Vanishing bone disease(Gorham-Stout syndrome) is a rare entity of unknown etiology, characterized by de struction of osseous matrix and proliferation of vascula structures, resulting in destruction and absorption o bo...Vanishing bone disease(Gorham-Stout syndrome) is a rare entity of unknown etiology, characterized by de struction of osseous matrix and proliferation of vascula structures, resulting in destruction and absorption o bone. Despite the extensive investigation of the patho genetic mechanisms of the disease, its etiology hasn'been clarified and several theories exist. The syndrome can affect one or multiple bones of the patient, includ ing the skull, the upper and lower extremities, the spine and pelvis. The clinical presentation of a patient suffer ing from vanishing bone disease includes, pain, func tional impairment and swelling of the affected region although asymptomatic cases have been reported, as well as cases in which the diagnosis was made after a pathologic fracture. In this short review we summarize the theories regarding the etiology as well as the clini cal presentation, the diagnostic approach and treat ment options of this rare disease.展开更多
Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical proced...Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, aresome of the parameters that might contribute more to achieving the optimal results for the patients.展开更多
In the modern era,preoperative planning is substantially facilitated by artificial reality technologies,which permit a better understanding of patient anatomy,thus increasing the safety and accuracy of surgical interv...In the modern era,preoperative planning is substantially facilitated by artificial reality technologies,which permit a better understanding of patient anatomy,thus increasing the safety and accuracy of surgical interventions.In the field of orthopedic surgery,the increase in safety and accuracy improves treatment quality and orthopedic patient outcomes.Artificial reality technologies,which include virtual reality(VR),augmented reality(AR),and mixed reality(MR),use digital images obtained from computed tomography or magnetic resonance imaging.VR replaces the user’s physical environment with one that is computer generated.AR and MR have been defined as technologies that permit the fusing of the physical with the virtual environment,enabling the user to interact with both physical and virtual objects.MR has been defined as a technology that,in contrast to AR,enables users to visualize the depth and perspective of the virtual models.We aimed to shed light on the role that MR can play in the visualization of orthopedic surgical anatomy.The literature suggests that MR could be a valuable tool in orthopedic surgeon’s hands for visualization of the anatomy.However,we remark that confusion exists in the literature concerning the characteristics of MR.Thus,a more clear description of MR is needed in orthopedic research,so that the potential of this technology can be more deeply understood.展开更多
Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,ther...Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,therapeutic protocols have not yet been completely clarified. Conservative as well as surgical treatment has been recommended, while several operative techniques have been applied. We present a case of a 39-yearold man with an isolated lesser tuberosity fracture who was treated surgically in our institution. Due to fracture comminution, a two-level reconstruction technique with headless screws and buttress plate was applied. As far as we know, this method of fixation of this type of fracture has not been previously described in the literature.The patient tolerated the procedure well and excellent results were obtained at the latest follow-up.展开更多
文摘Vanishing bone disease(Gorham-Stout syndrome) is a rare entity of unknown etiology, characterized by de struction of osseous matrix and proliferation of vascula structures, resulting in destruction and absorption o bone. Despite the extensive investigation of the patho genetic mechanisms of the disease, its etiology hasn'been clarified and several theories exist. The syndrome can affect one or multiple bones of the patient, includ ing the skull, the upper and lower extremities, the spine and pelvis. The clinical presentation of a patient suffer ing from vanishing bone disease includes, pain, func tional impairment and swelling of the affected region although asymptomatic cases have been reported, as well as cases in which the diagnosis was made after a pathologic fracture. In this short review we summarize the theories regarding the etiology as well as the clini cal presentation, the diagnostic approach and treat ment options of this rare disease.
文摘Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, aresome of the parameters that might contribute more to achieving the optimal results for the patients.
文摘In the modern era,preoperative planning is substantially facilitated by artificial reality technologies,which permit a better understanding of patient anatomy,thus increasing the safety and accuracy of surgical interventions.In the field of orthopedic surgery,the increase in safety and accuracy improves treatment quality and orthopedic patient outcomes.Artificial reality technologies,which include virtual reality(VR),augmented reality(AR),and mixed reality(MR),use digital images obtained from computed tomography or magnetic resonance imaging.VR replaces the user’s physical environment with one that is computer generated.AR and MR have been defined as technologies that permit the fusing of the physical with the virtual environment,enabling the user to interact with both physical and virtual objects.MR has been defined as a technology that,in contrast to AR,enables users to visualize the depth and perspective of the virtual models.We aimed to shed light on the role that MR can play in the visualization of orthopedic surgical anatomy.The literature suggests that MR could be a valuable tool in orthopedic surgeon’s hands for visualization of the anatomy.However,we remark that confusion exists in the literature concerning the characteristics of MR.Thus,a more clear description of MR is needed in orthopedic research,so that the potential of this technology can be more deeply understood.
文摘Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,therapeutic protocols have not yet been completely clarified. Conservative as well as surgical treatment has been recommended, while several operative techniques have been applied. We present a case of a 39-yearold man with an isolated lesser tuberosity fracture who was treated surgically in our institution. Due to fracture comminution, a two-level reconstruction technique with headless screws and buttress plate was applied. As far as we know, this method of fixation of this type of fracture has not been previously described in the literature.The patient tolerated the procedure well and excellent results were obtained at the latest follow-up.
