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Tag Archives: Synthes

The Evolving Role of Bone-Graft Substitutes

It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and indicate a shortage in the availability of musculoskeletal donor tissue traditionally used in these reconstructions. This reality has stimulated a proliferation of corporate interest in supplying what is seen as a growing market in bone replacement materials. These graft alternatives are subjected to varying degrees of regulatory scrutiny, and thus their true safety and effectiveness in patients may not be know prior to their use by orthopaedic surgeons. It is thus important to gain insight into this emerging class of bone-substitute alternatives.

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Bone Graft Substitutes: Facts, Fictions & Applications

It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and indicate a shortage in the availability of musculoskeletal donor tissue traditionally used in these reconstructions. This reality has stimulated a proliferation of corporate interest in supplying what is seen as a growing market in bone replacement materials. These graft alternatives are subjected to varying degrees of regulatory scrutiny, and thus their true safety and effectiveness in patients may not be know prior to their use by orthopaedic surgeons. It is thus important to gain insight into this emerging class of bone-substitute alternatives.

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Bone Graft Substitutes: Facts, Fictions & Applications

It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and indicate a shortage in the availability of musculoskeletal donor tissue traditionally used in these reconstructions. This reality has stimulated a proliferation of corporate interest in supplying what is seen as a growing market in bone replacement materials. These graft alternatives are subjected to varying degrees of regulatory scrutiny, and thus their true safety and effectiveness in patients may not be know prior to their use by orthopaedic surgeons. It is thus important to gain insight into this emerging class of bone-substitute alternatives.

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Biomechanical Properties of Fixed-Angle Volar Distal Radius Plates Under Dynamic Loading

Distal radius fractures are commonly encountered in general orthopaedic and hand subspecialty practices. Most surgeons are comfortable with both operative and nonoperative management of these fractures. Treatment options have evolved with fracture pattern governing the specific treatment modality. Casting with or without reduction, percutaneous pinning, external fixation, and open reduction with internal fixation employing dorsal, volar and fragment specific plates are all common methods used to treat these injuries. A paradigm shift has occurred in the treatment of dorsally displaced distal radius fractures. Previous volar plating techniques demonstrated a high failure rate when compared to distal buttress plating which prevented fracture settling and recurrent displacement. Orbay and others have developed volar plating constructs, which provide subchondral support to the distal radius, transferring radiocarpal forces experienced in the postoperative period to the plate and volar cortex. Previous studies have examined biomechanical differences between dorsal and volar plating while further investigations between specific volar plate constructs under static and dynamic loading conditions have been reported. This study compares the biomechanical properties of eight different fixed-angle volar distal radius plate designs under dynamic loading to determine their ability to withstand the forces which occur during fracture healing and early postoperative rehabilitation.

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The Current State of Cervical and Lumbar Spinal Disc Arthroplasty

The growth of spinal implant and orthobiologic technologies over the last several years is increasing in tempo and fast approaching the US hip and knee markets in annual dollar sales. During this time, a number of start-up and established medical device manufacturers have focused increasing resources on solutions for spinal problems. The role of the orthopaedic and neurosurgeon in these enterprises as inventor, owner, and user has contributed to this march of progress. This handout describes a small (<1%), but increasingly visible, aspect of these advancing technologies, that of artificial disc replacement.

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Scaphoid Fracture Repair: A Biomechanical Comparison of Contemporary Cancellous Bone Screws

Scaphoid fractures are common, but often challenging to treat. Clinic studies have demonstrated that both conservative treatment and internal fixation have successful long-term results with the latter providing earlier recovery of motion, decreased immobilization an dearly return to activity. Additionally, internal fixation is indicated as the preferred treatment for displaced or unstable scaphoid fractures, nonunions and late presenting fractures. Many surgeons have also advocated internal fixation for the treatment of acute nondisplaced fractures. Cancellous screw fixation of the scaphoid is one of the more popular and effective methods of treatment, as evidenced by the number of designs available to the orthopaedic surgeon. However, the clinical success of internal fixation is highly dependent upon the ability of the screw to obtain initial compression across the fracture site and its retention, under physiologic loading. This study compares the performance characteristics of seven, contemporary, scaphoid screw designs.

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Bone Graft Substitutes: Facts, Fictions & Applications

It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and indicate a shortage in the availability of musculoskeletal donor tissue traditionally used in these reconstructions. This reality has stimulated a proliferation of corporate interest in supplying what is seen as a growing market in bone-substitute materials. These graft alternatives have varying degrees of regulatory scrutiny and thus their true safety and effectiveness in patients may not be know prior to their use by orthopaedic surgeons. It is thus important to gain insight into this emerging class of bone-substitute alternatives. This handout provides an update of an emerging class of bone-graft substitutes, which have found application as osteoconductive fixation and structural media.

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