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Calcium Phosphate and Bioactive Glasses
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Osmar A. Chanes-Cuevas, José L. Barrera-Bernai, Iñigo Gaitán-S., David Masuoka
Some clinical studies have reported the use of CaP cement in fractures of the distal radius; in a prospective study 110 patients over 50 years with fracture of the distal radius were randomized to form two groups; a group with conventional immobilization treatment and another group with CaP cement treatment where patients treated with calcium phosphate, 82% had a satisfactory result, compared with a 56% result in the conventional immobilization group (Sanchez-Sotelo et al. 2000). Another small prospective randomized study compared calcium phosphate cement (Bone Source) with an autograft in the treatment of fractures with metaphyseal defects. Twenty-nine patients with 30 defects were evaluated for reduction radiographic loss and clinical outcome at 6 months follow-up. The majority of patients had sustained fracture of the tibial plateau or distal radius. Joint reduction was maintained in 83% of patients treated with calcium phosphate cement (Bone-Source), compared with 67% of those treated with autograft (Dickson et al. 2002). Despite the progress made towards the manufacture of CaP cements that possesses a variety of surface and chemical characteristics, the influence ofmaterial properties in the organization of cellular events such as adhesion and differentiation is still poorly understood (Samavedi et al. 2013).
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The knee consists of the tibiofemoral joint between the long bones of the lower extremity, where the femoral condyles articulate with the tibial plateau. The patellofemoral joint lies between the intertrochanteric groove of the femur and the patella (kneecap). The primary movement at the knee is flexion-extension in the sagittal plane (see planes and axes of movement). Typically, the knee has a range of motion of about 140° of flexion-extension, from about 5° of hyperextension to 135° of flexion. Secondary movements at the knee are abduction-adduction and internal-external rotation.
Proximal tibial fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Matthew D. Karam, J. Lawrence Marsh
Ligamentous injuries about the knee are commonly associated with tibial plateau fractures.14,15 For example, in lateral split depression injuries or local lateral compression fractures from a valgus load on the knee, a common injury pattern in the elderly population, a medial collateral ligament (MCL) injury may occur. However the incidence of MCL injury is generally thought to be higher in patients with normal bone stock since osteopenic bone protects ligamentous structures about the knee, as failure occurs through the bone rather than soft tissue.3
Open-Wedge HTO with Absorbable β-TCP/PLGA Spacer Implantation and Proximal Fibular Osteotomy for Medial Compartmental Knee Osteoarthritis: New Technique Presentation
Published in Journal of Investigative Surgery, 2021
Ruipeng Zhang, Shilun Li, Yingchao Yin, Jialiang Guo, Wei Chen, Zhiyong Hou, Yingze Zhang
Alignment correction of the varus deformity could also be accomplished without fibular osteotomy in the classical HTO procedure [13,14]. It was considered to be a biomechanically sound joint-preserving treatment for relatively younger patients with symptomatic varus knee OA. However, accurate eversion of the distal tibia to ideal alignment correction is technically demanding because of the resistance of the fibula. Furthermore, plate fixation with bone grafting may be essential to maintain the corrective effect. Secondary surgery is needed to remove the plate after the osteotomy line has healed. We previously found that fibular support for the lateral tibial plateau (asymmetrical subsidence) was the reason for medial compartmental knee OA [12]. Therefore, fibular osteotomy was applied to relieve the pain induced by mild knee OA in this study.
Design and application of personalized surgical guides to treat complex tibial plateau malunion
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Chi-Pin Hsu, Shang-Chih Lin, Aamer Nazir, Chen-Te Wu, Shih-Sheng Chang, Yi-Sheng Chan
Tibial plateau malunion (TPM) is a complex problem for orthopedic surgeons. When the fractured parts of the tibial plateau are depressed, the articular surfaces become unable to transmit the knee loads and increase the stress borne by the articular cartilage. Moreover, axial malalignment of the lower limb occurs, and the weight-bearing axis is shifted to the side of the depression. In cases of height differences of the articular surfaces greater than 2 mm, osteotomy and osteosynthesis are recommended to restore the anatomic position of the fracture parts and the mechanical axis of the lower limb (Abdel-Hamid et al. 2006; Huang et al. 2008; Kfuri and Schatzker 2017; Wang et al. 2017, 2018). Subsequently, the surgeon uses unilateral or bilateral internal fixation to stabilize the reconstructed configuration of the articular surfaces and enhance the bone union (Wang et al. 2017).
Importance of imaging in knee pain
Published in Baylor University Medical Center Proceedings, 2020
E. Jane Gibson, Pallavi Mukkamala, Lisa Lopez, Tove M. Goldson, Samuel N. Forjuoh
Alleviating factors included acetaminophen. On physical examination, the medial right knee was tender but devoid of effusion, erythema, or evidence of infection. The range of motion was 0–120 with minimal crepitus and no joint instability. She was able to bear weight. Osteoarthritis was considered the likely diagnosis. Due to her history of lung cancer and melanoma, radiographs with three views were performed and revealed a 3.8 × 3.4–cm lytic lesion within the proximal meta-epiphyseal region of the right tibia (Figure 1). In addition, the proximity of the lesion to the articular surfaces of the media-tibial plateau placed the patient at risk for future fracture. The patient was referred to hematology/oncology, who considered recurrence of the patient’s previous malignancies vs. possible myeloma and ordered a bone scan and computed tomography scan, which showed increased activity at the right media-tibial plateau corresponding to the lytic abnormality on the radiograph and consistent with metastatic disease. Mildly increased activity was also seen in a linear horizontal distribution at the sixth thoracic vertebral body that was consistent with remote vertebral body compression fracture. Interventional radiological biopsy of the right tibia bone showed metastatic, poorly differentiated carcinoma that was positive for TTF-1 (nuclear) as well as focally positive for Napsin-A (cytoplasmic) on immunostaining, compatible with metastasis from previous lung carcinoma (Figure 2).