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Archives of Orthopaedic and Trauma Surgery

Marc Dominique Horsthemke, Christoph Koenig, Georg Gosheger, Jendrik Hardes, Steffen Hoell
INTRODUCTION: The minimally invasive direct anterior approach (DAA) is an established approach for primary total hip arthroplasty (THA). The complication rates in hip revision arthroplasty are much higher in comparison with primary THA. A right positioning of the implants and a soft tissue, especially the abductors spearing approach, is important to get good functional results and low complication rates. The aim of this study was to show the clinical and radiological outcome of isolated revision hip arthroplasty of the cup by using the DAA...
November 11, 2018: Archives of Orthopaedic and Trauma Surgery
Chul Hyun Park, Chang Hyun Choi
INTRODUCTION: The osteochondral fracture of the talus is an uncommon condition, therefore, there are controversies for the optimal treatment. We report a novel surgical technique of bone peg fixation for osteochondral fracture of the talus. MATERIALS AND METHODS: We report two cases that underwent bone peg fixation for the acute osteochondral fractures of talus. Clinical and radiographic evaluations were performed at the last follow-up. RESULTS: At the last follow-up, mean ROM of ankle joint was 50° (range 45°-55°)...
November 11, 2018: Archives of Orthopaedic and Trauma Surgery
Bernd Fink, Uli Buntenbroich, Damian Oremek
INTRODUCTION: Modular revision stems with a short distal component can prevent the bypassing of the femoral isthmus and hereby theoretically have advantages concerning risk of periprosthetic fractures, breakage of the junction and a technically easier revision procedure. MATERIALS AND METHODS: Radiological evaluation of 202 stem revision operations with the modular curved revision stem "Revitan Curved" with a 2° taper was carried out after a mean follow-up period of 7...
November 10, 2018: Archives of Orthopaedic and Trauma Surgery
Alexander Antoniadis, Dimitris Dimitriou, Jean Pierre Canciani, Naeder Helmy
INTRODUCTION: Proper patient selection is a crucial factor for the outcome of the unicompartmental knee arthroplasty (UKA). However, there is still not a clear consensus on which patients could benefit the utmost from a UKA. The purpose of this prospective study was to introduce a novel, preoperative, predictive score (Unicompartmental Indication Score, UIS) to aid proper patient selection in UKA. MATERIALS AND METHODS: A total of 152 patients with an average age of 68 years and a mean follow-up of 27 months were evaluated preoperatively with the UIS and postoperative at every follow-up...
November 10, 2018: Archives of Orthopaedic and Trauma Surgery
S Schröter, H Nakayama, S Yoshiya, U Stöckle, A Ateschrang, J Gruhn
INTRODUCTION: The purpose of the study was to describe the development of the surgical technique of double level osteotomy in patients with severe varus malalignment and to investigate the clinical and radiological outcome. It was hypothesized that good clinical results without a higher complication rate can be achieved by double level osteotomy to normalize joint angles and avoid joint line obliquity even in cases of progressed osteoarthritis. MATERIALS AND METHODS: Between 2011 and 2014, 33 patients (37 knees) undergoing double level osteotomies (open wedge HTO and closed wedge DFO) were included; of these, 24 patients (28 knees) were available in mean of 18 ± 10 months for the follow-up examination...
November 10, 2018: Archives of Orthopaedic and Trauma Surgery
Naoya Iwata, Shingo Komura, Akihiro Hirakawa, Shigeo Kanamori, Takahiro Masuda, Yoshiki Ito, Haruhiko Akiyama
Fracture-dislocations of the fourth and fifth carpometacarpal (CMC) joints present a complex situation. Misdiagnosis and inadequate treatment may cause malunion and residual subluxation, which lead to painful arthritis and grip weakness. Open reduction along with internal fixation is the treatment of choice, but there is no consensus on an optimal treatment approach. We applied a novel surgical technique to treat a case of a fracture-dislocation of the fifth CMC joint with avulsion fracture of the hamate using a dorsal buttress plate between the hamate and the capitate...
November 9, 2018: Archives of Orthopaedic and Trauma Surgery
Leo R Brown, Nicholas D Clement, Deborah J MacDonald, Steffen J Breusch
INTRODUCTION: There is a paucity of survival data reporting the medium to long-term outcome of the LINK® Endo-Model® rotational hinge total knee arthroplasty (ERH-TKA). Such information is essential when counselling patients and predictors of survival would help inform patients of their likely outcome. MATERIALS AND METHODS: A series of patients, who received an ERH-TKA, with a minimum follow-up of 5 years, were retrospectively identified from an established arthroplasty database...
November 9, 2018: Archives of Orthopaedic and Trauma Surgery
Munir Khan, Kenneth S Rankin, Radha Todd, Emma Lethbridge, Craig Gerrand
BACKGROUND AND PURPOSE: We reviewed our experience of synovial sarcoma to identify factors predictive of local recurrence and overall survival, the impact of chemotherapy and outcomes after surgical excision alone. MATERIALS AND METHODS: 81 patients were treated between 1997 and 2014 of mean age 39 years (8-78). Tumours were in the extremity in 55 (67%). 9 patients presented with metastases and 10 with unresectable disease. Mean follow-up was 3.7 years (SD 3.8)...
November 8, 2018: Archives of Orthopaedic and Trauma Surgery
Thorsten Wichmann, T Fintan Moriarty, Iris Keller, Stefan Pfister, Vanessa Deggim-Messmer, Emanuel Gautier, Fabian Kalberer, Peter P Koch, Peter Wahl
INTRODUCTION: Knitted cotton outer gloves offer protection against surgical glove perforation and provide improved grip on instruments. These gloves absorb blood and other fluids during surgery, and may therefore also accumulate contaminating bacteria. To date, there is no published data on microbial contamination of such gloves during surgery. METHODS: Knitted cotton outer gloves used in primary and revision hip and knee arthroplasty from two Swiss hospitals were analysed by quantitative bacteriology...
November 7, 2018: Archives of Orthopaedic and Trauma Surgery
Sebastian G Walter, Robert Ossendorff, Frank A Schildberg
INTRODUCTION: Cartilage regeneration and restoration is a major topic in orthopedic research as cartilaginous degeneration and damage is associated with osteoarthritis and joint destruction. This systematic review aims to summarize current research strategies in cartilage regeneration research. MATERIALS AND METHODS: A Pubmed search for models investigating single-site cartilage defects as well as chondrogenesis was conducted and articles were evaluated for content by title and abstract...
October 31, 2018: Archives of Orthopaedic and Trauma Surgery
Emre Yilmaz, Halil Damla, Daniel C Norvell, Klaus Kalchschmidt, Christian Luering, Andre R Zahedi
INTRODUCTION: Dysplasia of the hip is a well known cause of secondary osteoarthritis of the hip. The triple pelvic osteotomy (TPO), according to the technique described by Toennis and Kalchschmidt, is a well established procedure to address dysplasia of the hip joint. Non-unions after triple pelvic osteotomies are rare and can occur at each of these osteotomies. The literature is lacking in studies investigating larger group of patients with non-unions after triple pelvic osteotomy. The aim of this study is to evaluate risk factors leading to a non-union after triple pelvic osteotomy...
October 31, 2018: Archives of Orthopaedic and Trauma Surgery
Antonio Pellegrini, Claudio Legnani, Enzo Meani
Periprosthetic joint infection (PJI) is a relatively frequent and devastating complication following prosthetic joint implantation. Several classification systems have been presented by various authors and are routinely used in clinical practice to help in early diagnosis and treatment. The most widely accepted classifications of periprosthetic infections rely on the timing of clinical presentation. Unfortunately, these schemes possess important shortcomings which limit their usefulness in clinical practice, as data reported in literature are contrasting, with success rate ranging from 60 to 80%, irrespectively of prosthetic infection timing...
October 29, 2018: Archives of Orthopaedic and Trauma Surgery
Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
INTRODUCTION: The purpose of the present study was to determine which factors affect the positional accuracy of iliosacral screws inserted using 3D fluoroscopic navigation. Specifically, we asked: (1) does the screw insertion angle in the coronal and axial planes affect the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation? (2) Is the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation affected by the type of screw (transsacral versus standard iliosacral), site of screw insertion (S1 versus S2), patient position (supine versus prone), presence of a dysmorphic sacrum, or AO/OTA classification (type B versus C)? MATERIALS AND METHODS: Twenty-seven patients with AO/OTA type B or C pelvic ring fracture were treated by percutaneous iliosacral screw fixation...
October 29, 2018: Archives of Orthopaedic and Trauma Surgery
Darius M Thiesen, Marielle Ernst, Jennifer Meyer, Alexander S Spiro, Jin Yamamura, Till O Klatte
INTRODUCTION: The number of patients above 40 years suffering an anterior shoulder dislocation for the first time has recently increased. This study investigated the role of glenoid version, inclination and rotator interval dimension in patients older than 40 years with an anterior shoulder dislocation. We hypothesize that the rotator interval plays a more important role than the osseus alignment in older patients. MATERIALS AND METHODS: Patients aged older than 40 years with a traumatic shoulder dislocation were compared with patients who had undergone magnetic resonance imaging (MRI) for a different reason...
October 26, 2018: Archives of Orthopaedic and Trauma Surgery
Alexander Maslaris, Frank Layher, Olaf Brinkmann, Matthias Bungartz, Timo Zippelius, Georg Matziolis
BACKGROUND: According to literature, more than 30% of revised knee arthroplasties will require at least one re-revision. Practical experience has shown that there are considerable product-specific differences in the explantability of cemented long-stem prostheses. In the registers of successful implants, stem geometry varies considerably between the manufacturers. However, comparative data on explantability of the respective stems are missing. Objective of the present study was to identify a correlation between the geometry of a smooth cemented long stem and the necessary explantation energy required until failure of the implant-cement interface occurs...
October 26, 2018: Archives of Orthopaedic and Trauma Surgery
H Bezstarosti, E M M Van Lieshout, L W Voskamp, K Kortram, W Obremskey, M A McNally, W J Metsemakers, M H J Verhofstad
INTRODUCTION: Standardized guidelines for treatment of fracture-related infection (FRI) are lacking. Worldwide many treatment protocols are used with variable success rates. Awareness on the need of standardized, evidence-based guidelines has increased in recent years. This systematic literature review gives an overview of available diagnostic criteria, classifications, treatment protocols, and related outcome measurements for surgically treated FRI patients. METHODS: A comprehensive search was performed in all scientific literature since 1990...
October 20, 2018: Archives of Orthopaedic and Trauma Surgery
Stefan Quadlbauer, Ch Pezzei, J Jurkowitsch, R Rosenauer, A Pichler, S Schättin, T Hausner, M Leixnering
INTRODUCTION: Distal radius fractures (DRF) are the most common fractures of the upper extremities. The incidence is expected to continue rising in the next years due to the increased life expectancy. Palmar locking plate stabilizing has since become the standard treatment for dorsally displaced DRF with a complication rate of 8-39% reported in the literature. Main aim of this study was to investigate the incidence of complications after DRF stabilization using palmar angular stable locking plate...
October 19, 2018: Archives of Orthopaedic and Trauma Surgery
Yoto Oh, Yoshiro Kurosa, Atsushi Okawa
Staged treatment for severe lower extremity fractures is coming into widespread use, and some reports have described internal fixation (IF) using a temporary external fixator for primary care as an intraoperative retention tool. However, the infection risk with this procedure has not been examined sufficiently. To our knowledge, this article is the first report focusing exclusively on this specific surgical technique. A key point of our developed protocol for internal plate fixation with this technique to avoid postoperative infection is a precisely structured sterilization procedure, which required multiple changes of sterile surgical gloves...
October 17, 2018: Archives of Orthopaedic and Trauma Surgery
C M Lameijer, H J Ten Duis, D Vroling, M T Hartlief, M El Moumni, C K van der Sluis
INTRODUCTION: Outcomes of non-osteoporotic patients who sustained a distal radius fracture (DRF) have not gained much attention in recent literature. The aims of this study were to determine the prevalence of posttraumatic arthritis (PA), to analyze associations of radiological measurements, clinician-reported and patient-reported outcomes (CROs and PROs) with PA and gain insight into employment changes after DRF in non-osteoporotic patients. METHODS: Non-osteoporotic patients following a DRF were selected...
October 13, 2018: Archives of Orthopaedic and Trauma Surgery
Yann Philippe Charles, Yves Ntilikina, Benjamin Blondel, Stéphane Fuentes, Jérémy Allia, Nicolas Bronsard, Maxime Lleu, Benjamin Nicot, Vincent Challier, Joël Godard, Pascal Kouyoumdjian, Nicolas Lonjon, Paulo Marinho, Julien Berthiller, Eurico Freitas, Cédric Barrey
PURPOSE: The French Society of Spine Surgery (SFCR) conducted a prospective epidemiologic multicenter study. The purpose was to investigate mortality, complication, and fusion rates in patients with odontoid fracture, depending on age, comorbidities, fracture type, and treatment. METHODS: Out of 204 patients, 60 were ≤ 70 years and 144 were > 70 years. Demographic data, comorbidities, treatment types and complications (general medical, infectious, neurologic, and mechanical), and death were registered within the first year...
October 13, 2018: Archives of Orthopaedic and Trauma Surgery
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