Notes

The force storage space actions of a phosphate-based cathode materials throughout normal rechargeable zinc electric batteries.
Ramp lesions are important injuries that are difficult to detect on MRI and pose a challenge to diagnose on arthroscopy since they require inspection of the posteromedial compartment. No bony injury has been reported in the literature as an associated injury with the ramp lesion. We report a rare case of complete ramp tear of the posterior capsule-meniscal junction associated with fracture of the rim of the posterior medial tibial plateau and a double injury to the posterior medial meniscus forming a terrible triad with poor prognosis. This report has implications on the classifications of ramp lesions, posterior root injuries of the medial meniscus and meniscal tears as fracture of the rim adds a new dimension to these injuries.
Virtual Reality (VR) simulators are playing an increasingly prominent role in orthopaedic training and education. Face-validity - the degree to which reality is accurately represented - underpins the value of a VR simulator as a learning tool for trainees. Despite the importance of tactile feedback in arthroscopy, there is a paucity for evidence regarding the role of haptics in VR arthroscopy simulator realism.

To assess the difference in face validity between two high fidelity VR simulators employing passive and active haptic feedback technology respectively.

38 participants were recruited and divided into intermediate and expert groups based on orthopaedic training grade. Each participant completed a 12-point diagnostic knee arthroscopy VR module using the active haptic Simbionix ARTHRO Mentor and passive haptic VirtaMed ArthroS simulators. Subsequently, each participant completed a validated simulator face validity questionnaire.

The ARTHRO Mentor active haptic system failed to achieve face validitrties of the knee joint provide a significantly more realistic training experience for both intermediate and expert arthroscopists.
Current active haptic technology which employs motors to simulate tactile feedback fails to demonstrate sufficient face-validity or match the sophistication of passive haptic systems in high fidelity arthroscopy simulators. Textured rubber phantoms that mirror the anatomy and haptic properties of the knee joint provide a significantly more realistic training experience for both intermediate and expert arthroscopists.
Cardiac arrest (CA) has been identified as a potential complication following Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA). This retrospective, case-controlled study aims to identify risk factors in order to improve the management of patients undergoing THA or TKA with known preoperative comorbidities.

CPT codes were used to investigate the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for patients who underwent THA or TKA from 2010 to 2017. Patients were classified as having cardiac arrest (CA) by the NSQIP guidelines. Patient samples with all possible covariates were included for the multivariate logistic regression analysis and assessed for independent association.

Patients receiving perioperative transfusion, experiencing dyspnea with moderate exertion, dyspnea at rest, patients currently on dialysis, and patients aged ≥72 are all independently associated with increased rates of cardiac arrest (CA) following THA. Patients receiving f CA following THA and TKA to prevent this complication.
Patients sustaining hip fractures experience blood loss as a direct result the fracture independent of surgery. The objective of this study was to quantify the expected non-surgical blood loss for proximal femur fractures using hemoglobin values.

A retrospective chart review of patients at a level 1 trauma center sustaining proximal femur fractures between October 2015 and January 2018 was performed. Patients were ≥30 years of age, had sustained intertrochanteric, subtrochanteric, or femoral neck fractures and had hemoglobin values documented at admission and after 12h but before surgery. Patients with concomitant fractures, other hemorrhagic injuries, or blood transfusions before their second hemoglobin result were excluded. A multivariate linear regression model was constructed to evaluate the predictive ability of age, sex, BMI, number of comorbidities, fracture type, anticoagulation/antiplatelet therapy, admission hemoglobin, timing of surgical intervention and changes in electrolyte levels on subseqund increased time to surgery. The identification of demographic, fracture type, and treatment characteristics may help surgeons identify patients at the greatest risk for blood loss, and provide more effective perioperative care.
Proximal femur fractures cause a significant amount of blood loss prior to surgical intervention. Patients at particular risk include those with comorbidities, intertrochanteric fractures, low admission hemoglobin values, and increased time to surgery. The identification of demographic, fracture type, and treatment characteristics may help surgeons identify patients at the greatest risk for blood loss, and provide more effective perioperative care.Iatrogenic nerve injuries can cause patients and surgeons a great deal of distress and anxiety. To help prevent such injuries, surgeons should remain mindful for potential distortion of anatomy due to scarring and adhesions. Peripheral nerves are vulnerable to thermal injury, as well as mechanical injury by laceration and traction. Revision arthroplasty may involve removal of the implant and cement mantle. During this removal process, breaches in cortical bone can occur, with resultant cement extrusion within the soft tissues. Screw holes left vacant following screw removal may also allow for cement leakage. Thermal energy is released during the exothermic polymerisation process of cement curing. As a result, this thermal energy can also lead to injury to neural tissue. In this article, we present three cases of radial nerve palsy associated with cement extrusion during revision arthroplasty, in order to highlight pitfalls and learning points in the management. In addition, we propose strategies to avoid such injuries. Surgeons are reminded to be vigilant for cortical breaches intraoperatively, and if recognised, steps should be taken to minimise the risk of nerve injury.
Spine is a rapidly growing branch with fully-dedicated peer-reviewed journals. Journal impact factor (JIF), speed of publication, and readership are some critical factors affecting the author's choice for submission. This study aimed to find the bibliometric data of spine journals.

Fourteen Spine journals in NCBI (National centre for Biotechnology information, USA) database, meeting the inclusion criterion were analyzed for original articles, collected via stratified sampling from each issue of the journal. The dates to submission (DS), acceptance (DA), and publication (DP), study design, corresponding author's details like-subject specialization and country of affiliation were recorded for each original article. Data on JIF, number of issues/years, open access availability (OA), article processing charges (APC) were also retrieved. Correlation and geographic plot were used to display the findings.

The median (interquartile range) time for submission to publication/total time (TT) in spine journals was blication speed with other biomedical journals; all spine journals had OA options. Observational study dominates the pattern in spine research. The contribution is mainly from orthopaedician, but the trend is changing towards collaborative research with neurosurgeons.
Adequate reconstruction of the soft tissue defect following resection of bone tumors is challenging. Prolene mesh, despite being a useful tool, is not widely used due to the fear of deep infection. The aim of this study was to evaluate the functional outcome and complications of using a Prolene mesh in oncological reconstructions.

A retrospective study was conducted in bone tumor patients with soft tissue reconstruction using Prolene mesh between January 2017 and June 2019. Functional evaluation was done using MSTS 93 score. Complications were recorded and were classified as mechanical (dislocation and extension lag) or biological failure (wound problems and deep infection). Comparison was performed between groups with and without biological failure to identify predictive variables.

Of 116 patients, 68 were males and 48 were females, with median age of 22.5 years. Thirty nine patients had tumors of proximal tibia, 23 of proximal femur, 25 of proximal humerus, 24 of pelvis, and five tumors at other siteshe soft tissue defects following bone tumor resections. It is readily available, reliable and provides reproducible results, with no added risk of wound complications.
Tourniquet use is ubiquitous in orthopaedic surgery to create a bloodless field and to facilitate safe surgery, however, we know of the potential complications that can occur as a result of prolonged tourniquet time. Experimental and clinical research has helped define the safe time limits but there is not much literature specific to foot and ankle surgery.

A retrospective review of the postoperative course of patients with prolonged tourniquet time (longer than 180min) for foot and ankle procedures was done. Data related to the patient factors and the surgical procedure was collected. The length of stay, re-admissions and complications were the important indicators of the individual patient's recovery.

Twenty patients were identified with longer than 180-min tourniquet times for complex foot and ankle procedures. The average uninterrupted tourniquet time was 191min. Eight of the twenty procedures were revision surgeries. check details The average length of stay was 3 days and there were no re-admissions within 30 daemic effects of tourniquet is not complete and this study demonstrates that the complications do not necessarily increase in a linear fashion in relation to the tourniquet time.Diabetic foot ulcer treatment is a challenge for the healthcare world. Widespread infection and the presence of critical ischemia (especially with end-stage renal disease) can lead to major amputation rather than amenable to conservative treatment. Surgical strategies of the diabetic foot have been changing over the past 10 years and are now focused on reconstructive treatment and limb salvage. These goals were achieved, thanks to an evolution of distal revascularization techniques and a distinct approach, which integrates various methods focused on limb salvage. Podoplastic techniques of the diabetic foot are focused on infection clearance, the surgical treatment of corrective deformities, soft tissue coverage and limb ischemia correction along with the management of diabetes and the comorbidities that compromise tissue repair processes. The reconstructive techniques used in diabetic foot treatment owe their effectiveness in part to the results of technological improvements such as the circular external fixator as a tool for stabilization and surgical site protection. In the last decade, many studies have shown that circular external fixation should be considered as the most useful method to protect the reconstructive surgical site in limb salvage of the diabetic foot. The objective of this review is to highlight the role of surgical offloading using circular external fixation as an adjunct to the podoplastic diabetic foot reconstruction procedures.
My Website: https://www.selleckchem.com/products/isrib.html