The study of bone tissue regeneration in orthopaedic diseases has stimulated great interest among bone tissue engineering specialists and orthopaedic surgeons. Combinations of biomaterials, growth factors and stem cells for repairing bone have been much studied and researched, yet remain a challenge for both scientists and clinicians pursuing regenerative medicine. The purpose of this review was to elucidate the role of sequential release of bone morphogenetic protein-2 and vascular endothelial growth factor in producing better outcomes in the field of bone tissue regeneration.
The vertebral hemangioma with cord compression is a challenge to surgeons for therapeutic improvement, and an active involvement of several disciplines as well as performance of multidisciplinary surgical treatment can be crucial in achieving favorable results.
Aims To examine the long-term outcome of arthrodesis of the hip undertaken in a paediatric population in treating painful arthritis of the hip. In our patient population, most of whom live rurally in hilly terrain and have limited healthcare access and resources, hip arthrodesis has been an important surgical option for the monoarticular painful hip in a child. Methods A follow-up investigation was undertaken on a cohort of 28 children previously reported at a mean of 4.8 years. The present study looked at 26 patients who had an arthrodesis of the hip as a child at a mean follow-up of 20 years (15 to 29). Results The mean Harris Hip Score (HHS) increased from 39.60 (SD 11.06) preoperatively to 81.02 (SD 8.86; p = 0.041) at final review. At latest follow-up, the HHS was found to be excellent in four patients (15%), good in 11 (42%), and fair in 11 (42%). A total of 16 patients (62%) reported mild low back pain, five (19%) had moderate pain, and five (19%) patients had no back pain. Mild ipsilateral knee pain was reported by 19 (73%), moderate pain by one (4%), and no pain by six (23%) patients. Mild contralateral hip pain was reported by ten patients (38%), and no pain by 16 (62%). The 36-Item Short Form Health Survey scores were very good in four patients (15%), good in 18 (70%), and poor in four (15%), with a mean score of 70.92 (SD 12.65). Of 13 female patients who had given birth, 12 did so with uncomplicated vaginal delivery. All patients had to modify their posture for toileting, putting on lower body clothes, foot care, and putting on shoes. Conclusion Our results show that with hip arthrodesis, most patients have relatively good function at long-term follow-up, although some pain is experienced in adjacent joints, and modification in some activities of daily living is common. Cite this article: Bone Joint J 2022;104-B(9):1089–1094.
A pavement is considered a multi-layer system that distributes the vehicular load over a large area and transfers it to the foundation. Flexible pavement is mainly deteriorated due to the failure of its layer as well as the subgrade soil. Resisting the vehicular load requires the appropriate thickness of the sub-base and base with optimization of cost. This study aims to find the effect of the cement-treated base on thickness, unit cost, and life cycle cost. Design traffic was estimated for 15 years design period with an annual traffic growth rate of 5% for the Pathlaiya-Nijgadh Section of the East-West Highway of Nepal. The thickness of the granular base and the cement-treated base was 500 mm and 357.43 mm for design traffic of 34.86 million standard axles (msa) and the total pavement thickness for design traffic of 34.86 msa was 590 mm and 457.43 mm respectively. The comparison of cost estimates for the base course revealed that there was a 5.63% reduction in the per km cost of the cement-treated base as compared to the granular base. The cement-treated base seems to be a viable alternative to the base course for road construction as compared to the granular base. The pavement maintenance using a Cement-Treated Base (CTB) was 47.31% more economical than pavement maintenance using a granular base course. The total cost including initial investment and the cost of the maintenance of the pavement construction using CTB was 24.39% lower than that of the granular base.
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