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Cyril Mauffrey - One of the best experts on this subject based on the ideXlab platform.
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Study protocol: trial of inflation osteoplasty in the management of tibial plateau fractures
European Journal of Orthopaedic Surgery & Traumatology, 2014Co-Authors: R Jordan, Douglas Gibula, Robert Fader, Cyril MauffreyAbstract:Introduction Restoration of articular congruency is a key factor in preventing post-traumatic osteoarthritis following tibial plateau fractures. Current surgical techniques using a Bone Tamp carry the risk of joint perforation and comminution of the depressed fragments which affect patient outcome. Successful use of inflation osteoplasty has been reported in both in vitro studies (Broome et al. in J Orthopaed Traumatol 13(2):89–95, 2012 ; Mauffrey et al. in Patient Saf Surg 6:6, 2012 ) and case reports in the management of fractures of the calcaneus, cuboid, distal radius, tibial plateau and acetabulum (Gupta et al. in Foot Ankle Int 32(2):205–210, 2011 ; Heim et al. in Foot Ankle Int 29(11):1154–1157, 2008 ; Konig et al. in Case Rep Unfallchirurg 109(4):328–331, 2006 ; Reiley in J Orthop Trauma 17:141–163, 2006 ). The aim of our study is to assess whether the use of the balloon osteoplasty improves the quality of reduction of a depressed tibial plateau fracture when compared to traditional methods of fracture reduction. Method This is a single-centred randomised trial. We will recruit 24 adult patients admitted with either a depressed or split depressed tibial plateau fracture (medial or lateral) requiring surgical intervention. Consenting patients will be randomly allocated to the two treatment groups. Patients with concomitant injuries influencing the management of the tibial plateau fracture will be excluded from our study. The primary outcome measure is the quality of reduction based on the post-operative CT scan. Secondary outcome measures will be any surgical complication and patient satisfaction, measured using the Oxford Knee score and SF12 questionnaire at 3, 6 and 12 months. Principal analysis will be for the success of fracture reduction from the two techniques and the effect the operative technique had on patient satisfaction and the prevalence of surgical complications.
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Study protocol: trial of inflation osteoplasty in the management of tibial plateau fractures.
European Journal of Orthopaedic Surgery and Traumatology, 2013Co-Authors: Robert W. Jordan, Douglas Gibula, Robert Fader, J. Hao, Cyril MauffreyAbstract:Introduction Restoration of articular congruency is a key factor in preventing post-traumatic osteoarthritis following tibial plateau fractures. Current surgical techniques using a Bone Tamp carry the risk of joint perforation and comminution of the depressed fragments which affect patient outcome. Successful use of inflation osteoplasty has been reported in both in vitro studies (Broome et al. in J Orthopaed Traumatol 13(2):89–95, 2012; Mauffrey et al. in Patient Saf Surg 6:6, 2012) and case reports in the management of fractures of the calcaneus, cuboid, distal radius, tibial plateau and acetabulum (Gupta et al. in Foot Ankle Int 32(2):205–210, 2011; Heim et al. in Foot Ankle Int 29(11):1154–1157, 2008; Konig et al. in Case Rep Unfallchirurg 109(4):328–331, 2006; Reiley in J Orthop Trauma 17:141–163, 2006). The aim of our study is to assess whether the use of the balloon osteoplasty improves the quality of reduction of a depressed tibial plateau fracture when compared to traditional methods of fracture reduction.
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Incidence and pattern of technical complications in balloon-guided osteoplasty for depressed tibial plateau fractures: a pilot study in 20 consecutive patients
Patient Safety in Surgery, 2013Co-Authors: Cyril Mauffrey, Robert Fader, E Mark Hammerberg, Philip F StahelAbstract:Background Inflation Bone Tamps are becoming increasingly popular as a reduction tool for depressed tibial plateau fractures. A number of recent publications have addressed the technical aspects of balloon inflation osteoplasty. However, no study has yet been published to describe the technical limitations, intraoperative complications, and surgical bailout strategies for this new technology. Methods Observational retrospective study of all patients managed with inflatable Bone Tamps for depressed tibial plateau fractures between October 1, 2010 and December 1, 2012. The primary outcome parameter was the rate of complications, which were stratified into “minor” and “major” depending on the necessity for altering the surgical plan intraoperatively, and based on the risk for patient harm. This study was approved by the Institutional Review Board of the State of Colorado. Results A consecutive series of 20 patients were managed by balloon inflation osteoplasty for depressed tibial plateau fractures during the 15 months study period. The mean age was 42.8 years (range 20–79), with 9 females and 11 males. A total of 13 patients sustained an adverse intraoperative event (65%), with three patients sustaining multiple technical complications. Minor events ( n = 8) included the burst of a balloon with extrusion of contrast dye, and the unintentional posterior wall displacement during balloon inflation. Major events ( n = 5) included the intra-articular injection of calcium phosphate in the knee joint, and the inability to elevate the depressed articular fragment with the inflatable Bone Tamp. Conclusion The observed intraoperative complication rate of 65% reflects a steep learning curve for the use of inflation Bone Tamps to reduce depressed tibial plateau fractures. Specific surgical bailout options are provided in this article, based on our early anecdotal experience in a pilot series of 20 consecutive cases. Patients should be advised on the benefits and risks of this new technology as part of the shared decision-making process during the informed consent.
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Open Access
2013Co-Authors: Case Report, Cyril MauffreyAbstract:Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable Bone Tamp: description of a novel and safe techniqu
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Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Brandon Broome, Cyril Mauffrey, Jeremy Statton, Michael J Voor, David SeligsonAbstract:Background Anatomic reduction of intra-articular fractures of the tibial plateau and distal radius can be difficult to achieve. Treatment goals are centered on restoring the native anatomy and articular congruency. Several surgeons in the USA have begun using an inflatable Bone Tamp to reduce these fracture patterns. The concept is built on the success of the Tamp in kyphoplasty of the spine, but it has yet to be tested in the lab for use in the extremities. We performed an investigation into the safety and efficacy of using an inflatable Bone Tamp for intra-articular fracture reduction of the tibial plateau and distal radius. Materials and methods Paired cadaveric specimens were obtained for a total of six proximal tibias and six distal radii. Intra-articular depression-type fractures were created in all specimens. The inflatable Bone Tamp was then used to reduce the depression. For comparison, the tibias were fractured on the medial and lateral side and a conventional metal Tamp was used on the contralateral side of the balloon. Fine-cut micro-computed tomography (CT) scans were performed on all intact specimens, which were then fractured, and again after fracture reduction. CT data was used to measure the amount of restoration of the normal anatomy and to compare the effectiveness of the balloon to conventional methods. Results The inflatable Bone Tamp was equivalent to conventional methods in large, minimally displaced fracture fragments and proved superior when comminution was present at the articular surface. No instances of overreduction or penetration into the joint were encountered with the balloon, whereas this was a common occurrence with conventional metal Tamps. The inflatable Tamp was successful in reducing all distal radius fractures without complication. Conclusion Anatomic reduction of impacted articular fractures should be the goal of any treating surgeon. In our cadaveric models, we have shown the inflatable Bone Tamp to be safe and effective in reducing depressed articular fractures around the tibial plateau and distal radius. The balloon offers the advantage of being minimally invasive and creating a symmetric, contained defect to hold Bone filler for subchondral support.
David Seligson - One of the best experts on this subject based on the ideXlab platform.
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Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Brandon Broome, Cyril Mauffrey, Jeremy Statton, Michael J Voor, David SeligsonAbstract:Background Anatomic reduction of intra-articular fractures of the tibial plateau and distal radius can be difficult to achieve. Treatment goals are centered on restoring the native anatomy and articular congruency. Several surgeons in the USA have begun using an inflatable Bone Tamp to reduce these fracture patterns. The concept is built on the success of the Tamp in kyphoplasty of the spine, but it has yet to be tested in the lab for use in the extremities. We performed an investigation into the safety and efficacy of using an inflatable Bone Tamp for intra-articular fracture reduction of the tibial plateau and distal radius. Materials and methods Paired cadaveric specimens were obtained for a total of six proximal tibias and six distal radii. Intra-articular depression-type fractures were created in all specimens. The inflatable Bone Tamp was then used to reduce the depression. For comparison, the tibias were fractured on the medial and lateral side and a conventional metal Tamp was used on the contralateral side of the balloon. Fine-cut micro-computed tomography (CT) scans were performed on all intact specimens, which were then fractured, and again after fracture reduction. CT data was used to measure the amount of restoration of the normal anatomy and to compare the effectiveness of the balloon to conventional methods. Results The inflatable Bone Tamp was equivalent to conventional methods in large, minimally displaced fracture fragments and proved superior when comminution was present at the articular surface. No instances of overreduction or penetration into the joint were encountered with the balloon, whereas this was a common occurrence with conventional metal Tamps. The inflatable Tamp was successful in reducing all distal radius fractures without complication. Conclusion Anatomic reduction of impacted articular fractures should be the goal of any treating surgeon. In our cadaveric models, we have shown the inflatable Bone Tamp to be safe and effective in reducing depressed articular fractures around the tibial plateau and distal radius. The balloon offers the advantage of being minimally invasive and creating a symmetric, contained defect to hold Bone filler for subchondral support.
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inflation osteoplasty in vitro evaluation of a new technique for reducing depressed intra articular fractures of the tibial plateau and distal radius
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Brandon Broome, Cyril Mauffrey, Jeremy Statton, Michael J Voor, David SeligsonAbstract:Anatomic reduction of intra-articular fractures of the tibial plateau and distal radius can be difficult to achieve. Treatment goals are centered on restoring the native anatomy and articular congruency. Several surgeons in the USA have begun using an inflatable Bone Tamp to reduce these fracture patterns. The concept is built on the success of the Tamp in kyphoplasty of the spine, but it has yet to be tested in the lab for use in the extremities. We performed an investigation into the safety and efficacy of using an inflatable Bone Tamp for intra-articular fracture reduction of the tibial plateau and distal radius. Paired cadaveric specimens were obtained for a total of six proximal tibias and six distal radii. Intra-articular depression-type fractures were created in all specimens. The inflatable Bone Tamp was then used to reduce the depression. For comparison, the tibias were fractured on the medial and lateral side and a conventional metal Tamp was used on the contralateral side of the balloon. Fine-cut micro-computed tomography (CT) scans were performed on all intact specimens, which were then fractured, and again after fracture reduction. CT data was used to measure the amount of restoration of the normal anatomy and to compare the effectiveness of the balloon to conventional methods. The inflatable Bone Tamp was equivalent to conventional methods in large, minimally displaced fracture fragments and proved superior when comminution was present at the articular surface. No instances of overreduction or penetration into the joint were encountered with the balloon, whereas this was a common occurrence with conventional metal Tamps. The inflatable Tamp was successful in reducing all distal radius fractures without complication. Anatomic reduction of impacted articular fractures should be the goal of any treating surgeon. In our cadaveric models, we have shown the inflatable Bone Tamp to be safe and effective in reducing depressed articular fractures around the tibial plateau and distal radius. The balloon offers the advantage of being minimally invasive and creating a symmetric, contained defect to hold Bone filler for subchondral support.
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Inflation osteoplasty for the reduction of depressed tibial plateau fractures: description of a new technique
European Journal of Orthopaedic Surgery & Traumatology, 2010Co-Authors: Brandon Broome, David SeligsonAbstract:Current techniques for the reduction of depressed tibial plateau fractures are difficult and often imprecise. Treatment goals are centered on restoring the native anatomy and articular congruency. Reduction methods currently consist of manually elevating any depressed fragments and filling the subsequent void. Current instruments are imprecise and considerable variability exists as to acceptable reduction limits. Often the void is small and insufficient space available for Bone filler to provide adequate support. Recently, we have begun using an inflatable Bone Tamp for the reduction of depressed tibial plateau fractures. The concept is built upon the success of the Tamp in kyphoplasty of the spine, but it has yet to be described for use in the extremities. We describe a technique for percutaneous reduction of depressed articular fragments using the inflatable Tamp. It is safe and effective and offers the benefit of minimizing soft tissue trauma and creating an expanded void to be filled with graft or other Bone substitute.
Brandon Broome - One of the best experts on this subject based on the ideXlab platform.
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Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Brandon Broome, Cyril Mauffrey, Jeremy Statton, Michael J Voor, David SeligsonAbstract:Background Anatomic reduction of intra-articular fractures of the tibial plateau and distal radius can be difficult to achieve. Treatment goals are centered on restoring the native anatomy and articular congruency. Several surgeons in the USA have begun using an inflatable Bone Tamp to reduce these fracture patterns. The concept is built on the success of the Tamp in kyphoplasty of the spine, but it has yet to be tested in the lab for use in the extremities. We performed an investigation into the safety and efficacy of using an inflatable Bone Tamp for intra-articular fracture reduction of the tibial plateau and distal radius. Materials and methods Paired cadaveric specimens were obtained for a total of six proximal tibias and six distal radii. Intra-articular depression-type fractures were created in all specimens. The inflatable Bone Tamp was then used to reduce the depression. For comparison, the tibias were fractured on the medial and lateral side and a conventional metal Tamp was used on the contralateral side of the balloon. Fine-cut micro-computed tomography (CT) scans were performed on all intact specimens, which were then fractured, and again after fracture reduction. CT data was used to measure the amount of restoration of the normal anatomy and to compare the effectiveness of the balloon to conventional methods. Results The inflatable Bone Tamp was equivalent to conventional methods in large, minimally displaced fracture fragments and proved superior when comminution was present at the articular surface. No instances of overreduction or penetration into the joint were encountered with the balloon, whereas this was a common occurrence with conventional metal Tamps. The inflatable Tamp was successful in reducing all distal radius fractures without complication. Conclusion Anatomic reduction of impacted articular fractures should be the goal of any treating surgeon. In our cadaveric models, we have shown the inflatable Bone Tamp to be safe and effective in reducing depressed articular fractures around the tibial plateau and distal radius. The balloon offers the advantage of being minimally invasive and creating a symmetric, contained defect to hold Bone filler for subchondral support.
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inflation osteoplasty in vitro evaluation of a new technique for reducing depressed intra articular fractures of the tibial plateau and distal radius
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Brandon Broome, Cyril Mauffrey, Jeremy Statton, Michael J Voor, David SeligsonAbstract:Anatomic reduction of intra-articular fractures of the tibial plateau and distal radius can be difficult to achieve. Treatment goals are centered on restoring the native anatomy and articular congruency. Several surgeons in the USA have begun using an inflatable Bone Tamp to reduce these fracture patterns. The concept is built on the success of the Tamp in kyphoplasty of the spine, but it has yet to be tested in the lab for use in the extremities. We performed an investigation into the safety and efficacy of using an inflatable Bone Tamp for intra-articular fracture reduction of the tibial plateau and distal radius. Paired cadaveric specimens were obtained for a total of six proximal tibias and six distal radii. Intra-articular depression-type fractures were created in all specimens. The inflatable Bone Tamp was then used to reduce the depression. For comparison, the tibias were fractured on the medial and lateral side and a conventional metal Tamp was used on the contralateral side of the balloon. Fine-cut micro-computed tomography (CT) scans were performed on all intact specimens, which were then fractured, and again after fracture reduction. CT data was used to measure the amount of restoration of the normal anatomy and to compare the effectiveness of the balloon to conventional methods. The inflatable Bone Tamp was equivalent to conventional methods in large, minimally displaced fracture fragments and proved superior when comminution was present at the articular surface. No instances of overreduction or penetration into the joint were encountered with the balloon, whereas this was a common occurrence with conventional metal Tamps. The inflatable Tamp was successful in reducing all distal radius fractures without complication. Anatomic reduction of impacted articular fractures should be the goal of any treating surgeon. In our cadaveric models, we have shown the inflatable Bone Tamp to be safe and effective in reducing depressed articular fractures around the tibial plateau and distal radius. The balloon offers the advantage of being minimally invasive and creating a symmetric, contained defect to hold Bone filler for subchondral support.
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Inflation osteoplasty for the reduction of depressed tibial plateau fractures: description of a new technique
European Journal of Orthopaedic Surgery & Traumatology, 2010Co-Authors: Brandon Broome, David SeligsonAbstract:Current techniques for the reduction of depressed tibial plateau fractures are difficult and often imprecise. Treatment goals are centered on restoring the native anatomy and articular congruency. Reduction methods currently consist of manually elevating any depressed fragments and filling the subsequent void. Current instruments are imprecise and considerable variability exists as to acceptable reduction limits. Often the void is small and insufficient space available for Bone filler to provide adequate support. Recently, we have begun using an inflatable Bone Tamp for the reduction of depressed tibial plateau fractures. The concept is built upon the success of the Tamp in kyphoplasty of the spine, but it has yet to be described for use in the extremities. We describe a technique for percutaneous reduction of depressed articular fragments using the inflatable Tamp. It is safe and effective and offers the benefit of minimizing soft tissue trauma and creating an expanded void to be filled with graft or other Bone substitute.
Stephen M. Belkoff - One of the best experts on this subject based on the ideXlab platform.
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An Ex Vivo Biomechanical Evaluation of an Inflatable Bone Tamp Used in the Treatment of Compression Fracture
2015Co-Authors: Stephen M. Belkoff, John M. Mathis, David C. Fenton, Robert M. Scribner, Mark E. Reiley, Karen TalmadgeAbstract:Study Design. Ex vivo biomechanical study using os-teoporotic cadaveric vertebral bodies. Objectives. To determine if the inflatable Bone Tamp (Tamp) restores height to compressed vertebral bodies and to compare the biomechanical properties of isolated, fractured osteoporotic vertebral bodies treated by kypho-plasty (Tamp) or vertebroplasty. Summary of Background Data. Previous biomechani-cal studies have shown that vertebroplasty increases ver-tebral body strength and restores vertebral body stiffness, but does not restore vertebral body height lost as a result of compression fracture. Methods. Compression fractures were experimentally created in 16 osteoporotic VBs assigned to either the Tamp or percutaneous vertebroplasty group. The tam
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An Ex Vivo Evaluation of an Inflatable Bone Tamp Used to Reduce Fractures Within Vertebral Bodies Under Load
2015Co-Authors: Stephen M. Belkoff, Louis E. Jasper, Sheila S. StevensAbstract:Study Design. Ex vivo biomechanical study using os-teoporotic cadaveric vertebral bodies. Objective. To determine if fracture reduction could be achieved by the inflatable Bone Tamp (Tamp) in vertebral bodies under simulated physiologic loads. Summary of Background Data. Previous ex vivo bio-mechanical studies showed that kyphoplasty restored vertebral body height with vertebral body endplates un-der stress-free conditions. Methods. Simulated compression fractures were ex-perimentally created in 18 osteoporotic vertebral bodies alternatingly assigned to one of two treatment (Tamp in-flation) groups: low axial load (111 N) or high axial load (222 N). Each vertebral body was then placed between two platens in a special radiolucent loading fixture an
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Histopathologic analysis of human vertebral bodies after vertebral augmentation with polymethylmethacrylate with use of an inflatable Bone Tamp. A case report.
Journal of Bone and Joint Surgery American Volume, 2005Co-Authors: Umasuthan Srikumaran, Stephen M. Belkoff, Wade Wong, Edward F. MccarthyAbstract:V ertebroplasty, first described by Galibert et al.1 for the treatment of vertebral angiomas, is now often used to treat painful osteoporotic compression fractures of vertebral bodies and the pain associated with malignant tumor osteolysis2,3. Vertebral augmentation with percutaneous injection of polymethylmethacrylate cement after the use of an inflatable Bone Tamp is a variant of vertebroplasty that is commonly called kyphoplasty, a term that we will use hereafter. Inflation of the balloon Tamp elevates the vertebral body end plates to reduce kyphosis4-6. Although infrequent, the complications of these procedures include leakage of cement into perispinal areas or the epidural space, embolization of cement, and spinal infection. Cement leakage is responsible for neurologic complications, including transient radiculopathies and spinal cord compression2,7,8. Thermal necrosis is a well-established consequence of cement-curing in conjunction with arthroplasty9-11, but the role of the exothermic polymerization of polymethylmethacrylate in vertebroplasty is unknown. Temperatures measured in an ex vivo study were sufficiently high for thermal necrosis to be considered a possibility12,13. The authors of a histopathologic study14 attributed a zone of necrosis around polymethylmethacrylate cement that had been injected into a metastatic vertebral tumor to thermal necrosis, but there may be other causes. We are aware of only two previous postmortem human studies in which augmented vertebral bodies were analyzed histologically14,15. The aim of our study was to investigate histopathologically the response of vertebral bodies to augmentation with polymethylmethacrylate cement introduced in a kyphoplasty. Fig. 1 Lateral radiograph of a spine specimen, showing four vertebrae (T11, L2, L4, and L5) containing polymethylmethacrylate. Compression fractures can be seen in several other vertebrae. Aseventy-five-year-old man presented with multiple, extremely painful compression fractures of the …
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An ex vivo evaluation of an inflatable Bone Tamp used to reduce fractures within vertebral bodies under load.
Spine, 2002Co-Authors: Stephen M. Belkoff, Louis E. Jasper, Sheila S. StevensAbstract:Study Design. Ex vivo biomechanical study using osteoporotic cadaveric vertebral bodies. Objective. To determine if fracture reduction could be achieved by the inflatable Bone Tamp (Tamp) in vertebral bodies under simulated physiologic loads. Summary of Background Data. Previous ex vivo biomechanical studies showed that kyphoplasty restored vertebral body height with vertebral body endplates under stress-free conditions. Methods. Simulated compression fractures were experimentally created in 18 osteoporotic vertebral bodies alternatingly assigned to one of two treatment (Tamp inflation) groups: low axial load (111 N) or high axial load (222 N). Each vertebral body was then placed between two platens in a special radiolucent loading fixture and subjected to the preassigned load to simulate in vivo physiologic loading. The Tamps were inflated and post-reduction heights were measured fluoroscopically. The effect of applied load and condition on vertebral body height was checked for significance (P < 0.05). Results. Comparing the experimental conditions (initial, postcompression, postinflation), there were no significant vertebral body height differences between the load groups (low load vs. high load). However, vertebral body height differences between conditions within each load group were all significant. For the low-load and high-load groups, mean postinflation heights (24.4 and 24.4 mm) were significantly greater than mean postcompression heights (21.6 and 22.5 mm) but significantly less than initial vertebral body heights (26.6 and 26.3 mm), respectively. Initial heights were fully restored in 22% (two of nine) of vertebral bodies in both groups. Conclusion. The inflatable Bone Tamp restored some of the height lost to compression fractures in vertebral bodies under simulated physiologic loads.
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an ex vivo biomechanical evaluation of an inflatable Bone Tamp used in the treatment of compression fracture
Spine, 2001Co-Authors: Stephen M. Belkoff, John M. Mathis, David C. Fenton, Robert M. Scribner, Mark E. Reiley, Karen TalmadgeAbstract:of compression fracture. Methods. Compression fractures were experimentally created in 16 osteoporotic VBs assigned to either the Tamp or percutaneous vertebroplasty group. The Tamp treatment consisted of inserting balloon-like devices into the vertebral body, inflating the Bone Tamp, and filling the void with Simplex P (Howmedica, Rutherford, NJ) Bone cement. The percutaneous vertebroplasty treatment consisted of directly injecting Cranioplastic Bone cement (CMW, Blackpool, UK) into the vertebral body. Pre- and posttreatment heights were measured, and the repaired vertebral bodies were recompressed to determine posttreatment strength and stiffness values. Results. The Tamp treatment resulted in significant restoration (97%) of vertebral body height lost after compression, whereas percutaneous vertebroplasty treatment resulted in a significantly lower restoration of lost height (30%) (P , 0.05). Both treatments resulted in significantly stronger vertebral bodies relative to their initial state (P , 0.05). The Tamp treatment restored vertebral body stiffness to initial values, but the percutaneous vertebroplasty treatment did not (P , 0.05). Conclusions. Tamp treatment resulted in significantly greater height restoration than did percutaneous vertebroplasty, without loss of vertebral body strength or stiff
Karen Talmadge - One of the best experts on this subject based on the ideXlab platform.
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An Ex Vivo Biomechanical Evaluation of an Inflatable Bone Tamp Used in the Treatment of Compression Fracture
2015Co-Authors: Stephen M. Belkoff, John M. Mathis, David C. Fenton, Robert M. Scribner, Mark E. Reiley, Karen TalmadgeAbstract:Study Design. Ex vivo biomechanical study using os-teoporotic cadaveric vertebral bodies. Objectives. To determine if the inflatable Bone Tamp (Tamp) restores height to compressed vertebral bodies and to compare the biomechanical properties of isolated, fractured osteoporotic vertebral bodies treated by kypho-plasty (Tamp) or vertebroplasty. Summary of Background Data. Previous biomechani-cal studies have shown that vertebroplasty increases ver-tebral body strength and restores vertebral body stiffness, but does not restore vertebral body height lost as a result of compression fracture. Methods. Compression fractures were experimentally created in 16 osteoporotic VBs assigned to either the Tamp or percutaneous vertebroplasty group. The tam
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an ex vivo biomechanical evaluation of an inflatable Bone Tamp used in the treatment of compression fracture
Spine, 2001Co-Authors: Stephen M. Belkoff, John M. Mathis, David C. Fenton, Robert M. Scribner, Mark E. Reiley, Karen TalmadgeAbstract:of compression fracture. Methods. Compression fractures were experimentally created in 16 osteoporotic VBs assigned to either the Tamp or percutaneous vertebroplasty group. The Tamp treatment consisted of inserting balloon-like devices into the vertebral body, inflating the Bone Tamp, and filling the void with Simplex P (Howmedica, Rutherford, NJ) Bone cement. The percutaneous vertebroplasty treatment consisted of directly injecting Cranioplastic Bone cement (CMW, Blackpool, UK) into the vertebral body. Pre- and posttreatment heights were measured, and the repaired vertebral bodies were recompressed to determine posttreatment strength and stiffness values. Results. The Tamp treatment resulted in significant restoration (97%) of vertebral body height lost after compression, whereas percutaneous vertebroplasty treatment resulted in a significantly lower restoration of lost height (30%) (P , 0.05). Both treatments resulted in significantly stronger vertebral bodies relative to their initial state (P , 0.05). The Tamp treatment restored vertebral body stiffness to initial values, but the percutaneous vertebroplasty treatment did not (P , 0.05). Conclusions. Tamp treatment resulted in significantly greater height restoration than did percutaneous vertebroplasty, without loss of vertebral body strength or stiff