Base de dados : MEDLINE
Pesquisa : E07.858.442 [Categoria DeCS]
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[PMID]:29188975
[Au] Autor:Sätilä H; Lähdesmäki J; Mäkelä E; Kähärä V; Hietaharju A
[Ti] Título:Hirayama disease.
[So] Source:Duodecim;132(19):1797-803, 2016.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Hirayama is a form of cervical myelopathy affecting mainly young men. The cardinal features include progressive, either symmetrical or asymmetrical muscular weakness and atrophy of muscles innervated by C7-Th1 motoneurons. The application of soft daytime collar during the early stage of illness can halt the progression of illness.
[Mh] Termos MeSH primário: Equipamentos Ortopédicos
Atrofias Musculares Espinais da Infância/diagnóstico
Atrofias Musculares Espinais da Infância/terapia
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Progressão da Doença
Seres Humanos
Imagem por Ressonância Magnética
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:29292334
[Au] Autor:Su EP; Justin DF; Pratt CR; Sarin VK; Nguyen VS; Oh S; Jin S
[Ad] Endereço:Hospital for Special Surgery, New York, USA.
[Ti] Título:Effects of titanium nanotubes on the osseointegration, cell differentiation, mineralisation and antibacterial properties of orthopaedic implant surfaces.
[So] Source:Bone Joint J;100-B(1 Supple A):9-16, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The development and pre-clinical evaluation of nano-texturised, biomimetic, surfaces of titanium (Ti) implants treated with titanium dioxide (TiO ) nanotube arrays is reviewed. and evaluations show that TiO nanotubes on Ti surfaces positively affect the osseointegration, cell differentiation, mineralisation, and anti-microbial properties. This surface treatment can be superimposed onto existing macro and micro porous Ti implants creating a surface texture that also interacts with cells at the nano level. Histology and mechanical pull-out testing of specimens in rabbits indicate that TiO nanotubes improves bone bonding nine-fold (p = 0.008). The rate of mineralisation associated with TiO nanotube surfaces is about three times that of non-treated Ti surfaces. In addition to improved osseointegration properties, TiO nanotubes reduce the initial adhesion and colonisation of Collectively, the properties of Ti implant surfaces enhanced with TiO nanotubes show great promise. Cite this article: 2018;100-B(1 Supple A):9-16.
[Mh] Termos MeSH primário: Anti-Infecciosos/farmacologia
Nanotubos
Equipamentos Ortopédicos/microbiologia
Próteses e Implantes/microbiologia
Titânio/farmacologia
[Mh] Termos MeSH secundário: Animais
Anti-Infecciosos/administração & dosagem
Aderência Bacteriana/efeitos dos fármacos
Fenômenos Biomecânicos
Calcificação Fisiológica/efeitos dos fármacos
Diferenciação Celular/efeitos dos fármacos
Desenho de Equipamento
Seres Humanos
Osseointegração/efeitos dos fármacos
Coelhos
Propriedades de Superfície/efeitos dos fármacos
Titânio/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents); 15FIX9V2JP (titanium dioxide); D1JT611TNE (Titanium)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0551.R1


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[PMID]:29176406
[Au] Autor:Bertrand K; Raymond MH; Miller WC; Martin Ginis KA; Demers L
[Ad] Endereço:From the Université de Montréal, Faculty of Medicine, School of Rehabilitation, Montreal, Quebec, Canada (KB, M-HR, LD); Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada (WCM); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (WCM); School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada (KAMG); and Research Centre, Institut Universitaire de gériatrie de Montréal, CIUSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada (LD).
[Ti] Título:Walking Aids for Enabling Activity and Participation: A Systematic Review.
[So] Source:Am J Phys Med Rehabil;96(12):894-903, 2017 Dec.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this systematic literature review, we examined whether and how walking aids (i.e., canes, crutches, walkers, and rollators) enable activity and participation among adults with physical disabilities. Medline, Embase, all EBM reviews, PsychInfo, CINAHL, and Web of Science databases were used to identify studies published since 2008. Quantitative and qualitative designs were included. Data regarding participants, assistive device use, outcome measures, and domains of participation were extracted. Two reviewers independently rated the level of evidence and methodological quality of the studies. Outcomes were categorized per types of walking aids and activity and participation domains. Thirteen studies were included. Two studies involved canes, four pertained to rollators, and seven dealt with multiple types of walking aids. Mobility was the most frequently examined domain of activity and participation. Both negative and positive results were found. Negative outcomes were linked to the physical characteristics of the device, the use, environment, and personal reluctance. When incorporated in daily life, walking aids were found to enable several domains of activity and participation. Whether walking aids facilitate activity and participation may depend on the user's ability to overcome obstacles and integrate them in daily life. More high-quality research is needed to draw conclusions about their effectiveness.
[Mh] Termos MeSH primário: Pessoas com Deficiência/reabilitação
Equipamentos Ortopédicos/utilização
Qualidade de Vida
Equipamentos de Autoajuda/utilização
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Bengala/utilização
Muletas/utilização
Avaliação da Deficiência
Estudos de Avaliação como Assunto
Feminino
Seres Humanos
Masculino
Resultado do Tratamento
Andadores/utilização
Caminhada/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000836


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[PMID]:28877266
[Au] Autor:Sohirad S; Wilson D; Waugh C; Finnamore E; Scott A
[Ad] Endereço:Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.
[Ti] Título:Feasibility of using a hand-held device to characterize tendon tissue biomechanics.
[So] Source:PLoS One;12(9):e0184463, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To examine the feasibility of using the MyotonPRO digital palpation device in measuring the transverse stiffness of tendon tissue. DESIGN: Experimental study. METHODS: The MyotonPRO was used to measure the stiffness and related properties of ballistics gel in comparison with an external materials testing system (PCB electronics). The device was then used to measure the same properties of avian Achilles tendons before and after the removal of the overlying skin and subcutaneous tissue. Next, the test-retest reliability of the Achilles and patellar tendons was determined in humans. Finally, the stiffness of the Achilles tendon was measured before and after competitive running races of varying distances (10, 21 and 42 km, total number of athletes analyzed = 66). RESULTS: The MyotonPRO demonstrated a high degree of consistency when testing ballistics gel with known viscoelastic properties. The presence of skin overlying the avian Achilles tendon had a statistically significant impact on stiffness (p<0.01) although this impact was of very small absolute magnitude (with skin; 728 Nm ±17 Nm, without skin; Nm 704 Nm ±7 Nm). In healthy adults of normal body mass index (BMI), the reliability of stiffness values was excellent both for the patellar tendon (ICC, 0.96) and the Achilles tendon (ICC,0.96). In the the field study, men had stiffer tendons than women (p<0.05), and the stiffness of the Achilles tendon tended to increase following running (p = 0.052). CONCLUSIONS: The MyotonPRO can reliably determine the transverse mechanical properties of tendon tissue. The measured values are influenced by the presence of overlying skin, however this does not appear to compromise the ability of the device to record physiologically and clinically relevant measurements.
[Mh] Termos MeSH primário: Tendão do Calcâneo/patologia
Equipamentos Ortopédicos
Ligamento Patelar/patologia
Corrida
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos
Índice de Massa Corporal
Módulo de Elasticidade/fisiologia
Elasticidade
Estudos de Viabilidade
Feminino
Géis
Seres Humanos
Masculino
Imagens de Fantasmas
Reprodutibilidade dos Testes
Projetos de Pesquisa
Estresse Mecânico
Viscosidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Gels)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184463


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[PMID]:28375897
[Au] Autor:Okike K; Pollak R; O'Toole RV; Pollak AN
[Ad] Endereço:1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland 2Case Western Reserve University, Cleveland, Ohio.
[Ti] Título:"Red-Yellow-Green": Effect of an Initiative to Guide Surgeon Choice of Orthopaedic Implants.
[So] Source:J Bone Joint Surg Am;99(7):e33, 2017 Apr 05.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Orthopaedic procedures are expensive, and devices account for a large proportion of the overall costs. Hospitals have employed a variety of strategies to decrease implant costs, but many center on restricting surgeon choice. At our institution, we developed an implant selection tool that guides surgeons toward more cost-effective implants, while minimally restricting choice. The purpose of this study was to assess the effect of this tool on preferred implant usage rates, vendor attitudes toward pricing structure, and hospital implant expenditures. METHODS: For 6 commonly used orthopaedic trauma devices, similar constructs were created for the 4 vendors used at our hospital, and the costs were determined. On the basis of these costs, the available options for each device type were categorized as "green" (preferred vendor), "yellow" (midrange), or "red" (used for patient-specific requirements). The "Red-Yellow-Green" chart was posted on the wall of each orthopaedic trauma operating room. To assess the effect of the tool, we compared implant usage patterns before and after implementation of the implant selection tool. We also assessed changes in vendor contract prices, as well as overall savings to our institution. RESULTS: Implant usage changed significantly from 30% "red," 56% "yellow," and 14% "green" prior to the intervention, to 9% "red," 21% "yellow," and 70% "green" after the intervention (p < 0.0001). As a result of price renegotiation with vendors following implementation, we observed average price decreases that ranged from 1.1% to 22.4%. Average expenditures on these 6 implants decreased 20% during the study period, which represented a savings of $216,495 per year. CONCLUSIONS: At our institution, we designed and implemented "Red-Yellow-Green," a simple tool that guides surgeons toward the selection of lower-cost implants without violating vendor confidentiality clauses, limiting the implants from which surgeons can choose, or requiring surgeons to discern the prices of complex constructs. Following implementation, hospital implant expenditures decreased as a result of a combination of increased preferred vendor usage by surgeons, as well as increased competition among vendors, which resulted in lower overall prices.
[Mh] Termos MeSH primário: Tomada de Decisão Clínica/métodos
Equipamentos Ortopédicos/utilização
Cirugiões Ortopédicos/psicologia
Próteses e Implantes/utilização
[Mh] Termos MeSH secundário: Baltimore
Cor
Redução de Custos
Técnicas de Apoio para a Decisão
Gastos em Saúde
Seres Humanos
Meia-Idade
Equipamentos Ortopédicos/economia
Cirugiões Ortopédicos/economia
Próteses e Implantes/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00271


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[PMID]:28315800
[Au] Autor:Keorochana G; Pairuchvej S; Trathitephun W; Arirachakaran A; Predeeprompan P; Kongtharvonskul J
[Ad] Endereço:Orthopedics Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
[Ti] Título:Comparative Outcomes of Cortical Screw Trajectory Fixation and Pedicle Screw Fixation in Lumbar Spinal Fusion: Systematic Review and Meta-analysis.
[So] Source:World Neurosurg;102:340-349, 2017 Jun.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We conducted a systematic review and meta-analysis to compare the postoperative outcomes of cortical screw and pedicle screw (PS) fixation techniques for posterior lumbar interbody fusion (PLIF). METHOD: We searched all comparative studies that compared postoperative outcomes of cortical screw and PS fixation techniques for lumbar spinal fusions from the PubMed and Scopus databases up to 2 October 2016. RESULTS: Eight of 1147 studies (N = 466 patients) were eligible: 5 back pain Visual Analog Scale (VAS); 4 leg pain VAS; 3 Oswestry Disability Index; 2 Japanese Orthopaedic Association scale; 5 intraoperative complications (dural tear and misplacement); 6 postoperative complications (hematoma, infection, adjacent segment disease and fracture); and 4 fusion rate studies were included. The unstandardized mean difference of back and leg pain VAS and Oswestry Disability Index of cortical bone trajectory (CBT) screw fixation was -0.14 (95% confidence interval [CI]: -2.46, 2.19), -0.46 (95% CI: -1.21, 0.29), and -1.64 (95% CI: -4.17, 0.89) scores lower than PS fixation for PLIF, but without statistical significance. Whereas PLIF with CBT screw fixation was insignificant higher Japanese Orthopaedic Association score of 0.87 (95% CI: -0.06, 1.81) when compared with PS fixation. CBT had a statistically significantly lower chance of postoperative complications by 0.49 (95% CI: 0.25, 0.95) when compared with PS fixation technique. However, CBT had no insignificant lower chance of intraoperative complication by 0.82 (95% CI: 0.28, 2.41) when compared with the PS technique. CONCLUSIONS: PLIF with CBT screw fixation had postoperative back and leg pain, disabilities, and function score.
[Mh] Termos MeSH primário: Equipamentos Ortopédicos
Ortopedia/métodos
Parafusos Pediculares
Doenças da Coluna Vertebral/cirurgia
Fusão Vertebral
[Mh] Termos MeSH secundário: Seres Humanos
Vértebras Lombares/cirurgia
Fusão Vertebral/instrumentação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170320
[St] Status:MEDLINE


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[PMID]:28291189
[Au] Autor:Yang BW; Iorio ML; Day CS
[Ad] Endereço:1Harvard Medical School, Boston, Massachusetts 2Department of Orthopaedic Surgery and Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts 3Bone and Joint Center, St. Elizabeth's Medical Center, Brighton, Massachusetts.
[Ti] Título:Orthopaedic Device Approval Through the Premarket Approval Process: A Financial Feasibility Analysis for a Single Center.
[So] Source:J Bone Joint Surg Am;99(6):e26, 2017 Mar 15.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The 2 main routes of medical device approval through the U.S. Food and Drug Administration are the premarket approval (PMA) process, which requires clinical trials, and the 510(k) premarket notification, which exempts devices from clinical trials if they are substantially equivalent to an existing device. Recently, there has been growing concern regarding the safety of devices approved through the 510(k) premarket notification. The PMA process decreases the potential for device recall; however, it is substantially more costly and time-consuming. Investors and medical device companies are only willing to invest in devices if they can expect to recoup their investment within a timeline of roughly 7 years. Our study utilizes financial modeling to assess the financial feasibility of approving various orthopaedic medical devices through the 510(k) and PMA processes. The expected time to recoup investment through the 510(k) process ranged from 0.585 years to 7.715 years, with an average time of 2.4 years; the expected time to recoup investment through the PMA route ranged from 2.9 years to 24.5 years, with an average time of 8.5 years. Six of the 13 orthopaedic device systems that we analyzed would require longer than our 7-year benchmark to recoup the investment costs of the PMA process. With the 510(k) premarket notification, only 1 device system would take longer than 7 years to recoup its investment costs. Although the 510(k) premarket notification has demonstrated safety concerns, broad requirements for PMA authorization may limit device innovation for less-prevalent orthopaedic conditions. As a result, new approval frameworks may be beneficial. Our report demonstrates how current regulatory policies can potentially influence orthopaedic device innovation.
[Mh] Termos MeSH primário: Aprovação de Equipamentos
Equipamentos Ortopédicos
Ortopedia
[Mh] Termos MeSH secundário: Segurança de Equipamentos
Seres Humanos
Políticas
Vigilância de Produtos Comercializados
Estados Unidos
United States Food and Drug Administration
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00050


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[PMID]:28132971
[Au] Autor:Hagiwara Y; Yabe Y; Yamada H; Watanabe T; Kanazawa K; Koide M; Sekiguchi T; Hatano H; Itoi E
[Ad] Endereço:Department of Orthopaedic Surgery, Tohoku University School of Medicine.
[Ti] Título:Effects of a wearable type lumbosacral support for low back pain among hospital workers: A randomized controlled trial.
[So] Source:J Occup Health;59(2):201-209, 2017 Mar 28.
[Is] ISSN:1348-9585
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine the effects of a new wearable type of lumbosacral support on low back pain. METHODS: A total of 121 healthcare workers participated in this study. They were randomly allocated into the experimental and control groups and the former wore the support with signals of compression on the back by poor posture for the first 3 months. The control group remained on a waiting list for the first 3 months. Medical history, musculoskeletal symptoms, feeling in good posture, sleep habits, psychological distress, Roland-Morris Disability Questionnaire, and Somatosensory Amplification Scale (SSAS) were evaluated. The range of motion (ROM) in the shoulder and hip joints as well as spinal alignment were evaluated. Our primary concern was the difference in the change of low back pain measured by visual analog scale (VAS) between the two groups. RESULTS: A total of 54 participants in the experimental and 53 participants in the control groups were analyzed. VAS and SSAS scores as well as lumbar spinal ROM in the experimental group significantly decreased. Low back pain (OR=0.401, 95% CI=0.168-0.954) and neck pain in the experimental group (OR=0.198, 95% CI=0.052-0.748) significantly decreased. CONCLUSIONS: The new lumbar support reduced VAS and SSAS scores, lumbar spinal ROM, low back pain, and neck pain. This new type of lumbar support reduced low back pain among healthcare workers.
[Mh] Termos MeSH primário: Dor Lombar/prevenção & controle
Dor Lombar/terapia
Equipamentos Ortopédicos
Recursos Humanos em Hospital/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Avaliação da Deficiência
Ergonomia/métodos
Feminino
Seres Humanos
Japão/epidemiologia
Dor Lombar/epidemiologia
Região Lombossacral
Masculino
Meia-Idade
Postura
Amplitude de Movimento Articular
Transtornos do Sono-Vigília
Estresse Psicológico
Escala Visual Analógica
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE
[do] DOI:10.1539/joh.16-0203-OA


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[PMID]:27737804
[Au] Autor:Golish SR; Reed ML
[Ad] Endereço:Department of Surgery, Jupiter Medical Center, Palm Beach, FL, USA. Electronic address: ray@golish.com.
[Ti] Título:Spinal devices in the United States-investigational device exemption trials and premarket approval of class III devices.
[So] Source:Spine J;17(1):150-157, 2017 Jan.
[Is] ISSN:1878-1632
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND CONTEXT: Recently, there has been increased public awareness of regulatory actions by the United States Food and Drug Administration (FDA) on spinal devices. There has also been increased scrutiny of the pivotal clinical trials of these devices. PURPOSE: To investigate the premarket approval (PMA) of class III spinal devices in the United States since the turn of the century. To explore clinically relevant issues that affect the interpretation of investigational device exemption trials. STUDY DESIGN: Literature review. METHODS: From 2000 to 2015, data on PMA applications for spinal devices were obtained from two sources. First, meetings of FDA's Orthopaedic and Rehabilitation Devices Panel were identified from the Federal Register. Second, the FDA database of approved PMA applications was queried. For each device, two authors reviewed all archival data. There was no external source of funding. RESULTS: Twenty-one devices met the study criteria. There were 76.2% that received approval and 47.6% that went to panel. Arthroplasty devices were most common (52.4%), least likely to go to panel (3 of 11), and most likely to be approved after panel (3 of 3). Biologic devices were most likely to go to panel (3 of 3) and least likely to be approved after panel (1 of 3). Before and after 2009, there was no decrease in the number of spinal devices approved. All 21 devices were studied in a pivotal clinical trial. All trials except one were randomized controlled trials, and all trials except one were two-arm noninferiority designs. CONCLUSIONS: There has been no decrease in the number of new FDA-approved class III spinal devices since the turn of the century. The majority of devices have been for cervical arthroplasty. By contrast, biologic devices were most likely to go to panel and least likely to be approved after panel. The pivotal trials for nearly all devices were randomized, two-arm, noninferiority trials.
[Mh] Termos MeSH primário: Ensaios Clínicos como Assunto/normas
Aprovação de Equipamentos/normas
Equipamentos Ortopédicos/normas
[Mh] Termos MeSH secundário: Artroplastia/instrumentação
Seres Humanos
Equipamentos Ortopédicos/economia
Equipamentos Ortopédicos/estatística & dados numéricos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE


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[PMID]:27682019
[Au] Autor:Hein C; Inceoglu S; Juma D; Zuckerman L
[Ad] Endereço:*Department of Orthopaedics, Loma Linda University Medical Center, Loma Linda, CA; and †Center for Health Research, School of Public Health, Loma Linda University, Loma Linda, CA.
[Ti] Título:Heat Generation During Bone Drilling: A Comparison Between Industrial and Orthopaedic Drill Bits.
[So] Source:J Orthop Trauma;31(2):e55-e59, 2017 Feb.
[Is] ISSN:1531-2291
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Cortical bone drilling for preparation of screw placement is common in multiple surgical fields. The heat generated while drilling may reach thresholds high enough to cause osteonecrosis. This can compromise implant stability. Orthopaedic drill bits are several orders more expensive than their similarly sized, publicly available industrial counterparts. We hypothesize that an industrial bit will generate less heat during drilling, and the bits will not generate more heat after multiple cortical passes. METHODS: We compared 4 4.0 mm orthopaedic and 1 3.97 mm industrial drill bits. Three types of each bit were drilled into porcine femoral cortices 20 times. The temperature of the bone was measured with thermocouple transducers. The heat generated during the first 5 drill cycles for each bit was compared to the last 5 cycles. These data were analyzed with analysis of covariance. RESULTS: The industrial drill bit generated the smallest mean increase in temperature (2.8 ± 0.29°C) P < 0.0001. No significant difference was identified comparing the first 5 cortices drilled to the last 5 cortices drilled for each bit. The P-values are as follows: Bosch (P = 0.73), Emerge (P = 0.09), Smith & Nephew (P = 0.08), Stryker (P = 0.086), and Synthes (P = 0.16). The industrial bit generated less heat during drilling than its orthopaedic counterparts. The bits maintained their performance after 20 drill cycles. CONCLUSIONS: Consideration should be given by manufacturers to design differences that may contribute to a more efficient cutting bit. Further investigation into the reuse of these drill bits may be warranted, as our data suggest their efficiency is maintained after multiple uses.
[Mh] Termos MeSH primário: Transferência de Energia
Fêmur/fisiologia
Fêmur/cirurgia
Temperatura Alta
Equipamentos Ortopédicos
Osteotomia/instrumentação
[Mh] Termos MeSH secundário: Animais
Temperatura Corporal/fisiologia
Desenho de Equipamento
Análise de Falha de Equipamento
Fricção
Indústrias/instrumentação
Suínos
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160930
[St] Status:MEDLINE
[do] DOI:10.1097/BOT.0000000000000723



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