Systematic Review and Comparative Meta-Analysis of Outcomes Following Pedicled Muscle versus Fasciocutaneous Flap Coverage for Complex Periprosthetic Wounds in Patients with Total Knee Arthroplasty

Economides, James M.,DeFazio, Michael V.,Golshani, Kayvon,Cinque, Mark,Anghel, Ersilia L.,Attinger, Christopher E.,Evans, Karen Kim Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.2

Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.

Systematic Review and Comparative Meta-Analysis of Outcomes Following Pedicled Muscle versus Fasciocutaneous Flap Coverage for Complex Periprosthetic Wounds in Patients with Total Knee Arthroplasty

James M. Economides,Michael V. DeFazio,Kayvon Golshani,Mark Cinque,Ersilia L. Anghel,Christopher E Attinger,Karen Kim Evans 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.2

Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.

Top 50 cited articles on dental stem cell research

Kodonas, Konstantinos,Fardi, Anastasia,Gogos, Christos,Economides, Nikolaos The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.1

Objectives: Citation analysis provides a unique insight into how scientific interests and research trends have changed over time. The aim of this study was to report on the 50 top-cited papers in dental stem cell research using the Science Citation Index Expanded provided by the Web of Science database to determine the academic importance of each contribution. Materials and Methods: After the screening, article title and type, total citations and citations per year, publication journal, publication year, first and senior authors, country of origin, institution, and university of reprint author were documented for the 50 top-cited articles in dental stem cell research. Keyword analysis was performed to determine which keywords were most/least popular. Results: Top 50-cited articles were cited between 179 to 2,275 times. The majority of papers were published in 2008 and originated from the United States with the highest contribution from the National Institute of Dental & Craniofacial Research. Journal of Dental Research published the highest number of top-cited articles, followed by Stem Cells and Journal of Endodontics. The greatest number of articles was published by two individual authors, Shi and Gronthos. Among 197 unique keywords, dental pulp stem cells and mesenchymal stem cells were the most frequently used. Thirty-eight of the 50 most cited articles were original articles, and 37 of them were in the field of basic science. Conclusions: Basic science studies in dental stem cell research published in high impact factor journals had the highest citation rates.

Top 50 cited articles on dental stem cell research

Kodonas Konstantinos,Fardi Anastasia,Gogos Christos,Economides Nikolaos 대한치과보존학회 2020 Restorative Dentistry & Endodontics Vol.45 No.2

Objectives: Citation analysis provides a unique insight into how scientific interests and research trends have changed over time. The aim of this study was to report on the 50 top�cited papers in dental stem cell research using the Science Citation Index Expanded provided by the Web of Science database to determine the academic importance of each contribution. Materials and Methods: After the screening, article title and type, total citations and citations per year, publication journal, publication year, first and senior authors, country of origin, institution, and university of reprint author were documented for the 50 top-cited articles in dental stem cell research. Keyword analysis was performed to determine which keywords were most/least popular. Results: Top 50-cited articles were cited between 179 to 2,275 times. The majority of papers were published in 2008 and originated from the United States with the highest contribution from the National Institute of Dental & Craniofacial Research. Journal of Dental Research published the highest number of top-cited articles, followed by Stem Cells and Journal of Endodontics. The greatest number of articles was published by two individual authors, Shi and Gronthos. Among 197 unique keywords, dental pulp stem cells and mesenchymal stem cells were the most frequently used. Thirty-eight of the 50 most cited articles were original articles, and 37 of them were in the field of basic science. Conclusions: Basic science studies in dental stem cell research published in high impact factor journals had the highest citation rates.

Flow characteristics and alkalinity of novel bioceramic root canal sealers

Katakidis Anastasios,Sidiropoulos Konstantinos,Koulaouzidou Elisabeth,Gogos Christos,Economides Nikolaos 대한치과보존학회 2020 Restorative Dentistry & Endodontics Vol.45 No.4

Objective: This study aimed to examine the physical properties (pH and flow) of 2 novel bioceramic sealers. Materials: and Methods The tested sealers were a calcium hydroxide sealer (Sealapex) and 2 bioceramic sealers (BioRoot RCS and TotalFill BC Sealer). Flow measurements were conducted according to ISO 6876/2012, with a press method of 0.05 mL of sealer. The pH of fresh samples was tested immediately after manipulation, while set samples were stored for 3 times the recommended setting time. The predetermined time intervals ranged from 3 minutes to 24 hours for fresh samples and from 10 minutes to 7 days and 4 weeks for the set samples. Analysis of variance was performed, with p = 0.05 considered indicating significance. Results: The mean flow values were 26.99 mm for BioRoot, 28.19 for Sealapex, and 30.8 mm for TotalFill BC Sealer, satisfying the ISO standard. In the set samples, BioRoot RCS had higher pH values at 24 hours to 1 week after immersion in distilled water. At 2 weeks, both bioceramic sealers had similar pH values, greater than that of Sealapex. In the fresh samples, the bioceramic sealers had significantly higher initial pH values than Sealapex (p < 0.05). At 24 hours post-immersion, all sealers showed an alkaline pH, with the highest pH observed for TotalFill. Conclusions: The TotalFill BC Sealer demonstrated the highest flow. The bioceramic sealers initially presented higher alkaline activity than the polymeric calcium hydroxide sealer. However, at 3 and 4 weeks post-immersion, all sealers had similar pH values.