The varieties and capabilities of artificial intelligence and machine learning in orthopedic surgery are extensively expanding.One promising method is neural networks,emphasizing big data and computer-based learning s...The varieties and capabilities of artificial intelligence and machine learning in orthopedic surgery are extensively expanding.One promising method is neural networks,emphasizing big data and computer-based learning systems to develop a statistical fracture-detecting model.It derives patterns and rules from outstanding amounts of data to analyze the probabilities of different outcomes using new sets of similar data.The sensitivity and specificity of machine learning in detecting fractures vary from previous studies.AI may be most promising in the diagnosis of less-obvious fractures that are more commonly missed.Future studies are necessary to develop more accurate and effective detection models that can be used clinically.展开更多
Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by...Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.展开更多
The first issue of World Journal of Orthopedics(WJO),whose preparatory work was initiated on March 11,2010,will be published on November 18,2010.The WJO Editorial Board has now been established and consists of 114 dis...The first issue of World Journal of Orthopedics(WJO),whose preparatory work was initiated on March 11,2010,will be published on November 18,2010.The WJO Editorial Board has now been established and consists of 114 distinguished experts from 26 countries.Our purpose of launching WJO is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.展开更多
After three rounds of rigorous evaluation of core journals in orthopedics conducted by the Reference Citation Analysis(RCA)editorial team of Baishideng Publishing Group(Baishideng),the RCA database of Baishideng offic...After three rounds of rigorous evaluation of core journals in orthopedics conducted by the Reference Citation Analysis(RCA)editorial team of Baishideng Publishing Group(Baishideng),the RCA database of Baishideng officially released the 2022 Journal Article Influence Index(2022 JAII)of 104 core journals and a list of high-quality academic journals in orthopedics,for the first time on August 9,2022.The list of 104 core journals can be found at:https://www.referencecitationanalysis.com/SearchJournal.Among them,the highest 2022 JAII is 55.015 and the lowest is 3.076.This article introduces the 21 high-quality academic journals and describes the calculation method for the 2022 JAII,the evaluation process,and the inclusion principles for journals in the RCA.These steps are the underpinning of the RCA’s empirical journal academic evaluation service by which the digital platform addresses the needs of authors to select reliable journals for submission,readers to select high-quality literature for reading,and editors to track their own journal citation performance.As such,the RCA core journal list will serve as a useful Find-a-Journal tool.Any interested party is welcome to use this journal list and recommend it to their peers.展开更多
On behalf of the Editorial Office of World Journal of Orthopedics(WJO),we extend our sincere gratitude to our authors,subscribers,readers,Editorial Board members,and peer reviewers,thanking each and every one for thei...On behalf of the Editorial Office of World Journal of Orthopedics(WJO),we extend our sincere gratitude to our authors,subscribers,readers,Editorial Board members,and peer reviewers,thanking each and every one for their contributions to WJO in 2020 and with wishes for a Happy New Year.It was the support of all our Editorial Board members and peer reviewers that allowed the Baishideng Publishing Group Inc to successfully carry out the complete peer review,editing and publishing processes for WJO in 2020.We have analyzed the data of WJO's manuscript submissions and article publications in 2020,the invited manuscripts for 2021,manuscript peer review,composition of Editorial Board,and citation of WJO's articles,and present the findings here.We expect to be even more productive and to further raise the academic rank of WJO in 2021.展开更多
The primary objective of this article is to explore effects of latest development in the area of three dimensional(3D)printing&to assess its abilities,and further undertake helpful reporting.Here the focus is to a...The primary objective of this article is to explore effects of latest development in the area of three dimensional(3D)printing&to assess its abilities,and further undertake helpful reporting.Here the focus is to assess ad vantages of 3D printing in orthopedics and analyze how 3D printed models help solve complex 3D orthopedics distortions.This study identified that 3D models manufactured by 3D printing models reduce medical parts de velopment cost and surgical planning time.Integrating 3D printing with orthopaedics helps in understanding the conditions of problems and achieving the operation succssfully.This technology can enable doctors/surgeons to design,produce,recreate and plan operations more accurately,carefully,and economicaly.3D models can assist specialists with a visual comprehension of the patient-particular pathology and life structures.Innovation in 3D printing initiated a scaffold for the virtual outline and execution of medical procedures.This research proposes the utilisation of 3D printers as an elective procedure for the fabrication of parts.It empowers surgeons/patients for better raining,education and research.In the future,there is a foreseeable expansion of additive manufacturing in orthopedics.展开更多
Based on the development and application of new technology,as a new interdisciplinary subject,digital orthopedics becomes an important development direction of modern medicine in the past years.Using digital orthopedi...Based on the development and application of new technology,as a new interdisciplinary subject,digital orthopedics becomes an important development direction of modern medicine in the past years.Using digital orthopedics technology,such as 3D digital printing technology,mixed reality technology,provides new impetus of orthopedic surgery and indicates its great potential of precision medicine and personalized therapy for orthopedic disorders.In 2017,Hubei Branch of China Digital Orthopaedic Society of SociétéInternationale de Chirurgie Orthopédique et de Traumatologie(SICOT)was founded.It is an important milestone and academic event for the development of digital orthopedics in Hubei.After that,Hubei's digital orthopedics professionals have made great progress in clinical,scientific research,conference and social activities.The development of 5G technologies in China will provide more opportunities and challenges for global digital orthopedics in the near future.展开更多
Normal variants of lower limb development such as in-toeing, out-toeing, flat feet, bow-legs and knock knees are a common cause for parental concern and also a common source of referral to pediatric clinics. A thoroug...Normal variants of lower limb development such as in-toeing, out-toeing, flat feet, bow-legs and knock knees are a common cause for parental concern and also a common source of referral to pediatric clinics. A thorough history and clinical examination is usually all that is required to make the diagnosis of a normal variant. They also help to exclude pathological conditions that may present in a similar fashion. Radiological and other investigations are not routinely required in children with normal variants of the lower limb except to exclude pathological conditions. Shoe inserts, orthoses and physical therapy are not to be encouraged as they provide no benefit. In the majority of cases the natural history is one of spontaneous resolution of the deformity. Surgery may, however, be required in a small number of patients greater than eight years in whom severe in or out-toeing is present. Parental education and reassurance is an important part of the treatment and must be re-emphasized.展开更多
In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and advers...In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.展开更多
This paper introduces the application of intelligent robot in orthopedic treatment and nursing research progress,and summarizes the advantages and disadvantages of intelligent robot,the prospect.The aim is to help med...This paper introduces the application of intelligent robot in orthopedic treatment and nursing research progress,and summarizes the advantages and disadvantages of intelligent robot,the prospect.The aim is to help medical staff understand the basic overview of intelligent robot,and learn cutting-edge knowledge,promote the deep integration of intelligent robot technology and orthopedics field,and provide reference for the future research direction of intelligent robot technology in orthopedics field.展开更多
As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treat...As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treatment still need to be further popularized.In this report,our team have exhibited several classic cases of integrating 3D printing into orthopedic clinical application,thereby further elaborating thoughts and opinions on the significance of 3D printing in the orthopedic clinical application,technical advantages,existing main problems and coping strategies.展开更多
Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital....Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.展开更多
Ultrasonography has advantages over other imaging modalities in terms of availability and comfort,safety,and diagnostic potential.Operating costs are low compared with both computed tomography(CT)and magnetic resonanc...Ultrasonography has advantages over other imaging modalities in terms of availability and comfort,safety,and diagnostic potential.Operating costs are low compared with both computed tomography(CT)and magnetic resonance imaging(MRI).The portable equipment is accessible at locations distant from medical centers.Importantly,ultrasonography is performed while patients lie in a comfortable position,without pain or claustrophobia.Ultrasonography is a totally safe noninvasive imaging technique.In contrast to CT and X-rays,it does not emit ionizing radiation.Unlike MRI,it is safe for all patients,including those with cardiac pacemakers and metal implants,without any contraindications.Of the many indications for musculoskeletal ultrasonography,the evaluation of soft tissue pathology is particularly common.In addition,ultrasonography is useful for the detection of fluid collection,and for visualization of cartilage and bone surfaces.Color or power Doppler provides important physiological information,including that relating to the vascular system.The capability of ultrasonography in delineating structures according to their echotextures results in excellent pictorial representation.This imaging principle is based on physical changes in composition,as compared to imaging with MRI,which is based on changes in chemical composition.This article reviews the contribution of sonography to the evaluation of the musculoskeletal system.展开更多
Objective:To study the influence of general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia method on stress reaction and hemodynamics for elderly orthopedics patients during operations.Met...Objective:To study the influence of general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia method on stress reaction and hemodynamics for elderly orthopedics patients during operations.Methods: A total of 90 cases of elder patients who received orthopedic operations were randomly divided to group A, B and C, with 30 cases per group. Three groups of patients were separately given by general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia for operations;The variations of adrenocorticotrophic hormone (ACTH), Cortisol (Cor),β-endorphin (β-EP), Angiotensin-Ⅱ(Ang-Ⅱ), heart rate (HR) and blood pressure (SBP, DBP) on patients in three groups before anesthesia (T0), during skin incision (T1), after skin incision (T2) and extubation after operation (T3) were compared and analyzed.Results:During T1, T2, ACTH, Cor,β-EP and Ang-Ⅱlevels in 3 groups of patients were significantly higher than those during T0;SBP and DBP were significantly lower than that during T0;HR during T2 was significantly lower than that during T0;During T3, every index in 3 groups were recovered to levels close to that during T0;During T1, T2, ACTH, Cor,β-EP, Ang-Ⅱlevels in group B and C were significantly lower than that in group A. And levels in C was lower than that in B;SBP and DBP in group B and C were significantly higher than A. No HR statistical significance appeared between each group.Conclusions: During clinical anesthesia, we should choose suitable anesthesia method combined with actual situations of patients. Combined spinal and epidural anesthesia had a slight influence on hemodynamics of elder orthopedics patients during operation, and it could effectively alleviate stress reaction during operation.展开更多
Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized tre...Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized treatment.These challenges not only impact treatment outcomes but also severely impact patients’daily lives.Layer-by-Layer(LbL)serves as a simple surface coating technique,in simple terms,to functionalize implants by sequentially adsorbing oppositely charged materials onto a substrate.In orthopaedics,LbL self-assembly technology solves some of the challenges by loading various drugs or biological agents on the implant surface and controlling their release precisely to the site of bone defects in a personalized way.This review will introduce the basic principle and the development of LbL in orthopaedics,review and analyze the chemical strategy of LbL in the preparation of bone implants to ensure the stability of the implant,and introduce the use of LbL bone implants in orthopaedics in recent years.The application of LbL includes the realization of programmed drug delivery and sustained release,thereby promoting osseointegration and the formation of new blood vessels,antibacterial,antioxidant,etc.This review focuses on the LbL technology,involving the technology selection for the preparation of bone implants,the chemical strategies of the stability guarantee of LbL implants,the pharmacological properties,loading and release mechanisms of loaded drugs,and the molecular mechanisms of osteogenesis and angiogenesis.The aim of this review is to provide an overview of current research advances,and a prospect in this field was also described.展开更多
In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the...In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the exploratory stage.The paper first introduces the background of AI and orthopedic diseases,addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases,draws out the advantages of deep learning and machine learning in image detection,and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years,describing the contributions,strengths and weaknesses,and the direction of the future improvements that can be made in each study.Next,the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative,intraoperative,and postoperative orthopedic surgery,scientifically discussing the advantages and prospects of AI in orthopedic surgery.Finally,the article discusses the limitations of current research and technology in clinical applications,proposes solutions to the problems,and summarizes and outlines possible future research directions.The main objective of this review is to inform future research and development of AI in orthopedics.展开更多
BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional hardware.The expansion of computer assistance is evolvi...BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional hardware.The expansion of computer assistance is evolving with the employment of augmented reality.Yet,the accuracy of augmented reality navigation systems has not been determined.AIM To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee surgeon.METHODS From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral TKA.Revision cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial alignment.All patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every operation.Postoperatively,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane alignment.We recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior slope.Firstly,the expected values from the Augmented Reality system were documented.Then we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the operations.Concerning statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when needed.RESULTS A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of expected values and controlled measurements,a statistically significant difference between tibial varus values was detected(Z score=-2.33,P value=0.02),which was also statistically significantly lower than 1 degree(Z score=-4.99,P value<0.01).CONCLUSION The results indicate satisfactory postoperative coronal alignment without outliers across all three different implants utilized.Augmented reality navigation systems can bolster orthopaedic surgeons’accuracy in achieving precise axial alignment.However,further research is required to further evaluate their efficacy and potential.展开更多
文摘The varieties and capabilities of artificial intelligence and machine learning in orthopedic surgery are extensively expanding.One promising method is neural networks,emphasizing big data and computer-based learning systems to develop a statistical fracture-detecting model.It derives patterns and rules from outstanding amounts of data to analyze the probabilities of different outcomes using new sets of similar data.The sensitivity and specificity of machine learning in detecting fractures vary from previous studies.AI may be most promising in the diagnosis of less-obvious fractures that are more commonly missed.Future studies are necessary to develop more accurate and effective detection models that can be used clinically.
文摘Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.
文摘The first issue of World Journal of Orthopedics(WJO),whose preparatory work was initiated on March 11,2010,will be published on November 18,2010.The WJO Editorial Board has now been established and consists of 114 distinguished experts from 26 countries.Our purpose of launching WJO is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.
文摘After three rounds of rigorous evaluation of core journals in orthopedics conducted by the Reference Citation Analysis(RCA)editorial team of Baishideng Publishing Group(Baishideng),the RCA database of Baishideng officially released the 2022 Journal Article Influence Index(2022 JAII)of 104 core journals and a list of high-quality academic journals in orthopedics,for the first time on August 9,2022.The list of 104 core journals can be found at:https://www.referencecitationanalysis.com/SearchJournal.Among them,the highest 2022 JAII is 55.015 and the lowest is 3.076.This article introduces the 21 high-quality academic journals and describes the calculation method for the 2022 JAII,the evaluation process,and the inclusion principles for journals in the RCA.These steps are the underpinning of the RCA’s empirical journal academic evaluation service by which the digital platform addresses the needs of authors to select reliable journals for submission,readers to select high-quality literature for reading,and editors to track their own journal citation performance.As such,the RCA core journal list will serve as a useful Find-a-Journal tool.Any interested party is welcome to use this journal list and recommend it to their peers.
文摘On behalf of the Editorial Office of World Journal of Orthopedics(WJO),we extend our sincere gratitude to our authors,subscribers,readers,Editorial Board members,and peer reviewers,thanking each and every one for their contributions to WJO in 2020 and with wishes for a Happy New Year.It was the support of all our Editorial Board members and peer reviewers that allowed the Baishideng Publishing Group Inc to successfully carry out the complete peer review,editing and publishing processes for WJO in 2020.We have analyzed the data of WJO's manuscript submissions and article publications in 2020,the invited manuscripts for 2021,manuscript peer review,composition of Editorial Board,and citation of WJO's articles,and present the findings here.We expect to be even more productive and to further raise the academic rank of WJO in 2021.
文摘The primary objective of this article is to explore effects of latest development in the area of three dimensional(3D)printing&to assess its abilities,and further undertake helpful reporting.Here the focus is to assess ad vantages of 3D printing in orthopedics and analyze how 3D printed models help solve complex 3D orthopedics distortions.This study identified that 3D models manufactured by 3D printing models reduce medical parts de velopment cost and surgical planning time.Integrating 3D printing with orthopaedics helps in understanding the conditions of problems and achieving the operation succssfully.This technology can enable doctors/surgeons to design,produce,recreate and plan operations more accurately,carefully,and economicaly.3D models can assist specialists with a visual comprehension of the patient-particular pathology and life structures.Innovation in 3D printing initiated a scaffold for the virtual outline and execution of medical procedures.This research proposes the utilisation of 3D printers as an elective procedure for the fabrication of parts.It empowers surgeons/patients for better raining,education and research.In the future,there is a foreseeable expansion of additive manufacturing in orthopedics.
基金the Scientific Research Foundation of the Human Resource Ministry and the Education Ministry for Returned Chinese Scholars,China(Grant No.2016-176,201512,WJ2015Z012,and WX16B21)National Natural Science Foundation of China(Grant No.81974349 and 81201393).
文摘Based on the development and application of new technology,as a new interdisciplinary subject,digital orthopedics becomes an important development direction of modern medicine in the past years.Using digital orthopedics technology,such as 3D digital printing technology,mixed reality technology,provides new impetus of orthopedic surgery and indicates its great potential of precision medicine and personalized therapy for orthopedic disorders.In 2017,Hubei Branch of China Digital Orthopaedic Society of SociétéInternationale de Chirurgie Orthopédique et de Traumatologie(SICOT)was founded.It is an important milestone and academic event for the development of digital orthopedics in Hubei.After that,Hubei's digital orthopedics professionals have made great progress in clinical,scientific research,conference and social activities.The development of 5G technologies in China will provide more opportunities and challenges for global digital orthopedics in the near future.
文摘Normal variants of lower limb development such as in-toeing, out-toeing, flat feet, bow-legs and knock knees are a common cause for parental concern and also a common source of referral to pediatric clinics. A thorough history and clinical examination is usually all that is required to make the diagnosis of a normal variant. They also help to exclude pathological conditions that may present in a similar fashion. Radiological and other investigations are not routinely required in children with normal variants of the lower limb except to exclude pathological conditions. Shoe inserts, orthoses and physical therapy are not to be encouraged as they provide no benefit. In the majority of cases the natural history is one of spontaneous resolution of the deformity. Surgery may, however, be required in a small number of patients greater than eight years in whom severe in or out-toeing is present. Parental education and reassurance is an important part of the treatment and must be re-emphasized.
文摘In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.
文摘This paper introduces the application of intelligent robot in orthopedic treatment and nursing research progress,and summarizes the advantages and disadvantages of intelligent robot,the prospect.The aim is to help medical staff understand the basic overview of intelligent robot,and learn cutting-edge knowledge,promote the deep integration of intelligent robot technology and orthopedics field,and provide reference for the future research direction of intelligent robot technology in orthopedics field.
文摘As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treatment still need to be further popularized.In this report,our team have exhibited several classic cases of integrating 3D printing into orthopedic clinical application,thereby further elaborating thoughts and opinions on the significance of 3D printing in the orthopedic clinical application,technical advantages,existing main problems and coping strategies.
文摘Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.
文摘Ultrasonography has advantages over other imaging modalities in terms of availability and comfort,safety,and diagnostic potential.Operating costs are low compared with both computed tomography(CT)and magnetic resonance imaging(MRI).The portable equipment is accessible at locations distant from medical centers.Importantly,ultrasonography is performed while patients lie in a comfortable position,without pain or claustrophobia.Ultrasonography is a totally safe noninvasive imaging technique.In contrast to CT and X-rays,it does not emit ionizing radiation.Unlike MRI,it is safe for all patients,including those with cardiac pacemakers and metal implants,without any contraindications.Of the many indications for musculoskeletal ultrasonography,the evaluation of soft tissue pathology is particularly common.In addition,ultrasonography is useful for the detection of fluid collection,and for visualization of cartilage and bone surfaces.Color or power Doppler provides important physiological information,including that relating to the vascular system.The capability of ultrasonography in delineating structures according to their echotextures results in excellent pictorial representation.This imaging principle is based on physical changes in composition,as compared to imaging with MRI,which is based on changes in chemical composition.This article reviews the contribution of sonography to the evaluation of the musculoskeletal system.
文摘Objective:To study the influence of general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia method on stress reaction and hemodynamics for elderly orthopedics patients during operations.Methods: A total of 90 cases of elder patients who received orthopedic operations were randomly divided to group A, B and C, with 30 cases per group. Three groups of patients were separately given by general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia for operations;The variations of adrenocorticotrophic hormone (ACTH), Cortisol (Cor),β-endorphin (β-EP), Angiotensin-Ⅱ(Ang-Ⅱ), heart rate (HR) and blood pressure (SBP, DBP) on patients in three groups before anesthesia (T0), during skin incision (T1), after skin incision (T2) and extubation after operation (T3) were compared and analyzed.Results:During T1, T2, ACTH, Cor,β-EP and Ang-Ⅱlevels in 3 groups of patients were significantly higher than those during T0;SBP and DBP were significantly lower than that during T0;HR during T2 was significantly lower than that during T0;During T3, every index in 3 groups were recovered to levels close to that during T0;During T1, T2, ACTH, Cor,β-EP, Ang-Ⅱlevels in group B and C were significantly lower than that in group A. And levels in C was lower than that in B;SBP and DBP in group B and C were significantly higher than A. No HR statistical significance appeared between each group.Conclusions: During clinical anesthesia, we should choose suitable anesthesia method combined with actual situations of patients. Combined spinal and epidural anesthesia had a slight influence on hemodynamics of elder orthopedics patients during operation, and it could effectively alleviate stress reaction during operation.
文摘Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized treatment.These challenges not only impact treatment outcomes but also severely impact patients’daily lives.Layer-by-Layer(LbL)serves as a simple surface coating technique,in simple terms,to functionalize implants by sequentially adsorbing oppositely charged materials onto a substrate.In orthopaedics,LbL self-assembly technology solves some of the challenges by loading various drugs or biological agents on the implant surface and controlling their release precisely to the site of bone defects in a personalized way.This review will introduce the basic principle and the development of LbL in orthopaedics,review and analyze the chemical strategy of LbL in the preparation of bone implants to ensure the stability of the implant,and introduce the use of LbL bone implants in orthopaedics in recent years.The application of LbL includes the realization of programmed drug delivery and sustained release,thereby promoting osseointegration and the formation of new blood vessels,antibacterial,antioxidant,etc.This review focuses on the LbL technology,involving the technology selection for the preparation of bone implants,the chemical strategies of the stability guarantee of LbL implants,the pharmacological properties,loading and release mechanisms of loaded drugs,and the molecular mechanisms of osteogenesis and angiogenesis.The aim of this review is to provide an overview of current research advances,and a prospect in this field was also described.
基金This work was supported in part by the National Natural Science Foundation of China under Grants 61861007 and 61640014in part by theGuizhou Province Science and Technology Planning Project ZK[2021]303+2 种基金in part by the Guizhou Province Science Technology Support Plan under Grants[2022]017,[2023]096 and[2022]264in part by the Guizhou Education Department Innovation Group Project under Grant KY[2021]012in part by the Talent Introduction Project of Guizhou University(2014)-08.
文摘In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the exploratory stage.The paper first introduces the background of AI and orthopedic diseases,addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases,draws out the advantages of deep learning and machine learning in image detection,and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years,describing the contributions,strengths and weaknesses,and the direction of the future improvements that can be made in each study.Next,the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative,intraoperative,and postoperative orthopedic surgery,scientifically discussing the advantages and prospects of AI in orthopedic surgery.Finally,the article discusses the limitations of current research and technology in clinical applications,proposes solutions to the problems,and summarizes and outlines possible future research directions.The main objective of this review is to inform future research and development of AI in orthopedics.
文摘BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional hardware.The expansion of computer assistance is evolving with the employment of augmented reality.Yet,the accuracy of augmented reality navigation systems has not been determined.AIM To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee surgeon.METHODS From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral TKA.Revision cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial alignment.All patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every operation.Postoperatively,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane alignment.We recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior slope.Firstly,the expected values from the Augmented Reality system were documented.Then we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the operations.Concerning statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when needed.RESULTS A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of expected values and controlled measurements,a statistically significant difference between tibial varus values was detected(Z score=-2.33,P value=0.02),which was also statistically significantly lower than 1 degree(Z score=-4.99,P value<0.01).CONCLUSION The results indicate satisfactory postoperative coronal alignment without outliers across all three different implants utilized.Augmented reality navigation systems can bolster orthopaedic surgeons’accuracy in achieving precise axial alignment.However,further research is required to further evaluate their efficacy and potential.
