Journal of long-term effects of medical implants
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J Long Term Eff Med Implants · Jan 2012
Randomized Controlled Trial Comparative StudyTreatment of adhesive capsulitis of the shoulder with a static progressive stretch device: a prospective, randomized study.
Stress relaxation and static progressive stretch (SPS) are techniques that may be used to nonoperatively restore joint range of motion in the setting of adhesive capsulitis. The purpose of this study was to prospectively compare standard physical therapy alone to a combination of physical therapy with a static progressive stretch orthosis in the treatment of shoulder adhesive capsulitis. A prospective, randomized, blinded, controlled study was conducted with a total of 60 patients diagnosed with shoulder adhesive capsulitis (30 patients in the control group, 30 patients in the treatment group). ⋯ Mean external rotation was 73° and 52°, respectively. DASH scores were significantly better when a static progression stretch orthosis was used (5 vs.15 points). Use of a static progressive stretch orthosis for patients with shoulder adhesive capsulities resulted in significantly better range of motion and DASH scores within 1 month of beginning treatment than physical therapy alone.
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J Long Term Eff Med Implants · Jan 2011
Comparative StudyA comparison of the compressive strength of various distal locking screw options in the treatment of tibia fractures with intramedullary nails.
Treatment of distal metaphyseal tibia fractures is often challenging. Newer tibial intramedullary (IM) nails are designed with a wider variety of distal locking options to offer greater stability in treating these fractures. In this study we attempted to determine the most biomechanically stable number and configuration of distal locking screws when treating distal metaphyseal tibia fractures with IM nails. ⋯ The load-carrying capacity of the Group III samples with these locking screws was higher than those of Group I & II, although this difference was not statistically significant. This work is being continued to compare the load-carrying capacity of the bone samples with the cortical thickness of bone. We also plan to examine the relationship between the load-carrying capacity of these surgical constructs with the bone mineral density of the metaphysis of these tibial specimens.
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J Long Term Eff Med Implants · Jan 2011
Comparative StudyFixation of femoral neck fractures using divergent versus parallel cannulated screws.
Controversy exists regarding the optimal method of internal fixation in femoral neck fractures. Biomechanical data suggest that calcar fixation is superior to central screws placement. We propose a divergent technique for placing 3 cannulated stainless steel screws engaging the calcar femorale. ⋯ In conclusion, parallel screw placement is not critical for an excellent clinical outcome. Our proposed fixation method using 3 screws that diverge and lie in different coronal planes (1 engaging the calcar femorale) with a free-hand technique may offer enhanced fixation. Biomechanical data along with larger clinical studies are needed to establish our proposed method.
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Medical implants fall under the larger category of medical devices, which are defined as products used for medical purposes in patients, in diagnosis and/or treatment. There are three classes of devices that are controlled by the Food and Drug Administration (FDA). ⋯ Class III is the most scientifically rigorous classification of medical devices and encompasses most of the orthopedic implants on the market today. In this paper, different categories of orthopedic implants will be discussed, including the development of artificial anterior cruciate ligament (ACL) grafts and FDA approval of alumina ceramic-on-ceramic (COC) total hip prostheses.