Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Basic Research 171 articles

Articles

Variations in the Innervation of the Long Head of the Triceps Brachii: A Cadaveric Investigation

Alexandra J. Erhardt DO, Bennett Futterman MD

Some leading anatomy texts state that all three heads of the triceps brachii are innervated by the radial nerve. The posterior cord of the brachial plexus bifurcates to terminate as the radial and axillary nerves. Studies have noted the presence of axillary innervation to the long head of the triceps brachii muscle, patterns different from the classic exclusive radial nerve supply. An understanding of these variations may assist the clinician in the assessment of shoulder weakness and in preoperative and operative planning of radial and axillary neuropathies.

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

Hiroyuki Iwasawa MSc, Masato Nomura MSc, Naoyoshi Sakitani MSc, Kosuke Watanabe MSc, Daichi Watanabe MSc, Hideki Moriyama PhD

Contractures are a prevalent and potentially severe complication in patients with neurologic disorders. Although heat, cold, and stretching are commonly used for treatment of contractures and/or spasticity (the cause of many contractures), the sequential effects of these modalities remain unclear.

Head-Neck Osteoplasty has Minor Effect on the Strength of an Ovine Cam-FAI Model: In Vitro and Finite Element Analyses

Ghislain Maquer PhD, Alexander Bürki MSc, Katja Nuss DVM, Philippe K. Zysset PhD, Moritz Tannast MD

Osteochondroplasty of the head-neck region is performed on patients with cam femoroacetabular impingement (FAI) without fully understanding its repercussion on the integrity of the femur. Cam-type FAI can be surgically and reproducibly induced in the ovine femur, which makes it suitable for studying corrective surgery in a consistent way. Finite element models built on quantitative CT (QCT) are computer tools that can be used to predict femoral strength and evaluate the mechanical effect of surgical correction.

Transsacral Osseous Corridor Anatomy Is More Amenable To Screw Insertion In Males: A Biomorphometric Analysis of 280 Pelves

Florian Gras PD Dr med, Heiko Gottschling Dr rer nat, Manuel Schröder Dr rer nat, Ivan Marintschev DM, Gunther O. Hofmann Prof Dr med Dr rer nat, Rainer Burgkart PD Dr med

Percutaneous iliosacral screw placement is the standard procedure for fixation of posterior pelvic ring lesions, although a transsacral screw path is being used more frequently in recent years owing to increased fracture-fixation strength and better ability to fix central and bilateral sacral fractures. However, biomorphometric data for the osseous corridors are limited. Because placement of these screws in a safe and effective manner is crucial to using transsacral screws, we sought to address precise sacral anatomy in more detail to look for anatomic variation in the general population.

High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

Ashton H. Goldman MD, Emanuel Haug BS, John R. Owen MS, Jennifer S. Wayne PhD, Gregory J. Golladay MD

Surgical gloves can be damaged during the course of a procedure, which can place the surgeon and patient at risk. Glove perforation may not always be readily apparent, and determining the risk factors for glove perforation can aid the surgeon in deciding when a glove change is advisable. Time of wear and needle sticks have been well studied; however, other mechanisms including mechanical stress from surgical equipment have had limited evaluation to date.

Cement Augmentation in Sacroiliac Screw Fixation Offers Modest Biomechanical Advantages in a Cadaver Model

Georg Osterhoff MD, Andrew E. Dodd MD, FRCSC, Florence Unno MD, Angus Wong, Shahram Amiri MSc, PhD, Kelly A. Lefaivre MD, MSc, FRCSC, Pierre Guy MD, MBA, FRCSC

Sacroiliac screw fixation in elderly patients with pelvic fractures is prone to failure owing to impaired bone quality. Cement augmentation has been proposed as a possible solution, because in other anatomic areas this has been shown to reduce screw loosening. However, to our knowledge, this has not been evaluated for sacroiliac screws.

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

Pan Tang MD, Ren Zhu MD, Wei-Ping Ji MD, Ji-Ying Wang MD, Shuai Chen MD, Shun-Wu Fan MD, Zhi-Jun Hu PhD

Modic changes are the MRI signal changes of degenerative lumbar vertebral endplate and which lead to or accelerate intervertebral disc degeneration. NLRP3, caspase-1, and interleukin-1β (IL-1β) play a pivotal role in the pathogenesis of many inflammatory diseases, such as osteoarthritis. However, the roles of IL-1β and its activators caspase-1 and NLRP3 are unclear in the degenerative endplate.

Tendon Collagen Crosslinking Offers Potential to Improve Suture Pullout in Rotator Cuff Repair: An Ex Vivo Sheep Study

Roland S. Camenzind MD, Karl Wieser MD, Gion Fessel PhD, Dominik C. Meyer MD, Jess G. Snedeker PhD

The suture-tendon interface is often the weakest link in tendon to bone repair of massive rotator cuff tears. Genipin is a low-toxicity collagen crosslinker derived from the gardenia fruit that has been shown to augment collagen tissue strength and mechanically arrest tendon-tear progression.

Do Longer Surgical Procedures Result in Greater Contamination of Surgeons’ Hands?

Pooria Hosseini MD, MSc, Gregory M. Mundis MD, Robert Eastlack MD, Allen Nourian MD, Jeff Pawelek BS, Stacie Nguyen MPH, Behrooz A. Akbarnia MD

A surgical site infection is a substantial cause of complications in patients. Different methods are being used to decrease surgical site infections; however, these infections still can cause complications, especially in patients undergoing longer operations (> 3 hours). There is evidence that the efficacy of the scrubbing material fades after 3 hours. However, we do not know the longevity of hand cleanliness after application of scrubbing materials in a long operation. It can be postulated that if the surgeon’s scrubbed hands are recolonized after a certain time, they may serve as a progressive source of contamination during surgery.

Does a PEEK Femoral TKA Implant Preserve Intact Femoral Surface Strains Compared With CoCr? A Preliminary Laboratory Study

Kathryn E. Rankin PhD, Alexander S. Dickinson PhD, Adam Briscoe PhD, Martin Browne PhD

Both the material and geometry of a total knee arthroplasty (TKA) component influence the induced periprosthetic bone strain field. Strain, a measure of the local relative deformation in a structure, corresponds to the mechanical stimulus that governs bone remodeling and is therefore a useful in vitro biomechanical measure for assessing the response of bone to new implant designs and materials. A polyetheretherketone (PEEK) femoral implant has the potential to promote bone strains closer to that of natural bone as a result of its low elastic modulus compared with cobalt-chromium (CoCr).