scholarly journals Autologous Concentrated Bone Marrow Grafting for the Treatment of Osteonecrosis of the Humeral Head: A Report of Five Shoulders in Four Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Takeshi Makihara ◽  
Tomokazu Yoshioka ◽  
Hisashi Sugaya ◽  
Masashi Yamazaki ◽  
Hajime Mishima
Keyword(s):  
Bone Marrow ◽  
Range Of Motion ◽  
Humeral Head ◽  
Concentration Ratio ◽  
Replacement Surgery ◽  
Concentrated Bone Marrow ◽  
Vas Scores ◽  
Centrifugation Technique ◽  
The Mean ◽  
Bone Marrow Grafting

Five shoulders in four patients affected by advanced osteonecrosis of the humeral head were treated with autologous concentrated bone marrow grafting. Bone marrow sample was aspirated from the iliac crests, concentrated by a centrifugation technique, and injected into the necrotic site. The shoulders were evaluated radiologically with X-ray scoring and clinically with measurement of range of motion and pain score (visual analogue scale, VAS). The mean follow-up period was 49.4 (range, 24–73) months. The concentration ratio of nucleated cells was calculated and the number of transplanted mesenchymal stem cells (MSC) was estimated by a colony-forming assay. All four shoulders with stage 3 disease achieved joint sparing. One shoulder with stage 4 disease required replacement surgery. Clinical evaluation of the spared joints showed improvement in range of motion in two cases and deterioration in two cases. VAS scores were 0 after surgery in three cases. The mean concentration ratio was 2.73, and the mean number of transplanted MSC was 1125. The outcomes of autologous concentrated bone marrow grafting for advanced osteonecrosis of the humeral head were varied. Further research is needed to determine the effectiveness and the indications of the present surgery.

scholarly journals THE EFFECT OF TRANEXAMIC ACID INJECTION ON HEMOGLOBIN LEVEL, ALBUMIN LEVEL, AND PAIN ON PATIENT RECEIVING TOTAL KNEE REPLACEMENT

2019 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Dwikora Novembri Utomo ◽  
Teddy Heri Wardhana ◽  
Ahmad Hannan Amrullah ◽  
Hamzah Hamzah
Keyword(s):  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Blood Transfusions ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Vas Scores ◽  
Total Knee ◽  
The Mean

Background: The high number of knee osteoarthritis cases could lead arthroplasty more frequent. Total Knee Replacement (TKR) surgery procedure is at risk of massive bleeding. Bleeding can affect albumin levels and the onset of intra-compartment pressure on the nerves. The use of tranexamic acid could be done to reduce bleeding.Objective: Proving the effect of intravenous tranexamic acid administration on patients who will undergo TKR surgery.Methods: The experiment was conducted experimentally using primary laboratory data obtained before and after surgery in patient which will be performed TKR operation starting from April 2017.Result: There are 64 patients who had undergone total knee replacement surgery. The mean preoperative hemoglobin in the tranexamic acid group and without tranexamic acid was 13.06±1.46g/dl and 12.44±0.87g/dl. The mean hemoglobin after surgery was 10.29 ±1.14 g/dl and 9.16±0.97 g/dl. In the group receiving tranexamic acid, 32 (100%) reported low postoperative VAS scores, did not require blood transfusions and did not require albumin transfusion. Groups not receiving tranexamic acid, 32 (100%) moderate postoperative VAS scores, 4 people (12.5%) required the blood transfusion, and 3 (9.4%) required transfusion of albumin.Conclusion: The results of this study showed that the group given tranexamic acid had higher hemoglobin levels after surgery than the untreated group of tranexamic acid; there was no difference in albumin levels after surgery in both groups; the administration of tranexamic acid will decrease the amount of blood loss, decrease the degree of pain, and decrease the need for blood transfusions after total knee replacement surgery.

The effect of autologous concentrated bone-marrow grafting on the healing of femoral shaft non-unions after locked intramedullary nailing

Injury ◽  
2014 ◽  
Vol 45 ◽  
pp. S7-S13 ◽  
Author(s):  
João Antonio Matheus Guimarães ◽  
Maria Eugenia L Duarte ◽  
Marco B Cury Fernandes ◽  
Verônica F Vianna ◽  
Tito H N Rocha ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Intramedullary Nailing ◽  
Femoral Shaft ◽  
Concentrated Bone Marrow ◽  
Bone Marrow Grafting

scholarly journals Concentrated Bone Marrow Aspirate Injection for Hallux Sesamoid Disorders

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0039
Author(s):  
Yoshiharu Shimozono ◽  
Dexter Seow ◽  
John G. Kennedy
Keyword(s):  
Quality Of Life ◽  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Shockwave Therapy ◽  
Vas Score ◽  
Concentrated Bone Marrow ◽  
The Mean

Category: Midfoot/Forefoot, Sports Introduction/Purpose: Sesamoidectomy is the most common surgical procedure for the treatment of hallux sesamoid pathology, including fracture, acute separation of bipartite sesamoid, sesamoiditis, and avascular necrosis (AVN). However, there is a concern of complications following sesamoidectomy, such as the development of hallux valgus/varus and transfer metatarsalgia due to the altered mechanical loading on the forefoot. Recent systematic review showed high complication rate of 22.5% following sesamoidectomy, prompting surgeons to find alternative methods. Concentrated bone marrow aspirate (CBMA) may have the potential to treat sesamoid disorders with avoidance of sesamoid resection. However, there is no studies investigating the effect of CBMA for sesamoid disorders. The purpose of this study was to evaluate the functional outcomes following the use of CBMA for hallux sesamoid disorders. Methods: A retrospective cohort study investigating consecutive patients treated with CBMA injection for the treatment of sesamoid disorders were performed. The sesamoid disorders included sesamoiditis, symptomatic bipartite or chronic nonunited sesamoid and AVN. The CBMA injection was indicated for patients with failed a minimum of 3 months non-surgical management including activity limitation, customized orthotics, physiotherapy and extracorporeal shockwave therapy. Clinical outcomes were evaluated using the Foot and Ankle Outcome Scores (FAOS), Short-Form 12 (SF-12), and visual analog scale (VAS) scores preoperatively and at final follow-up. Results: Total of 13 feet were included. The mean age was 26.9 years and mean follow-up time was 19.1 months. Patient demographic is shown in Table 1. Mean symptoms, pain, daily activities, sports activities and quality of life scores in FAOS significantly improved from 63.9, 55.4, 68.4, 37.3, and 30.9 preinjection to 91.2, 84.1 92.9, 72.7, and 64.8 postinjection, respectively at final follow-up (p<0.001). The mean SF-12 and VAS score significantly improved (34.3 to 62.5, 5.7 to 1.5, respectively, p<0.001). Of 9 patients played sports at preinjection, 7 patients returned to play at previous level. Two patients failed the treatment. One had second-CBMA injection and final VAS score was 1.0. Another one required subsequent shockwave-therapy followed by platelet-rich plasma injection with final VAS score of 1.5. Conclusion: No complications and adverse effects were reported in this cohort. In addition, no patients had any signs of progression or new emerge of AVN on plain radiographs. The current study demonstrates that CBMA injection is a safe and effective treatment for hallux sesamoid disorders when conservative treatment fails, with avoidance of sesamoid resection. CBMA injection can be a valid alternative for the treatment of sesamoid disorders, as it permits preservation of the biomechanical stability provided by the sesamoids which is an element inevitably vital for long-term quality of life. Further studies investigating long-term effects of this treatment should be warranted.

Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion

2013 ◽  
Vol 24 (5) ◽  
pp. 671-678 ◽  
Author(s):  
Hisashi Sugaya ◽  
Hajime Mishima ◽  
Katsuya Aoto ◽  
Meihua Li ◽  
Yukiyo Shimizu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Concentrated Bone Marrow ◽  
Bone Marrow Grafting

Range of Motion after the Sauvé–Kapandji and Darrach Procedures without Extensor Tendon Rupture

2020 ◽  
Author(s):  
Tomoyuki Kato ◽  
Taku Suzuki ◽  
Makoto Kameyama ◽  
Masato Okazaki ◽  
Yasushi Morisawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
The Mean ◽  
Therapeutic Study ◽  
Loss Of Motion

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

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