Michael Held
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View article: The CAPE TOWN modified squat and smile test: correlation with fracture union in long bone fractures of the lower limb
The CAPE TOWN modified squat and smile test: correlation with fracture union in long bone fractures of the lower limb Open
View article: Digital PCR detection of Mycobacterium tuberculosis, HIV-1 co-localization and reciprocal expansion in spinal tuberculosis biopsies
Digital PCR detection of Mycobacterium tuberculosis, HIV-1 co-localization and reciprocal expansion in spinal tuberculosis biopsies Open
DdPCR has high sensitivity for STB diagnosis. Confirming reciprocal relationships exists between Mtb and HIV-1 abundance in spinal tissue in PLWH on ART, supports characterising the immune microenvironment in co-infected tissue sites to el…
View article: Orthopaedics for Primary Health Care
Orthopaedics for Primary Health Care Open
Orthopaedics for Primary Health Care Volume 2 Most patients with orthopaedic pathology in low- to middle-income countries are treated by non-specialists. A curriculum to prepare undergraduate medical students for this duty should reflect t…
View article: The Modified Squat and Smile Test: Correlation with Fracture Union in Long Bone Fractures of the Lower Limb
The Modified Squat and Smile Test: Correlation with Fracture Union in Long Bone Fractures of the Lower Limb Open
Purpose Assessing fracture union remains a significant challenge in low-resource settings, such as those across Sub-Saharan Africa. The original Squat and Smile Test was developed as a potential surrogate measure for lower limb fracture un…
View article: Digital PCR detection of <i>Mycobacterium tuberculosis</i> and HIV-1 co-localization in spinal tuberculosis biopsies
Digital PCR detection of <i>Mycobacterium tuberculosis</i> and HIV-1 co-localization in spinal tuberculosis biopsies Open
Background Mycobacterium tuberculosis ( Mtb ) and HIV-1 co-infection in tissues is suggested to favour reciprocal replication, infection and reservoir expansion. Yet, confirmation of this detrimental synergism in diseased tissues is limite…
View article: Surgical Technique of Single-Graft Double-Bundle Posterior Cruciate Ligament Reconstruction Using the Peroneus Longus Tendon
Surgical Technique of Single-Graft Double-Bundle Posterior Cruciate Ligament Reconstruction Using the Peroneus Longus Tendon Open
The posterior cruciate ligament is the primary posterior stabilizer of the knee. Posterior cruciate ligament reconstruction (PCLR) has been demonstrated to improve outcomes and stability of the knee compared with conservative management. N…
View article: Comparing gene expression profiles of adults with isolated spinal tuberculosis to disseminated spinal tuberculosis identified by 18FDG-PET/CT at time of diagnosis, 6- and 12-months follow-up: classifying clinical stages of spinal tuberculosis and monitoring treatment response (Spinal TB X cohort study)
Comparing gene expression profiles of adults with isolated spinal tuberculosis to disseminated spinal tuberculosis identified by 18FDG-PET/CT at time of diagnosis, 6- and 12-months follow-up: classifying clinical stages of spinal tuberculosis and monitoring treatment response (Spinal TB X cohort study) Open
View article: Multi-level tuberculosis of the spine identified by 18 F-FDG-PET/CT and concomitant urogenital tuberculosis: a case report from the spinal TB X cohort
Multi-level tuberculosis of the spine identified by 18 F-FDG-PET/CT and concomitant urogenital tuberculosis: a case report from the spinal TB X cohort Open
Background Tuberculosis (TB) is caused by Mycobacterium tuberculosis ( Mtb ) and typically infects the lungs. However, extrapulmonary forms of TB can be found in approximately 20% of cases. It is suggested, that up to 10% of extrapulmonary…
View article: Tuberculous Spondylodiscitis with Psoas Abscess Descending into the Anterior Femoral Compartment Identified Using 2-deoxy-2-[18F]fluoroglucose Positron Emission Tomography Computed Tomography
Tuberculous Spondylodiscitis with Psoas Abscess Descending into the Anterior Femoral Compartment Identified Using 2-deoxy-2-[18F]fluoroglucose Positron Emission Tomography Computed Tomography Open
A 24-year-old immunocompetent woman underwent whole-body 18F-FDG PET/CT for the evaluation of MRI-suspicious tuberculous spinal lesions. The PET/CT results showed no pathological uptake in either lung, and there were no pathological change…
View article: Optimising the Orthopaedic Trauma Society Open Fracture Classification system: a proposal for modification in the context of high civilian gunshot fractures
Optimising the Orthopaedic Trauma Society Open Fracture Classification system: a proposal for modification in the context of high civilian gunshot fractures Open
View article: Learning along the Way
Learning along the Way Open
The development of open educational resources (OER) plays a key role in addressing the challenge of access to affordable, appropriate, high-quality teaching and learning materials. This is particularly the case in health sciences in South …
View article: Higher Sensitivity of Xpert MTB/RIF Ultra Over Tuberculosis Culture for the Diagnosis of Spinal Tuberculosis With Open or Computed Tomography–Guided Biopsies
Higher Sensitivity of Xpert MTB/RIF Ultra Over Tuberculosis Culture for the Diagnosis of Spinal Tuberculosis With Open or Computed Tomography–Guided Biopsies Open
Background Diagnostic specimens for spinal tuberculosis (STB) are mostly collected via open surgery. Percutaneous computed tomography (CT)–guided biopsies are used in times of limited surgical availability. However, poor diagnostic accurac…
View article: Developing an antibiogram for empiric antibiotic prescribing for adult non-spinal orthopaedic infections in a developing world setting
Developing an antibiogram for empiric antibiotic prescribing for adult non-spinal orthopaedic infections in a developing world setting Open
Purpose Empiric antibiotic strategies in the treatment of fracture-related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis should be based on local microbiological antibiograms. This study aims to descri…
View article: Is human immunodeficiency virus a risk factor for the development of nonunion?—a case–control study
Is human immunodeficiency virus a risk factor for the development of nonunion?—a case–control study Open
Objective: Human immunodeficiency virus (HIV) infection has been suggested to be associated with an increased risk of the development of nonunion after a fracture. This prospective matched case–control study in South Africa investigated co…
View article: Coding guidelines for soft tissue knee procedures based on a national Delphi consensus study
Coding guidelines for soft tissue knee procedures based on a national Delphi consensus study Open
BackgroundNo guidelines for ethical coding practice of commonly performed soft tissue knee procedures exist in South Africa.The aim of our study was to establish and prioritise codes for these procedures via a consensus of knee surgeons. M…
View article: Evaluating Basic Knee Arthroscopy Skills in Orthopaedic Trainees in a Limited-Resource Setting
Evaluating Basic Knee Arthroscopy Skills in Orthopaedic Trainees in a Limited-Resource Setting Open
Background: Orthopaedic training in Southern Africa is largely focused on trauma, although elective procedures, such as knee arthroscopy, are increasing. This is especially true in the private sector where most trainees will practice. The …
View article: Primary hip and knee arthroplasty at district level is safe and may reduce the burden on tertiary care in a low-income setting
Primary hip and knee arthroplasty at district level is safe and may reduce the burden on tertiary care in a low-income setting Open
View article: Primary Hip and Knee Arthroplasty at District Level is Safe and May Reduce the Burden on Tertiary Care in a Low-income Setting
Primary Hip and Knee Arthroplasty at District Level is Safe and May Reduce the Burden on Tertiary Care in a Low-income Setting Open
Background: Arthroplasty procedures in low-income countries are mostly performed at tertiary centers, with waiting lists exceeding 12 to 24 months. Recently, this is further exacerbated by the impact of the Covid Pandemic on elective surge…
View article: Primary Hip and Knee Arthroplasty at District Level Is Safe and May Reduce the Burden on Tertiary Care in a Low-income Setting
Primary Hip and Knee Arthroplasty at District Level Is Safe and May Reduce the Burden on Tertiary Care in a Low-income Setting Open
Background: Arthroplasty procedures in low-income countries are mostly performed at tertiary centers, with waiting lists exceeding 12 to 24 months. Recently, this is further exacerbated by the impact of the Covid Pandemic on elective surge…
View article: Inclusion of open injuries in an updated Schenck classification of knee dislocations based on a global Delphi consensus study
Inclusion of open injuries in an updated Schenck classification of knee dislocations based on a global Delphi consensus study Open
Consensus for inclusion of various factors in a KD classification system was not easily achieved. The wide geographic distribution of participants provides diverse insight and makes the results of the study globally applicable. The most im…
View article: Orthopaedic surgical training exposure at a South African academic hospital - is the experience diverse and in depth?
Orthopaedic surgical training exposure at a South African academic hospital - is the experience diverse and in depth? Open
BACKGROUND: With increasing pressure on our training hospitals, we undertook to ascertain whether our clinical orthopaedic surgery training platform is providing adequate surgical exposure, both in diversity and the level of trainee partic…
View article: Not strong enough? Movements generated during clinical examination of sagittal and rotational laxity in a cadaver knee
Not strong enough? Movements generated during clinical examination of sagittal and rotational laxity in a cadaver knee Open
BACKGROUND: Injury to the anterior cruciate ligament (ACL) is associated with sagittal and rotational laxity, which is exacerbated by damage to the anterolateral capsuloligamentous structures, also known as the anterolateral ligament (ALL)…
View article: Simultaneous or Staged Bilateral Arthroscopic Rotator Cuff Repair: An Observational Study of Intraoperative and Postoperative Outcomes
Simultaneous or Staged Bilateral Arthroscopic Rotator Cuff Repair: An Observational Study of Intraoperative and Postoperative Outcomes Open
Background: Bilateral arthroscopic rotator cuff repair (ARCR) is frequently performed in patients with symptomatic bilateral rotator cuff tears. Purpose: To compare patient-reported outcomes and mobility between simultaneous and staged bil…
View article: Development and Validation of a Simplified Chinese Version and a Face-Scale Version of the Oxford Shoulder Score: A 2-Center Prospective Study
Development and Validation of a Simplified Chinese Version and a Face-Scale Version of the Oxford Shoulder Score: A 2-Center Prospective Study Open
Background: There has not yet been a pictorial version of a patient-reported outcome measure for shoulder pain. Purpose: To translate the English version of the Oxford Shoulder Score (OSS) to a simplified Chinese version (SC-OSS) and to va…
View article: Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: It was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak
Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: It was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak Open
We report a low 30-day mortality rate of 2.5% (n=8) for patients undergoing orthopaedic surgery at our hospital during the first COVID-19 peak. None of the deaths were COVID-19 related, and all patients who tested SARS-CoV-2-positive, befo…
View article: Orthopaedics for Primary Health Care
Orthopaedics for Primary Health Care Open
Most patients with orthopaedic pathology in low- to middle-income countries are treated by non-specialists. The contents of this book is informed by a modified Delphi consensus study with experts from Africa, Europe, and North America, wh…
View article: The gunshot-related injuries in trauma (GRIT) study: A profile of patients affected by gunshot-related orthopaedic injuries across South Africa
The gunshot-related injuries in trauma (GRIT) study: A profile of patients affected by gunshot-related orthopaedic injuries across South Africa Open
Gunshot-related orthopaedic injuries represent a significant burden of disease in the SA healthcare environment. This study highlights several areas for further research in the management of the injuries and associated outcomes.
View article: Fracture Healing in Patients With HIV in South Africa: A Prospective Cohort Study
Fracture Healing in Patients With HIV in South Africa: A Prospective Cohort Study Open
Background: HIV reduces bone mineral density, mineralization, and turnover and may impair fracture healing. Setting: This prospective cohort study in South Africa investigated whether HIV infection was associated with impaired fracture hea…
View article: Prioritised challenges in the management of acute knee dislocations are stiffness, obesity, treatment delays and associated limb-threatening injuries: a global consensus study
Prioritised challenges in the management of acute knee dislocations are stiffness, obesity, treatment delays and associated limb-threatening injuries: a global consensus study Open
View article: Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients
Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients Open