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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
Woo-Kie Min, Sang-Bong Na, Jin-An Jang
PURPOSE: To evaluate and compare the accuracy of the placement of thoracic pedicle screws between concave and convex side curve using freehand technique and triggered electromyogram (EMG). METHODS: Three-hundred sixty eight thoracic pedicle screws were included for the evaluation of accuracy from postoperative computed tomography (CT) scans in 24 patients with adolescent idiopathic scoliosis with a mean follow-up of 27 months (range 24-58 months). All screws had stimulation thresholds greater than 6 mA...
May 2018: Journal of Orthopaedic Surgery
Nathalie Declarador, Rani Ramason, Laura Tay, Wai Lim William Chan, Ernest Beng Kee Kwek
PURPOSE: Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program. METHODS: This is a prospective cohort study of hip fracture patients aged more than 60 years over 1 year. We collected data on demographics, premorbid mobility and functional status, time to surgery, postoperative complications, and inhospital mortality...
May 2018: Journal of Orthopaedic Surgery
Ante Prkić, Jetske Viveen, Bertram The, Christiaan Ja van Bergen, Koen Lm Koenraadt, Denise Eygendaal
PURPOSE: Objective and reliable force measurement is necessary to monitor the rehabilitation after triceps brachii pathology, injuries, and posterior approach-based surgery. It is unclear at which amount of extension the triceps is best tested and if comparison to the uninjured sided is reliable. This study aims to identify the most reliable elbow position at which elbow extension force is measured using a dynamometer. Furthermore, it aims to compare the extension strength of the dominant arm with that of the nondominant arm...
May 2018: Journal of Orthopaedic Surgery
Mohamed Abdel Rahman, Ayman Mohammad El Masry, Sherif Ishak Azmy
BACKGROUND: Aneurysmal bone cyst (ABC) is an aggressive benign lesion that may sometimes be difficult to treat. Lesions that occur in the proximal femur require to be addressed aggressively because of the high rate of local recurrence and the risk of fracture. Few articles report the experience of management of ABC in the proximal femur. This location presents a surgical challenge due to its anatomical and biomechanical peculiarity. METHODS: We retrospectively reviewed 16 cases with ABC in the proximal femur that were treated in our institution between 2005 and 2014, utilizing extended curettage and liquid nitrogen as adjuvant therapy and reconstruction using nonvascularized autogenous fibular strut graft...
May 2018: Journal of Orthopaedic Surgery
Tatsuya Tamaki, Taishi Ninomiya, Kurato Jonishi, Yoko Miura, Kazuhiro Oinuma, Hideaki Shiratsuchi
BACKGROUND: The direct anterior approach has gained popularity in total hip arthroplasty (THA) over the past decade. However, there are few reports that describe the use of this approach for cases of complex revision. The purpose of this study was to report the surgical procedure and early clinical results of acetabular revision in the presence of bone defects using a Kerboull-type reinforcement device through the direct anterior approach. METHODS: Eleven patients who had undergone acetabular reconstruction using a Kerboull-type reinforcement device for aseptic or septic loosening bone defects were enrolled...
May 2018: Journal of Orthopaedic Surgery
Jun-Dong Chang, In-Sung Kim, Sameer Ajit Mansukhani, Vishwas Sharma, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces. METHODS: A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0-9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated...
May 2018: Journal of Orthopaedic Surgery
Jun Komatsu, Tomoya Muta, Nana Nagura, Masumi Iwabuchi, Hironari Fukuda, Kazuo Kaneko, Osamu Shirado
BACKGROUND: Lumbar spinal canal stenosis surgery has recently improved with the use of minimally invasive techniques. Less invasive procedures have emerged, and microendoscopic decompression through smaller incisions is frequently performed. Tubular surgery with the assistance of endoscopic surgery procedures has led to particularly remarkable changes in surgery, with reduced tissue trauma and morbidity. PURPOSE: The purpose of this study was to compare the clinical outcomes of two different minimally invasive decompressive surgical techniques (microendoscopic bilateral decompression surgery using the unilateral approach [microendoscopic laminectomy (MEL)] and microendoscopy-assisted muscle-preserving interlaminar decompression (MILD; ME-MILD)) using spinal endoscopy for lumbar spinal canal stenosis measured using a visual analog scale (VAS), the Japanese Orthopedic Association (JOA) score, and the JOA Back Pain Evaluation Questionnaire (JOABPEQ), which is based on a patient-oriented scoring system...
May 2018: Journal of Orthopaedic Surgery
Christopher J DeFrancesco, Daniel J Miller, Patrick J Cahill, David A Spiegel, John M Flynn, Keith D Baldwin
PURPOSE: Feeding difficulties are common among patients with cerebral palsy (CP) and neuromuscular (NM) scoliosis. We theorize that posterior spinal fusion (PSF) reduces intra-abdominal pressure, resulting in improved feeding and subsequent weight gain. We hypothesized that, among nonambulatory patients with CP and NM scoliosis, we would observe significant gain in weight following PSF. METHODS: Fifty subjects with nonambulatory CP who underwent PSF for NM scoliosis were included...
May 2018: Journal of Orthopaedic Surgery
Shih-Chieh Yang, Tsung-Ting Tsai, Hung-Shu Chen, Chi-Jung Fang, Yu-Hsien Kao, Yuan-Kun Tu
PURPOSE: Sacral insufficiency fractures (SIFs) can cause severe lower back pain and immobility, which have limited therapeutic options. No previous studies have compared clinical outcomes and radiographic findings of sacroplasty with or without balloon assistance for the treatment of SIFs. METHODS: Forty-five patients with SIFs were divided into two groups. One group had 18 patients treated using sacroplasty with balloon assistance, and the other had 27 patients treated without balloon assistance...
May 2018: Journal of Orthopaedic Surgery
Min-Cheol Kim, Sang-Don Joo, Sung-Taek Jung
PURPOSE: To evaluate the role of fractures on pathologic bone in healing of proximal humerus unicameral bone cysts (UBCs) and investigate the clinical factors that affect healing of UBCs after fractures on pathologic bone. METHODS: This prospective study was carried out between 2002 and 2014. We evaluated 56 patients with a UBC accompanying fractures on pathologic bone in the proximal humerus. Clinical data were collected from the patients' medical records. Age, gender, degree of fracture displacement, location of cyst, and cyst size were investigated, and we assessed how these factors affected cyst healing...
May 2018: Journal of Orthopaedic Surgery
Kwang Jun Oh, Byung Kag Kim, Myung Il Jo, Byung Mun Ahn
INTRODUCTION: The purpose of this study was to compare acetabular cup positioning using an imageless navigation-assisted total hip arthroplasty (THA) to a case-matched control group using the conventional technique in Asian physique. METHODS: Case matching controlled study using retrospectively collected data for THAs was done. Matching criteria were gender, age ± 5 years, and body mass index ± 5 kg/m2 . Thirty patients who had navigation THAs were manually matched to a conventional group of 30 patients...
May 2018: Journal of Orthopaedic Surgery
Can Chen, Hongbin Lu, Jianzhong Hu, Xuqiang Qiu, Xiong Li, Deyi Sun, Jin Qu, Tao Zhang, Daqi Xu
INTRODUCTION: Anatomic repair of the anterior talofibular ligament (ATFL) is challenging when the local ligamentous tissue is severely attenuated. Anatomic reconstruction of the ATFL with tibial tuberosity-patellar tendon (TT-PT) autograft is a feasible choice that can avoid the complicated tendon-bone healing and restore ankle stability. MATERIALS AND METHODS: From 2009 to 2015, 31 chronic lateral ankle instability (CLAI) patients (31 ankles), who had a serious injury on the ATFL only, were treated with anatomic reconstruction of ATFL with TT-PT...
May 2018: Journal of Orthopaedic Surgery
Muhammad Haseeb, Khalid Muzafar, Abdul Ghani, Khurshid A Bhat, M Farooq Butt
INTRODUCTION: Open reduction and internal fixation using plates is the gold standard for the treatment of displaced forearm bone fractures in adults. The ulna being subcutaneous throughout has a constant approach. However, the radius is approached from either the dorsal or the volar side. Both the dorsal and the volar approaches to the radial shaft involve meticulous dissection and preservation of important neurovascular structures. The posterior interosseus nerve is at risk in the dorsal approach and the radial artery and its branches in the volar approach...
May 2018: Journal of Orthopaedic Surgery
Shigeki Kubota, Hideki Kadone, Yukiyo Shimizu, Yuki Hara, Tadashi Kubo, Hiroki Watanabe, Yasushi Hada, Naoyuki Ochiai, Yoshiyuki Sankai, Masashi Yamazaki
This study aimed to evaluate the effectiveness and safety of using the upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) during elbow flexion training following elbow flexor reconstruction for brachial plexus injury (BPI). We present the cases of two patients in whom the upper limb HAL-SJ was implemented 5 and 7 months postoperatively following elbow flexor reconstruction for BPI. They underwent elbow flexor reconstruction with intercostal nerve crossing-to-musculocutaneous nerve (ICN-MCN crossing) after BPI...
May 2018: Journal of Orthopaedic Surgery
Erica Kholinne, Hassan Al-Ramadhan, Abdulrahman M Bahkley, Malak Q Alalwan, In-Ho Jeon
PURPOSE: Injury to the distal triceps brachii tendon is rare. Imaging radiographs are used to confirm the findings of physical examination, classify the extent of injury, and guide treatment. Magnetic resonance imaging (MRI) is considered the gold standard of diagnostic imaging. However, no previous study has reported on the accuracy of differentiation between partial- and full-thickness triceps tendon tears. Our study's aim was to define the accuracy of MRI in differentiating partial- from full-thickness tear of the distal triceps tendon...
May 2018: Journal of Orthopaedic Surgery
Saeed Ahmad, Irfan Qadir, Atiq Uz Zaman, Chiragh Muhammad Khan, Shahzad Javed, Naeem Ahmad, Amer Aziz
INTRODUCTION: Treatment of developmental dysplasia of hip (DDH) diagnosed after 10 years of age is extremely difficult because of the soft tissue and bone deformities. In this study, we evaluated short-term results of a single-stage procedure performed with surgical hip dislocation, femoral shortening and capsular arthroplasty. PATIENTS AND METHODS: A retrospective review of charts of five patients with DDH, older than 10 years, who underwent capsular arthroplasty at Ghurki Trust Teaching Hospital between 2013 and 2015 was performed...
May 2018: Journal of Orthopaedic Surgery
Daniel Mittelstaedt, David Kahn, Yang Xia
PURPOSE: To detect early osteoarthritis (OA) in a canine Pond-Nuki model 3 weeks after anterior cruciate ligament (ACL) transection surgery, both topographically over the medial tibial surface and depth-dependently over the cartilage thickness. METHODS: Four topographical locations on each OA and contralateral medial tibia were imaged individually by magnetic resonance imaging (MRI) at 17.6 µm transverse resolution. The quantitative MRI T2 relaxation data were correlated with the biomechanical stress-relaxation measurements from adjacent locations...
May 2018: Journal of Orthopaedic Surgery
Benny Dahl, Casper Dragsted, Søren Ohrt-Nissen, Thomas Andersen, Martin Gehrchen
PURPOSE: The objective of this study was to assess the outcome of patients treated with magnetically controlled growing rods (MCGRs) using a standardized distraction procedure with intended distraction-to-stall and to compare the outcomes between idiopathic and nonidiopathic patients. METHODS: This was a retrospective single-center cohort study. Conversion cases were excluded. Distractions were performed with 2- to 3-month intervals with the intention of distraction-to-stall on both rods...
May 2018: Journal of Orthopaedic Surgery
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