RESUMO

PURPOSE: Infection at the pin site remains the most common complication of external fixators (EFs). It is known that hydroxyapatite (HA)-coated pins increase bone adhesion and may lead to reduced rates of reported infections. The present study compares the rates of pin track infection associated with stainless steel and HA-coated pins. METHODS: This is a prospective, multicenter, nonrandomized, comparative intervention study among patients undergoing surgical treatment with EFs of any type between April 2018 and October 2021. Patients were followed up until the removal of the EF, or the end of the study period (ranging from 1 to 27.6 months). The definition of pin track infection was based upon the Maz-Oxford-Nuffield (MON) pin infection grading system. RESULTS: Overall, 132 patients undergoing external fixation surgery were included. Of these, 94 (71.2%) were male, with a mean age of 36.9 years (SD ± 18.9). Infection of any type (score > 1) was observed in 63 (47.7%) patients. Coated and uncoated-pin track-infection occurred in 45.7% and 48.5% of patients, respectively (P= 0.0887). The probability of developing infection (defined as a score ≥ 2) adjusted for comorbidities and follow-up time was not statistically higher among those who received uncoated pins compared to those who received pins coated with HA (odds ratio (OR) = 1.56, 95% confidence interval (95% CI): 0.67-3.67, p <0.05). CONCLUSION: In the present study, the external fixator pin infection rates were similar when using HA coating and standard steel pins.

Assuntos

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Regenerative medicine proposes to regenerate or even replace human damaged tissues to return to normal functions. Hence, biomaterials have been used to provide appropriate environment for cell development. Among the groups of biodegradable biomaterials, hydrogels, which are characterized by three-dimensional and cross-linked networks of water-soluble polymers, have been highlighted as suitable matrices for such applications. An injectable hydrogel based on oxidized galactomannan (OxGM) from Delonix regia and N-succinyl chitosan (NSC) was developed and characterized according to its physicochemical and biocompatible properties. The hydrogel was formed by Schiff base (-CH = N-) cross-linking between aldehyde groups from OxGM and NH2 groups from NSC, in few minutes (9.7 min) without any external stimulus. A hydrogel with macroporous structure, interconnected pores, and porosity of 69% was obtained. The biomaterial exhibited excellent injectability. No change in volume or integrity was observed in the hydrogel after its swelling in phosphate buffered saline (PBS) medium. This is an important property because when the hydrogel is injected into the site of interest and it fills the environment, it will not have additional space to occupy. Biocompatibility studies were conducted in vitro, which revealed the non-cytotoxic nature of the material and demonstrated the potential of the hydrogel based on dialdehyde galactomannan and N-succinyl chitosan for cell culture and soft tissue engineering.

Assuntos

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OBJECTIVE: To evaluate patients affected by osteochondral fractures of the talus who were treated surgically by means of arthroscopy-assisted microperforation. METHODS: A retrospective study was carried out on 24 patients with osteochondral lesions of the talus who underwent microperforation assisted by videoarthroscopy of the ankle. They were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score system before and after the operation. RESULTS: There were 19 men and 5 women, with a mean age of 35.3 years (minimum of 17 years and maximum of 54 years). The minimum follow-up was two years (maximum of 39 months). All the patients showed an improvement in AOFAS score after surgery, with an average improvement of around 22.5 points. CONCLUSION: Videoarthroscopy-assisted microperforation is a good option for treating osteochondral lesions of the talus and provides good functional results.