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Journal of Orthopaedic Surgery

Rahul Ranjan, Sahil Gaba, Lakshay Goel, Naiyer Asif, Mukesh Kalra, Ramesh Kumar, Arvind Kumar
INTRODUCTION: There is a lack of in vivo studies comparing the functional outcome and knee stability after anterior cruciate ligament reconstruction (ACLR) using fixed loop (EndoButton (EB) CL) and adjustable loop (TightRope (TR) RT) devices for femoral fixation of soft tissue grafts. MATERIALS AND METHODS: Functional outcomes were assessed in terms of the International Knee Documentation Committee (IKDC) and Lysholm scores, knee stability by anteroposterior laxity and side-to-side difference (SSD) using KT-1000 arthrometer...
May 2018: Journal of Orthopaedic Surgery
Uriel Giwnewer, Guy Rubin, Eithan Dohovni, Nimrod Rozen, Noam Bor
BACKGROUND: Congenital pseudoarthrosis of the clavicle (CPC) is rare and may require treatment, usually because of an unacceptable appearance or occasionally because of pain in an adolescent patient. Spontaneous union is unknown, and consequently any desired union requires open reduction and bone grafting. Many authors recommend performing the operation at the age of 3-5 years and using different fixation methods. We present our experience with three cases and literature review in an attempt to further elucidate the appropriate timing of the procedure and the fixation method...
May 2018: Journal of Orthopaedic Surgery
Purushotham Lingaiah, Kameshwaran Jaykumar, Sumit Sural, Anil Dhal
AIM: Early tendon transfer has shown good outcomes in peripheral nerve injuries of upper limb. However, there is lack of knowledge on early tendon transfer for peripheral nerve palsy in lower limb. This study has been designed to study the functional outcomes of early tendon transfer in the lower limb, particularly for foot drop. PATIENTS AND METHODS: We enrolled 30 cases of foot drop due to traumatic sciatic/common peroneal nerve (CPN) palsy between September 2012 and March 2016...
May 2018: Journal of Orthopaedic Surgery
Erhan Sukur, Abdulhalim Akar, Ahmet Çagrı Uyar, Ozgur Cicekli, Alauddin Kochai, Mehmet Turker, Huseyin Nevzat Topcu
PURPOSE: Changes in weight-bearing patterns after partial foot amputations may lead to new localized high-pressure points and keratosis due to ulcerations in patients with neuropathies and hypovascular limbs. As a result, diabetic foot ulcers (DFUs) after partial foot amputations are very complex. The aim of this study was to compare the effectiveness of vacuum-assisted closure (VAC) therapy with conventional moist wound dressings in the treatment of diabetic wound ulcers after partial foot amputations...
May 2018: Journal of Orthopaedic Surgery
Ofir Uri, Eyal Behrbalk, Yoram Folman
BACKGROUND: Deficient osteogenic capacity of bone marrow stem cells plays a critical role in the pathophysiology of osteoporosis. Adipose-derived stem cells (ADSCs) have emerged as a promising source of skeletal progenitor cells. The capacity of ADSCs to undergo osteogenic differentiation and induce mineralized tissue formation may be beneficial in the treatment of osteoporosis. We question whether administration of autologous ADSCs into the proximal femur of osteoporotic rats will induce osteogenesis and enhance bone quality and strength...
May 2018: Journal of Orthopaedic Surgery
Chih-Kai Hong, Cheng-Li Lin, Fa-Chuan Kuan, Ping-Hui Wang, Ming-Long Yeh, Wei-Ren Su
PURPOSE: The purpose of this study was to analyze the effects of different intervals between stitch throws on tendon graft fixation with the Krackow stitch. METHODS: Forty-four porcine flexor profundus tendons were randomly divided into four groups of 11 specimens each. The Krackow stitch with various stitch intervals (2.5, 5.0, 7.5, and 10.0 mm) were evaluated, and named the K-2.5, K-5.0, K-7.5, and K-10.0 groups, respectively. A braided nonabsorbable suture was used to complete each suture-tendon construct...
May 2018: Journal of Orthopaedic Surgery
Mehmet Faruk Çatma, Alper Öztürk
PURPOSE: We studied the effect of using wide contoured pneumatic tourniquet (PT) versus ultra-narrow sterile exsanguination tourniquet (SET) on the length of hamstring autograft for anterior cruciate ligament (ACL) reconstruction in patients with tubular and conical thighs. METHODS: Fifty-eight patients undergoing ACL reconstruction between 2012 and 2013 were assigned to either SET or PT groups. We measured the tendon graft length and width as well as the patients' height, weight, and thigh circumference of 10 cm proximal to the patella and the distance from the anterior-superior iliac spine to the medial malleolus (ASIS-MM)...
May 2018: Journal of Orthopaedic Surgery
Yavuz Arikan, Abdulhamit Misir, Devrim Ozer, Turan Bilge Kizkapan, Kadir Ilker Yildiz, Mehmet Selcuk Saygili, Mustafa Alper Incesoy, Yasar Mahsut Dincel, Sukru Sarper Gursu, Vedat Sahin
PURPOSE: Primary bone tumors of the fibula are rare. There are only a few studies reporting the incidence, histologic, and anatomic distribution of primary fibula tumors. This study aimed to comprehensively report the incidence, presenting symptoms, and histologic tumor types with the anatomic and histologic distribution of primary bone tumors of the fibula. METHODS: Between January 1983 and December 2017, 6457 primary bone tumors and tumor-like lesions were diagnosed and treated in our musculoskeletal oncology surgery clinic...
May 2018: Journal of Orthopaedic Surgery
Werner H Hettwer, Peter F Horstmann, Chunsen Wu, Michael M Petersen
OBJECTIVE: To examine the effect of an alternative wound closure method after tumor arthroplasty of the hip compared to routine wound closure with skin staples. METHOD: Single center, frequency matched cohort study. We reviewed all patients who underwent tumor resection and endoprosthetic reconstruction of the proximal femur for pathologic fracture due to metastatic bone disease or malignant hematologic bone disease at our center between 2010 and 2014. All patients treated with occlusive wound closure (OWC), a combination of intradermal suture, Steri-Strips™, and an occlusive skin adhesive, during this period ( n = 35), were compared to an equally sized frequency matched group of patients having undergone routine wound closure with conventional skin staples...
May 2018: Journal of Orthopaedic Surgery
T David Luo, Alejandro Marquez-Lara, Zachary K Zabarsky, Jeremy B Vines, Katie C Mowry, Alexander H Jinnah, Xue Ma, Benjamin W Berwick, Jeffrey S Willey, Zhongyu Li, Thomas L Smith, Tadhg J O'Gara
PURPOSE: Various animal models have been proposed to mimic the pathophysiologic process of intervertebral disc degeneration, a leading cause of back pain. The purpose of this study is to describe a minimally invasive technique via percutaneous needle puncture of the annulus fibrosus in New Zealand white rabbits. METHODS: Under fluoroscopic guidance, an 18-gauge spinal needle was inserted 2 cm lateral to the midline spinous process. The needle was slowly advanced at approximately 45° angle until it was adjacent to the L5/L6 disc space...
May 2018: Journal of Orthopaedic Surgery
Flavio César Ivalde, Gustavo Nizzo Miguens, Mariano Socolovsky
Even though one of the surgical techniques most frequently used to correct external rotation deformity of the shoulder in brachial plexus patients is a humeral derotational osteotomy, few intraoperative parameters has yet been identified to determine the appropriate degree of rotation. We present in this technical note our initial experience using the main elbow flexion skin crease to quantify the correct rotation of the humerus in four young, male patients with upper-type brachial plexus injuries. All patients had a functional elbow and a stable shoulder, but also an external rotation deficit...
May 2018: Journal of Orthopaedic Surgery
Nicholas Duncan Furness, Alistair Phillips, Sian Gallacher, James Charles Sherard Beazley, Jonathan Peter Evans, Andrew David Toms, William Thomas, Christopher David Smith
AIM: To determine whether a mechanical, high-frequency vibration device (Tenease™ ) can improve pain and function for the treatment of tennis elbow (TE), compared with standard treatment. METHODS: Adults presenting to an elbow clinic with a clinical diagnosis of TE were randomized to standard treatment with physiotherapy, activity modification and analgesia or standard treatment plus Tenease therapy. Tenease therapy consisted of a 6-week period of treatment using the Tenease device with three 10-min episodes each day...
May 2018: Journal of Orthopaedic Surgery
Toshiaki Takahashi, Manabu Takahashi, Haruyasu Yamamoto, Hiromasa Miura
PURPOSE: There has been no report to date on any biomechanical study regarding the strength of fixation at the osteotomy site in dome-shaped high tibial osteotomy (HTO). In this study, we evaluated the biomechanical strength of a spacer that we improved and determined the medial site of HTO. METHODS: HTO correction angles of 15° and 20° were used in all experiments, which were performed on lower leg specimens from pigs ( n = 12). The osteotomy site was fixed by a locking plate and screws with a spacer...
May 2018: Journal of Orthopaedic Surgery
Mustafa C Kir, Semih Ayanoglu, Haluk Cabuk, Suleyman S Dedeoglu, Yunus Imren, Bulent Karslioglu, Ali Yuce, Hakan Gurbuz
OBJECTIVE: Intra-articular displaced calcaneal fractures are common fractures and are often treated with surgical interventions. Sinüs tarsi approach provides secure access to lateral wall and joint facets. The aim of the study is to compare cannulated screw (CS) fixation and mini-plate (MP) fixation via sinus tarsi approach with Sanders types 2 and 3 fracture of calcaneus. METHODS: Sixty patients with Sanders types 2 and 3 calcaneal fracture underwent surgical intervention were randomly allocated into two groups as group MP fixation and group CS fixation regarding osteosynthesis method for 5-year period...
May 2018: Journal of Orthopaedic Surgery
Merrill Lee, Jerry Yongqiang Chen, Hao Ying, Pang Hee Nee, Darren Keng Jin Tay, Pak Lin Chin, Chia Shi Lu, Lo Ngai Nung, Yeo Seng Jin
PURPOSE: The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome. METHODS: One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012...
May 2018: Journal of Orthopaedic Surgery
M Shahnaz Hasan, Jin-Keat Tan, Chris Yin Wei Chan, Mun Keong Kwan, Fathil Syafiq Abdul Karim, Khean-Jin Goh
BACKGROUND: Drugs used in anesthesia can affect somatosensory evoked potential (SSEP) monitoring, which is used routinely for intraoperative monitoring of spinal cord integrity during spinal surgery. OBJECTIVE: The objective of this study was to determine whether combined total intravenous anesthesia (TIVA) technique with propofol/remifentanil is associated with less SSEP suppression when compared to combined volatile agent desflurane/remifentanil anesthesia during corrective scoliosis surgery at a comparable depth of anesthesia...
May 2018: Journal of Orthopaedic Surgery
Eduard Alentorn-Geli, Nathan R Wanderman, Andrew T Assenmacher, John W Sperling, Robert H Cofield, Joaquín Sánchez-Sotelo
BACKGROUND: Revision of failed anatomic total shoulder arthroplasty or hemiarthroplasty is a challenging procedure. Restoring adequate soft tissue balance in the revision setting can be particularly problematic. When persistent posterior instability is encountered in the revision setting, options include changing component position or size, posterior capsular plication (PCP), or conversion to a reverse arthroplasty. The purpose of this study was to report the clinical and radiographic outcomes, complications, and reoperations of PCP performed in the setting of revision anatomic shoulder arthroplasty...
May 2018: Journal of Orthopaedic Surgery
Chih-Wei Chang, Yen-Nien Chen, Chun-Ting Li, Yu-Hsuan Chung, Chih-Han Chang, Yao-Te Peng
PURPOSE: Clinical and biomechanical studies have reported that using supportive screws and a wire instead of the common Kirschner wires for modified tension band wiring improves the stability of fractured patellae. However, the effect of screw proximity on the fixation of a fractured patella remains unclear. Therefore a numerical study was conducted to examine the effects of screw proximity on biomechanical responses in a simulated patellar fracture fixed using two parallel cannulated screws and anterior tension band wiring...
May 2018: Journal of Orthopaedic Surgery
Bryon Jun Xiong Teo, William Yeo, Hwei-Chi Chong, Andrew Hwee Chye Tan
PURPOSE: Surgical site infection (SSI) is a serious complication following total knee arthroplasty (TKA) leading to considerable morbidity. The incidence is reported to be up to 2%. Risk factors continue to be an area of intense debate. Our study aims to report the incidence of SSI and identify possible risk factors in our patients undergoing TKA. METHODS: Prospectively collected data for 905 patients who underwent elective unilateral TKA by a single surgeon from February 2004 to July 2014 were reviewed...
May 2018: Journal of Orthopaedic Surgery
Salduz Ahmet, Kılıçoğlu Önder İsmet, Ekinci Mehmet, Yıldız Eren, Tözün Remzi, Yazıcıoğlu Önder
INTRODUCTION: The aim of this study was to analyze the survival of the Echelon® femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. PATIENTS AND METHODS: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78...
May 2018: Journal of Orthopaedic Surgery
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