The Journal of Bone and Joint Surgery (American). 2008;90:133-145.
doi:10.2106/JBJS.H.00901
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Botulinum Neurotoxin as a Therapeutic Modality in Orthopaedic Surgery: More Than Twenty Years of Experience

Thorsten M. Seyler, MD1, Beth P. Smith, PhD1, David R. Marker, BS2, Jianjun Ma, MD, PhD1, Jian Shen, MD, PhD1, Tom L. Smith, PhD1, Michael A. Mont, MD2, Kat Kolaski, MD1 and L. Andrew Koman, MD1

1 Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1070. E-mail address for B.P. Smith: bpsmith@wfubmc.edu
2 Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, 2401West Belvedere Avenue, Baltimore, MD 21215

The first 150 words of the full text of this article appear below.


   Introduction
 
Botulinum neurotoxins are among the most potent toxins found in nature, and are produced by Clostridium botulinum, an anaerobic, gram-positive, spore-forming rod-shaped bacterium1. There are seven known serotypes of botulinum neurotoxins (termed A, B, C1, D, E, F, G) that cleave soluble N-ethyl-maleimide-sensitive factor attachment receptor (SNARE) proteins, preventing effective release of neurotransmitters across specialized synaptic junctions. Blocking SNARE protein function within neuromuscular junctions produces flaccid paralysis, results in anhidrosis within sweat glands, and increases nutritional blood flow in vascular beds. On the basis of these findings, it was hypothesized that controlled injections of botulinum neurotoxins could be used to treat neuromuscular disorders. The benefits of botulinum neurotoxin injections in the treatment of various neurological disorders have captured the attention of physicians from multiple specialties and have contributed to the widespread use of botulinum neurotoxins in modern medicine2.

Currently, only botulinum neurotoxin type-A (BoNT-A) and B (BoNT-B) . . . [Full Text of this Article]


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