell populations,including immune cells,may potentiate the reparative function of *** this editorial,we comment on a multicenter randomized trial regarding the efficacy of MFAT in treating knee *** discuss the study’s findings in the context of emerging evidence regarding adipose-derived regenerative *** underlying mechanism of action of ASCs is proposed while drawing important distinctions between the properties of isolated ASCs,SVF,and MFAT.

关键词： Knee osteoarthritis Mesenchymal stromal cells Adipose tissue Stromal vascular fraction Micro-fragmented adipose tissue Regeneration

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Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

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World Journal of Gastrointestinal surgery 2023年第5期15卷 757-775页

作者： Husham Abdelrahman Ayman El-Menyar Ruben Peralta Hassan Al-Thani trauma surgery Hamad Medical CorporationDoha 3050Qatar trauma and Vascular surgery Hamad Medical CorporationDoha 3050Qatar

Background:Modern surgical medicine strives to manage trauma while improving outcomes using functional *** of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus *** anastomosis after traumarelated resection is associated with a high rate of *** ability of the surgeon’s bare eye to determine bowel viability remains limited,and the need for a more standardized objective assessment has not yet been ***,there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize traumaassociated *** green(ICG)coupled with fluorescence angiography is a potential solution for this *** is a fluorescent dye that responds to near-infrared ***:We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective ***:ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical ***,there is a paucity of information regarding the use of this technology to treat ***,angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions,leading to fewer cases of anastomotic *** has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient ***,there is no consensus on the ideal dose,time,and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical ***:There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical *** review will impro

关键词： trauma Indocyanine green Fluorescence angiography Perfusion imaging Fluorescence guided surgery Acute care surgery

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Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

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World Journal of Orthopedics 2024年第6期15卷 501-511页

作者： Dario Regis Mattia Cason Bruno Magnan Department of Orthopedic and trauma surgery Integrated University HospitalVerona 37126VenetoItaly

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint ***,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic *** is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical *** most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of ***,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the *** spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after *** options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

关键词： Dislocation Total hip arthroplasty Revision surgery Review Risk factors Complication

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Advances and controversies in the management of acute cholecystitis in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency surgery and trauma guidelines

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 724-726页

作者： Megan Vidal Vladimir Neychev University of Central Florida College of Medicine OrlandoFLUSA Department of surgery UCF Lake Nona HospitalUniversity of Central Florida College of MedicineOrlandoFLUSA

There is an ongoing debate about the therapeutic strategies for acute cholecystitis in high-risk,critically ill patients,and finding the optimal management option is a work in *** the recent study“Acute cholecystitis management in high-risk,critically ill,and unfit-for-surgery patients:the Italian Society of Emergency surgery and trauma(SICUT)guidelines”,*** et *** current knowledge on treating acute cholecystitis in high risk,critically ill,and unfit for surgery patients(1).The article encompasses topics such as patient stratification,risk factors,and outcomes of non-operative gallbladder drainage and advances the knowledge of the field by proposing specific management recommendations for these patient groups.

关键词： Acute cholecystitis management high-risk patients

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