Showing papers by "Victor Valderrabano published in 2012"
TL;DR: This review focuses on the influence of biomechanics on the pathogenesis and progression of OA, and illustrates the pathological bioreactivity of soft tissues, subchondral bone and joint inflammation.
Abstract: Today, the most frequent chronic musculoskeletal disorder and the leading cause of disability in the elderly is osteoarthritis (OA) Approximately 43 million people in the United States and 15% of the world population are affected Due to demographic changes, the incidence of OA is rapidly increasing, leading to an ascending socioeconomical and personal burden Despite the exact cause of OA remains unknown, the pathogenic role of biomechanical dysfunction in OA is well established For weight-bearing joints altered loading mechanisms, increased mechanical forces and changed biomechanics are significant contributing factors for initiation and progression of OA Thus, OA is a disease of the whole joint, including muscles, tendons, ligaments, synovium and bone This review focuses on the influence of biomechanics on the pathogenesis and progression of OA We notably illustrate the pathological bioreactivity of soft tissues, subchondral bone and joint inflammation Procedures, conservative or surgical, which actively alter the biomechanics of the lower limb, are promising strategies to treat symptoms as well as to influence disease progression in OA
173 citations
TL;DR: Retinacular lengthening showed less medial instability, less quadriceps atrophy, and a better clinical outcome at 2 years compared with retinacular release, and it is believed that this may be explained by the controlled preservation of the lateral patellar muscle-capsuloligamentous continuity after retinocular lengthening.
Abstract: Purpose To compare complication rates and outcome of open lateral retinacular (LR) lengthening and open LR release in the treatment of lateral patellar hypercompression syndrome (LPHS). Methods In a prospective double-blinded study, 28 patients (mean age, 48 years; 21 women and 7 men) received either LR release (14 patients) or LR lengthening (14 patients) in alternating fashion over the same lateral parapatellar skin incision for LPHS (blinding of patients to surgical procedure [i.e., single blinding]). Strict inclusion criteria (retinacular pain, tight retinaculum, decreased patellar mobility) were used to exclude other reasons for anterior knee pain (patellar instability, leg malalignment or maltorsion, trochlear dysplasia, patella alta). The surgeon and postsurgical rehabilitation were the same. Preoperatively and at 3, 6, 12, and 24 months postoperatively, complications, muscle atrophy, and Kujala patellofemoral outcome score were documented by examiners blinded to the surgical procedure (double blinding). All patients completed 2 years of follow-up. Results The results of 2 years of follow-up showed that recurrence of LPHS, as indicated by the patellar tilt test and decreased medial patellar glide test, developed in 2 cases after LR release and 1 case after LR lengthening ( P > .999). Medial patellar subluxation, as indicated by the gravitation-subluxation test and increased medial patellar glide test, developed in 5 cases after LR release and no case after LR lengthening ( P = .041). Quadriceps atrophy, as indicated by the mean circumference difference compared with the healthy contralateral side, was significantly higher ( P = .001) in the LR release group (1.8 cm) than in the LR lengthening group (0.2 cm). The mean Kujala score was significantly lower ( P = .035) in the LR release group (77.2 points) than in the LR lengthening group (88.4 points). Conclusions In this prospective double-blinded study, retinacular lengthening showed less medial instability, less quadriceps atrophy, and a better clinical outcome at 2 years compared with retinacular release. We believe that this may be explained by the controlled preservation of the lateral patellar muscle-capsuloligamentous continuity after retinacular lengthening. Level of Evidence Level II, prospective double-blinded comparative study.
96 citations
TL;DR: It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms, and physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass.
Abstract: Osteoarthritis (OA) is a major health burden of our time Age is the most prominent risk factor for the development and progression of OA The mechanistic influence of aging on OA has different facets On a molecular level, matrix proteins such as collagen or proteoglycans are modified, which alters cartilage function Collagen cross-linking within the bone results in impaired plasticity and increased stiffness Synovial or fat tissue, menisci but also ligaments and muscles play an important role in the pathogenesis of OA In the elderly, sarcopenia or other causes of muscle atrophy are frequently encountered, leading to a decreased stability of the joint Inflammation in form of cellular infiltration of synovial tissue or subchondral bone and expression of inflammatory cytokines is more and more recognized as trigger of OA It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms Therefore physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass A reduced stem cell capacity in the elderly is likely associated with a decrease of repair mechanisms of the musculoskeletal system New treatment strategies, for example with mesenchymal stem cells (MSC) are investigated, despite clear evidence for their efficacy is lacking
68 citations
Journal Article•
TL;DR: 1H-NMR is a fast analytic tool with possible implications in synovial fluid diagnostics as a distinctive metabolism is observed in septic arthritis whereas metabolites in OA are similar to those in inflammatory arthritis.
Abstract: Objectives Currently there are no reliable biomarkers in the synovial fluid available to differentiate between septic and non-septic arthritis or to predict the prognosis of osteoarthritis, respectively. Nuclear magnetic resonance (NMR) spectroscopy is an analytical technique that allows a rapid, high throughput metabolic profiling of biological fluids or tissues. Methods Proton (1H)-nuclear magnetic resonance (NMR) spectroscopy was performed in synovial fluid samples from patients with septic arthritis, crystal arthropathy, different forms of inflammatory arthritis or osteoarthritis (OA). The metabolic environment based on the low molecular weight components was compared in disease subsets and principal component analysis (PCA) was performed. Results Fifty-nine samples from patients with OA, gout, calcium pyrophosphate disease, spondylarthritis, septic arthritis and rheumatoid arthritis (RA) were analysed. NMR yielded stable and reproducible metabolites over time. Thirty-five different metabolites as well as paracetamol and ibuprofen were identified in synovial fluid. The metabolic profile of septic arthritis assessed by PCA was distinguishable from the other samples whereas no differences were seen in OA compared to crystal-associated arthritis, RA or spondylarthritis. Conclusions 1H-NMR is a fast analytic tool with possible implications in synovial fluid diagnostics. A distinctive metabolism is observed in septic arthritis whereas metabolites in OA are similar to those in inflammatory arthritis.
65 citations
TL;DR: Ten normal cadaveric knees were assessed using a standard medial parapatellar TKA approach with patellar subluxation, and in general, the lateral compartment could be stretched further than the medial compartment, and the corresponding flexion gap values were significantly larger.
62 citations
TL;DR: Asymmetric ankle osteoarthritis patients had a lower hindfoot dorsiflexion and rotation range of motion as well as reduced peak ground reaction forces and peak kinetic values, and principal component analysis revealed those principal component vectors affecting the amplitudes had significantly lower principal component scores in patients than in controls.
57 citations
TL;DR: A systematic literature review was conducted to assess possible differences in clinical outcomes, including prosthesis survivorship and postoperative range of motion between mobile- and fixed-bearing total ankle prostheses.
Abstract: SUMMARY TAR is undoubtedly gaining acceptance among foot and ankle surgeons as a valuabletreatment option in patients with end-stage ankle OA. Current reports of this proce-dure show consistently good to excellent mid-term results with substantial pain relief,good functional outcome, and high patient satisfaction. 45 The unacceptable highfailure rate of the first-generation ankle prostheses has been thoroughly analyzed,and the TAR designs have been significantly improved. Current fixation withoutcement has become the gold standard using biologic surfaces (eg, introduction ofhydroxyapatite in the 1990s) for better and faster osseous integration of metallic pros-thesis components. 100,101 A variety of prosthesis designs are available. Although in the United States theSTAR prosthesis is the only 3-component total ankle design with FDA approval, 2,77,102 in Europe the most common ankle prostheses are 3-component. 7,102104 The mobileanatomic, nonconstrained, 3-component total ankle designs also predominate inavailable national arthroplasty registers.
51 citations
TL;DR: Due to the small sample sizes, different study designs, and heterogeneity of strength measurement techniques, definite recommendations on surgical technique cannot be made but presented information might help in the decision making process for foot and ankle surgeons.
Abstract: Purpose
The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures.
46 citations
TL;DR: This first intra-subject, randomised, prospective controlled trial comparing daily pin tract care to no Pin tract care at all shows that routinePin tract care is unnecessary in external fixation treatment of injuries.
Abstract: Introduction Pin site infections are seen in up to 40% of external fixators (ExFix) and are therefore the most common complication with this device. There is no consensus in the literature as to the appropriate regimen for pin tract care and infection prevention. This study is the first intra-subject, randomised, prospective controlled trial comparing daily pin tract care to no pin tract care at all. Method Consecutive patients series (56 patients, 16 female, age 4–68y, mean 24y, in total 204 pins) recruited in the National Referral Hospital in Honiara in the Solomon Islands over a 2 year period. Exclusion criteria were application of ExFix for less than two weeks or a non-standard ExFix. Pin treatment was allocated into groups anatomically, proximal and distal. Randomisation was intra-subject and intra-group: 101 pins had daily pin site care and 103 had no treatment at all. Endpoints Soft-tissue interface, stability of the pins, torsional stability as determined with a torque metre, osteolysis and pain. Assessment of pin sites blinded. Statistical analysis using the paired t test for parametric data and the Wilcoxon rank test for non-parametric data (Stat View). Results No significant difference between the two groups. Soft-tissue interface 36% vs. 35% (granulation/secretion), stability 20 vs 25 pins with loosening. No significant osteolysis (7 vs. 6 pins). Torque: mean 0.75 Nm, max.: 3.05 Nm vs. 0.60 Nm, max.: 3.55 Nm, no significant difference. No differences in demographics (age, localisation, sex, time of fixation). Conclusion This study shows that routine pin tract care is unnecessary in external fixation treatment of injuries.
43 citations
TL;DR: The biomechanics and morphology of the arthritic valgus ankle is reviewed in this article and therapeutic strategies, including joint preserving and nonpreserving modalities are presented.
Abstract: The ankle joint is part of a biomechanical hindfoot complex. Approximately 1% of the world's adult population is affected by ankle osteoarthritis (AO). Trauma is the primary cause of ankle OA, often resulting in varus or valgus deformities. Only 50% of patients with end-stage ankle OA have a normal hindfoot alignment. The biomechanics and morphology of the arthritic valgus ankle is reviewed in this article and therapeutic strategies, including joint preserving and nonpreserving modalities are presented. Pitfalls are discussed and the literature is reviewed regarding outcomes in patients with valgus deformity who underwent total ankle replacement.
32 citations
TL;DR: The aim of this study was to characterize the patients' muscle activation during isometric ankle torque measurements and level walking to assess whether surgical interventions of ankle OA can reestablish the muscle activation patterns.
TL;DR: It is concluded that unilateral ankle joint osteoarthritis leads to an overall lower leg muscle atrophy, but significant atrophy of the M. soleus and all muscles of the affected leg undergo a fatty degeneration.
Abstract: Purpose
Muscle atrophy is a commonly encountered problem in osteoarthritis (OA). The aim of this study was to estimate the amount of muscle atrophy and fatty degeneration of the lower leg muscles related to ankle OA by magnetic resonance imaging (MRI).
TL;DR: A new way to measure the ATL in a consistent way in healthy subjects and showed correlations between ATL, TL and body height and defined an algorithm of ATL based on TL, which might be important in patients with impaired tendons such as AT ruptures.
Abstract: Objective: The optimal intraoperative Achilles tendon length (ATL) adjustment is crucial for the physiological functioning of the musculotendinous unit. To date, the resting ATL and its relation to tibia length (TL) have never been defined in healthy subjects. We thus performed metric measurements of the ATL and TL. Design: Case series. Setting: Clinical and radiological measurements. Participants: Fifty-two subjects placed in a 3-T magnetic resonance imaging with the ankle in neutral position. Main Outcome Measures: Unilateral ATL measured from the calcaneal insertion to the beginning of the medial gastrocnemius muscle, TL measured from the intercondylar eminence to the center of the ankle, and qualitative tendon parameters in T2 sequences and human parameters were noted; results were correlated with age, gender, body height, weight, body mass index (BMI), and side of the AT and TL. Results: The mean ATL was 180.6 ± 25.0 mm and the mean TL was 371.9 ± 25.4 mm with an ATL:TL ratio of 49 ± 5%. Achilles tendon length correlated significantly with body height (R 2 = 38%, P , 0.0001) and with TL (R 2 = 41%, P , 0.0001) but did not correlate with age, BMI, and side of the AT. TL correlated with body height (R 2 = 83%, P , 0.0001) and in multivariate linear regression, TL was the only independent predictor of ATL following the algorithm, ATL (mm) = 0.6 · TL (mm) 2 53 (R 2 = 41%). Conclusions: We defined a new way to measure the ATL in a consistent way in healthy subjects and showed correlations between ATL, TL and body height and defined an algorithm of ATL based on TL. The ATL and the ATL-algorithm might be important in patients with impaired tendons such as AT ruptures.
TL;DR: The findings suggest that low levels of joint loading for prolonged periods, as occurs in endurance exercise or physical labour, may cause chondrocyte death, thereby predisposing joints to degeneration.
TL;DR: Treatment of an injured/degenerating disc with cells, cells plus biomaterial or biomaterial alone has a potential for at least a partial regeneration of the disc, but so far, none of the treatments is able to effectively restore the properties of a healthy disc.
TL;DR: The aim of this case report is to describe the use of a large solid bolt for fusion of the medial column of the foot in a patient with collapse of the midfoot due to diabetic neuroarthropathy.
Abstract: Medial column fixation for rocker-bottom deformity in Charcot arthropathy is commonly performed. However, implant failure is commonly encountered because of uncontrolled weight bearing by the patient. The aim of this case report is to describe the use of a large solid bolt for fusion of the medial column of the foot in a patient with collapse of the midfoot due to diabetic neuroarthropathy.
TL;DR: The talar geometry was assessed by measuring the coronal and sagittal talar edge radius and the frontal talar profile in multiplanar reconstructions of computer tomographic studies of 79 patients (83 feet) with a healthy ankle joint.
Abstract: To successfully surgically reconstruct osteochondral lesions of the talus, the exact three-dimensional (3D) configuration of the upper articular surface of the talus has to be respected. We assessed the talar geometry by measuring the coronal and sagittal talar edge radius and the frontal talar profile in multiplanar reconstructions of computer tomographic (CT) studies of 79 patients (83 feet) with a healthy ankle joint. An image visualization software designated for coordinate measurement was used to perform the measurement. In the coronal plane, the mean lateral talar edge radius was 4.0 mm and the medial 4.5 mm. In the sagittal planes the mean lateral talar edge radius was 20.3 mm, the radius of the sulcus 20.7 mm and the medial talar edge radius 20.4 mm. The talus showed a concave shape in coronal cuts. These results show a significant difference between medial and lateral talar edge configuration in coronal planes. The measurements of the lateral and medial sagittal radius and the mid-sagittal radius in the sulcus tali show no statistically significant difference. The depth of the talar sulcus shows no correlation to age or sex. Different sizes of custom-made tissue-engineered grafts according to the location of the osteochondral lesion at the talus are needed for exact surgical reconstruction of the anatomy. Osteochondral lesions are three dimensional; therefore, a 3D preoperative planning tool by CT scan or MRI is mandatory.
TL;DR: The case of a patient with a large isolated osteochondral lesion of the distal tibia treated by a novel operative technique using cancellous bone from the iliac crest and a collagen I/III matrix demonstrates autologous matrix-induced chondrogenesis-aided reconstruction of large osteochondrals of distalTibia to be a promising treatment method.
Abstract: Isolated osteochondral lesions (OCL) of the distal tibia are rare and lack clear treatment guidelines. With the case we present here, we suggest a novel surgical approach and report the successful use of autologous matrix-induced chondrogenesis–aided reconstruction for OCL of the distal tibia. A 29-year-old male patient complained about persisting pain of the left ankle joint and a restricted activity level 12 months after an ankle sprain. Imaging revealed edema of the subchondral bone and thinning of the cartilage above the osseous defect at the lateral distal tibia. The OCL was debrided followed by microfracturing of the underlying sclerotic bone. A cancellous bone plug was harvested from the iliac crest and impacted into the defect. A collagen matrix was then fixed on the defect. After 12 months, the patient was free of pain and returned to full activity. Conventional radiographs at 1 year showed successful osseous integration of the plug and a nearly anatomic shape of the tibial joint line. Delayed gadolinium-enhanced MRI of cartilage scans at 36 months showed an intact cartilage layer over the defect and glycosaminoglycan content, indicating hyaline-like cartilage repair. This case demonstrates autologous matrix-induced chondrogenesis–aided reconstruction of large osteochondral lesions of distal tibia to be a promising treatment method. Our aim was to describe the case of a patient with a large isolated osteochondral lesion of the distal tibia treated by a novel operative technique using cancellous bone from the iliac crest and a collagen I/III matrix.
TL;DR: The midfoot index of load was the most important pedobarographic predictor for belonging to the healthy volunteers rather than the ankle or tibiotalocalcaneal arthrodesis groups and was an independent predictor for the AOFAS score.
TL;DR: Whether implant alignment can be accurately and precisely examined with CT-based CM, and whether correct positioning of a transversal support implant can be attained using a specially developed aiming instrument are determined.
Abstract: The rapid development of navigation systems designed to improve implant alignment calls for precise methods to verify positioning. One new approach to assess knee implant alignment is coordinate measurement (CM) using reference objects on 3-dimensional reconstructions of computed tomographic (CT) image sequences. The objectives of this study were to determine whether implant alignment can be accurately and precisely examined with CT-based CM, and whether correct positioning of a transversal support implant can be attained using a specially developed aiming instrument. Average deviation of CT measurements from those made with a digital caliper remained within the caliper's range of error. This level of accuracy was observer independent. CT-based CM can be used for accurate and precise alignment verification. As well, precise alignment of transversal support can be achieved during implantation with a conventional aiming device, assuming the bony landmarks are appropriately recognized.
TL;DR: A rigid attachment of the joint surface supports of the transversal support tibial plateau appears to offer increased primary stability regarding bone anchoring.
Abstract: AbStrA ct Purpose: t he important roles of the anterior cruciate ligament regarding knee stability, physiologic kinematics, and pro- prioception are unquestioned. t hus, various efforts have been made to retain the A cL during total knee arthroplasty (tKA). neither of the existing solutions to this problem, i.e. bicruciate retaining prostheses and implantation of two unicondylar prostheses, has been successful because of concept-specific problems as well as general difficulties with implant fixation. t he new transversal support tibial plateau concept is a prosthesis of two individual joint surfaces reinforced beneath the articular line by joint surface supports and buttressed by a single transversal support. t his configuration, which enables retention of both cruciate ligaments, should provide good bone fixation and ensure long-term alignment of the individual joint surfaces. Methods: In the current study, four prototypes based on this novel concept were developed and the resulting primary stabil- ity was analyzed using adapted load testing. t he test set-up, with the model-loading of specially prepared Sawbones ® and a sinusoidal oscillating load transmission with 25 000 cycles over 10 increasing load levels, achieved subsidence, which enabled comparison of the four different model variants regarding primary stability in view of bone anchoring. Results: t he model variant (tS mobile ) that allowed transverse glide of the joint surface supports along the transversal support revealed the largest subsidence. Conclusions: A rigid attachment of the joint surface supports of the transversal support tibial plateau thus appears to offer increased primary stability regarding bone anchoring.
TL;DR: Daher muss ein instabiles OSG wenn notig auch operativ versorgt werden um eine regelrechte Gelenkmechanik zu gewahrleisten.
Abstract: Zusammenfassung Sportverletzungen sind immer noch die haufigste Ursache fur die Instabilitat des oberen Sprunggelenkes. Es muss zwischen einer akuten Instabilitat (AI) und einer chronischen Instabilitat (CI) unterschieden werden. Eine exakte klinische Untersuchung ist entscheidend fur die adaquate Therapie und die moglichst fruhzeitige Festlegung der definitiven Behandlung. Primar wird eine konservative Behandlung angestrebt (Level of Evidence (LoE) II), falls keine Begleitverletzungen vorliegen. Die operative Therapie ist bei der akuten Verletzung nur in selektiven Fallen indiziert (LoE II). Eine symptomatische CI des OSG stellt eine Praarthrose dar und der Langzeitverlauf bei nicht adaquater Therapie ist schlecht (LoE IV). Daher muss ein instabiles OSG wenn notig auch operativ versorgt werden um eine regelrechte Gelenkmechanik zu gewahrleisten.
TL;DR: The osteochondrale lasion (OCL) des Talus is eine haufige Erkrankung junger Erwachsener. as discussed by the authors The genese der OCL is multifaktoriell, sowohl genetische, vaskulare, mechanische als auch traumatische Faktoren werden diskutiert.
TL;DR: The World Karate Federation-Europameisterschaft 2011 ergab sich eine Verletzungsrate von 8,5% bei 480 Kampfen (Kumite 10,3%, Kata 1,1%), 70,7% waren leichte VerletZungen wie Epistaxis oder Lippenlazeration, 19, 5% mittelschwere Verletzhauber, z.B. Nasenbeinfrakturen oder nahtpflichtige Wunden,
Abstract: Zusammenfassung Beim Karate denkt man sofort an schwere Verletzungen wie Frakturen, Knock-outs und Bauchverletzungen, welche jedoch eine Seltenheit darstellen. Der Sportler ist vielmehr durch scheinbar leichte Verletzungen beeintrachtigt. „Karate-Do", der „Weg der leeren Hand" wird ohne Waffen ausgetragen, die Einteilung erfolgt anhand des Impacts in Voll-, Halb- und Lowkontakt. Aus einer eigenen Erfassung der World Karate Federation-Europameisterschaft 2011 ergab sich eine Verletzungsrate von 8,5% bei 480 Kampfen (Kumite 10,3%, Kata 1,1%). 70,7% waren leichte Verletzungen wie Epistaxis oder Lippenlazeration, 19,5% mittelschwere Verletzungen wie z.B. Nasenbeinfrakturen oder nahtpflichtige Wunden. Insgesamt lag das Verletzungsrisiko von schweren Verletzungen bei lediglich 0,8% pro Kampf.
01 Jan 2012
TL;DR: In this article, the authors describe operative and non-operative methods of treatment for ankle osteoarthritis including rationale for decision-making, including joint-preserving surgery in valgus ankles and varus ankles.
Abstract: Primary osteoarthritis of the ankle is rare. Post-traumatic conditions play a significant role. The following article describes operative and non-operative methods of treatment for ankle osteoarthritis including rationale for decision-making. Joint-preserving surgery in valgus ankles and varus ankles is presented. Ankle replacement and ankle fusion are discussed as non-joint-preserving treatment options.
01 Jan 2012
TL;DR: Eccentric training is an established gold standard in the treatment of Achilles tendinopathies and sclerosing therapies as well as insoles in combination with physiotherapy, and functional bracing is clearly advantageous over cast immobilization.
Abstract: Summary Achilles tendon (AT) tendinopathies and ruptures are the most common diagnoses in AT disorders. Eccentric training is an established gold standard in the treatment of Achilles tendinopathies (LoE 1). Equally effective are doppler-ultrasound guided operations and sclerosing therapies as well as insoles in combination with physiotherapy (LoE 1). Currently not advisable are orthoses, low-lever laser, night splint therapies or nitroglycerin patches (LoE 1-2). The current trend goes towards non-operative treatment of AT ruptures in the sedentary population and recreational athletes (LoE 1). In elite athletes, an operation with the associated lower rerupture rate is advised (LoE1). No operation technique (open vs. percutaneous) can be advised as the single best. Functional bracing is clearly advantageous over cast immobilization (LoE 1). Platelet-rich plasma (PRP) can at the current point (not yet) be advised, neither for Achilles tendinopathies (LoE 1) nor AT ruptures (LoE 1), even though a positive effect has been shown in animal models.
TL;DR: PRP is a promising and interesting tool for orthopedic surgeons to support established treatment algorithms and large prospective, randomized-controlled trials are essential to assess and decide about the use of PRP in the future.
Abstract: Summary The use of orthobiologics and the progress in tissue engineering have an important and increasing impact in orthopedic surgery. Especially the use of PRP (platelet-rich plasma) is one of the most intense investigated therapeutical options in this field. The application of an autologue, platelet enriched suspension is supposed to cause multiple effects: The induction of a local inflammation process and the release and activation of multiple growth factors within complex signaling cascades. This is included in the wound healing process supporting tissue regeneration. The use and especially a detailed review of the evidence for PRP remains difficult. A clear definition of the cellular composition of PRP in the literature is still missing. Additionally the options to apply PRP are heterogeneous and complicate a final assessment. In the literature a supporting beneficial effect of PRP is described for rotator cuff repair and treatment of tennis-elbow, as well as wound- and bone healing. In Summary PRP is a promising and interesting tool for orthopedic surgeons to support established treatment algorithms. Large prospective, randomized-controlled trials are essential to assess and decide about the use of PRP in the future.
01 Mar 2012
TL;DR: FD-CT—guided joint infiltration is a feasible method for diagnostic infiltration of midfoot and hindfoot joints and may become an alternative to commonly used 2D-fluoroscopically guidance.
Abstract: Purpose
Image guidance is valuable for diagnostic injections in foot orthopaedics Flat-detector computed tomography (FD-CT) was implemented using a C-arm, and the system was tested for needle guidance in foot joint injections