Thesis (MMedVet (Chir.))--University of Pretoria, 2004. / Includes bibliographical references.

Thesis (M. Phil.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 67-68).

Τα κατάγματα της κοτύλης είναι σοβαρά ενδαρθρικά κατάγματα, υψηλής ενέρ-γειας κακώσεις που συμβαίνουν κυρίως σε τροχαία ατυχήματα ή από πτώσεις από μεγάλο ύψος και τα θύματα είναι συνήθως νεαροί ενήλικες. Συχνά συνο-δεύονται από κακώσεις σε άλλα μέρη του σώματος που μπορεί να είναι απει-λητικές για τη ζωή ή να απαιτήσουν νο-σηλεία σε Μονάδα Εντατικής Θεραπείας. Για πολλές δεκαετίες η αντιμετώπισή τους ήταν συντηρητική με πτωχά αποτε-λέσματα στις περισσότερες περιπτώσεις. Κατά τις τελευταίες δεκαετίες όμως η αντιμετώπισή τους άλλαξε και έγινε χει-ρουργική στα παρεκτοπισμένα κατάγμα-τα ή αυτά που αφορούν φορτιζόμενη ε-πιφάνεια της κοτύλης, καθώς αυτή προ-σφέρει ικανοποιητικότερα αποτελέσμα-τα. Οι επιπλοκές τόσο της συν-τηρητικής όσο και της χειρουργικής αντιμετώπισης περιλαμβάνουν τη μετα-τραυματική οστεοαρθρίτιδα και την άσηπτη νέκρωση της μηριαίας κεφαλής. Επιπλοκές που παρατηρούνται κυρίως μετά από χειρουργική αντιμετώπιση εί-ναι η έκτοπη οστεοποίηση, η πάρεση του ισχιακού νεύρου, η πνευμονική εμβολή και η φλεγμονή του χειρουργικού τραύματος. Μελετήθηκαν κλινικά και ακτινολο-γικά 75 ασθενείς που αντιμετωπίστηκαν χειρουργικά για παρεκτοπισμένο κάταγ-μα κοτύλης τουλάχιστο κατά 3 mm, σε ένα διάστημα 6 ετών. Η διάρκεια της μετεγχειρητικής παρακο-λούθησης ήταν από 10 – 15 έτη με μέσο όρο 12,5 έτη. Συνοδές κακώσεις παρατηρήθηκαν στο 46% των ασθενών που απαίτησαν χειρουργική αντιμετώπιση ή παρατε-ταμένη νοσηλεία στη Μονάδα Εντατικής θεραπείας. Το συνολικό ικανοποιητικό κλινικό αποτελέσματα που περιλαμβάνει τους ασθενείς με άριστο ή καλό κλινικό απο-τέλεσμα ήταν 80%. Υπήρξε στενή συ-σχέτιση μεταξύ κλινικού και ακτινολο-γικού αποτελέσματος. Η πιο συχνή επι-πλοκή ήταν η έκτοπη οστεοποίηση, που παρατηρήθηκε σε 19 ασθενείς (25,3%). Στην εκτεταμένη λαγονομηριαία προ-σπέλαση παρατηρήθηκε η μεγαλύτερη επίπτωση έκτοπης οστεοποίησης, ενώ η οστεοτομία του μείζονος τροχαντήρα στην προσπέλαση Kocher – Langenbeck μείωσε ελαφρά την επίπτωση της έκτο-πης οστεοποίησης. Επιπλέον, μετατραυ-ματική οστεοαρθρίτιδα παρατηρήθηκε σε 8 ασθενείς (10,7%) και άσηπτη νέ-κρωση της μηριαίας κεφαλής σε 6 (8%). Άλλες επιπλοκές ήταν μία εν τω βάθει φλεβοθρόμβωση, μία πνευμονική εμβο-λή, μία ψευδάρθρωση τροχαντήρα και μία πάρεση ισχιακού. Συμπερασματικά, ο στόχος της χει-ρουργικής αντιμετώπιης των καταγμά-των της κοτύλης είναι η ανατομική ανά-ταξη και η συναρμογή με τη μηριαία κεφαλή προκειμένου να επιτευχθεί καλό μακροχρόνιο αποτέλεσμα. Στις περισσό-τερες περιπτώσεις η προσπέλαση Kocher – Langenbeck είναι επαρκής και η ο-στεοτομία του μείζονος τροχαντήρα, η οποία ενδείκνυται για τα συνδυασμένα κατάγματα, προσφέρει διεύρυνση του χειρουργικού πεδίου, διευκολύνει την ανάταξη και την τοποθέτηση των υλικών και παρά τις υφιστάμενες διαφωνίες, δε φαίνεται να σχετίζεται με την ανάπτυξη έκτοπης οστεοποίησης. / Fractures of the acetabulum are severe intra-articular fracture, highenergy injuries, they are usually the result of Road Traffic Accidents or fall from a height and the victims are usually young adults. They are often accompanied by other skeletal or visceral injuries than may be lifethreatening or may require prolonged treatment in the Intensive Care Unit. For many decades their treatment was conservative with poor results in most cases. In the past few decades their treatment has changed to surgical in displaced ones or those than involve the loaded area of the acetabulum, because the surgical treatment has better results. Complications of both conservative and surgical treatment are post-traumatic osteoarthrosis and osteonecrosis of the femoral head. Complications observed mainly after surgical treatment are heterotopic ossification, sciatic nerve palsy, pulmonary embolism and surgical wound infection. Seventy-five patients were studied clinically and roentgenographically with a displaced acetabular fracture of at least 3 mm that were treated surgically over a six-year period. The duration of the follow-up was from 10 to 15 years, with a mean of 12.5 years. Forty-six percent of the patients had associated injuries that required surgical intervention or prolonged treatment in the intensive care unit. The over-all satisfactory clinical result, grouping together the excellent and good results, is 80%. There was a good correlation between clinical and radiological results. The most common complication was heterotopic ossification observed in 19 patients (25.3%). The extended iliofemoral approach had the greater incidence of heterotopic ossification (40%) and the osteotomy of the greater trochanter in the Kocher- Langenebeck approach slightly decreased the incidence of heterotopic ossification. Moreover, post-traumatic osteoarthrosis was seen in 8 patients (10.7%) and osteonecrosis of the femoral head in 6 (8%). One case of deep vein thrombosis, one pulmonary embolism, one non-union of the greater trochanter and one sciatic nerve palsy were other post-surgical complications. In conclusion, surgical treatment of the acetabular fractures in order to achieve anatomical reduction of the acetabulum and congruency with the femoral head, is the ultimate goal for excellent functional outcome in long- term. In most of them, K-L approach is adequate and trochanteric osteotomy, which is indicated for associated acetabular fractures, greatly facilitates the exposure, anatomical reduction and metal work application, and despite the exsisting controversy, it is not correlated to the incidence of heterotopic ossification.

Zugl.: Berlin, Freie Universiẗat, Diss., 2007. / Includes bibliographical references.

Thesis (M.A.)--Georgia State University, 2009. / Title from title page (Digital Archive@GSU, viewed June 25, 2010) Lindsey L. Cohen, committee chair; Erin Tone, Chris Henrich, committee members. Includes bibliographical references (p. 40-44).

Osteoarthritis (OA) is the most common form of arthritis, often thought of as a disease of the elderly, but post traumatic OA predominantly impacts younger individuals. Articular cartilage is the tissue that coats the end of your bones in synovial joints. Since cartilage has limited healing capacity, defects, or injuries to it progressively erodes down to the subchondral bone. Unfortunately, current treatment options all have limitations, particularly for younger patients. Cartilage has a specific zonal architecture that is distinguished by the different cell morphologies and arrangements, biochemical composition, and mechanical properties. 3D bioprinting is a tissue engineering technique that involves the simultaneous extrusion of biomaterials and cells to fabricate constructs. The layer-by-layer nature of 3D bioprinting and the frequent use of hydrogels as biomaterials make it a promising technique to engineer zonal articular cartilage. The goal of this dissertation was to develop and use novel human reporter chondrocytes to determine optimal combinations of biomaterials to 3D bioprint both the middle-deep and surface zones of articular cartilage. Human articular chondrocytes were transduced with either a type II collagen promoter- or lubricin promoter-driven Gaussia luciferase. Upon promoter stimulation, luciferase is secreted by the cells enabling a high-throughput, temporal, assessment of either type II collagen or lubricin. The human chondrocyte reporter system was combined with a Design of Experiment approach which streamlined the process of biomaterial optimization. To 3D bioprint the deep zone, an optimal combination of gelatin methacrylate (GelMA) and hyaluronic acid methacrylate (HAMA) was determined based on type II collagen promoter-driven luminescence, chondrocyte mobility and biomaterial stiffness. While an optimal combination of GelMA and oxidized methacrylated alginate (OMA) was determined for the surface zone based on lubricin promoter-driven luminescence, lubricin secretion, and construct shape fidelity. Together these results highlight the effectiveness of human reporter chondrocyte optimization for 3D bioprinting zonal cartilage.

Bone dysplasia’s affect every 1 in 5,000 babies; most of these dysplasia’s are incurable, and some are even lethal (Stembalska et al., 2021). Hundreds of skeletal dysplasia’s are heritable, yet the genes involved are not well defined (Krakow, 2015). Most of the skeleton forms through a process called endochondral ossification (EO). There are three parts of EO: chondrogenesis, maturation, and ossification. During chondrogenesis, mesenchymal progenitor cells condense and then differentiate into chondrocytes. After differentiation, chondrocytes will elongate, then proliferate and mature to set up for primary ossification. We know that this process happens through many activated genes, but the sequential steps through which this is achieved has yet to be elucidated. In order to understand the cause of skeletal dysplasia’s and find new treatments, the molecular mechanisms controlling EO requires further investigation. This study focuses on one gene, CXXC1 Finger Protein, Cfp1, and its role in chondrocyte maturation during skeletal mouse development. Cfp1 was specifically deleted in chondrocytes, and the resultant effects on cartilage and bone were analyzed. A mild phenotype was observed in the knockout mouse model. It was found that loss of Cfp1 in chondrocytes leads to delayed ossification in the vertebrae, tibias, metatarsals, and metacarpals. Therefore, Cfp1 is necessary for normal chondrocyte maturation.

Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Thesis (M. Phil.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.