Tag Archives: orthopaedics

VOSCON 2019

VOSCON 2019

We participated in VOSCON 2019  Event held at City Sports Club(CSC) resort, NH-6, Amravti Road, Akola on 19th & 20th October 2019.

We exhibited our Spinal Implants, Trauma Implants, Intramedullary Nailing system, Hip & Knee Replacement System and instruments.

Postoperative Care for Spinal Fusion Surgery

The extended healing period required after lumbar spinal fusion surgery makes postoperative care especially important. While spinal fusion surgery has a high success rate for stabilizing 2 or more adjacent vertebrae and enabling a return to previous normal activity levels, the recovery time can vary based on many factors. These factors include the extent of the surgery, other medical conditions, and how closely the care instructions are followed.

Spinal Fusion Recovery Time

Most people are able to return home from the hospital about 2 to 4 days after lumbar spinal fusion surgery (if there are other people at home). Driving may be resumed a couple weeks after that if off opioid medications. It typically takes about 4 to 6 weeks to return to an office or sedentary job, but it can take 3 months or longer to return to activities that are more physical.

Despite the name of the surgery, the spine is not actually fused during a lumbar spinal fusion procedure. Instead, during the surgery a bone graft or substitute is placed in the spine that facilitates bone growth between the adjacent vertebrae to eventually form one bone, a process that usually takes about 3 to 6 months. The new bone will immobilize the spine at that segment. Screws, cages, plates, and rods may be implanted during surgery to stabilize the area while the bone heals and becomes solid. Some patients also wear a brace during recovery that limits motion.

The bone continues to mature and solidify over 12 to 18 months after the surgery. Many people with a single-level fusion are able to return to all activities even vigorous ones such as weightlifting or construction work—about 6 months after surgery.

Walking and Moving After Spinal Fusion Surgery

Keeping the spine aligned correctly is important after surgery in order to minimize its workload and reduce the risk of disrupting the healing process. Patients work with physical and occupational therapists each day to learn the safest ways to dress, sit, stand, walk, and take part in other activities without putting added stress on the back. Even getting out of bed requires a special technique—known as log-rolling—to avoid twisting the spine.

In some cases, the physical therapist may advise the patient to use a walker for stability. The occupational or physical therapist also helps arrange medical equipment for later use in the person’s home, if needed.

Many people find it helpful to bring sturdy slip-on shoes with them to the hospital, since surgeons and hospital staff encourage patients to get up and walk around as quickly as possible after the surgery.

 

From : spine-health.com

Sarcopenia’s Role in Knee OA Progression

The incidence of total knee arthroplasty to treat end-stage knee osteoarthritis (OA) continues to rise even in the face of patient risk-stratification tools and alternative payment models. Consequently, payers, patients, and their doctors are placing a premium on methods to prolong the native knee joint and delay or avoid surgery. This partly explains the explosion of interest in biologics and the subsequent checkreins being put in place regarding their use.

As the AAOS clinical practice guidelines for the management of knee arthritis clearly state, the best management for symptoms of knee arthritis remains weight loss and self-directed physical activity. However, there is uncertainty regarding which subtypes of patients are likely to achieve OA symptom benefits with different weight-loss strategies.

A recent large, multicenter cohort study published in Arthritis & Rheumatology attempted to further characterize patient body composition and its association with knee OA.  Using whole-body dual x-ray absorptiometry (DXA) measures of fat and muscle mass, researchers classified patients into one of four categories: nonobese nonsarcopenic, sarcopenenic nonobese, nonsarcopenic obese, or sarcopenic obese. Sarcopenia is the general loss of muscle mass associated with aging. If orthopaedic surgeons better understand how fat and muscle metabolism change with time and affect inflammation and chronic disease, they may be able to provide patients with additional insight into preventive measures.

Using DXA-derived calculations, the authors observed that among older adults, the relative risk of developing clinically significant knee osteoarthritis (Kellgren-Lawrence grade ≥2) at 5 years was about 2 times greater in both sarcopenic and nonsarcopenic obese male and female patients compared to nonobese, nonsarcopenic patients.  Sarcopenia alone was not associated with risk of knee OA in women or men. In a sensitivity analysis focusing on BMI, men showed a 3-fold greater risk of knee OA if they were sarcopenic and obese, relative to nonobese nonsarcopenic patients.

The takeaway from this study is that focusing solely on fat/weight loss may overlook a valuable opportunity to slow the progression of knee arthritis in some patients.  Further studies are needed to validate the contribution of low muscle mass to the development and progression of symptomatic knee arthritis.

 Credit to : Jeffrey Stambough, MD(royortho.com)

Postoperative Care for Hip Replacement

Before hip replacement surgery even takes place, a surgeon and patient will talk about a recovery and rehabilitation plan. This plan can help the patient:

  • Leave the hospital sooner
  • Regain hip strength and function more quickly
  • Reduce the risk of developing a post-surgical limp
  • Resume independent living sooner

People are typically able to take care of themselves and resume most activities 6 weeks after surgery, and are 90% recovered after 3 months. It can take up to a full year before they are 100% recovered.

Faster and slower recoveries
Healing and rehabilitation times vary among patients. Deviation from the “typical” recovery timeline cannot always be predicted, but differences are usually okay as long as the patient, physical therapist, and doctor continue to work together towards a full recovery.

Waking Up from Hip Replacement Surgery

A patient may wake up from anesthesia with a triangle-shaped pillow between his or her legs, keeping the legs slightly spread. This pillow is meant to stabilize the hips. A doctor may suggest a patient use the pillow while sleeping and resting in bed during the days following surgery.

In the hours after surgery, the patient will begin to regain feeling in his or her legs. The doctor will pre-emptively treat pain using a combination of pain-relief methods that complement each other and minimize side effects, an approach that is called multimodal analgesia.

If pain is reasonably under control, the patient may be asked to do gentle exercises in bed, such as:

  • Bending and flexing the ankle (ankle pump)
  • Contracting and relaxing the quadriceps muscles
  • Contracting and relaxing the gluteal muscles

Gentle exercises may be done for few minutes each hour (interrupting sleep is not necessary) to facilitate blood flow.

The patient may be asked to stand up and take a few steps with the aid of a physical therapist and/or a walker. Patients who get up and bear some weight (with assistance) on their new hips soon after surgery tend to recover more quickly than patients who do not.

How Much Weight Can Be Put On the New Hip?

A surgeon or nurse will give each patient weight-bearing guidelines to follow in the hospital and at home. Initially, a patient may be advised to put just a small percentage of weight on the affected leg, with incrementally more weight being applied over time.

Exactly how much pressure the new hip can bear will depend on factors such as:

  • The type of surgery and prostheses used
  • The condition of the patient’s natural bone
  • How the prostheses was fixated to the natural bone

For example, patients who have a cementless prostheses may need to wait longer to put weight on the hip, because the bone tissue needs time to grow and bond with the prostheses.

Full Credit To : arthritis-health.com

Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage

Platelet-rich plasma (PRP) is a concentrate of autologous blood growth factors which has been shown to provide some symptomatic relief in early osteoarthritis (OA) of the knee. Platelet-rich plasma therapy is a simple and minimally invasive intervention which is feasible to deliver in primary care to treat osteoarthritis of the knee joint.

Researchers ascertained if patient satisfaction with platelet-rich plasma (PRP) therapy was correlated with the degree of cartilage damage quantified with magnetic resonance imaging (MRI). A pre-treatment MRI was performed and analyzed according to Peterfy and colleagues by a senior consultant radiologist with the whole-organ MRI scoring method (WORMS) to assess the level of osteoarthritis. They performed PRP in 59 patients using a low-leukocyte autologous conditioned plasma system. Findings suggested that intraarticular injection of PRP may improve symptoms of osteoarthritis and decrease pain in patients with knee joint osteoarthritis regardless of the level of cartilage damage quantified by the whole-organ MRI scoring method WORMS.

Credit to : www.mdlinx.com

Orthopedic Implants to Dominate the Global 3D Printed Medical Devices Market

Increasing prevalence of chronic diseases and rising awareness regarding personal care will drive future growth.

The global 3D printed medical devices market is expected to expand at a compound annual growth rate (CAGR) of 18.1 percent through 2027. An increasing prevalence of chronic diseases and rising awareness regarding personal care are major factors twill drive growth of the market during this period, according to Future Market Insights.

Increased Ability to Innovate Aids the Global 3D Printed Medical Devices Market
With increasing popularity of 3D printing, medical devices manufacturers are particularly focused on innovations. Substantial need for individualized yet economical medical solutions is met through 3D printing. Complex features of integration such as hard and soft areas, solid and porous structures, multi-material and multi-color, which seemed to be difficult by implementing conventional manufacturing techniques, is made simpler through 3D printing. Patient-specific implants are being manufactured based on computed tomography (CT) and magnetic resonance imaging (MRI) scans provided by surgeons, which results in reduction of the overall surgical cost. This has increased the popularity of 3D printed medical devices all around the world.

The global 3D printed medical devices market is segmented based on application, technology, material type, end user and region. On the basis of application, the market has been segmented into orthopedic Implants, dental implants and cranio-maxillofacial implants. Orthopedic implants application segment accounted for a higher revenue share in global 3D printing devices as compared to others in application segment. Orthopedic implants segment in the application category of the global 3D printed medical devices market was estimated to be valued at nearly $170 million in 2017 and is slated to reach a valuation of nearly $970 million in 2027, exhibiting a 19.2 percent CAGR during the period of assessment.

Based on the material type, 3D printed medical devices market is segmented into metals and alloys, biomaterial inks and plastics. The biomaterial inks segment was estimated to be valued at nearly $65 million in 2017 and is anticipated to reach a valuation of nearly $400 million in 2027, displaying a CAGR of 20 percent during the period of forecast.

Based on the end user, 3D printed medical devices market is segmented into hospitals, ambulatory surgical centres and diagnostic centres. Hospital end user segment accounts for higher demand for 3D printing devices as compared to other distribution channel segments such as ambulatory surgical centres and diagnostic centres, registering a CAGR of 18.7 percent over the forecast period.

On the basis of region, the global 3D printed medical devices market has been segmented into North America, Latin America, Western Europe, Eastern Europe, Asia Pacific excluding Japan, Japan and the Middle East and Africa. Revenues in Western Europe are expected to grow at a CAGR of 18.6 percent, whereas Eastern Europe is anticipated to grow at 15.5 percent over the forecast period. The Western Europe 3D printed medical devices market was estimated to be valued at nearly $65 million in 2017 and is slated to reach a value of nearly $360 million in 2027. The Eastern Europe 3D printed medical devices market was estimated to be valued at nearly $40 million in 2017 and is anticipated to reach a value of nearly $160 millin in 2027.

Some of the players in the global 3D printed medical devices market include 3D Systems Inc., Arcam AB, Stratasys Ltd., FabRx Ltd., EOS GmbH Electro Optical Systems, EnvisionTEC, Cyfuse Biomedical K.K. and Formlabs Inc., among others. Key players are focusing on strengthening their position by establishing new facilities in North America region. Moreover, companies are targeting Asia-Pacific region and Europe by distribution agreements with local players. In order to increase their revenue, major players in the North America region are entering into agreements with hospitals and academic institutes.

Future Market Insights provides market intelligence and consulting services, serving clients in over 150 countries. FMI is headquartered in London and has delivery centers in the United States and India.

From : www.odtmag.com

Surgical treatment of avulsion fracture around joints of extremities using hook plate fixation

Purpose

This study proposed to access the clinical outcome of avulsion fractures around joints of extremities using the hook plate.

Methods

A total of 60 patients with avulsion fractures of joints admitted in their hospital between January 2011 and June 2016 were performed the surgery of hook plate fixation. Functional recovery was evaluated using the Lysholm knee score, Kaikkonen ankle injury score, Mayo elbow and wrist function score, and Neer shoulder function score.

Results

All the patients were healed within 3 months after surgery with stage They healing incision without vascular or nerve injuries. The average follow-up period was 18.1 months. At the last follow-up, no instability of joints, looseness of internal fixation or traumatic arthritis was observed. Mild joint fibrosis occurred in 5 cases. A total of 57 patients were well recovered with the excellent and good rate of 95%. Three patients with humeral avulsion fracture of the greater tuberosity had shoulder joint adhesion and peri humeral inflammation at the last follow-up due to the poor cooperation for early rehabilitation exercise. In the last follow-ups, the functional score of the affected limb was markedly greater than that in the 3-month follow-ups (p < 0.05).

Conclusion

Hook plate fixation has the therapeutic effect on treating avulsion fractures around joints of extremities with the advantages of reliable fixation, early rehabilitation after operation, high recovery rates of joint function, wide indications, and convenient uses.

Copyright : MDLinx.com

Efficacy and tolerability of duloxetine in patients with knee osteoarthritis

Researchers assessed the effectiveness and tolerability of duloxetine in patients with knee osteoarthritis (OA), one of the most common joint diseases. Data from six randomized controlled trials were pooled, including 2059 participants. According to findings, duloxetine is effective in managing chronic pain and physical function loss in knee OA with acceptable adverse events despite having no advantage in the treatment of joint rigidity.

 

Read the Full Article On :

https://www.mdlinx.com/journal-summaries/knee-osteoarthritis-duloxetine-meta-analysis-randomized/2019/05/08/7564361?spec=orthopedics

In MDLinx (A meta-analysis of randomized controlled trials)

What is a Distal Radius Fracture?

The radius is one of two forearm bones and is located on the thumb side. The part of the radius connected to the wrist joint is called the distal radius. When the radius breaks near the wrist, it is called a distal radius fracture.

The break usually happens due to falling on an outstretched or flexed hand. It can also happen in a car accident, a bike accident, a skiing accident or another sports activity.

A distal radius fracture can be isolated, which means no other fractures are involved. It can also occur along with a fracture of the distal ulna (the forearm bone on the small finger side). In these cases, the injury is called a distal radius and ulna fracture.

Depending on the angle of the distal radius as it breaks, the fracture is called a Colles or Smith fracture.

  • Colles fracture may result from direct impact to the palm, like if you use your hands to break up a fall and land on the palms. The side view of a wrist after a Colles fracture is sometimes compared to the shape of a fork facing down. There is a distinct “bump” in the wrist similar to the neck of the fork. It happens because the broken end of the distal radius shifts up toward the back of the hand.
  • Smith fracture is the less common of the two. It may result from an impact to the back of the wrist, such as falling on a bent wrist. The end of the distal radius typically shifts down toward the palm side in this type of fracture. This usually makes for a distinct drop in the wrist where the longer part of the radius ends.

What are the symptoms of a distal radius fracture?

  • Immediate pain with tenderness when touched
  • Bruising and swelling around the wrist
  • Deformity — the wrist being in an odd position

What is the treatment for a distal radius fracture?

Decisions on how to treat a distal radius fracture may depend on many factors, including:

  • Fracture displacement (whether the broken bones shifted)
  • Comminution (whether there are fractures in multiple places)
  • Joint involvement
  • Associated ulna fracture and injury to the median nerve
  • Whether it is the dominant hand
  • Your occupation and activity level

Surgery for Distal Radius Fractures

This option is usually for fractures that are considered unstable or can’t be treated with a cast. Surgery is typically performed through an incision over the volar aspect of your wrist (where you feel your pulse). This allows full access to the break. The pieces are put together and held in place with one or more plates and screws.

In certain cases, a second incision is required on the back side of your wrist to re-establish the anatomy. Plates and screws will be used to hold the pieces in place. If there are multiple bone pieces, fixation with plates and screws may not be possible. In these cases, an external fixator with or without additional wires may be used to secure the fracture. With an external fixator, most of the hardware remains outside of the body.

After the surgery, a splint will be placed for two weeks until your first follow-up visit. At that time, the splint will be removed and exchanged with a removable wrist splint. You will have to wear it for four weeks. You will start your physical therapy to regain wrist function and strength after your first clinic visit. Six weeks after your surgery, you may stop wearing the removable splint. You should continue the exercises prescribed by your surgeon and therapist. Early motion is key to achieving the best recovery after surgery.

Written By : Johns Hopkins Medicine

Clavicle Fracture

A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. This type of fracture is fairly common—accounting for about 5 percent of all adult fractures. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks. A broken collarbone can be very painful and can make it hard to move your arm.Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. With some clavicle fractures, however, the pieces of bone move far out of place when the injury occurs. For these more complicated fractures, surgery may be needed to realign the collarbone.

Anatomy

The clavicle is located between the ribcage (sternum) and the shoulder blade (scapula). It is the bone that connects the arm to the body.

The clavicle lies above several important nerves and blood vessels. However, these vital structures are rarely injured when a fracture occurs.

Description

Clavicle fractures are fairly common and occur in people of all ages. Most fractures occur in the middle portion, or shaft, of the bone. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade.

Clavicle fractures vary. The bone can crack just slightly or break into many pieces (comminuted fracture). The broken pieces of bone may line up straight or may be far out of place (displaced fracture).

Cause

Clavicle fractures are most often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In a baby, a clavicle fracture can occur during the passage through the birth canal.

Symptoms

A clavicle fracture can be very painful and may make it hard to move your arm. Other signs and symptoms of a fracture may include:

  • Sagging of the shoulder downward and forward
  • Inability to lift the arm because of pain
  • A grinding sensation when you try to raise the arm
  • A deformity or “bump” over the break
  • Bruising, swelling, and/or tenderness over the collarbone

    We offer a wide variety of safe and advanced Orthopedic Implants and fixators. At the helm of the company’s operations is Mr. Vinodbhai, the Director. His enterprising skills and experience in the industry continue to play a pivotal role in the company’s growth.We are based in Ahmedabad city West Part of India.

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