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3D-printing technologies can assist the surgical planning and prosthesis engineering for the management of extended chest wall resection. Different types of prosthesis have been utilized over time, but some concerns remain about their impact on the respiratory function. Here we present a new kind of 3D-printed titanium prosthesis designed to be either strong and flexible. The prosthesis was created on a 1:1 3D-printed anatomic replica of the chest, used to delineate surgical margins and to define the reconstructive requirements.
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INTRODUCTION: A total ankle replacement in a jet pilot after an open, high-energy foot and ankle fracture and dislocation with talar extrusion in a plane crash was carefully evaluated before considering fitness to fly.CASE REPORT: A 33-yr-old male test pilot of the Italian Air Force was involved in a plane crash and reported an open high-energy fracture/dislocation of the right ankle, with the expulsion of the right talus due to the impact, and other fractures. A titanium replica was inserted inside the ankle. However, the patient suffered from intolerable pain and developed arthritic changes in the cartilage of the tibial plafond. For these reasons, a decision was made to perform a custom-made total ankle replacement.DISCUSSION: The 2-yr follow-up after the last operation and the evaluation of the pilot's fitness to fly are reported in this case study. The pilot was assessed fit to fly, including high performance military aircrafts.Verde P, Guardigli S, Morgagni F, Roberts S, Monopoli D, Scala A. Total ankle replacement in a military jet pilot. Aerosp Med Hum Perform. 2020; 91(7):597-603.
Assuntos
Fraturas do Tornozelo , Artroplastia de Substituição do Tornozelo , Militares , Adulto , Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Humanos , Masculino , Tálus/lesões , Tálus/cirurgiaRESUMO
Osseointegration of metal prosthetic implants is a yet unresolved clinical need that depends on the interplay between the implant surface and bone cells. The lack of a relationship between bone cells and metal has traditionally been solved by coating the former with "organic" ceramics, such as hydroxyapatite. A novel approach is hereby presented, immobilizing covalently dendrimeric structures onto titanium implants. Amide-based amino terminal dendrons were synthetized and coupled to titanium surfaces in a versatile and controlled way. The dendritic moieties provide an excellent scaffold for the covalent immobilization of bioactive molecules, such as extracellular matrix (ECM) protein components or antibiotics. Herein, tripeptide arginine-glycine-aspartic acid (RGD) motifs were used to decorate the dendritic scaffolds and their influence on cell adhesion and proliferation processes was evaluated.
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Tibial tuberosity advancement (TTA) is used to treat cranial cruciate ligament rupture of the stifle joint in dogs. Tibial tuberosity fracture/fissure is a complication of TTA that may have a favorable prognosis. The aim of this study was to detect how tibial tuberosity fracture/fissure through the Maquet hole worsens the progression of osteoarthritis (OA) in the stifle joint of dogs treated with porous TTA. Seventeen cases were included in the study, divided into two groups. The first group (n = 10) included subjects that had tibial tuberosity fracture/fissure through the Maquet, and the second group included subjects that had no complications (n = 7). Both groups showed significant progression compared to OA at 3 months after surgery. We observed that at T0, the control group showed a higher level of OA. For this reason, we normalized the OA scores, evaluating the percentage difference from T0 and T1. We verified that there were no statistically significant differences between the two groups. The results confirm that OA progression in subjects undergoing TTA was not significantly influenced by fracture/fissure of the tibial tuberosity through the Maquet hole. Therefore, fracture fissure through the Maquet hole should be considered as a common minor complication during TTA.