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Orthopedic Reviews

Maximilian Lenz, Carolin Meyer, Christoph Kolja Boese, Jan Siewe, Peer Eysel, Max Joseph Scheyerer
Previous studies have shown coherence between obesity and higher rates of complications following spinal surgery. However, there is a lack of information about the influence of obesity and the mass of outer abdominal fat (OAF) on adjacent segment instability after spinal fusion surgery. Radiographs of 194 patients with spinal fusion surgery were assessed retrospectively. Radiographs were performed after surgery during two years' follow-up and signs of adjacent segment instability were documented. Patients were classified regarding their BMI and extent of OAF was assessed using CT at the umbilical level...
June 14, 2018: Orthopedic Reviews
Yehia H Bedeir, Andrew E Jimenez, Brian M Grawe
Retears of the rotator cuff, following operative repair, is not an uncommon event. Various factors have been shown to influence recurrence including the technique of repair. Multiple techniques have been performed with varying results and complications. The repair technique significantly affects the rate and pattern of retears. Although risk of retears with double row and suture bridge techniques is relatively low, medial cuff failure is a potential complication which poses significant challenges when revision repair is undertaken...
June 14, 2018: Orthopedic Reviews
Gordon Mao, Nouman Aldahak, Dorian Kusyk, Matthew Yeager, Daniel Cook, Jeffrey Cameron, Boyle Cheng, Michael Oh
Sacroiliac joint (SIJ) dysfunction and its surgical treatment remain a controversial topic in spine surgery. Determining success after SIJ fusion may be difficult due to preexisting back pain, lumbar fusion (LF), and functional disability. We examine the utility of Oswestry Disability Index (ODI) as a measure of clinical outcomes after minimally invasive SIJ fusion. A retrospective review of 24 patients with at least 12- months follow-up. Patients were divided into two groups based on presence of previous LF...
June 14, 2018: Orthopedic Reviews
Afshin Taheriazam, Amin Saeidinia
Total hip arthroplasty is one of the best treatments for restoring function and activity in young patients with advanced joint diseases. One-Stage Bilateral Total Hip Arthroplasty (BTHA) offers many advantages, which are important to younger patients and diminished costs and time in comparison with sequential THA. There is currently much concern about the safety of this procedure. The current study was designed to provide more information regarding THA in patients aged 30 years old or younger. Between April 2010 and September 2015, arthroplasty procedures were performed on 180 patients at the surgical centers of Erfan and Milad, Tehran, Iran...
June 14, 2018: Orthopedic Reviews
Michael-Alexander Malahias, Dimitrios Chytas, Fritz Thorey
The focal metallic cartilage resurfacing is a surgical method that offers an appropriate step between the biological techniques and arthroplasty in middle-aged patients with full-thickness cartilage defects. The advantages of this technique are that it addresses the defect, respects healthy tissues and provides stability and contoured surface similar to a full arthroplasty. A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (MM and DC) independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews (CDSR)...
June 14, 2018: Orthopedic Reviews
Alexander Franz, Laura Joseph, Constantin Mayer, Jan-Frieder Harmsen, Holger Schrumpf, Julia Fröbel, Martin S Ostapczuk, Rüdiger Krauspe, Christoph Zilkens
Osteoarthritis (OA) is the most frequently diagnosed joint disorder worldwide with increasing prevalence and crucial impact on the quality of life of affected patients through chronic pain, decreasing mobility and invalidity. Although some risk factors, such as age, obesity and previous joint injury are well established, the exact pathogenesis of OA on a cellular and molecular level remains less understood. Today, the role of nitrosative and oxidative stress has not been investigated conclusively in the pathogenesis of OA yet...
June 14, 2018: Orthopedic Reviews
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
Kalpit N Shah, Gregory Walker, Sarath C Koruprolu, Alan H Daniels
Instrumentation failure is a common complication following complex spinal reconstruction and deformity correction. Rod fracture is the most frequent mode of hardware failure and often occurs at or near a 3-column osteotomy site. Titanium (Ti) rods are commonly utilized for spinal fixations, however, theoretically stiffer materials, such as cobalt-chrome (CoCr) rods are also available. Despite ongoing use in clinical practice, there is little biomechanical evidence that compares the construct ability to withstand fatigue stress for Ti and Co-Cr rods...
March 29, 2018: Orthopedic Reviews
Ahmed Hosny Khalifa, Timo Stübig, Oliver Meier, Christian Walter Müller
Following lumbar fusion, adjacent segment degeneration has been frequently reported. Dynamic systems are believed to reduce main fusion drawbacks. We conducted a retrospective study on patients with degenerative lumbar disease treated with posterior dynamic stabilization with monoaxial hinged pedicular screws and lumbar decompression. VAS and ODI were used to compare clinical outcomes. As radiological outcomes, LL and SVA were used. 51 patients were included with an average follow-up of 24 months. 13 patients were revised because of postoperative radiculopathy (n=4), subcutaneous hematoma (n=2), L5 screw malposition (n=1) and adjacent segment disease (n=6)...
March 29, 2018: Orthopedic Reviews
Philipp Jan Gebel, Malte Tryzna, Thomas Beck, Bernd Wilhelm
The purpose was to analyze tibial plateau fractures (TPF) by computed tomography (CT) by creating a frequency map (FM). We hypothesized that a FM shows clinically important aspects of involvement that are not expressed in classic classifications. 185 TPF were retrospectively evaluated in this single center study. We created a FM onto an axial template of an intact subarticular tibial plateau and separated the joint surface in 9 areas, counted the frequency of involvement. The FM gives information of location and grade of damage and expressed three major fracture areas in 76%...
March 29, 2018: Orthopedic Reviews
Azeem Tariq Malik, Shahryar Noordin
Total Ankle Arthroplasty (TAA) is a relatively new and evolving field in Foot and Ankle surgery. We conducted a citation analysis to identify the characteristics of the top 50 most cited articles on total ankle arthroplasty. Using the Web of Science database and the search strategy total ankle arthroplasty OR total ankle replacement , we identified 2445 articles. After filtering for relevant articles, the top 50 cited articles on total ankle arthroplasty were retrieved for descriptive and statistical analysis...
March 29, 2018: Orthopedic Reviews
Nicole Verdecchia, Julie Johnson, Mark Baratz, Steven Orebaugh
Nerve dysfunction after upper extremity orthopedic surgery is a recognized complication, and may result from a variety of different causes. Hand and wrist surgery require incisions and retraction that necessarily border on small peripheral nerves, which may be difficult to identify and protect with absolute certainty. This article reviews the rates and ranges of reported nerve dysfunction with respect to common surgical interventions for the distal upper extremity, including wrist arthroplasty, wrist arthrodesis, wrist arthroscopy, distal radius open reduction and internal fixation, carpal tunnel release, and thumb carpometacarpal surgery...
March 29, 2018: Orthopedic Reviews
Mark Ayzenberg, Michael Narvaez, James Raphael
Casting is routinely used for acute and post-operative immobilization and remains a cornerstone in the non-operative management of fractures and deformities. The application of a properly fitted and wellmolded cast, especially for a trainee, can be challenging. We present a simple method of prolonging cure time of fiberglass cast - placing ice in the dip water. Eight-ply, fiveinch fiberglass cast was circumferentially applied to an aluminum-wrapped cardboard cylinder. An electronic, 2-channel temperature sensor (TR-71wf Temp Logger, T&D Corporation, Matsumoto, Japan), accurate to 0...
March 29, 2018: Orthopedic Reviews
Christiane Kruppa, Gabriele Wiechert, Thomas A Schildhauer, Marcel Dudda
Purpose of the study was to retrospectively analyze the complication rates after operatively treated femoral shaft fractures in childhood and adolescence. Retrospective evaluation of 42 children with operatively treated femoral shaft fractures between 2000 and 2014. Fractures were classified as 27 A type, 12 B type and 3 C type fractures according the OTA/AO classification. 8 (19.05%) fractures were open. Age averaged 10.2 years (3-16). Fracture treatment was recorded as temporary or definitive external fixation, ESIN, plate fixation or IMN...
December 14, 2017: Orthopedic Reviews
Andrea Messori, Sabrina Trippoli
Cost-effectiveness evaluations concerning devices for total knee arthroplasty (TKA) have little impact on real-life management of these devices. This study explored how pharmacoeconomic models can inform the procurement of TKA devices to improve their value for money. Our study included three phases: i) literature search for data of outcome, cost, and device type in TKA; ii) development of a Markov model predicting costs, QALYs, and net monetary benefit (NMB); iii) simulation of tenders aimed at value-based device procurement...
December 14, 2017: Orthopedic Reviews
Vishesh Khanna, Senthil N Sambandam, Munis Ashraf, Varatharaj Mounasamy
Critical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. This appraisal aimed at providing the reader with an up-todate overview of the research carried out on, and existent evidence of EAD correction while planning a TKA. We reviewed the current English literature on TKA in extra-articular knee deformities...
December 14, 2017: Orthopedic Reviews
Yudha Manggala, Chayanin Angthong, Andri Primadhi, Supoj Kungwan
This study was to report the comparison of outcomes between Ilizarov ring fixator (IRF) and Taylor Spatial Frame® (Smith & Nephew, Memphis, Tenn.; TSF) in terms of the effectiveness of ankle-foot deformities correction, follow-up results, and complications. Fourteen patients with ankle-foot deformities were corrected using circular external fixation (IRF group = 7 patients; TSF group = 7 patients) and related procedures. Baseline data and treatment variables were recorded. The patients' mean age was 42...
December 14, 2017: Orthopedic Reviews
Molly Vora, Emily Curry, Amanda Chipman, Elizabeth Matzkin, Xinning Li
Patellofemoral pain syndrome (PFPS) is one of the most common causes of knee pain and is present in females disproportionately more relative to males. PFPS causes tend to be multifactorial in nature and are described in this review. From a review of the current literature, it is clear that there needs to be further research on PFPS in order to better understand the complex etiology of this disorder in both males and females. It is known that females with patellofemoral pain syndrome demonstrate a decrease in abduction, external rotation and extension strength of the affected side compared with healthy patients...
December 14, 2017: Orthopedic Reviews
Andrew R Summers, Travis Philipp, Jacob D Mikula, Kenneth R Gundle
Metastatic bone disease affects approximately 300,000 people in the United States, and the burden is rising. These patients experience significant morbidity and decreased survival. The management of these patients requires coordinated care among a multidisciplinary team of physicians, including orthopaedic surgeons. This article reviews the role of radiation therapy after orthopaedic stabilization of impending or realized pathologic extremity fractures. Orthopaedic surgeons have an opportunity to benefit patients with metastatic bone disease by referring them for consideration of post-operative radiation therapy...
December 14, 2017: Orthopedic Reviews
Marwan Hanafy, Martin Schwonzen, Cornelius Kuhnen, Bernhard Schley, Axel Wilke
We describe a primary leiomyosarcoma of bone located in the distal fibula in a 67- year-old man. Plain radiographs and computer tomography scan revealed a lytic destructive lesion in the distal metaepiphyseal region of the left fibula with little involvement of the surrounding soft tissues. The lesion was composed of proliferating spindle-shaped cells with very slim cytoplasm and narrow oval cigar shaped nuclei. Immunohistochemistry studies demonstrated a strong positivity for actin and desmin, and weak positivity for caldesmon...
December 14, 2017: Orthopedic Reviews
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