Thando Ncube

#Orthopaedic Surgeon🇿🇼🇿🇦🇬🇧 #SportsMedicine , #Scholar, Musculoskeletal health for all, STEM education advocate, #Bulawayo

[Thando Ncube @Ncube_Ortho]

#orthotwitter , #hiparthroscopy , #orthotrauma Any thoughts on how to tackle this. 30yr/M, MVA, Rt posterior hip dislocation reduced, stable post reduction, intact sciatic nerve. Non-op?, Reconstruct? Ant or Post approach?,Surgical hip dislocation?Arthroscopy?

[Thando Ncube @Ncube_Ortho]

@northwoods1980 The superior endplate collapse may in a way have reduced stress & strain at that level thereby explaining the less severe adjacent segment degeneration compared to motion segment below.

[Thando Ncube @Ncube_Ortho]

@northwoods1980 The distance travelled looks much greater than that allowed by the plane, no signs of screw cutout. C5 upper endplate gave in because it’s now in line with superior margin of the plate. It appears to have fractured and remodeled

[Cameron Tudor @camtudor]

Many assume an ACL graft is fully "healed" at 6 months because they see an athlete return to sport.

In reality, the graft is still maturing and can take up to 2 years to regain full strength.

Why does it matter? A quick 🧵 on graft healing and implications for rehab. 👇1/7

[Thando Ncube @Ncube_Ortho]

@generalorthomd @robgraymd @rkh_md @CE_HandSurg @handz98 @itius @ojedathies @orthotraumamd @orthogal21 @OrthopodReg @traumaticum @TraumaRuberINT @OrthoCurryMD @orthofacts Closed reduction, retrograde k-wires

[Dr. Edward Oates @traumaticum]

all wrapped up @ 9months, 3yrs post injury

[Official JAAOS @OfficialJAAOS]

What influences financial toxicity after orthopaedic trauma?

Learn here: https://t.co/7EApGDNp2g @COIRI_Research @shocktrauma @UMmedschool

[Dr. Pablo Gelber @doctorgelber]

Today is about HIP fresh osteochodral allograft transplantation! 💪🙌

[Robby Westermann @rwwesty]

@doctorgelber These are fun!

[Dr. Pablo Gelber @doctorgelber]

Patellar instability kills the cartilage 😢

[OrthoEvidence @OrthoEvidence]

💉PRP vs. Placebo for Knee Osteoarthritis: A Systematic Review and Meta-Analysis
An OE Original

Platelet-rich plasma (PRP) is one of the most popular, yet controversial, therapies in orthopaedics.

Some studies suggest it is safe and effective, while others have found no benefit.

We conducted a systematic review and meta-analysis comparing PRP vs. placebo to see what the current evidence says!

🏗️METHODS
We searched the MEDLINE, EMBASE, Cochrane, and OrthoEvidence databases for RCTs including adult patients with knee osteoarthritis comparing:

1⃣ Platelet-rich plasma injection(s)
2⃣ Placebo

We looked at the following outcomes of interest:
-pain
-WOMAC total scores (measures pain, stiffness & function)
-KOOS sub-scores (symptoms; activities of daily living; sports/rec; quality of life)
-IKDC scores (measure of function & symptoms)
-Injection site pain

We assessed the risk of bias of the included studies using the Cochrane Risk of Bias tool, and the GRADE approach to determine the quality of the evidence.

🔍RESULTS
We found 12 RCTs, with a total of 1,834 patients!

Risk of Bias
The included studies generally had a low risk of bias; however, the risk of bias in selective reporting was unclear in 7 trials.

Pain
Pooled pain scores at all time points, up to 12 months post-treatment, were significantly in favour of PRP!

WOMAC Scores
Pooled WOMAC total scores at all time points, up to 12 months post-treatment, were significantly better in the PRP group.

KOOS Scores
Only 2 studies reported KOOS scores: all pooled sub-scores were not significantly different between the two groups, except the sports/recreation sub-score which was significantly better in the PRP group (p=0.05).

IKDC Scores
Pooled IKDC scores were significantly better in the PRP group at 6 and 12 months post-treatment.

Injection Site Pain
The pooled risk of injection site pain was not significantly different between the PRP and placebo groups (p=0.09).

Subgroup Analyses
No differences were found in our sub-group analyses by number of injections or formulation (leukocyte-rich vs. leukocyte poor).

✅INTERPRETATION
Current evidence suggests that PRP injections are likely to be safe and effective vs. placebo for knee osteoarthritis.

Future high-quality studies, and comparison with other non-surgical interventions are of interest to further elucidate the potential utility of PRP!

[Poonam Soni @CodeByPoonam]

MIT University released free online courses.

No textbooks or fees required.

Here are 10 courses you don't want to miss:

[Thando Ncube @Ncube_Ortho]

@centerofhip @InvictaOrtho @Orthodoc2031 @stevemchale @bonesmith_ @pratikorho Problem is poor reduction. Basicervical and intertroch fracture lines present. Blade entered neck anteroinferiorly. GT is posterior to blade & nail. Neck effectively fixed onto shaft & without GT to buttress neck the construct gradually failed as the fracture “settled”.

[Thando Ncube @Ncube_Ortho]

@jointdocShields This could be a case where FAFO applies to Ortho

[John Fulkerson @Patelladoc]

Anteromedial TTO advances patella/extensor mechanism into the dysplastic curvilinear trochlea, eliminates J and optimizes articular loading thereby reducing risk of eventual arthritis while stabilizing extensor mechanism

[Mzala Tom @RealMzalaTom]

1. MZILIKAZI'S MIGRANT KINGDOM SOUTH OF THE LIMPOPO 🇿🇼🇿🇦

After the acrimonious fall out with Shaka, King Mzilikazi and his people crossed over uKhahlamba/Drakensberg mountain range. They then temporarily joined forces with Nxaba a chief of the Nguni Msene around 1822-23.

[Thando Ncube @Ncube_Ortho]

@orthotraumamd @Davembmd We are cruising

[Thando Ncube @Ncube_Ortho]

@centerofhip On another note, suppose there’s sciatic nerve palsy from the injury & or from the dislocation, how does that impact phantom limb symptoms?

[Thando Ncube @Ncube_Ortho]

@centerofhip Biology & mechanics unfavourable -poor acetabular stock, osteopaenic, screw pull out, book still open, oblique pelvis,poor soft tissues, short femur, bone lysis, possible low grade infection; I’d leave it

[Thando Ncube @Ncube_Ortho]

@orthofacts @UMY_35 Less is More, More is Less