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Orthopaedic Surgery

Xu Sun, Ze-Zhang Zhu, Xi Chen, Zhen Liu, Bin Wang, Yong Qiu
This paper presents a highly challenging technique involving posterior double vertebral column resections (VCRs) and satellite rods placement. This was a young adult case with severe angular thoracolumbar kyphosis of 101 degrees, secondary to anterior segmentation failure from T11 to L1 . There were hemivertebrae at T11 and T12 , and a wedged vertebra at L1 . He received double VCRs at T12 and T11 and instrumented fusion from T6 to L4 via a posterior only approach. Autologous grafts and a cage were placed between the bony surfaces of the osteotomy gap...
August 2016: Orthopaedic Surgery
Deng-Wei He, Wen-Jun Huang, Xiao-Yong Sheng, Li-Jun Wu, Shun-Wu Fan
A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction...
August 2016: Orthopaedic Surgery
Wei Tian, Han Wang, Ya-Jun Liu
Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies)...
August 2016: Orthopaedic Surgery
Liang Xiao, Hong-Guang Xu, Hong Wang, Ping Liu, Chen Liu, Xiang Shen, Tao Zhang, Yong-Ming Xu
OBJECTIVE: To establish a rabbit model for investigating the effects of intermittent cyclic mechanical tension (ICMT) on promoting degeneration of endplate cartilage. METHODS: Forty New Zealand white rabbits were subjected to surgery and randomly divided into three equal groups as follows: control group (no treatment, n = 10), sham group (animals underwent a sham operation but were not subjected to mechanical tensile strain, n = 15) and loaded group (discs were subjected to 1...
August 2016: Orthopaedic Surgery
Jin-Quan He, Xin-Long Ma, Xi Zhang, Jing-Yi Xin, Nan Li
OBJECTIVE: To provide more accurate reference data for the assessment and treatment of talar injuries by constructing 3-D computer-assisted models of the talus and comparing them with reference data obtained from measurements on cadaver specimens. METHODS: Three-dimensional talus models were constructed from CT data recorded for healthy Chinese volunteers using SuperImage Orthopedics software. Structural variables such as length, width, height and volume of talus were compared using the Fisher least significant difference test to determine the significance of bilateral or sex-specific differences in the study cohort...
August 2016: Orthopaedic Surgery
Nan Song, Ai-Xian Tian, Jian-Min Zhang, Hong-Qiang Jiang, Jia-Cheng Zang, Xin-Long Ma
OBJECTIVE: To evaluate the association between F11 rs2289252, rs2036914 polymorphisms and the activity of clotting factor XI in post-trauma patients with fractures receiving routine anticoagulation therapy for deep venous thrombosis (DVT). METHODS: A case-control study involving 110 consecutive post-trauma patients with fractures and DVT in our hospital was conducted from April 2014 to October 2015; these patients comprised a DVT group. Another 40 sex- and age-matched patients with fractures but without DVT served as controls...
August 2016: Orthopaedic Surgery
Fan Zhang, Hao-Cheng Xu, Bo Yin, Xin-Lei Xia, Xiao-Sheng Ma, Hong-Li Wang, Jun Yin, Ming-Hao Shao, Fei-Zhou Lyu, Jian-Yuan Jiang
OBJECTIVES: To evaluate the biomechanical characteristics of endplate-conformed cervical cages by finite element method (FEM) analysis and cadaver study. METHODS: Twelve specimens (C2 -C7 ) and a finite element model (C3 -C7 ) were subjected to biomechanical evaluations. In the cadaver study, specimens were randomly assigned to intact (I), endplate-conformed (C) and non-conformed (N) groups with C4-5 discs as the treated segments. The morphologies of the endplate-conformed cages were individualized according to CT images of group C and the cages fabricated with a 3-D printer...
August 2016: Orthopaedic Surgery
Hao-Hua Zhang, Song-Hua Yan, Chen Fang, Xin-Yuan Guo, Kuan Zhang
OBJECTIVE: To evaluate the effects of surgery and rehabilitation on patients undergoing total knee arthroplasty (TKA). METHODS: Twelve patients and 12 healthy controls were enrolled and their clinical scores evaluated by a doctor. Gait data, including walking velocity, stride length, single support time, foot fall and swing power, were collected using a portable gait analyzer from 12 patients before and 6 weeks and 6 months after surgery and from 12 healthy controls...
August 2016: Orthopaedic Surgery
Dong-Xu Feng, Kun Zhang, Yu-Min Zhang, Yue-Wen Nian, Jun Zhang, Xiao-Min Kang, Shu-Fang Wu, Yang-Jun Zhu
OBJECTIVES: Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. METHODS: From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis...
August 2016: Orthopaedic Surgery
Gang-Yong Huang, Guang-Lei Zhao, Jun Xia, Yi-Bing Wei, Si-Qun Wang, Jian-Guo Wu
OBJECTIVE: During total hip arthroplasty (THA), the location of the acetabular prosthesis is very important for guaranteeing successful surgery. However, this remains a challenge for many surgeons. This study aimed to investigate the feasibility of using the intraoperative fluoroscopic iliopubic tangential angle (IPTA) to determine the valgus angles of acetabular prostheses. METHODS: In the first stage, the IPTA and valgus angles of native acetabula were defined and measured in 102 THAs obtained from the picture archiving and communication systems of our hospital...
August 2016: Orthopaedic Surgery
Zhong-Li Zhang, Zhe Fu, Jian-Ping Yang, Kan Wang, Li-Wei Xie, Shu-Zhen Deng, Zhao-Qiang Chen
OBJECTIVE: To determine the incidence of residual dysplasia after closed reduction (CR) of developmental dysplasia of the hip (DDH) and assess correlations between quality of arthrogram-guided CR and residual dysplasia using a new intraoperative radiographic criterion. METHODS: Data of a consecutive series of 126 patients with DDH in 139 hips treated at our institution by arthrogram-guided CR from March 2006 to June 2013 were reviewed in this retrospective study...
August 2016: Orthopaedic Surgery
Bo Zhang, Cheng-Kung Cheng, Tie-Bing Qu, Yong Hai, Yuan Lin, Jiang Pan, Zhi-Wei Wang, Liang Wen
OBJECTIVE: Whether the entire posterior cruciate ligament (PCL) should be retained during cruciate-retaining total knee arthroplasty (CR TKA) is controversial. The goal of this study was to compare the early clinical outcomes of partial versus intact PCL-retaining TKA. METHODS: Ninety-two patients who had undergone unilateral CR TKA from March 2012 to June 2013 were enrolled in this study. Forty-six of these patients were randomly selected to undergo intact PCL-retaining TKA (intact group), whereas the remaining 46 patients underwent tibial osteotomy together with anterolateral bundle and bone island resection (partial group)...
August 2016: Orthopaedic Surgery
Nabil A Ebraheim, Grant S Buchanan, Xiaochen Liu, Maxwell E Cooper, Nicholas Peters, Jacob A Hessey, Jiayong Liu
OBJECTIVE: To report and evaluate the outcomes of patients undergoing definitive treatment for distal femur nonunion after initial treatment with a locking plate. METHODS: Fourteen patients who had undergone definitive treatment at an academic Level 1 trauma center from May 2007 to December 2013 for distal femur nonunion were identified from a fracture database. Thirteen of them were female; the average age was 65 years (range, 50-84 years). Ten patients had sustained their injuries in falls at ground level, and four in motor vehicle accidents...
August 2016: Orthopaedic Surgery
Bing Zhang, Pan Hu, Kun-Lun Yu, Jiang-Bo Bai, De-Hu Tian, Gui-Sheng Zhang, Xin-Zhong Shao, Ying-Ze Zhang
OBJECTIVE: This study aimed to compare the clinical and radiologic outcomes of AO titanium locking plate and screw (ATLPS) and anterograde intramedullary (AIM) fixation for treating unstable metacarpal and phalangeal fractures. METHODS: Adult patients with isolated fresh unstable metacarpal and phalangeal fractures who met the inclusion criteria were enrolled into this prospective study from July 2013. Patients were divided into ATLPS or AIM groups when they were admitted to our department after considering their work requirement, fracture complexity, and surgeon's experience and were then treated accordingly...
August 2016: Orthopaedic Surgery
Søren S Morgen, Svend A Engelholm, Claus F Larsen, Rikke Søgaard, Benny Dahl
OBJECTIVE: Improvements in cancer treatment have resulted in an increased number of patients with metastatic spinal cord compression (MSCC). Because patients with MSCC often have a limited expected survival time, maintenance of a high functional level and quality of life are important. However, there is limited information about health-related quality of life (HRQoL) in patients with MSCC. The aim of this study was to examine the feasibility of routine assessment of HRQoL based on the Euroqol-5 dimensions (EQ-5D) questionnaire in a cohort of patients consecutively admitted for evaluation of acute symptoms of MSCC...
August 2016: Orthopaedic Surgery
Timothy L T Siu, Kainu Lin
OBJECTIVE: The concept of minimally invasive tubular discectomy is based on precise placement of the retractor over the surgical target to minimize collateral tissue trauma. For far lateral disc herniation, the junction between the pars and the transverse process has generally been adopted as the target for facilitating early nerve root exposure; however, this may limit access to the disc space and increase the risks of iatrogenic neuralgia. An alternative approach to help address these issues involving docking the retractor caudally directly over the disc space with the aid of a microscope is here proposed...
August 2016: Orthopaedic Surgery
Xu Jiang, Qian-Qian Wang, Cheng-Ai Wu, Wei Tian
The aim of this meta-analysis and systematic review of randomized controlled trials (RCTs) was to evaluate the efficacy and safety of adductor canal block (ACB) for early postoperative pain management in patients undergoing total knee arthroplasty (TKA). Relevant manuscripts comparing ACB with saline or femoral nerve block (FNB) in TKA patients were searched for in the databases of PubMed, EMBASE, and Cochrane library. The outcomes assessed included cumulative analgesic consumption, pain at rest or during movement, ability to ambulate, quadriceps strength, and complications (nausea, vomiting or sedation)...
August 2016: Orthopaedic Surgery
Xuan Jiang, Xin-Long Ma, Jian-Xiong Ma
The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of i.v. tranexamic acid (TXA) in simultaneous bilateral total knee arthroplasty (TKA). Potentially relevant published reports were identified from the following electronic databases: Medline, PubMed, Embase, ScienceDirect and Cochrane Library. RevMan v5.3was used to pool data. Two randomized controlled trials and four case-control studies met the inclusion criteria. The current meta-analysis identified significant differences between TXA group and control groups in terms of postoperative hemoglobin concentration (P < 0...
August 2016: Orthopaedic Surgery
Sukrit Jain, Adam E M Eltorai, Roy Ruttiman, Alan H Daniels
Since the late 1980s, spinal interbody cages (ICs) have been used to aid bone fusion in a variety of spinal disorders. Utilized to restore intervertebral height, enable bone graft containment for arthrodesis, and restore anterior column biomechanical stability, ICs have since evolved to become a highly successful means of achieving fusion, being associated with less postoperative pain, shorter hospital stay, fewer complications and higher rates of fusion when than bone graft only spinal fusion. IC design and materials have changed considerably over the past two decades...
August 2016: Orthopaedic Surgery
Kevin Phan, Ralph J Mobbs
Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes...
August 2016: Orthopaedic Surgery
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