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Pelvic Bone

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1. Pelvic modelling and the comparison between plate position for double pelvic osteotomy using artificial cancellous bone and finite element analysis (PubMed)

Pelvic modelling and the comparison between plate position for double pelvic osteotomy using artificial cancellous bone and finite element analysis Finite element analysis was used to compare fixation methods for double pelvic osteotomy (DPO). Using 3D scanning a stereolithography (stl) image was produced of a canine pelvis and this was subsequently refined in computer aided design (CAD). Using the CAD files, the images were imported in MSC Marc software to produce a working finite element (FE (...) ) model with 3 dimensional tetrahedral elements with linear shaped functions. The dimensions of a precontoured pelvic osteotomy plate with eight screws and a twisted seven screw straight plate were used to build the 2 fixations implants for the FE models. An equivalent load of 300 N was applied progressively on all FE models in order to facilitate its convergence. The load was applied in a distributed manner on the femur-hip joint contact area in order to simulate the actual behavior of the joint

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2018 BMC veterinary research

2. Correction: Cone-beam computed tomography with automated bone subtraction in preoperative embolization for pelvic bone tumors. (PubMed)

Correction: Cone-beam computed tomography with automated bone subtraction in preoperative embolization for pelvic bone tumors. [This corrects the article DOI: 10.1371/journal.pone.0175907.].

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2017 PLoS ONE

3. Urinary incontinence and pelvic organ prolapse in women: management

Urinary incontinence and pelvic organ prolapse in women: management Urinary incontinence and pelvic organ Urinary incontinence and pelvic organ prolapse in women: management prolapse in women: management NICE guideline Published: 2 April 2019 nice.org.uk/guidance/ng123 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view (...) in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Urinary incontinence and pelvic organ prolapse in women: management (NG123) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

4. Can Navigation Improve the Ability to Achieve Tumor-free Margins in Pelvic and Sacral Primary Bone Sarcoma Resections? A Historically Controlled Study. (PubMed)

Can Navigation Improve the Ability to Achieve Tumor-free Margins in Pelvic and Sacral Primary Bone Sarcoma Resections? A Historically Controlled Study. Anatomic and surgical complexity make pelvic and sacral bone sarcoma resections challenging. Positive surgical margins are more likely to occur in patients with pelvic and sacral bone sarcomas than in those with extremity sarcomas and are associated with an increased likelihood of local recurrence. Intraoperative navigation techniques have been (...) proposed to improve surgical accuracy in achieving negative margins, but available evidence is limited to experimental (laboratory) studies and small patient series. Only one small historically controlled study is available. Because we have experience with both approaches, we wanted to assess whether navigation improves our ability to achieve negative resection margins.Are navigated resections for pelvic and sacral primary bone sarcomas better able to achieve adequate surgical margins than nonnavigated

2019 Clinical Orthopaedics and Related Research

5. A study of dynamic contrast-enhanced MR imaging features and influence factors of pelvic bone marrow in adult females. (PubMed)

A study of dynamic contrast-enhanced MR imaging features and influence factors of pelvic bone marrow in adult females. Perfusion of the pelvic bone marrow is reduced in the postmenopausal group and with age. Quantitative dynamic contrast-enhanced MRI could reflect the blood supply characteristics and hemodynamic changes of the pelvic bone marrow. These results contribute to the description of osteoporosis in the postmenopausal females and the elderly.To investigate the effect of menstrual (...) status and age on the perfusion of pelvic bone marrow in adult females using quantitative dynamic contrast-enhanced MRI (DCE-MRI).In total, 96 adult females who underwent DCE-MRI between September 2017 and December 2017 were included. All the subjects' quantitative DCE-MRI parameters of pelvic bone marrow were measured and retrospectively analyzed, including Ktrans (volume transfer constant), Kep (efflux rate constant), and Ve (interstitial volume). According to their menstrual status, the subjects

2019 Osteoporosis International

6. Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse

-1.70 to -0.33; p=0.004). The mean symptom score stayed similar across time points in the control group, but decreased in the intervention group. Three adverse events were reported, all of which were in the intervention group (one women had a fall, one woman had a pain in her tail bone, and one woman had chest pain and shortness of breath). INTERPRETATION: Our study shows that pelvic floor muscle training leads to a small, but probably important, reduction in prolapse symptoms. This finding (...) Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Discover Portal Discover Portal Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Published on 6 June 2017 doi: Pelvic floor muscle training reduced symptoms at two years slightly more than the improvement seen in women who just received a leaflet with lifestyle advice. In addition

2019 NIHR Dissemination Centre

7. Are two retrograde 3.5 mm screws superior to one 7.3 mm screw for anterior pelvic ring fixation in bones with low bone mineral density? (PubMed)

Are two retrograde 3.5 mm screws superior to one 7.3 mm screw for anterior pelvic ring fixation in bones with low bone mineral density? Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible.The aim of the present study was to biomechanically compare retrograde intramedullary fixation (...) of the superior pubic ramus using either one large- or two small-diameter screws.A total of 12 human cadaveric hemipelvises were analysed in a matched pair study design. Bone mineral density of the specimens was 68 mgHA/cm3 (standard deviation (sd) 52). The anterior pelvic ring fracture was fixed with either one 7.3 mm cannulated screw (Group 1) or two 3.5 mm pelvic cortex screws (Group 2). Progressively increasing cyclic axial loading was applied through the acetabulum. Relative movements in terms

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2017 Bone & joint research

8. CT Simulation to Evaluate of Pelvic Lymph Node Coverage in Conventional Radiotherapy Fields Based on Bone and Vessels Landmarks in Prostate Cancer Patients (PubMed)

CT Simulation to Evaluate of Pelvic Lymph Node Coverage in Conventional Radiotherapy Fields Based on Bone and Vessels Landmarks in Prostate Cancer Patients Radiotherapy is the gold standard for treatment of prostrate cancer as it can cover an adequate area of tissues at risk for metastasis.We evaluated the Pelvic lymph node coverage of conventional radiotherapy fields based on bone and vessels landmarks using computed tomography (CT) simulation in patients with prostate cancer referred (...) rim was 12.30 ± 0.64 cm, sacral width was 8.29 ± 1.01 cm, anterior promontory symphysis distance was 12.02 ± 0.92 cm and posterior promontory symphysis distance was 10.98 ± 0.73 cm.We observed that conventional radiotherapy using CT simulation based on bone and vessels landmarks provided adequate coverage of pelvic lymph nodes in our patients with prostate cancer.

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2016 Iranian journal of cancer prevention

9. Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse

-1.70 to -0.33; p=0.004). The mean symptom score stayed similar across time points in the control group, but decreased in the intervention group. Three adverse events were reported, all of which were in the intervention group (one women had a fall, one woman had a pain in her tail bone, and one woman had chest pain and shortness of breath). INTERPRETATION: Our study shows that pelvic floor muscle training leads to a small, but probably important, reduction in prolapse symptoms. This finding (...) Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Discover Portal Discover Portal Pelvic floor exercises may reduce need for further treatments for pelvic organ prolapse Published on 6 June 2017 doi: Pelvic floor muscle training reduced symptoms at two years slightly more than the improvement seen in women who just received a leaflet with lifestyle advice. In addition

2018 NIHR Dissemination Centre

10. BMI and gender increase risk for sacral fractures after multilevel instrumented spinal fusion compared to bone mineral density and pelvic parameters. (PubMed)

BMI and gender increase risk for sacral fractures after multilevel instrumented spinal fusion compared to bone mineral density and pelvic parameters. Sacral fractures are a rare but potentially devastating complication. Long-fusion constructs, including the sacrum, that do not extend to the pelvis may result in sacral fractures. Besides established risk factors including gender, age, and number of levels fused, body mass index (BMI), pelvic parameters, and bone mineral density (BMD) have also (...) , our data do not show any difference in preoperative pelvic parameters and BMD between the groups. This is in line with previous reports that indicate only a few patients with sacral fracture after fusion surgery have clear evidence of osteoporosis. Bone mineral density as a measure of bone quantity, rather than bone quality, may not be as important in these fractures as previously thought. Obesity, however, was associated with higher odds of experiencing postoperative sacral fractures. The present

2018 The Spine Journal

11. The segmentation of bones in pelvic CT images based on extraction of key frames (PubMed)

The segmentation of bones in pelvic CT images based on extraction of key frames Bone segmentation is important in computed tomography (CT) imaging of the pelvis, which assists physicians in the early diagnosis of pelvic injury, in planning operations, and in evaluating the effects of surgical treatment. This study developed a new algorithm for the accurate, fast, and efficient segmentation of the pelvis.The proposed method consists of two main parts: the extraction of key frames (...) and the segmentation of pelvic CT images. Key frames were extracted based on pixel difference, mutual information and normalized correlation coefficient. In the pelvis segmentation phase, skeleton extraction from CT images and a marker-based watershed algorithm were combined to segment the pelvis. To meet the requirements of clinical application, physician's judgment is needed. Therefore the proposed methodology is semi-automated.In this paper, 5 sets of CT data were used to test the overlapping area, and 15 CT

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2018 BMC Medical Imaging

12. Can Augmented Reality Be Helpful in Pelvic Bone Cancer Surgery? An In Vitro Study. (PubMed)

Can Augmented Reality Be Helpful in Pelvic Bone Cancer Surgery? An In Vitro Study. Application of surgical navigation for pelvic bone cancer surgery may prove useful, but in addition to the fact that research supporting its adoption remains relatively preliminary, the actual navigation devices are physically large, occupying considerable space in already crowded operating rooms. To address this issue, we developed and tested a navigation system for pelvic bone cancer surgery assimilating (...) augmented reality (AR) technology to simplify the system by embedding the navigation software into a tablet personal computer (PC).Using simulated tumors and resections in a pig pelvic model, we asked: Can AR-assisted resection reduce errors in terms of planned bone cuts and improve ability to achieve the planned margin around a tumor in pelvic bone cancer surgery?We developed an AR-based navigation system for pelvic bone tumor surgery, which could be operated on a tablet PC. We created 36 bone tumor

2018 Clinical Orthopaedics and Related Research

13. Upshifting the Ipsilateral Proximal Femur May Provide Satisfactory Reconstruction of Periacetabular Pelvic Bone Defects After Tumor Resection. (PubMed)

Upshifting the Ipsilateral Proximal Femur May Provide Satisfactory Reconstruction of Periacetabular Pelvic Bone Defects After Tumor Resection. Pelvic ring reconstruction after resection of pelvic malignancies or aggressive benign tumors remains challenging, especially when the tumor invades periacetabular bone, resulting in a Type II resection as classified by Enneking and Dunham (removal of part or all of the acetabulum). Although numerous treatment approaches are in use, none is clearly (...) tumors included osteotomy of the femoral shaft, harvesting the proximal femur as a graft. The length of the femoral graft was determined by the extent of the pelvic defect. The proper placement was selected after a comparison of the proximal femur and the pelvic defect. A curved reconstruction plate and cancellous bone screws were used for pelvic fixation. The operative duration and total blood loss were recorded. Of the 11 patients who underwent this approach, all but one had at least 2 years

2018 Clinical Orthopaedics and Related Research

14. Acetabular Reconstruction Using a Trabecular Metal Cup with a Novel Pelvic Osteotomy Technique for Severe Acetabular Bone Defect (PubMed)

Acetabular Reconstruction Using a Trabecular Metal Cup with a Novel Pelvic Osteotomy Technique for Severe Acetabular Bone Defect A 79-year-old woman with an extreme bone defect after failed cementless total hip arthroplasty underwent revision arthroplasty with a novel technique that involved cutting the anterior iliac bone and sliding it distally to reconstruct the anterior acetabular wall. A three-dimensional printed bone model enabled understanding the details of the bone defect. The clinical (...) outcome at 3 years after surgery was favorable.The advantages of this technique are twofold, namely, stable fixation of the cup sandwiched between the anterior and posterior walls and reconstruction of the anterior wall using living bone, which allows bone ingrowth into the cup.

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2018 Case reports in orthopedics

15. A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty) (PubMed)

A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty) Percutaneous approaches for pelvic bone procedures (bone biopsies, tumour ablation and cementoplasty) are multiple and less well systematised than for the spine or extremities. Among the different imaging techniques that can be used for guidance, computed tomography (CT) scan is the modality of choice because of the complex pelvic anatomy. In specific cases, such as cementoplasty (...) where real-time evaluation is a determinant, a combination of CT and fluoroscopy is highly recommended. The objective of this article is to propose a systematic approach for image-guided pelvic bone procedures, as well as to provide some technical tips. We illustrate the article with multiple examples, and diagrams of the approaches and important structures to avoid to perform these procedures safely.• Pelvic bone procedures are safe to perform if anatomical landmarks are recognised. • The safest

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2018 Insights into imaging

16. Outcomes of Pelvic Exenteration with en Bloc Partial or Complete Pubic Bone Excision for Locally Advanced Primary or Recurrent Pelvic Cancer. (PubMed)

Outcomes of Pelvic Exenteration with en Bloc Partial or Complete Pubic Bone Excision for Locally Advanced Primary or Recurrent Pelvic Cancer. Neoplasms infiltrating the pubic bone have until recently been considered a contraindication to surgery. Paucity of existing published data in regard to surgical techniques and outcomes exist.This study aims to address outcomes of our recently published technique for en bloc composite pubic bone excision during pelvic exenteration.A prospective database (...) was reviewed to identify patients who underwent a partial or complete pubic bone composite excision over a 12-year period.This study was conducted at a tertiary level exenteration unit.Primary outcomes measured were resection margin and survival. Secondary outcomes included patient and operative demographics, type of cancer, extent of pubic bone excision, morbidity, and 30-day mortality.Twenty-nine of over 500 patients undergoing exenterations (mean age, 57.9; 20 males) underwent en bloc complete (11

2016 Diseases of the Colon & Rectum

17. Pharmacological interventions for the prevention of insufficiency fractures and avascular necrosis associated with pelvic radiotherapy in adults. (PubMed)

Pharmacological interventions for the prevention of insufficiency fractures and avascular necrosis associated with pelvic radiotherapy in adults. Pelvic radiotherapy is a treatment delivered to an estimated 150,000 to 300,000 people annually across high-income countries. Fractures due to normal stresses on weakened bone due to radiotherapy are termed insufficiency fractures. Pelvic radiotherapy-related interruption of the blood supply to the hip is termed avascular necrosis and is another (...) of pharmacological interventions in adults over 18 years of age undergoing radical pelvic radiotherapy as part of anticancer treatment for a primary pelvic malignancy. We excluded studies involving radiotherapy for bone metastases. We assessed use of pharmacological interventions at any stage before or during pelvic radiotherapy. Interventions included calcium or vitamin D (or both) supplementation, bisphosphonates, selective oestrogen receptor modulators, hormone replacement therapy (oestrogen or testosterone

2018 Cochrane

18. Incorporating <sup>18</sup>FDG-PET-defined pelvic active bone marrow in the automatic treatment planning process of anal cancer patients undergoing chemo-radiation. (PubMed)

Incorporating 18FDG-PET-defined pelvic active bone marrow in the automatic treatment planning process of anal cancer patients undergoing chemo-radiation. To investigate whether the incorporation of 18FDG-PET into the automatic treatment planning process may be able to decrease the dose to active bone marrow (BM) for locally advanced anal cancer patients undergoing concurrent chemo-radiation (CHT-RT).Ten patients with locally advanced anal cancer were selected. Bone marrow within (...) the pelvis was outlined as the whole outer contour of pelvic bones or employing 18FDG-PET to identify active BM within osseous structures. Four treatment planning solutions were employed with different automatic optimization approaches toward bone marrow. Plan A used iliac crests for optimization as per RTOG 05-29 trial; plan B accounted for all pelvic BM as outlined by the outer surface of external osseous structures; plan C took into account both active and inactive BM as defined using 18FDG-PET; plan

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2017 BMC Cancer

19. Solitary breast cancer metastasis to pelvic bone treated with a unique method of surgery combined with local doxorubicin administration (PubMed)

Solitary breast cancer metastasis to pelvic bone treated with a unique method of surgery combined with local doxorubicin administration Treatment of bone metastasis is a major challenge for current and future orthopedic and oncology specialists. For the treatment of single metastases, there is a continuing search for effective local treatments that do not affect the whole patient. The current report describes the case of single breast cancer metastasis to the pelvic bone in a 50-year-old woman (...) treated surgically by bone osteotomy combined with local doxorubicin application. The presence of cancer cells was confirmed by histopathological examination. After 6 months, the same defect was operated on again and a successful therapeutic result was confirmed by negative tumor pathology tests. The bone defect caused by osteotomy was reconstructed with allogenic bone grafts that healed completely over 14 months. To the best of our knowledge, this report is the first to combine the removal bone

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2017 Contemporary Oncology

20. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study (PubMed)

How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection.CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimics software: sacroiliac, biplanar supra-acetabular, two parallel iliopubic and ischial (...) accuracy of pelvic bone tumour resection in a cadaveric study. Bone Joint Res 2017;6:577-583. DOI: 10.1302/2046-3758.610.BJR-2017-0094.R1.© 2017 Sallent et al.

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2017 Bone & joint research

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