Dr Michell Ruiz
Cirugía de hombro y del Manguito rotador
miércoles, 30 de julio de 2014
martes, 29 de julio de 2014
Ream and run for B2 glenoid - beach smashball at 13 weeks
http://shoulderarthritis.blogspot.mx/2014/07/ream-and-run-for-b2-glenoid-beach.html
Ream and run for B2 glenoid - beach smashball at 13 weeks
A man in his late 40s had a ream and run for the bad arthritic triad (BAT) which developed after a previous repair for anterior instability ( = capsulorrhaphy arthropathy). His preoperative films showed complete loss of the joint space and the arthritic triad: a biconcave glenoid, glenoid retroversion and posterior subluxation of the humeral head on the face of the glenoid.
Thirteen weeks ago, he had a ream and run with a 56 21 anteriorly eccentric head and a rotator interval plication.
His postoperative films show centering of the humeral head on the glenoid.
He recently send a video of his playing smashball on the beach 13 weeks after surgery - possibly a new way to rehabilitate a shoulder.
lunes, 28 de julio de 2014
Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for
Monday, July 28, 2014
Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for
A man is his early twenties presented with pain and stiffness in the shoulder after two prior instability procedures, the last being a Latarjet in 2012.
After surgery he was started on the 'yellow' antibiotic protocol. Range of motion exercises were started on day one and he had 150 degrees of motion on discharge two days later.
Five days after surgery, the cultures grew out coagulase negative staph in one specimen and Propionibacterium in three (capsule, humeral head #1 and humeral head #2). At that time a PICC line was plaeced and he was converted to the 'red' antibiotic protocol.
Comment: It would have been easy to miss this infection. Our index of suspicion was heightened by the generalized destruction of the joint surface in contrast to the local destruction that would be expected from contact of the humeral head with the screw.
He had a primary hemiarthroplasty with removal of the screw, the head of which was rubbing on his humeral head. Because of the global loss of cartilage seen on his preoperative films, we obtained cultures before administering antibiotics.
At surgery there was no obvious evidence of infection. The humeral head showed global loss of cartilage as shown here.
His postoperative films are shown here.
After surgery he was started on the 'yellow' antibiotic protocol. Range of motion exercises were started on day one and he had 150 degrees of motion on discharge two days later.
Five days after surgery, the cultures grew out coagulase negative staph in one specimen and Propionibacterium in three (capsule, humeral head #1 and humeral head #2). At that time a PICC line was plaeced and he was converted to the 'red' antibiotic protocol.
Comment: It would have been easy to miss this infection. Our index of suspicion was heightened by the generalized destruction of the joint surface in contrast to the local destruction that would be expected from contact of the humeral head with the screw.
sábado, 26 de julio de 2014
jueves, 24 de julio de 2014
martes, 22 de julio de 2014
What's the difference between a reverse total shoulder and a CTA prosthesis
http://shoulderarthritis.blogspot.mx/2011/10/whats-difference-between-reverse-total.html
Wednesday, October 26, 2011
What's the difference between a reverse total shoulder and a CTA prosthesis
This question is asked often. Here are the 'cliff notes'.
Both are used to help manage the combination of shoulder arthritis and rotator cuff deficiency or rotator cuff tear arthropathy.
A CTA prosthesis is a resurfacing of the upper humerus that requires an intact coracoacromial arch for stability and active elevation of over 90 degrees before surgery.
Both are used to help manage the combination of shoulder arthritis and rotator cuff deficiency or rotator cuff tear arthropathy.
A CTA prosthesis is a resurfacing of the upper humerus that requires an intact coracoacromial arch for stability and active elevation of over 90 degrees before surgery.
A reverse total shoulder is a constrained shoulder that fixes the fulcrum for the deltoid when the shoulder is unstable or has pseudoparalysis (it cannot be elevated away from the side).
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Reemplazo de Hombro y Prótesis Invertida en pacientes con dolor de hombro - Dr. Sanchez-Sotelo
Publicado el 26/3/2014
El Dr. Joaquín Sanchez-Sotelo, cirujano ortopedista de Mayo Clinic, nos habla sobre la evaluación, diagnóstico, procedimiento y tratamiento del Reemplazo de Hombro y Prótesis Invertida en Pacientes con Dolor de Hombro.
For more information, visit:http://www.mayoclinic.org/departments...
For more information, visit:http://www.mayoclinic.org/departments...
Excelente VIDEO sobre el reemplazo de hombro y prótesis invertida http://t.co/0iCXbYRUaR #ortopedia #salud @traumatologoalD
— Clinica Mayo (@ClinicaMayo) julio 11, 2014
Tenogenic Induction of Human MSCs by Anisotropically Aligned Collagen Biotextiles
http://onlinelibrary.wiley.com/doi/10.1002/adfm.201400828/abstract
Tenogenic Induction of Human MSCs by Anisotropically Aligned Collagen Biotextiles
Tenogenic Induction of Human MSCs by Anisotropically Aligned Collagen Biotextiles
Keywords:
A novel biofabrication modality, electrophoretic compaction with macromolecular alignment, is utilized to make collagen threads that mimic the native tendon's structure and mechanical properties. A device with kinematic electrodes is designed to fabricate collagen threads in continuous length. For the first time, a 3D-biotextile is woven purely from collagen. Mechanical properties and load-displacement behavior of the biotextile mimic those of the native tendon while presenting a porosity of 80%. The open pore network facilitates cell seeding across the continuum of the bioscaffold. Mesenchymal stem cells (MSCs) seeded in the woven scaffold undergo tenogenic differentiation in the absence of growth factors and synthesize a matrix that is positive for tenomodulin, COMP and type I collagen. Up-regulation of tenomodulin, a tendon specific marker, is 11.6 ± 3.5 fold, COMP is up-regulated 16.7 ± 5.5 fold, and Col I is up-regulated 6.9 ± 2.7 fold greater on ELAC threads when compared to randomly oriented collagen gels. These results demonstrate that a bioscaffold woven using collagen threads with densely compacted and anisotropically aligned substrate texture stimulates tenogenesis topographically, rendering the electrochemically aligned collagen as a promising candidate for functional repair of tendons and ligaments.
Palabras clave:
ingeniería de tejidos; alineación de celdas; anisotropía de rigidez del sustrato; células madre; diferenciación; andamios de colágeno tejidas
Una nueva modalidad de biofabricación, compactación electroforética con la alineación macromolecular, se utiliza para hacer hebras de colágeno que imitan la estructura del tendón nativo y propiedades mecánicas. Un dispositivo con electrodos cinemáticos está diseñado para fabricar hebras de colágeno en longitud continua. Por primera vez, un-biotextile 3D se teje puramente a partir de colágeno. Las propiedades mecánicas y el comportamiento de carga-desplazamiento de la biotextile son similares a los del tendón nativo al tiempo que presenta una porosidad de 80%. La red de poros abiertos facilita la siembra de células en todo el continuo de la bioscaffold. Las células madre mesenquimales (MSCs) se sembraron en el andamio de tejido se someten a diferenciación tenogenic en ausencia de factores de crecimiento y sintetizar una matriz que es positivo para tenomodulin, COMP y colágeno de tipo I. Sobre regulación de tenomodulin, un marcador específico del tendón, es de 11,6 ± 3,5 veces, COMP es regulado hasta 16,7 ± 5,5 veces, y Col I es regulada hasta 6,9 ± 2,7 veces mayor en las roscas de ELAC en comparación con orientación al azar geles de colágeno. Estos resultados demuestran que un bioscaffold tejida con hilos de colágeno con textura sustrato densamente compactada y anisotrópicamente alineado estimula tenogenesis topográficamente, haciendo que el colágeno electroquímicamente alineado como un candidato prometedor para la reparación funcional de los tendones y los ligamentos....
lunes, 21 de julio de 2014
Are We Overtreating Clavicular Fractures?
Do you think #orthopedic surgeons fix too many #clavicle #fractures? Join the discussion at #OrthoBuzz http://t.co/s53ZIp4WLK #meded #health
— Marc Swiontkowski,MD (@swion001) julio 21, 2014
sábado, 19 de julio de 2014
domingo, 13 de julio de 2014
Patient to Receive First 3D Printed Shoulder Prosthesis in the Netherlands
Patient to Receive First 3D Printed Shoulder Prosthesis in the Netherlands http://t.co/zzZ40LLY3S
— Victor Ravens (@bibliomanazteca) julio 13, 2014
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