Browsing by Author "Carmona, Maximiliano"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Periprosthetic Hip Fracture due to Ballistic Injuries
    (2024) Sandoval, Felipe; Valenzuela, Joaquin; Carmona, Maximiliano; Guiloff, Benjamin; Salgado, Martin
    Periprosthetic hip fractures are a common cause for revision. To date, however, there are no reports of periprosthetic fractures (PFs) in total hip arthroplasty caused by ballistic injury (BI). There are no current recommendations on the management of this pathology in the literature. The objective of this paper is to report on 2 successfully treated cases of PF caused by BIs. Additionally, a brief review of the literature regarding open fracture secondary to BIs is carried out. What we consider appropriate initial and definitive management for these patients is outlined. According to our clinical results and current evidence, adequate management for a BI Vancouver B1 femoral PF consists of early antibiotic therapy, surgical debridement, osteosynthesis with variable angle locking plate, structural allograft, cerclage wires, and negative pressure wound therapy. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).
  • No Thumbnail Available
    Item
    Tibial subchondral trabecular bone micromechanical and microarchitectural properties are affected by alignment and osteoarthritis stage
    (2020) Renault, Jean-Baptiste; Carmona, Maximiliano; Tzioupis, Chris; Ollivier, Matthieu; Argenson, Jean-Noel; Parratte, Sebastien; Chabrand, Patrick
    At advanced knee osteoarthritis (OA) stages subchondral trabecular bone (STB) is altered. Lower limb alignment plays a role in OA progression and modify the macroscopic loading of the medial and lateral condyles of the tibial plateau. How the properties of the STB relate to alignment and OA stage is not well defined. OA stage (KL scores 2-4) and alignment (HKA from 17 degrees Varus to 8 degrees Valgus) of 30 patients were measured and their tibial plateau were collected after total knee arthroplasty. STB tissue elastic modulus, bone volume fraction (BV/TV) and trabecula thickness (Tb.Th) were evaluated with nanoindentation and mu CT scans (8.1 mu m voxel-size) of medial and lateral samples of each plateau. HKA and KL scores were statistically significantly associated with STB elastic modulus, BV/TV and Tb.Th. Medial to lateral BV/TV ratio correlated with HKA angle (R = -0.53, p = 0.016), revealing a higher ratio for varus than valgus subjects. STB properties showed lower values for KL stage 4 patients. Tissue elastic modulus ratios and BV.TV ratios were strongly correlated (R = 0.81, p < 0.001). Results showed that both micromechanical and microarchitectural properties of STB are affected by macroscopic loading at late stage knee OA. For the first time, a strong association between tissue stiffness and quantity of OA STB was demonstrated.