Arthroplasty/Joint Replacement

Michele Manuel, PhD, Associate Professor of Materials Science and Engineering at the University of Florida in Gainesville, has developed a surgical pin made from magnesium and is working to control the rate at which the pin biodegrades in the body. In laboratory tests, the pin offered several advantages over traditional titanium, plastic, or stainless steel pins.

“The idea with this pin is that it would dissolve over time, and after it’s finished, your body is basically in the same state it was before you had an injury,” stated Dr. Manuel. “Surgical pins don’t have to become permanent fixtures in the body.”

In addition to being biodegradable, the pin also aids in the healing process. Magnesium builds bone, so it can function as a pin and as a nutrient. According to Dr. Manuel, the trick to using magnesium is controlling the rate at which it breaks down to give the body time to absorb the hydrogen that is release as a byproduct of breakdown. Along with controlling the rate at which the magnesium breaks down, Dr. Manuel is seeking to determine how much torque can be applied before the screw is stripped.

In laboratory tests, the magnesium pin has been inserted into the tibia of rats. X-rays show the rate at which the magnesium pins dissolve. At 6 weeks the new bone is indistinguishable from the bone before the break.

“People who have sensitivity to metal or inflammation from a foreign material in the body could benefit from this,” stated Dr. Manuel. “There are a lot of different applications that could be possible.”

Michele Manuel, PhD, Associate Professor of Materials Science and Engineering at the University of Florida in Gainesville, has developed a surgical pin made from magnesium and is working to control the rate at which the pin biodegrades in the body. In laboratory tests, the pin offered several advantages over traditional titanium, plastic, or stainless steel pins.

“The idea with this pin is that it would dissolve over time, and after it’s finished, your body is basically in the same state it was before you had an injury,” stated Dr. Manuel. “Surgical pins don’t have to become permanent fixtures in the body.”

In addition to being biodegradable, the pin also aids in the healing process. Magnesium builds bone, so it can function as a pin and as a nutrient. According to Dr. Manuel, the trick to using magnesium is controlling the rate at which it breaks down to give the body time to absorb the hydrogen that is release as a byproduct of breakdown. Along with controlling the rate at which the magnesium breaks down, Dr. Manuel is seeking to determine how much torque can be applied before the screw is stripped.

In laboratory tests, the magnesium pin has been inserted into the tibia of rats. X-rays show the rate at which the magnesium pins dissolve. At 6 weeks the new bone is indistinguishable from the bone before the break.

“People who have sensitivity to metal or inflammation from a foreign material in the body could benefit from this,” stated Dr. Manuel. “There are a lot of different applications that could be possible.”

Michele Manuel, PhD, Associate Professor of Materials Science and Engineering at the University of Florida in Gainesville, has developed a surgical pin made from magnesium and is working to control the rate at which the pin biodegrades in the body. In laboratory tests, the pin offered several advantages over traditional titanium, plastic, or stainless steel pins.

“The idea with this pin is that it would dissolve over time, and after it’s finished, your body is basically in the same state it was before you had an injury,” stated Dr. Manuel. “Surgical pins don’t have to become permanent fixtures in the body.”

In addition to being biodegradable, the pin also aids in the healing process. Magnesium builds bone, so it can function as a pin and as a nutrient. According to Dr. Manuel, the trick to using magnesium is controlling the rate at which it breaks down to give the body time to absorb the hydrogen that is release as a byproduct of breakdown. Along with controlling the rate at which the magnesium breaks down, Dr. Manuel is seeking to determine how much torque can be applied before the screw is stripped.

In laboratory tests, the magnesium pin has been inserted into the tibia of rats. X-rays show the rate at which the magnesium pins dissolve. At 6 weeks the new bone is indistinguishable from the bone before the break.

“People who have sensitivity to metal or inflammation from a foreign material in the body could benefit from this,” stated Dr. Manuel. “There are a lot of different applications that could be possible.”

Professional baseball pitchers with poor core stability are more likely to miss 30 or more days in a single season because of injury compared with pitchers who have good control of muscles in their pelvis and lower back, according to a study published August 26 online ahead of print in the American Journal of Sports Medicine.

The study shows association, not causation, but does suggest that pitchers might benefit from training to improve their lumbopelvic control. “The nice thing about lumbopelvic control is that there’s not any downside we can think of to trying to improve it,” said Ajit Chaudhari, PhD, Associate Professor of Health and Rehabilitation Sciences and of Orthopedics at The Ohio State University and lead author of the study.

A total of 347 pitchers were assessed for lumbopelvic control during spring training, then followed for the ensuing season. Most participants were between the ages of 18 and 22 years and played on teams at the developmental, minor league, or major league level.

Investigators tested their lumbopelvic control by assessing how much the pelvis tilted forward or backward as pitchers lifted a single foot about 10 cm in a movement similar to stepping up onto a curb or beginning a pitch. Study authors then placed an iPod-based tilt sensor on each participant’s sacrum and a score was assigned to each player based on the magnitude of the tilt.

Medical staff from each baseball organization recorded how many missed days players had throughout the season that followed spring training (a missed day was defined as any day a study participant could not complete his scheduled work because of an injury suffered during baseball-related activity). The majority of injuries recorded were elbow strains, shoulder strains, tears, and fractures. The subjects also were placed into 1 of 3 categories—those whose pelvises tilted less than 4 degrees, between 4 and 7.9 degrees, and more than 8 degrees from the starting position.

Players were categorized by the total numbers of days missed during the season (fewer than 30 days or 30 or more days). The analysis showed that the chances of missing 30 or more days in the season were 3 times higher for the high-tilt group than for pitchers in the lowest-tilt group. It was also 2.2 times higher than for players in the moderate-tilt group.

Further analysis suggested that of the 108 (31.1%) participants who missed at least 1 day because of injury, the average number of days missed was significantly different among the 3 groups. On average, those with poor lumbopelvic control missed 99 days, those with moderate control missed 46 days, and the well-controlled group missed 44 days.

“The core could help prevent injury by spreading out the energy load, allowing pitchers to use their legs more and their throwing arm less,” Dr. Chaudhari said.

Professional baseball pitchers with poor core stability are more likely to miss 30 or more days in a single season because of injury compared with pitchers who have good control of muscles in their pelvis and lower back, according to a study published August 26 online ahead of print in the American Journal of Sports Medicine.

The study shows association, not causation, but does suggest that pitchers might benefit from training to improve their lumbopelvic control. “The nice thing about lumbopelvic control is that there’s not any downside we can think of to trying to improve it,” said Ajit Chaudhari, PhD, Associate Professor of Health and Rehabilitation Sciences and of Orthopedics at The Ohio State University and lead author of the study.

A total of 347 pitchers were assessed for lumbopelvic control during spring training, then followed for the ensuing season. Most participants were between the ages of 18 and 22 years and played on teams at the developmental, minor league, or major league level.

Investigators tested their lumbopelvic control by assessing how much the pelvis tilted forward or backward as pitchers lifted a single foot about 10 cm in a movement similar to stepping up onto a curb or beginning a pitch. Study authors then placed an iPod-based tilt sensor on each participant’s sacrum and a score was assigned to each player based on the magnitude of the tilt.

Medical staff from each baseball organization recorded how many missed days players had throughout the season that followed spring training (a missed day was defined as any day a study participant could not complete his scheduled work because of an injury suffered during baseball-related activity). The majority of injuries recorded were elbow strains, shoulder strains, tears, and fractures. The subjects also were placed into 1 of 3 categories—those whose pelvises tilted less than 4 degrees, between 4 and 7.9 degrees, and more than 8 degrees from the starting position.

Players were categorized by the total numbers of days missed during the season (fewer than 30 days or 30 or more days). The analysis showed that the chances of missing 30 or more days in the season were 3 times higher for the high-tilt group than for pitchers in the lowest-tilt group. It was also 2.2 times higher than for players in the moderate-tilt group.

Further analysis suggested that of the 108 (31.1%) participants who missed at least 1 day because of injury, the average number of days missed was significantly different among the 3 groups. On average, those with poor lumbopelvic control missed 99 days, those with moderate control missed 46 days, and the well-controlled group missed 44 days.

“The core could help prevent injury by spreading out the energy load, allowing pitchers to use their legs more and their throwing arm less,” Dr. Chaudhari said.

Professional baseball pitchers with poor core stability are more likely to miss 30 or more days in a single season because of injury compared with pitchers who have good control of muscles in their pelvis and lower back, according to a study published August 26 online ahead of print in the American Journal of Sports Medicine.

The study shows association, not causation, but does suggest that pitchers might benefit from training to improve their lumbopelvic control. “The nice thing about lumbopelvic control is that there’s not any downside we can think of to trying to improve it,” said Ajit Chaudhari, PhD, Associate Professor of Health and Rehabilitation Sciences and of Orthopedics at The Ohio State University and lead author of the study.

A total of 347 pitchers were assessed for lumbopelvic control during spring training, then followed for the ensuing season. Most participants were between the ages of 18 and 22 years and played on teams at the developmental, minor league, or major league level.

Investigators tested their lumbopelvic control by assessing how much the pelvis tilted forward or backward as pitchers lifted a single foot about 10 cm in a movement similar to stepping up onto a curb or beginning a pitch. Study authors then placed an iPod-based tilt sensor on each participant’s sacrum and a score was assigned to each player based on the magnitude of the tilt.

Medical staff from each baseball organization recorded how many missed days players had throughout the season that followed spring training (a missed day was defined as any day a study participant could not complete his scheduled work because of an injury suffered during baseball-related activity). The majority of injuries recorded were elbow strains, shoulder strains, tears, and fractures. The subjects also were placed into 1 of 3 categories—those whose pelvises tilted less than 4 degrees, between 4 and 7.9 degrees, and more than 8 degrees from the starting position.

Players were categorized by the total numbers of days missed during the season (fewer than 30 days or 30 or more days). The analysis showed that the chances of missing 30 or more days in the season were 3 times higher for the high-tilt group than for pitchers in the lowest-tilt group. It was also 2.2 times higher than for players in the moderate-tilt group.

Further analysis suggested that of the 108 (31.1%) participants who missed at least 1 day because of injury, the average number of days missed was significantly different among the 3 groups. On average, those with poor lumbopelvic control missed 99 days, those with moderate control missed 46 days, and the well-controlled group missed 44 days.

“The core could help prevent injury by spreading out the energy load, allowing pitchers to use their legs more and their throwing arm less,” Dr. Chaudhari said.

Researchers have developed algorithms to pinpoint weak spots in the tendons, bones, and muscles that are prone to breaking or tearing, according to a study published online August 27 in the Journal of the Royal Society Interface.

“Tendons are constantly stretching as muscles pull on them, and bones also bend or compress as we carry out everyday activities,” said senior investigator Stavros Thomopoulos, PhD, Professor of Orthopaedic Surgery at Washington University in St. Louis. “Small cracks or tears can result from these loads and lead to major injuries. Understanding how these tears and cracks develop over time therefore is important for diagnosing and tracking injuries.”

The investigators developed a way to visualize and predict spots where tissues are weakened. This was accomplished by stretching tissues and tracking the results as their shapes changed. Algorithms were then developed that can identify areas of weakening prior to breakage. The algorithm was tested in various materials and in animal models. “The new algorithm allowed us to find the places where the tears were beginning to form and to track them as they extended. Older algorithms are not as good at finding and tracking localized strains,” the researchers reported.

One of the two algorithms is 1,000 times more accurate than older methods at quantifying very large stretches near tiny cracks and tears. A second algorithm has the ability to predict where cracks and failures are likely to form.

Overall, the researchers aim to use these algorithms to prevent additional injuries following surgery to repair shoulders, knees, and other tissue. “It’s vital to understand the ways that physical forces cause structures and tissues to deform so that we can identify the onset of failures and eventually predict them.”

Researchers have developed algorithms to pinpoint weak spots in the tendons, bones, and muscles that are prone to breaking or tearing, according to a study published online August 27 in the Journal of the Royal Society Interface.

“Tendons are constantly stretching as muscles pull on them, and bones also bend or compress as we carry out everyday activities,” said senior investigator Stavros Thomopoulos, PhD, Professor of Orthopaedic Surgery at Washington University in St. Louis. “Small cracks or tears can result from these loads and lead to major injuries. Understanding how these tears and cracks develop over time therefore is important for diagnosing and tracking injuries.”

The investigators developed a way to visualize and predict spots where tissues are weakened. This was accomplished by stretching tissues and tracking the results as their shapes changed. Algorithms were then developed that can identify areas of weakening prior to breakage. The algorithm was tested in various materials and in animal models. “The new algorithm allowed us to find the places where the tears were beginning to form and to track them as they extended. Older algorithms are not as good at finding and tracking localized strains,” the researchers reported.

One of the two algorithms is 1,000 times more accurate than older methods at quantifying very large stretches near tiny cracks and tears. A second algorithm has the ability to predict where cracks and failures are likely to form.

Overall, the researchers aim to use these algorithms to prevent additional injuries following surgery to repair shoulders, knees, and other tissue. “It’s vital to understand the ways that physical forces cause structures and tissues to deform so that we can identify the onset of failures and eventually predict them.”

Researchers have developed algorithms to pinpoint weak spots in the tendons, bones, and muscles that are prone to breaking or tearing, according to a study published online August 27 in the Journal of the Royal Society Interface.

“Tendons are constantly stretching as muscles pull on them, and bones also bend or compress as we carry out everyday activities,” said senior investigator Stavros Thomopoulos, PhD, Professor of Orthopaedic Surgery at Washington University in St. Louis. “Small cracks or tears can result from these loads and lead to major injuries. Understanding how these tears and cracks develop over time therefore is important for diagnosing and tracking injuries.”

The investigators developed a way to visualize and predict spots where tissues are weakened. This was accomplished by stretching tissues and tracking the results as their shapes changed. Algorithms were then developed that can identify areas of weakening prior to breakage. The algorithm was tested in various materials and in animal models. “The new algorithm allowed us to find the places where the tears were beginning to form and to track them as they extended. Older algorithms are not as good at finding and tracking localized strains,” the researchers reported.

One of the two algorithms is 1,000 times more accurate than older methods at quantifying very large stretches near tiny cracks and tears. A second algorithm has the ability to predict where cracks and failures are likely to form.

Overall, the researchers aim to use these algorithms to prevent additional injuries following surgery to repair shoulders, knees, and other tissue. “It’s vital to understand the ways that physical forces cause structures and tissues to deform so that we can identify the onset of failures and eventually predict them.”

Iroko Pharmaceuticals (Philadelphia, Pennsylvania) announced that the FDA has approved Zorvolex (diclofenac) capsules, a nonsteroidal anti-inflammatory drug (NSAID) for the management of mild to moderate acute pain and osteoarthritis pain. This marks the second indication for the drug, which was approved by the FDA in October 2013 for treatment of mild to moderate acute pain in adults.

Zorvolex was created to align with recommendations from the FDA and several medical organizations that NSAIDs be used at the lowest effective dose and for the shortest possible duration. This low-dose NSAID was developed using SoluMatrix Fine Particle Technology. Zorvolex contains diclofenac as submicron particles that are approximately 20 times smaller than their original size. The reduction in particle size provides an increased surface area, which leads to faster dissolution.

“NSAIDs continue to be an integral part of the management for osteoarthritis and their use is likely to increase as the US population continues to age and the incidence of osteoarthritis rises,” said Roy Altman, MD, Professor of Medicine in Rheumatology at UCLA.

The approval of Zorvolex is supported by data from a 12-week multicenter, randomized, double-blind, parallel-group, placebo-controlled study. The study included 305 patients aged 41 to 90 years with osteoarthrisis of the knee or hip. Half of the patients were between the ages of 61 and 90 years. They were randomized to 35 mg of Zorvolex three times a day, 35 mg twice daily, or placebo. The Supplemental New Drug Application also included data from a 12-month open-label safety study of 602 patients.

Zorvolex is available in 18 mg or 35 mg capsules. “The approval of Zorvolex is a welcome and meaningful advance and is the first SoluMatrix NSAID option approved by the FDA for osteoarthritis pain,” Dr. Altman stated.

Iroko Pharmaceuticals (Philadelphia, Pennsylvania) announced that the FDA has approved Zorvolex (diclofenac) capsules, a nonsteroidal anti-inflammatory drug (NSAID) for the management of mild to moderate acute pain and osteoarthritis pain. This marks the second indication for the drug, which was approved by the FDA in October 2013 for treatment of mild to moderate acute pain in adults.

Zorvolex was created to align with recommendations from the FDA and several medical organizations that NSAIDs be used at the lowest effective dose and for the shortest possible duration. This low-dose NSAID was developed using SoluMatrix Fine Particle Technology. Zorvolex contains diclofenac as submicron particles that are approximately 20 times smaller than their original size. The reduction in particle size provides an increased surface area, which leads to faster dissolution.

“NSAIDs continue to be an integral part of the management for osteoarthritis and their use is likely to increase as the US population continues to age and the incidence of osteoarthritis rises,” said Roy Altman, MD, Professor of Medicine in Rheumatology at UCLA.

The approval of Zorvolex is supported by data from a 12-week multicenter, randomized, double-blind, parallel-group, placebo-controlled study. The study included 305 patients aged 41 to 90 years with osteoarthrisis of the knee or hip. Half of the patients were between the ages of 61 and 90 years. They were randomized to 35 mg of Zorvolex three times a day, 35 mg twice daily, or placebo. The Supplemental New Drug Application also included data from a 12-month open-label safety study of 602 patients.

Zorvolex is available in 18 mg or 35 mg capsules. “The approval of Zorvolex is a welcome and meaningful advance and is the first SoluMatrix NSAID option approved by the FDA for osteoarthritis pain,” Dr. Altman stated.

Iroko Pharmaceuticals (Philadelphia, Pennsylvania) announced that the FDA has approved Zorvolex (diclofenac) capsules, a nonsteroidal anti-inflammatory drug (NSAID) for the management of mild to moderate acute pain and osteoarthritis pain. This marks the second indication for the drug, which was approved by the FDA in October 2013 for treatment of mild to moderate acute pain in adults.

Zorvolex was created to align with recommendations from the FDA and several medical organizations that NSAIDs be used at the lowest effective dose and for the shortest possible duration. This low-dose NSAID was developed using SoluMatrix Fine Particle Technology. Zorvolex contains diclofenac as submicron particles that are approximately 20 times smaller than their original size. The reduction in particle size provides an increased surface area, which leads to faster dissolution.

“NSAIDs continue to be an integral part of the management for osteoarthritis and their use is likely to increase as the US population continues to age and the incidence of osteoarthritis rises,” said Roy Altman, MD, Professor of Medicine in Rheumatology at UCLA.

The approval of Zorvolex is supported by data from a 12-week multicenter, randomized, double-blind, parallel-group, placebo-controlled study. The study included 305 patients aged 41 to 90 years with osteoarthrisis of the knee or hip. Half of the patients were between the ages of 61 and 90 years. They were randomized to 35 mg of Zorvolex three times a day, 35 mg twice daily, or placebo. The Supplemental New Drug Application also included data from a 12-month open-label safety study of 602 patients.

Zorvolex is available in 18 mg or 35 mg capsules. “The approval of Zorvolex is a welcome and meaningful advance and is the first SoluMatrix NSAID option approved by the FDA for osteoarthritis pain,” Dr. Altman stated.