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As hospitals seek to control variable expenses, orthopaedic surgeons have come under scrutiny because of relatively high implant costs. We aimed to determine whether feedback to surgeons regarding implant costs results in changes in implant selection.
Implant wastage is an under-reported issue in orthopaedics, yet it has been shown to have a significant cost burden on healthcare budgets. In a background of a perilous financial climate in the UK health service, our aim was to define the frequency and costs of implant wastage in orthopaedic trauma.
Mechanical fixation of the implant to host bone is an important contributor to orthopaedic implant survivorship. The relative importance of bone-implant contact, trabecular bone architecture, and cortical bone geometry to implant fixation strength has never been directly tested, especially in the settings of differential implant surface properties. Thus, using a rat model where titanium rods were placed into the intramedullary canal of the distal femur, we determined the relative contribution of bone-implan...
Conventional imaging techniques are routinely used in the diagnostic work-up of patients with suspected osteomyelitis or orthopaedic implant-associated infections. Hybrid nuclear medicine imaging techniques are a suitable alternative to routine imaging modalities as they provide anatomical and functional information within one procedure. Our study investigated the performance of anti-granulocyte SPECT/CT using Tc-labelled monoclonal antibodies in the diagnosis of osteomyelitis and orthopaedic implant-associ...
Implant selection is the first opportunity for surgeons to control costs of fracture fixation. The current literature has demonstrated surgeons' poor understanding of implant costs. Our study evaluated implant cost variability for surgically treated ankle fractures and distal tibia fractures. Our hypothesis was that significant cost variation exists among providers. The goal was to identify cost drivers and determine whether specialty training is linked to implant selection.
In 2016, the AG 11 (work group for implant-material-intolerance) of the German society for Orthopaedics and Orthopaedic Surgery (DGOOC) created a histopathologic implant register (HIR). The goal was to conduct a retrospective data analysis based on the revised SLIM-consensus-classification, which defines eight different failure mechanisms.
Orthopaedic implant use increases infection risk. Implant infection risk can be explained by the "race for the surface" concept, where there is competition between host-cell integration and bacterial colonisation. Although generally accepted, the temporal dynamics have not been elucidated in vivo. Using a bilateral intramedullary rat model, Staphylococcus aureus was injected into the tail vein either immediately after or 1, 3 and 7 d following implant placement. This allowed assessment of the temporal inter...
Infection and inflammation are a common occurrence with orthopaedic procedures. Anatomical modalities can show the transformation in the disease process; however, these may occur later when compared with functional imaging modalities that are more likely to identify early disease patterns. Various molecular imaging modalities such as three-phase bone scintigraphy, labelled leucocyte scintigraphy, as well as radiolabelled antibiotics and immunoglobulins have been considered and have played key roles in assis...
Significant debate persists about posterior cruciate-retaining (CR) versus posterior cruciate-substituting (PS) implant design for total knee arthroplasty (TKA). This study sought to test the hypothesis that CR TKA will facilitate improved early functional outcomes in gait compared with PS TKA. Patients were randomized to either the CR or PS implant. Various patient-reported and surgeon-reported outcomes as well as gait analyses were obtained pre- and postoperatively. Patients undergoing PS TKA had higher U...
With value-based payment models on the horizon, this study was designed to examine the perceptions of value-based care among orthopaedic traumatologists and how they influence their practice.
Peri-implant mucositis is very common and, when left untreated, can progress to the more serious condition of peri-implantitis. Therefore, early diagnosis, adequate treatment and, in particular, adherence to a peri-implant supportive therapy are extremely important for the management of peri-implant mucositis.
The aim of the present study was (1) to evaluate the relationship between dental implant mucosa and dental implant papilla levels, and (2) to identify the clinical parameters associated with peri-implant soft tissue stability over time.
It is uncertain, which is the optimal attachment for a mandibular 2-implant overdenture (2IOD).
Both fracture-related infections (FRI) and periprosthetic joint infections (PJI) include orthopaedic implant-associated infections. However, key aspects of management differ due to the bone-and soft tissue damage in FRI and the option of removing the implant after fracture healing. In contrast to PJI, research and guidelines for diagnosis and treatment in FRI are scarce.
Radiographs are the most commonly available diagnostic imaging modalities used to evaluate orthopaedic conditions. In addition to suspected findings based on the initial indication to obtain radiographic images, incidental findings may be observed as well, some of which may have notable medical and legal ramifications. This study evaluates the number of incidental findings reported from orthopaedic radiographs ordered in an academic orthopaedic multispecialty group over 1 year.
Dynamic navigation (DN) has been used by many fields previously and recently applied to dental implant surgery. DN allows the implant surgeon to evaluate a patient, scan the patient, plan the implant position, and perform the implant surgery in the same day without the delay or cost of fabrication of a static surgical guide stent. The current DN workflow requires (1) cone-beam computed tomography with fiducials, (2) virtual implant planning, (3) calibration, and (4) implant placement in accordance to the 3-...
This study evaluated the influence of the performance of the first cochlear implant (CI-1) on the second implant (CI-2) and the significance of inter-implant intervals in children with sequential cochlear implantation.
Reducing Implant Infection in Orthopaedics (RIIiO): Results of a Pilot Study Comparing the Influence of Forced Air and Resistive Fabric Warming Technologies on Post-Operative Infections following Orthopaedic Implant Surgery.
Active warming during surgery prevents perioperative hypothermia but the effectiveness and post-operative infection rates may differ between warming technologies. We report results of a pilot study in patients over the age of 65 undergoing hemiarthroplasty following fractured neck of femur.
Orthopaedic surgery has a shortage of women surgeons. An even geographic distribution of women orthopaedic surgeons may provide more uniform care to patients. However, little is known about the geographical distribution of women orthopaedic surgeons.
To describe persistent remnants of dexamethasone intravitreal implant (DEX implant) and evaluate the risk factors for remnant persistence in patients who received a DEX implant.
RigidTack is a newly developed implant for total temporary epiphyseodesis. The implant combines the technical advantages of the traditionally used rigid Blount-staples and the newer flexible eight-plates . Thus the implant is rigid like the Blount-staples, which may be a biomechanically advantage in temporary epiphyseodesis, and has an easy and guided implantation-technique like the eight-plate . As in eight-plates , supposedly only two RigidTacks are sufficient for temporary epiphyseodesis compared to six ...
Several studies have identified discrepancies in salary between male and female surgeons. Our aim was to investigate the impact of sex on an orthopaedic surgeon's yearly earnings by evaluating stratified income and specialty data from a large sample survey of orthopaedic surgeons.
Implant surface roughness after air abrasive therapy has not been measured precisely in previous research. Debridement with air abrasion facilitates the mechanical removal of bacterial biofilms but may damage implant surfaces on a microscopic level.
Advanced practice physiotherapists (APP) have helped improve accessibility to orthopaedic outpatient care. Several studies have validated the APP practice model in orthopaedic care, demonstrating high agreement between APPs and orthopaedic surgeons (OS) regarding diagnosis and management. However, as APPs tend to be experienced senior physiotherapists, such a study involving physiotherapy students (PS) has not yet been explored. The objective of this study was to evaluate the agreement for orthopaedic diagn...
Osseointegrated implants for transfemoral amputees facilitate direct load transfer between the prosthetic limb and femur; however, implant loosening is a common complication, and the associated implant-bone loads remain poorly understood. This case study aimed to use patient-specific computational modeling to evaluate bone-implant interface loading during standing and walking in a transfemoral amputee with an osseointegrated implant prior to prosthesis loosening and revision surgery.