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June 27, 2024Abstract The potential for regeneration and repair of bone is well known. This article conveys the current progress in the realm of bone morphogenetic proteins and their potential for initiating fracture repair cascade. Demineralized bone matrix induces bone formation and has served as a model for the bone repair cascade. A family of bone morphogenetic proteins has been identified, isolated, and cloned from the demineralized bone matrix. Bone morphogenetic proteins are pleiotropic regulators of chemotaxis, mitosis, and differentiation. The bone morphogenetic protein receptors, Types I and II, bind bone morphogenetic proteins and act in collaboration to transduce the phosphorylation of Smad 1 and Smad 5, which enter the nucleus in partnership with Smad 4 to initiate bone morphogenetic protein responses including fracture healing. The accumulated information on bone morphogenetic proteins may aid in accelerating fracture repair and the potential use of bone morphogenetic protein antibodies to inhibit heterotopic bone formation and fibrodysplasia ossificans progressiva. Full-text article [...] Read more...
June 27, 2024Indications Discuss indications and more general concerns. Preoperative Planning Material to be reviewed and conditions to be addressed before surgery. Include any exams preformed under anesthesia Positioning Describe and provide OR photos to illustrate positioning Approach Consider the various approaches. Provide links to relevant anatomy and surgical approaches. Techniques Step by step description to illustrate surgical technique Pearls and Pitfalls Tips and problems to avoid Postoperative Care Include immediate postoperative care and rehabilitation Outcome Include functional and prosthetic survivorship data as applicable Complications Include overview of complications References Include limited reference list [...] Read more...
June 27, 2024Location Knee Diagnosis Bucket-handle tear of the menisci Discussion Sagittal T1 weighted MRI of the knee through the intercondylar notch reveals a fragment of torn meniscus, which appears as a low-signal intensity, longitudinally oriented band lying beneath and parallel to the PCL, creating a double cruciate configuration. This is referred to as the double PCL sign. This sign of a bucket-handle tear on MRI relates to the peripheral (bucket) portion of the meniscus and the displaced inner fragment (handle) portion. The inner fragment can be displaced for a variable distance over the tibial plateau surface. If displaced as far as the intercondylar notch, in the case of the medial meniscus, the inner fragment can come to lie between the PCL and the underlying tibia. Reference Weiss KL, Morehouse HT, Levy IM: Sagittal MR images of the knee: a low-signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear. AJR Am J Roentgenol 1991 Jan;156(1):117-9. Ruff C, Weingardt JP, Russ PD, Kilcoyne RF: MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol 1998 Jan;170(1):63-7. Figures Click thumbnail for larger image Attachments: buckethandle2pcl.jpg (image/jpeg) [...] Read more...
June 27, 2024Classification Type I: Fracture at the level of the lesser trochanter Type II: Fracture within 2.5 cm of the lesser trochanter Type III: Fracture between 2 and 2.5 cm of the lesser trochanter Explanation Provide an explanation for key principles and pertinent aspects of the classification Figures   Reference(s) Provide the citation for the landmark article and recent review articles describing the classification Attachments: Fielding_Classification_Subtrochanteric_Fractures.bmp (image/bmp) Fielding_Classification_Subtrochanteric_Fractures.jpg (image/jpeg) Fielding_Classification_Subtrochanteric_Fractures2.PNG (image/png) Fielding_Classification_Subtrochanteric_Fractures2.PNG (image/png) [...] Read more...
June 27, 2024Attachments: Cost_Effective_Algorithm_Fehring.mp4 (application/octet-stream) thumbnail.jpg (image/jpeg) [...] Read more...

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Abstract For more than 50 years, it has been known that vertebrates engage in a wide range of motor activities and that they possess muscle types with a similarly large range of contractile properties. However, only during the past 15 years has it been shown experimentally that the contractile properties of muscle fibers are well adjusted to their in vivo function. Arriving at this conclusion has required an integrative approach, that is, comparing measurements of muscle fiber properties with measurements of fiber use during normal motor activity. Because the muscles of mammals (and humans) generally are heterogenous in fiber type, this makes it technically very difficult to measure either the contractile properties of different fiber types or their use during normal motor activity. Therefore, many of the advances in the understanding of the design and function of vertebrate muscular systems have come from work on lower vertebrates. Fish, because of the anatomic separation of different muscle fiber types, have provided a key experimental model on which much of what is known about muscle design has been determined. Frogs, because of the near homogeneity of their large extensor muscles used during jumping, also provide an important model which will, in the near future, serve as the first platform where molecular properties of muscle (calcium and cross-bridge kinetics) can be related to whole body movement in a meaningful and predictive manner. Full-text article [...] Read more...
Introduction Define/describe the condition Anatomy Describe the pertinent anatomy Pathogenesis Describe the biomechanics/biologic basis of the disorder or the mechanism of injury Natural History Describe the natural history, epidemiology and prognosis Clinical Presentation Describe the means to elicit the most useful information from the patient history and physical examination as well as the relevant findings Imaging and Diagnostic Studies Describe appropriate radiologic and other diagnostic studies Classification Include a list with links to relevant conditions Treatment Include: Medical therapy Nonoperative treatment Operative treatment – include links to pages with detailed surgical techniques Indications and contraindications Outcome Include functional and prosthetic survivorship data as applicable Complications Include overview of complications Pearls and Pitfalls Tips and problems to avoid Controversy Include current controversies in diagnosis or treatment References Insert selected references and landmark articles [...] Read more...
Introduction Define/describe the condition Anatomy Describe the pertinent anatomy Pathogenesis Describe the biomechanics/biologic basis of the disorder or the mechanism of injury Natural History Describe the natural history, epidemiology and prognosis Clinical Presentation Describe the means to elicit the most useful information from the patient history and physical examination as well as the relevant findings Imaging and Diagnostic Studies Describe appropriate radiologic and other diagnostic studies Classification Include a list with links to relevant conditions Treatment Include: Medical therapy Nonoperative treatment Operative treatment – include links to pages with detailed surgical techniques Indications and contraindications Outcome Include functional and prosthetic survivorship data as applicable Complications Include overview of complications Pearls and Pitfalls Tips and problems to avoid Controversy Include current controversies in diagnosis or treatment References Insert selected references and landmark articles [...] Read more...
Indications Discuss indications and more general concerns. Preoperative Planning Material to be reviewed and conditions to be addressed before surgery. Include any exams preformed under anesthesia Positioning Describe and provide OR photos to illustrate positioning Approach Consider the various approaches. Provide links to relevant anatomy and surgical approaches. Techniques Step by step description to illustrate surgical technique Pearls and Pitfalls Tips and problems to avoid Postoperative Care Include immediate postoperative care and rehabilitation Outcome Include functional and prosthetic survivorship data as applicable Complications Include overview of complications References Include limited reference list [...] Read more...
This video demonstrates the infiltration technique of a non-opioid local analgesic indicated for administration into the surgical site to produce postsurgical analgesia in a partial knee arthroplasty About Pacira Pacira Pharmaceuticals, Inc. is an emerging specialty pharmaceutical company focused on the development, commercialization and manufacture of new pharmaceutical products, based on its proprietary DepoFoam® drug delivery technology, for use in hospitals and ambulatory surgery centers. Learn more at www.pacira.com [...] Read more...

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