Rodica Marinescu

Bio: Rodica Marinescu is an academic researcher from Carol Davila University of Medicine and Pharmacy. The author has contributed to research in topics: Medicine & Materials science. The author has an hindex of 8, co-authored 23 publications receiving 409 citations.

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery.

Abstract: This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.

Minimally invasive-percutaneous surgery - recent developments of the foot surgery techniques.

Abstract: Percutaneous techniques are currently more and more used in many surgical procedures on the soft tissues and bones of the foot. Practical advantages include lower complication rates and faster recovery times. Potential disadvantages are related to the need for specific equipment and extensive learning curve. One of the most frequent techniques involves a combination of chevron osteotomy of the first metatarsal with osteotomy of the first phalanx, both internally fixated. Lateral metatarsal misalignment and toe deformities can also be addressed by percutaneous treatment, with lower morbidity rates than open techniques. The most commonly performed percutaneous procedures are described, with their current indications, outcomes, and recent developments.

Clavicle anatomical osteosynthesis plate breakage - failure analysis report based on patient morphological parameters

Abstract: Clavicle fracture reported incidence is about 5% of fractures in adult; among them, those located in the middle third of the shaft represent more than 80% from the total of cases. Due to the special morphological and biomechanical constraints of the clavicle, several methods for restoring morphological integrity in these fractures are described, including conservative, non-surgical treatment. The last 10 years of clinical studies in the field have favored the surgical treatment for selected cases; several osteosynthesis implants are in use - mostly anatomical plates with specific advantages and documented complications. A failed anatomical clavicle plate was explanted and analyzed after a protocol using stereomicroscopy, scanning electron microscopy and energy dispersive spectrometry. Based on the computed tomography (CT) scan determination of patient morphological parameters, a finite elements analysis of the failure scenario was completed. The failure analysis has proved that the plate breakage had occurred in the point of maximal elastic stress and minor deformation. The clinical implication is that no hole should remain free of screw during clavicle plate fixation and the implant should be chosen based on patient morphological parameters. In comminuted clavicle fracture, anatomic bridging with locked plate technique may lead to implant failure due to increase of the stress in the midshaft area. Thorough knowledge of anatomy and morphology of complex bones like the clavicle is necessary. Modern osteosynthesis anatomical implants are still to be improved.

A late and difficult diagnosis of ochronosis.

Abstract: Alkaptonuria is a rare autosomal recessive disorder of metabolism caused by deficiency of homogentisic acid oxidase and resulting in accumulation of homogentisic acid in collagenous structures. This causes the classic clinical triad: (1) homogentisic aciduria (urine blackens on standing when oxidized or alkalinized); (2) eumelanin-like pigmentation of skin, sclera, cartilages, etc and (3) degenerative ochronic arthropathies usually in the fourth decade of life. Other important but more rare consequences of alkaptonuric ochronosis are cardiovascular and urinary tract involvement. We present a case of ochronosis with multiple visceral involvement: skin (fingers, ear sclera), severe spondylarthropaty with extensive calcifications of intervertebral discs and reduced mobility, osteoarthritis of both knees, right hip ostonecrosis, cardiovascular involvement (severe stenosis and insufficiency of aortic valve that) and urinary tract involvement (nephrolitiasis)

Meniscal Repair Versus Partial Meniscectomy: A Systematic Review Comparing Reoperation Rates and Clinical Outcomes

Abstract: Purpose The aim of this investigation was to compare reoperation rates and clinical outcomes after meniscal repair and partial meniscectomy Methods A systematic literature review was performed to identify outcome studies of arthroscopic meniscal repair (inside-out, outside-in, and all-inside techniques) or partial meniscectomy in patients with traumatic meniscal tears The studies included patients with no previous injuries or operations Results At short- and long-term follow-up, partial meniscectomy had a lower reoperation rate (14% [2 of 143] and 39% [52 of 1,319], respectively) than isolated meniscal repair (165% [47 of 284] and 207% [30 of 145], respectively) There was a slightly higher reoperation rate after partial lateral meniscectomy compared with partial medial meniscectomy Repairs of the medial meniscus resulted in higher reoperation rates than repairs of the lateral meniscus Meniscal repairs at the time of anterior cruciate ligament reconstruction had a lower failure rate than isolated repairs In the limited number of studies with long-term clinical outcome scores, meniscal repair was associated with higher Lysholm scores and less radiologic degeneration than partial meniscectomy Conclusions Whereas meniscal repairs have a higher reoperation rate than partial meniscectomies, they are associated with better long-term outcomes Level of Evidence Level IV, systematic review of Level I–IV studies

Surgical and tissue engineering strategies for articular cartilage and meniscus repair.

Abstract: Injuries to articular cartilage and menisci can lead to cartilage degeneration that ultimately results in arthritis. Different forms of arthritis affect ~50 million people in the USA alone, and it is therefore crucial to identify methods that will halt or slow the progression to arthritis, starting with the initiating events of cartilage and meniscus defects. The surgical approaches in current use have a limited capacity for tissue regeneration and yield only short-term relief of symptoms. Tissue engineering approaches are emerging as alternatives to current surgical methods for cartilage and meniscus repair. Several cell-based and tissue-engineered products are currently in clinical trials for cartilage lesions and meniscal tears, opening new avenues for cartilage and meniscus regeneration. This Review provides a summary of surgical techniques, including tissue-engineered products, that are currently in clinical use, as well as a discussion of state-of-the-art tissue engineering strategies and technologies that are being developed for use in articular cartilage and meniscus repair and regeneration. The obstacles to clinical translation of these strategies are also included to inform the development of innovative tissue engineering approaches.

A Systematic Survey of FDM Process Parameter Optimization and Their Influence on Part Characteristics

Abstract: Fused deposition modeling (FDM) is an additive manufacturing (AM) process that is often used to fabricate geometrically complex shaped prototypes and parts. It is gaining popularity as it reduces cycle time for product development without the need for expensive tools. However, the commercialization of FDM technology in various industrial applications is currently limited due to several shortcomings, such as insufficient mechanical properties, poor surface quality, and low dimensional accuracy. The qualities of FDM-produced products are affected by various process parameters, for example, layer thickness, build orientation, raster width, or print speed. The setting of process parameters and their range depends on the section of FDM machines. Filament materials, nozzle dimensions, and the type of machine determine the range of various parameters. The optimum setting of parameters is deemed to improve the qualities of three-dimensional (3D) printed parts and may reduce post-production work. This paper intensively reviews state-of-the-art literature on the influence of parameters on part qualities and the existing work on process parameter optimization. Additionally, the shortcomings of existing works are identified, challenges and opportunities to work in this field are evaluated, and directions for future research in this field are suggested.