Weight-bearing Capacity Research Articles

Single-leg weight limit of fixation model of simple supracondylar fracture of femur

Early postoperative rehabilitation training for supracondylar fracture of femur aids in accelerating healing with shorter recovery periods. Presently, clinical studies on early postoperative weight training are still in the nascent stage. The weight-bearing capacity at different healing stages typically depends on clinical experience, and there is a lack of standards to quantify the weight that is conducive to healing of fractures. In this paper, a three-dimensional (3D) geometric model of the femur is obtained using imaging data, a locking plate fixation model of a simple supracondylar fracture of the femur, considering the angle and spatial direction of the fracture surface, is established, the stress distribution and load transmission mechanism of the fracture fixation model in a single-leg standing posture are studied, and the weight-bearing capacity of a standing single leg at the early stage of fracture is given. This provides the basis for objective quantification of early postoperative weight-bearing capacity.

Role of locking plate in fractures of shaft of humerus in elderly patients

Fractures of humeral diaphysis constitute 3% of all the bony injuries. Operative technique which have been devised for the treatment of humeral diaphyseal fractures include ORIF with plate osteosynthesis, intramedullary nailing and External fixation using ilizarov ring fixators or AO tubular fixators. Open reduction and internal fixation with plate osteosynthesis supplemented with bone grafting has been the gold standard for treatment of the humeral diaphysis when other methods are compared. The key to this new generation of plates is the locking mechanism of the screw to the plate, which provides angular stability and avoids compression of the plate to the periosteum. Loss of screw purchase is an important factor related to the failure of fixation in osteo porotic bone. Fracture plating technology recently has evolved to include locked plating. The main goal is to obtain the most rigid fixation possible. It is a prospective study of 30 elderly patients who attended either the outpatient department or emergency room who had sustained injury to the arm and diagnosed as facture shaft of humerus in NRI Medical college and general hospital during the period of 2 years (November 2016 to October 2018). All the cases followed at 6weeks, 3 months and at 12months. The results are assessed by Constant and Murley’s scoring system. Post-menopausal osteoporotic females accounted for 40% of patients. In our study internal fixation using locking compression plating techniques achieved union in all cases. 95% of fractures united within 16 weeks. The functional outcome was more than 90%. These results are comparable with those obtained by R Vander Griend et al open reduction and internal fixation using AO plating techniques (97%). Treatment of long bone fractures with osteoporosis in elderly patients is technically challenging in terms of fracture fixation, maintainance of reduction and achieving bony union with good clinical outcome. Locking Compression Plate offers higher weight bearing capacity than the conventional plates interms of good fixation and stability. In osteoporosis or poor bone quality, bicortical engagement of screws is recommended.

Vertebral body resection and lumbar corpectomies

Corpectomies in the lumbar spine are unique operations with important and well-deserving nuances that determine their ultimate safety and efficacy. Lumbar vertebral resections are indicated in deformity and non-deformity settings. For deformities, they are reserved for those that are severe and rigid. Infections, fractures, and tumors that compromise the weight-bearing capacity of the anterior and middle columns of the spine are also indicated for lumbar vertebrectomy. Anterior column structural support is required in non-deformity situations and may be accomplished with the use of polymethyl methacrylate (PMMA) cement, osseous strut grafts (i.e. allografts/autograft), or titanium cages (static vs. expandable). The newest generation of cages have wide, rectangular footprints that span the apophyseal ring and provide a sound biomechanical environment and minimize the risk of cage subsidence compared to those with circular footprints. Neural decompression and placement of structural support can be accomplished by a variety of surgical approaches. While a traditional anterior approach is the gold-standard for lumbar vertebrectomies, minimally invasive lateral approaches and a posterior-only approach are viable management strategies. Supplemental fixation is also required and may be achieved with anterior-only instrumentation, posterior-only instrumentation, and circumferential instrumentation. In the review to follow, an evidence-based approach will be used to outline appropriate indications, surgical technique, and concomitant reconstructive and stabilization options for lumbar corpectomies. The discussion to follow ideally will help optimize outcomes for patients treated with vertebral resection and lumbar corpectomies in the lumbar spine.

The PI3K inhibitor buparlisib suppresses osteoclast formation and tumour cell growth in bone metastasis of lung cancer, as evidenced by multimodality molecular imaging.

Non-small cell lung cancer (NSCLC) metastasis commonly occurs in bone, which often results in pathological fractures. Sustained phosphoinositide-3-kinase (PI3K) signalling promotes the growth of PI3K-dependent NSCLC and elevates osteoclastogenic potential. The present study investigated the effects of a PI3K inhibitor on NSCLC growth in bone and osteoclast formation, and aimed to determine whether it could control symptoms associated with bone metastasis. A bone metastasis xenograft model was established by implanting NCI-H460-luc2 lung cancer cells, which contain a phosphatidylinositol- 4,5-bisphosphate 3-kinase catalytic subunit α mutation, into the right tibiae of mice. After 1 week, the tumours were challenged with a PI3K inhibitor (buparlisib) or blank control for 3 weeks. Tumour growth and burden were longitudinally assessed in vivo via reporter gene bioluminescence imaging (BLI), small animal positron emission tomography/computed tomography (CT) [18F-fluorodeoxyglucose (18F-FDG)] and single-photon emission computed tomography/CT [99mTc-methylene diphosphonate (99mTc-MDP)] imaging. Tibia sections of intraosseous NCI-H460 tumours were analysed by immunohistochemistry (IHC), western blotting and flow cytometry. Dynamic weight bearing (DWB) tests were further performed to examine the improvement of symptoms associated with bone metastasis during the entire study. Administration of buparlisib significantly inhibited the progression of bone metastasis of NSCLC, as evidenced by significantly reduced uptake of 18F-FDG, 99mTc-MDP and BLI signals in the treated lesions. In addition, buparlisib appeared to inhibit the expression of tartrate-resistant acid phosphatase and receptor activator of nuclear factor-κB ligand, as determined by IHC. Buparlisib also resulted in increased cell apoptosis, as determined by a higher percentage of Annexin V staining and increased caspase 3 expression. Furthermore, buparlisib significantly increased weight-bearing capacity, as revealed by DWB tests. The PI3K inhibitor, buparlisib, suppressed osteoclast formation in vivo, and exhibited antitumour activity, thus leading to increased weight-bearing ability in mice with bone metastasis of lung cancer. Therefore, targeting the PI3K pathway may be a potential therapeutic strategy that prevents the structural skeletal damage associated with bone metastasis of lung cancer.

3D printing in experimental orthopaedic surgery: do it yourself.

Periprosthetic infection is considered an increasing incidence pathology whose therapeutic strategies can be defined as unsatisfactory. Currently, animal models are employed to study its physiopathology and strategic therapies, but non-species-specific materials are implanted as foreign bodies. The use of these implants implies intrinsic instability, which hinders the development of a biofilm on their surfaces and complicates the post-operative recovery of the animal. The objective of the present study is the design of a species-specific implant for the New Zealand white (NZW) rabbit by means of 3D printing. A CT scan of the knee of a NZW rabbit was performed, and the tibial surface was reconstructed in order to fabricate a species-specific tibial plateau using Horos® and Autodesk® Meshmixer™ software. This implant was inserted in fifteen NZW rabbits, and the assessment of its stability was based on the position of the limb at rest and the animal weight-bearing capacity. Biofilm formation on the surface was demonstrated by crystal violet staining. A 1.81cm × 1cm × 1.24cm stainless steel implant was designed. It consisted of a 4-mm-thick tibial plate with a rough surface and an eccentric metaphyseal anchoring. All of the animals exhibited hyperflexion of the operated limb immediately post-operative, and 100% could apply full weight bearing from day 5 after surgery. The species-specific design of implants in experimental surgery encourages rapid recovery of the animal and the development of a biofilm on their surfaces, making them ideal for the study of the physiopathology and for establishing possible therapeutic targets for prosthetic infection.

Abstract P1-03-08: New diagnostic tools for bone health assessment: Perspectives in medical oncology

Abstract Background Pituitary down regulators, aromatase inhibitors tamoxifen and chemotherapeutic drugs, all have a negative impact on bone health in breast cancer patients. Although trabecular bone accounts for only 20% of skeleton mass, bone resistance depends also on the its micro-architecture, or quality, of, in addition to bone density. The BESTEST® is an innovative and inexpensive diagnostic method that gives an indication of the quality of the bone structure: it measures the weight-bearing capacity of the bone structure, evaluated from simulated application of loads on bone structure images acquired by radiograms in the proximal epiphysis of the hand. Results are expressed as BSI_T-score and BSI_Z-score (which refers the results to the average value for the same age) and provide precious add-on information to densitometry. We discuss the preliminary results obtained in female patients undergoing breast cancer treatment. Material and methods 100 Caucasian women, took BESTEST® as follow-up while undergoing oncological treatment. Femoral neck DXA T-score available in a subgroup of 60. 10 patients self-reported an osteoporotic fracture, DXA T-score available for 8. Control population: 200 women, accessing BESTEST® and DXA for screening purposes, 30 self-reporting an osteoporotic fracture. Results Statistics: mean (min, max). NAgeBSI_T-scoreBSI_Z-scoreDXA_T-scorePopulation10061 (33, 88)-1.7 (-3.4, -0.0)-1.3 (-2.6, 0.6)NADXA subgroup (of oncological population)6062 (35, 88)-1.8 (-3.4, -0.1)-1.3 (-2.6, 0.6)-1.6 (-3.2, 0.5)Fractured subgroup1067 (56, 82)-2.4 (-2.9, -1.3)-1.8 (-2.6 -0.1)NAFractured subgroup with DXA868 (60, 82)-2.4 (-2.9, -1.3)-1.8 (-2.6 -0.1)-1.5 (-2.9, 0.1)Control20063 (32, 89)-1.1 (-3.6, 2.9)-0.6 (-3.0, 2.9)-1.9 (-3.7, 1.0) The fractured subgroup exhibits significantly lower BSI T-score than the population (T-test p< 0.0100) and results are similar after BSI Z-score correction for age (T-test p = 0.0300). The BSI T-score of the DXA subgroup is representative of the oncological population undergoing treatment (T-test p=0.8668). As expected, BSI T-score and DXA T-score are not correlated: R2 = 0.0917 in the control and R2 = 0.0294 in the population. The DXA subgroup exhibit significantly lower BSI T-score than the control (T-test p = 0.0002) and similar results are obtained after BSI Z-score correction for age. A lower significance (T-test p = 0.0281) is found for DXA T-score. The 8 fractured oncological patients exhibit significantly lower values of BSI T-score that the oncological population (T-test p = 0.038) and all patients have a BSI T-score indicative of a compromised trabecular structure. DXA T-score values cannot be considered statistically different (T-test p = 0.6744) and results span all possible diagnostic results from high risk to normal. Conclusions Statistical analyses show that bone micro-architecture is indeed affected by oncological treatment and that bone alterations due to oncological treatment are easily detected with BESTEST, especially when associated with fractures. This preliminary study clearly provides a rational background for further, deeper investigations into the use of a new, rapid and safe technique for monitoring the effect of breast and prostate cancers therapies on bone micro-architecture modifications. Citation Format: Cosmi F, Del Conte A, Foltran L, Nicolosi A, Saracchini S. New diagnostic tools for bone health assessment: Perspectives in medical oncology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-03-08.

A facile slow-gel method for bulk Al-doped carboxymethyl cellulose aerogels with excellent flame retardancy

Bulk Al-doped carboxymethyl cellulose aerogels were obtained via a facile slow-gel method and freeze-drying technology. In this method, the cross-linker Al3+ was released slowly and completely with enough d-(+)-gluconic acid δ-lactone as a sustained-release agent. Depended on controlled releasing of Al3+, the reaction speed between Al3+ and carboxyl groups was controlled and Al3+ was well-distributed in the aerogels. The coordination type between Al3+ and carboxymethyl cellulose was the bidentate bridging coordination. By adjusting the amount of Al3+ and the degree of substitution of carboxymethyl cellulose, interconnected network and closely packed sheet-like structure presented, respectively. According to the nitrogen adsorption-desorption isotherms, the aerogels were a kind of mesoporous material with pore blocking or cavitation. In addition, the aerogels exhibited outstanding weight-bearing capacity and excellent flame retardancy. This work provided a valuable reference for doping metal ions into polysaccharide aerogels and expanding the application fields of aerogels.

Persistent inflammatory pain alters sexually-motivated behavior in male rats

Urine from pro-œstrus female rodents evokes increased levels of sexually-motivated behaviors in males, including sniffing and scent marking of the urine spot as well as activation of brain reward regions. Stressors such as social defeat can adversely impact urine scent marking behavior in male rodents, an effect that can be mitigated with anti-depressant drugs. Persistent pain is also known to be a potent stressor, producing elevated levels of plasma corticosterone as well as reduced sucrose preference and reduced social interaction. However, the effect of persistent pain on sexually-motivated behavior is unknown. Here, we compared urine scent marking behavior in male rats for up to 3 weeks following intra-articular injection of Complete Freund’s Adjuvant (CFA) or sham injection. CFA-injected rats exhibited profound and ongoing deficits in static weight bearing capacity. CFA-induced persistent inflammatory pain increased plasma corticosterone levels and reduced urine scent marking behavior in male rats. Moreover, while the vast majority of injured rats showed decreased urine scent marking preference for the pro-œstrus female urine spot, male rats with higher baseline scent marking preference also exhibited higher post-injury scent marking preference, more sniffing behavior and lower levels of plasma corticosterone, compared to those with lower baseline scent marking preference. Overall, scent marking behavior may be an ethologically relevant behavioral predictor of persistent pain-induced stress in rats, representing a novel translational approach to understanding chronic pain comorbidities.

A Placebo-Controlled Double-Blind Study Demonstrates the Clinical Efficacy of a Novel Herbal Formulation for Relieving Joint Discomfort in Human Subjects with Osteoarthritis of Knee.

LI73014F2 is a novel composition prepared from extracts of Terminalia chebula fruit, Curcuma longa rhizome, and Boswellia serrata gum resin with synergistic benefit in 5-Lipoxygenase (5-LOX) inhibition. This herbal composition with strong anti-5-LOX activity exhibited significant pain relief as indicated through improvements in weight-bearing capacity in a monosodium iodoacetate-induced osteoarthritis (OA) model of Sprague-Dawley rats. A 90-day randomized, placebo-controlled double-blind study evaluates the clinical efficacy and tolerability of LI73014F2 in the management of symptoms of OA of the knee (Clinical Trial Registration No. CTRI/2014/01/004338). Subjects, (n = 105), were randomized into three groups: placebo (n = 35), 200 mg/day of LI73014F2 (n = 35), and 400 mg/day of LI73014F2 (n = 35). All study participants were evaluated for pain and physical function by using standard tools, that is, Visual Analog Scale, Lequesne's Functional Index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at the baseline (day 0) and on day 14 ± 3, 30 ± 3, 60 ± 3, and at the end of the study (day 90 ± 3). In addition, routine examinations on biochemical parameters in serum, urine, and hematological parameters were conducted on each visit to assess the safety of the study material. At the end of the trial period, LI73014F2 conferred significant pain relief, improved physical function, and quality of life in OA patients. In conclusion, preclinical and clinical data together strongly suggest that the herbal formulation LI73014F2 is a safe and effective intervention for management of joint discomfort, demonstrating efficacy as early as 14 days.

The influence of the moisture content in historical masonry walls on the load bearing capacity

The moisture content in historical masonry walls, particularly on the ground floor, caused by i.e. lack of damp insulation, is a phenomenon of common occurrence. It is usually analysed in terms of mycological changes, thermal insulation and frost damage. The paper discusses the influence of the increased moisture content on the weight and load bearing capacity of the structure. The determination of moisture content in masonry elements, performed during the inspection of the building, provides information from which an increase in the structure's weight can be defined. Reliable tests for the moisture content and compressive strength of masonry and mortar components are invasive, and the number of testing in historical buildings should be limited to the minimum necessary to preserve their vintage nature. As a result, the received overall picture of the work of masonry may not be consistent with its actual state since historical buildings could have been rebuilt or repaired, and consequently, contain masonry conversions made of various materials with different properties. Absorbability can serve here as an example as it is a factor that disrupts a reliable determination of load bearing capacity values of masonry structures. The article attempts to determine the change in load bearing capacity of a moist masonry structure compared to the original - in the air-dry state - for various types of historical masonry and mortar components. The main influence analysed was due to capillary action, whereas the effect of other sources of moisture, i.e. salinity, was excluded.

Aging Induces Changes in the Somatic Nerve and Postsynaptic Component without Any Alterations in Skeletal Muscles Morphology and Capacity to Carry Load of Wistar Rats

The present study aimed to analyze the morphology of the peripheral nerve, postsynaptic compartment, skeletal muscles and weight-bearing capacity of Wistar rats at specific ages. Twenty rats were divided into groups: 10 months-old (ADULT) and 24 months-old (OLD). After euthanasia, we prepared and analyzed the tibial nerve using transmission electron microscopy and the soleus and plantaris muscles for cytofluorescence and histochemistry. For the comparison of the results between groups we used dependent and independent Student's t-test with level of significance set at p ≤ 0.05. For the tibial nerve, the OLD group presented the following alterations compared to the ADULT group: larger area and diameter of both myelinated fibers and axons, smaller area occupied by myelinated and unmyelinated axons, lower numerical density of myelinated fibers, and fewer myelinated fibers with normal morphology. Both aged soleus and plantaris end-plate showed greater total perimeter, stained perimeter, total area and stained area compared to ADULT group (p < 0.05). Yet, aged soleus end-plate presented greater dispersion than ADULT samples (p < 0.05). For the morphology of soleus and plantaris muscles, density of the interstitial volume was greater in the OLD group (p < 0.05). No statistical difference was found between groups in the weight-bearing tests. The results of the present study demonstrated that the aging process induces changes in the peripheral nerve and postsynaptic compartment without any change in skeletal muscles and ability to carry load in Wistar rats.

Evaluation of a novel biodegradable thermosensitive keto-hydrogel for improving postoperative pain in a rat model.

This study evaluates the sustained analgesic effect of ketorolac-eluting thermosensitive biodegradable hydrogel in the plantar incisional pain model of the rat hind-paw. A ketorolac-embedded 2, 2'-Bis (2-oxazolin) (BOX) linking methoxy-poly(ethylene glycol) and poly(lactide-co-glycolide) (mPEG-PLGA) diblock copolymer (BOX copolymer) was synthesized as keto-hydrogel based on optimal sol-gel phase transition and in vitro drug release profile. The effect of keto-hydrogel on postoperative pain (POP) was assessed using the established plantar incisional pain model in hind-paw of rats and compared to that of ketorolac solution. Pain and sensory threshold, as well as pain scoring, were evaluated with behavioral tests by means of anesthesiometer and incapacitance apparatus, respectively. Pro-inflammatory cytokine levels (TNF-α, IL-6, VEGF, and IL-1β) around incisional wounds were measured by ELISA. Tissue histology was assessed using hematoxylin and eosin and Masson’s trichrome staining. Ten mg/mL (25 wt%) keto-hydrogel showed a sol-gel transition at 26.4°C with a 10-day sustained drug release profile in vitro. Compared to ketorolac solution group, the concentration of ketorolac in tissue fluid was higher in the keto-hydrogel group during the first 18 h of application. Keto-hydrogel elevated pain and sensory threshold, increased weight-bearing capacity, and significantly reduced the levels of TNF-α, IL-6, and IL-1β while enhanced VEGF in tissue fluid. Histologic analysis reveals greater epithelialization and collagen deposition around wound treated with keto-hydrogel. In conclusion, our study suggests that keto-hydrogel is an ideal compound to treat POP with a secondary gain of improved incisional wound healing.

Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA).

The aim of this study was to determine the ability of undenatured native chicken type II collagen (UC-II) to prevent excessive articular cartilage deterioration in a rat model of osteoarthritis (OA). Twenty male rats were subjected to partial medial meniscectomy tear (PMMT) surgery to induce OA. Immediately after the surgery 10 rats received vehicle and another 10 rats oral daily dose of UC-II at 0.66mg/kg for a period of 8 weeks. In addition 10 naïve rats were used as an intact control and another 10 rats received sham surgery. Study endpoints included a weight-bearing capacity of front and hind legs, serum biomarkers of bone and cartilage metabolism, analyses of subchondral and cancellous bone at the tibial epiphysis and metaphysis, and cartilage pathology at the medial tibial plateau using histological methods. PMMT surgery produced moderate OA at the medial tibial plateau. Specifically, the deterioration of articular cartilage negatively impacted the weight bearing capacity of the operated limb. Immediate treatment with the UC-II preserved the weight-bearing capacity of the injured leg, preserved integrity of the cancellous bone at tibial metaphysis and limited the excessive osteophyte formation and deterioration of articular cartilage. Study results demonstrate that a clinically relevant daily dose of UC-II when applied immediately after injury can improve the mechanical function of the injured knee and prevent excessive deterioration of articular cartilage.

Multifunctional, Self-Activating Oxygen-Rich Holey Carbon Monolith Derived from Agarose Biopolymer

Agarose, a natural biopolymer, is carbonized to synthesize an economical lightweight (0.05 g cm–3) mesoporous carbon monolith with large BET surface area (625 m2 g–1). The monolith prepared at different temperatures (700, 800, 900 °C) exhibits interesting morphologies without using any activating agent. The holey pattern appearing at 900 °C, besides increasing the meso/microporosity, confirms the self-activation at higher temperature. Most interestingly, the thick sheet-like morphology obtained at 700 °C is changed to nanoporous carbon flakes as the synthesizing temperature is increased to 800 and 900 °C. This synthesis approach affords an oxygen-enriched meso/microporous carbon monolith that constitutes high pseudocapacitance in addition to electric double layer charge. Lightweight carbon monolith exhibits excellent thermal and mechanical characteristics having a weight bearing capacity of ∼5900 times compared to its weight without developing any deformity. The electrochemical performance of carbonized agarose (CAR) tested in 1 M H2SO4 exhibits superior charge storage capacity in CAR 900 (302 F g–1 at 5 mV s–1) compared to that of CAR 800 (124 F g–1) and CAR 700 (107 F g–1). The symmetric cell (1 × 1 cm2 area) fabricated using CAR 900 as electrodes exhibits excellent cell performance over 5000 charge/discharge cycles with ∼98% capacity retention. Three symmetric CAR 900 cells connected in series enable powering a red LED bulb (3 V) that indicates excellent sustainability of agarose-derived carbon in energy storage devices.

Sit-To-Stand Lift: Effects of Lifted Height on Weight Borne and Upper Extremity Strength Requirements.

To prevent back and shoulder injuries to nursing personnel, sit-to-stand lifts are used to transfer partial-weight-bearing patients with upper extremity strength. However, the weight-bearing capacity and upper extremity strength required of patients have not been defined. The objectives of this study were to determine: (a) the percentage of body weight borne by the patient when lifted to different heights in the lift and (b) whether a patient needs upper extremity strength. Nineteen healthy normal-weight volunteers (ages 19-39) were transferred from a hospital bed to a wheelchair using (a) a gait belt and (b) a sit-to-stand lift. With legs secured in the lift, participants were lifted to five different heights (knee angles 120-180 degrees) while holding and not holding the lift handles. Participants supported a greater percentage of body weight as they were lifted higher, increasing from 60% to almost 100% (p < .01). Holding the handles did not have an effect on weight borne overall. At low heights, slightly less weight was borne when not using the handles than with them, and no difference in weight borne was found at heights near standing (p < .01). All participants felt more comfortable and safer transferring from bed to wheelchair with the mechanical lift than with the gait belt (p < .01). Results are limited to normal-weight patients but suggest that sit-stand lifts can be used in patients without upper extremity strength. Patients with limited weight-bearing capacity can be transferred by not raising them high in the lift. © 2016 Wiley Periodicals, Inc.

Functional assessment of endoprosthesis in the treatment of bone tumors

ObjectivesEvaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb. MethodsWe analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS), in addition to the radiologic evaluation. ResultsEndoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence. ConclusionThe authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

Do Radiographic and Clinical Parameters in the Setting of a Bunion Predict Second Ray Pathology?

Category: Bunion Introduction/Purpose: Hallux valgus deformity is well known to cause second ray pathology, commonly manifested as a second hammertoe or second tarsometatarsal (TMT) joint osteoarthritis (OA). This likely results from decreased weight-bearing capacity of the first metatarsal in the setting of worsening metatarsus primus varus, TMT joint hypermobility, or an excessively long second metatarsal or second toe. It is not known for sure, however, which radiographic and clinical factors in the setting of hallux valgus are protective of second ray pathology and which lead to second hammertoe, TMT joint OA, or both. We hypothesized that the formation of second ray pathology would be correlated with increasing age, increased body mass index (BMI), increased hallux valgus angle (HVA), increased intermetatarsal angle (IMA), and increased second metatarsal length. Methods: All consecutive patients who underwent operative reconstruction for symptomatic hallux valgus from January 2007 to July 2015 by the senior author were included. Patients were grouped into those with 1) bunion only 2) bunion with hammertoe and 3) bunion with second TMT joint OA. Preoperative age, sex, and BMI were recorded. Pre-operative HVA, IMA, metatarsus adductus angle (MAA), and first and second metatarsal lengths were measured on weight-bearing anteroposterior (AP) radiographs. Talar-first metatarsal angle was measured on weight-bearing lateral radiographs. One-way analysis of variance (normality demonstrated) and Kruskal-Wallis (normality not demonstrated) were used to assess differences in continuous variables. Post hoc tests were conducted with Bonferroni technique. Associations between discrete variables and the study groups were analyzed using chi-square tests. Results: Increased age was associated with both hammertoe (P = 0.000) and TMT joint OA (P = 0.006). Increased BMI was associated with TMT joint OA (P = 0.016). Increased HVA was associated with both hammertoe (P = 0.039) and TMT joint OA (P = 0.038). When analyzed categorically, 29.7% of patients with TMT joint OA had a moderate HVA (30.0-39.9 degrees) whereas 22.2% of patients with a bunion only had a moderate HVA (P &lt; 0.05). A one-degree increase in HVA was associated with a 5% chance of having a hammertoe as compared to a bunion only. MAA correlated with TMT joint OA (P = 0.048) (Table 1). Conclusion: Our data suggests that increased age (a surrogate for bunion duration) and increased HVA may predispose patients with hallux valgus to second hammertoe and TMT joint OA formation. Increased BMI may lead to the development of TMT joint OA. Increased MAA may predispose to hammertoe formation. Increased MAA may lead to TMT joint OA. Alternatively, increased MAA could result as a consequence of midfoot cartilage and bone loss in the setting of hallux valgus. This data can help surgeons better inform patients about the optimal timing of bunion reconstruction with or without concomitant second ray surgery.

Ischemic-reperfusion of unilateral external iliac artery in rat: A new model for vasculitic femoral neuropathy

Clinically, ischemic environment during gynecological surgery at lithotomy position is most common causative factor for the development of vasculitic femoral neuropathy (VFN). The present study was designed to induce the clinically relevant rat model of VFN by ischemic-reperfusion (I/R) injury of unilateral external iliac artery (uEIA). The VFN was induced by 3, 4 and 5h occlusion of uEIA followed by reperfusion. The I/R of uEIA induced VFN was evaluated by (i) behavioral parameters i.e., hind limb temperature; weight bearing capacity; (ii) kinematic analysis i.e., paw posture, splay angle, static sciatic index (SSI), and ankle-angle tests; (iii) evaluation of pain perception i.e., plantar and pin prick; (iv) serum biochemical estimation i.e., nitrate, lipid peroxidation, TNF-α and calcium level; (v) evaluation of motor and sensory nerve conduction velocity; and (vi) measurement of nerve fiber density. The 4 and 5h occlusion of uEIA has produced the potential changes in behavioral, functional, electrophysiological, biochemical and histopathological assessment. The 5h occlusion of uEIA has shown to produce the mortality. Whereas, 3h occlusion does not produce the significant changes in the development of VFN. The 4h ischemic occlusion of uEIA has shown potential rat model of VFN due to its close mimicking capacity of VFN in human. Therefore, it can be useful to explore the newer anti-neuralgic medicine and with their pharmacodynamic action in the field of various neurovascular disorders.

Antiresorptive and Anabolic Bone Therapy Does not Improve Weight Bearing Capacity and Bone Strength in OA Rats

Objective: This manuscript reports the outcomes of medial meniscectomy (MM) surgery on cartilage and cortical bone strength and the reaction of cartilage and bone to intensive treatment with antiresorptive (zoledronate) and anabolic bone (PTH) therapies.

Antiresorptive and Anabolic Bone Therapy Does not Improve Weight Bearing Capacity and Bone Strength in OA Rats

Antiresorptive and Anabolic Bone Therapy Does not Improve Weight Bearing Capacity and Bone Strength in OA Rats