Innovations in orthopaedic trauma: Top advancements of the past two decades and predictions for the next two

Rodham, Paul; Giannoudis, Peter V.

doi:10.1016/j.injury.2022.09.002

Cited by 4 publications

(3 citation statements)

References 71 publications

(61 reference statements)

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“…The use of carbon plates within the field of Orthopaedic trauma represents an exciting potential advancement within a field that is continually innovating [ 7 ]. There is a relative paucity of evidence regarding the clinical use of carbon-based implants, with just two small RCTs available at present.…”

Section: Discussionmentioning

confidence: 99%

Patient perspective on the use of carbon fibre plates for extremity fracture fixation

Giannoudis

Rodham

Antypas

et al. 2023

Eur J Orthop Surg Traumatol

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Introduction Carbon fibre-reinforced polyetheretherketone (CFR-PEEK) plates represent an exciting development within trauma and orthopaedic surgery, offering advantages including radiolucency, material properties similar to bone, and lack of localised tissue reaction. As more call for trials examining their use, there is no data available as to the acceptability of these implants to patients. This study aimed to therefore examine the acceptability of CFR-PEEK plates to patients undergoing fracture surgery. Methods This was a prospective cross-sectional survey of patients undergoing surgery for a fracture of the ankle, distal femur, distal radius, or proximal humerus. Once a decision had been made to pursue operative fixation with a plate, patients were provided with descriptions of both CFR-PEEK and stainless steel and titanium metal implants alongside the current clinical evidence. All patients undertook a questionnaire examining their views as to the advantages and disadvantages of CFR-PEEK plates, and whether they would be happy to participate in a trial comparing both. Results Ninety-nine patients were happy to participate (64 females, mean age 50). Eighty-seven patients reported that they would want a CFR-PEEK implant for their fracture, and 76 reported that they would be willing to participate in an RCT comparing their use. Commonly reported advantages included radiolucency, low weight and biocompatibility. Disadvantages reported included cost and concerns regarding durability. Conclusions This study demonstrates that CFR-PEEK implants would be acceptable to patients undergoing fracture surgery, with high numbers of patients stating that they would be willing to participate in a randomised study examining their use.

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Section: Discussionmentioning

confidence: 99%

Patient perspective on the use of carbon fibre plates for extremity fracture fixation

Giannoudis

Rodham

Antypas

et al. 2023

Eur J Orthop Surg Traumatol

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“…There has been debate about the long-term efficacy and risk of resistance associated with coated implants. Meta-analysis of animal studies evaluating the performance of coated titanium implants to prevent S. aureus infections concluded that active coating of titanium implants produced positive data against both MSSA and MRSA [ 95 ], while patient data has shown that antibiotic-coated implants are beneficial in the management of open tibial fractures in patients at high risk of infection, reducing infection by 75% [ 170 , 171 ].…”

Section: Antimicrobial Surface Coatingsmentioning

confidence: 99%

Strategies to Mitigate and Treat Orthopaedic Device-Associated Infections

et al. 2022

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Orthopaedic device implants play a crucial role in restoring functionality to patients suffering from debilitating musculoskeletal diseases or to those who have experienced traumatic injury. However, the surgical implantation of these devices carries a risk of infection, which represents a significant burden for patients and healthcare providers. This review delineates the pathogenesis of orthopaedic implant infections and the challenges that arise due to biofilm formation and the implications for treatment. It focuses on research advancements in the development of next-generation orthopaedic medical devices to mitigate against implant-related infections. Key considerations impacting the development of devices, which must often perform multiple biological and mechanical roles, are delineated. We review technologies designed to exert spatial and temporal control over antimicrobial presentation and the use of antimicrobial surfaces with intrinsic antibacterial activity. A range of measures to control bio-interfacial interactions including approaches that modify implant surface chemistry or topography to reduce the capacity of bacteria to colonise the surface, form biofilms and cause infections at the device interface and surrounding tissues are also reviewed.

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“…Despite rapid progress in orthopedic medical technologies over the past 20 years, traditional casts made of plaster or fiberglass have remained a mainstay for limb immobilization [ 34 , 35 , 36 ]. The fiberglass tape used in such casts is impregnated with polyurethane, thereby presenting health risks to clinical staff given the frequent occupational exposure to isocyanates (see Figure 1 C) [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts

Stefanescu,

Timlin,

Moy

et al. 2023

Toxics

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The effects of occupational isocyanate exposure range from asthma and contact dermatitis to neurotoxicity and cancer. Respiratory sensitization due to orthopedic cast application has been well documented. This study aims to compare the safety of standard-of-care fiberglass casts and a novel waterproof cast alternative by measuring the amount of isocyanate released during off-gassing over time. A 3D-printed arm simulator with comparable casing material amounts was placed in a sealed chamber. An isocyanate-sensing color-changing (SafeAir) tag was used to measure the levels of toxic exposure. Triplicate trials were conducted across all time periods (15 min, 1 h, and 24 h) and conditions. The bare arm simulator and freshly opened tags served as negative controls. Normalized pixel intensity indexes and isocyanate release estimates in ppb were derived from ImageJ-analyzed SafeAir tag photos. Fiberglass casts exhibited greater isocyanate release than both the waterproof alternative (p = 0.0002) and no-cast controls (p = 0.0006), particularly at 24 h. The waterproof alternative and no-cast control did not statistically differ (p = 0.1603). Therefore, the waterproof alternative released less isocyanate than the fiberglass casts. Waterproof cast alternatives may be safer than fiberglass by limiting medical professionals’ exposure to toxic isocyanates and, thus, decreasing their risk of suffering occupational asthma.

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Innovations in orthopaedic trauma: Top advancements of the past two decades and predictions for the next two

Cited by 4 publications

References 71 publications

Patient perspective on the use of carbon fibre plates for extremity fracture fixation

Patient perspective on the use of carbon fibre plates for extremity fracture fixation

Strategies to Mitigate and Treat Orthopaedic Device-Associated Infections

Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts

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