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EFORT Open Reviews

Amer Sebaaly, Maroun Rizkallah, Guillaume Riouallon, Zhi Wang, Pierre Emmanuel Moreau, Falah Bachour, Ghassan Maalouf
Surgical treatment of patients with thoracolumbar vertebral fracture without neurological deficit is still controversial.Management of vertebral fracture with percutaneous fixation was first reported in 2004.Advantages of percutaneous fixation are: less tissue dissection; decreased post-operative pain; decreased bleeding and operative time (depending on the steep learning curve); better screw positioning with fluoroscopy compared with an open freehand technique; and a decreased infection rate.The limitations of percutaneous fixation of vertebral fractures include increased radiation exposure to the patient and the surgeon, together with the steep learning curve for this technique...
November 2018: EFORT Open Reviews
Bruno Direito-Santos, Guilherme França, Jóni Nunes, André Costa, Eurico Bandeira Rodrigues, A Pedro Silva, Pedro Varanda
Acetabular retroversion (AR) consists of a malorientation of the acetabulum in the sagittal plane. AR is associated with changes in load transmission across the hip, being a risk factor for early osteoarthrosis. The pathophysiological basis of AR is an anterior acetabular hyper-coverage and an overall pelvic rotation.The delay or the non-diagnosis of AR could have an impact in the overall management of femoroacetabular impingement (FAI). AR is a subtype of (focal) pincer deformity.The objective of this review was to clarify the pathophysiological, diagnosis and treatment fundaments inherent to AR, using a current literature review...
November 2018: EFORT Open Reviews
Alfonso Vaquero-Picado, E Carlos Rodríguez-Merchán
From the biomechanical and biological points of view, an arthroscopic meniscal repair (AMR) should always be considered as an option. However, AMR has a higher reoperation rate compared with arthroscopic partial meniscectomy, so it should be carefully indicated.Compared with meniscectomy, AMR outcomes are better and the incidence of osteoarthritis is lower when it is well indicated.Factors influencing healing and satisfactory results must be carefully evaluated before indicating an AMR.Tears in the peripheral third are more likely to heal than those in the inner thirds...
November 2018: EFORT Open Reviews
Georgios Kyriakopoulos, Lazaros Poultsides, Panayiotis Christofilopoulos
Total hip arthroplasty through an anterior approach has been increasing in popularity amongst surgeons and patients.Anterior approach hip arthroplasty seems to offer improved early outcomes in terms of pain, rehabilitation and length of stay.No difference in long-term outcomes has been shown between anterior and posterior or lateral approaches.Proper formal training, utilization of fluoroscopy and adequate experience can mitigate risks of complications and improve early and medium-term outcomes. Cite this article: EFORT Open Rev 2018;3:574-583...
November 2018: EFORT Open Reviews
Andreas F Mavrogenis, Panayiotis D Megaloikonomos, Thekla Antoniadou, Vasilios G Igoumenou, Georgios N Panagopoulos, Leonidas Dimopoulos, Konstantinos G Moulakakis, George S Sfyroeras, Andreas Lazaris
The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates.More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation.Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia...
September 2018: EFORT Open Reviews
Matthew Barrett, Anoop Prasad, Louis Boyce, Sebastian Dawson-Bowling, Pramod Achan, Steven Millington, Sammy A Hanna
The increasing prevalence of obesity has resulted in a marked increase in the number of total hip arthroplasties (THAs) carried out in patients with a high body mass index (BMI).THA in morbidly obese patients is often technically challenging owing to the associated co-morbidities and anatomical factors. Furthermore, the long-term clinical and functional outcomes of the procedure in these patients are not clear.The aim of this systematic review was to compare the long-term failure rate and functional outcomes of THA in morbidly obese versus non-obese patients...
September 2018: EFORT Open Reviews
Ali-Asgar Najefi, Luckshmana Jeyaseelan, Matthew Welck
Turf toe is a condition that describes injury to the plantar metatarsophalangeal-sesamoid complex of the great toe.It is a relatively rare and debilitating condition, particularly seen in American footballers after the introduction of harder, artificial 'turf' surfaces.Turf toe represents a significant injury to the hallux and requires a high index of suspicion.If unrecognized, it can lead to chronic problems including reduced push-off strength, persistent pain, progressive deformity and eventual joint degeneration...
September 2018: EFORT Open Reviews
Morten Schultz Larsen, Hagen Schmal
Atypical femoral fractures (AFF) are stress or 'insufficiency' fractures, often complicated by the use of bisphosphonates or other bone turnover inhibitors. While these drugs are beneficial for the intact osteoporotic bone, they probably prevent a stress fracture from healing which thus progresses to a complete fracture.Key features of atypical femoral fractures, essential for the diagnosis, are: location in the subtrochanteric region and diaphysis; lack of trauma history and comminution; and a transverse or short oblique configuration...
September 2018: EFORT Open Reviews
Manuel Monteagudo, Pilar Martínez de Albornoz, Borja Gutierrez, José Tabuenca, Ignacio Álvarez
Plantar fasciopathy is very prevalent, affecting one in ten people in their lifetime.Around 90% of cases will resolve within 12 months with conservative treatment.Gastrocnemius tightness has been associated with dorsiflexion stiffness of the ankle and plantar fascia injury.The use of eccentric calf stretching with additional stretches for the fascia is possibly the non-operative treatment of choice for chronic plantar fasciopathy.Medial open release of approximately the medial third of the fascia and release of the first branch of the lateral plantar nerve has been the most accepted surgical treatment for years...
August 2018: EFORT open reviews
John Edwin, Shahbaz Ahmed, Shobhit Verma, Graham Tytherleigh-Strong, Karthik Karuppaiah, Joydeep Sinha
The sternoclavicular joint (SCJ) is an integral part of the shoulder girdle that connects the upper limb to the axial skeleton.Swelling of the SCJ is commonly due to trauma, degeneration, infections and other disease processes that affect synovial joints.This review also focuses on uncommon conditions that could affect the SCJ, including SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, Friedrich's disease and Tietze syndrome.The scope of this review is limited to the analysis of the current evidence on the various conditions affecting the SCJ and also to provide an algorithm to manage these conditions...
August 2018: EFORT open reviews
Vikki Wylde, Andrew Beswick, Julie Bruce, Ashley Blom, Nicholas Howells, Rachael Gooberman-Hill
Despite a good outcome for many patients, approximately 20% of patients experience chronic pain after total knee arthroplasty (TKA).Chronic pain after TKA can affect all dimensions of health-related quality of life, and is associated with functional limitations, pain-related distress, depression, poorer general health and social isolation.In both clinical and research settings, the approach to assessing chronic pain after TKA needs to be in-depth and multidimensional to understand the characteristics and impact of this pain...
August 2018: EFORT Open Reviews
Jean-Charles Aurégan, Catherine Bosser, Morad Bensidhoum, Thierry Bégué, Thierry Hoc
Skin and bone share similarities in terms of biochemical composition.Some authors have hypothesized that their properties could evolve concomitantly with age, allowing the estimation of the parameters of one from those of the other.We performed a systematic review of studies reporting the correlation between skin and bone parameters in women with postmenopausal osteoporosis.Fourteen studies - including 1974 patients - were included in the review.Three of these studies included two groups of participants - osteoporotic and non-osteoporotic - in order to compare skin parameters between them: two studies found a significant difference between the two groups and one did not...
August 2018: EFORT Open Reviews
Michele Vasso, Alexander Antoniadis, Naeder Helmy
Despite the excellent success rates of modern implants, unicompartmental knee arthroplasty (UKA) continues to show relatively high failure and revision rates, especially when compared with total knee arthroplasty (TKA).These higher rates of failure and revision are mainly observed during the early (< 5 years) post-operative period and are often due to incorrect indications and/or surgical errors.The correct clinical and radiological indications for UKA have therefore been analysed and correlated as far as possible with the principal mechanisms and timing of failures of UKA...
August 2018: EFORT Open Reviews
Pablo A Slullitel, José I Oñativia, Martin A Buttaro, Marisa L Sánchez, Fernando Comba, Gerardo Zanotti, Francisco Piccaluga
Acute peri-prosthetic joint infection (PJI) following total hip arthroplasty (THA) is a potentially devastating and undesired complication, with a prevalence of 0.3% to 2.9%. Its suspicion begins with a meticulous physical examination and anamnesis. Diagnosis should be made on the basis of the Musculoskeletal Infection Society criteria. Serum and synovial biomarkers are very useful tools when major criteria are absent.Although sometimes not possible due to medical conditions, surgery is usually the first line of treatment...
July 2018: EFORT Open Reviews
Evrim Sirin, Nuri Aydin, Osman Mert Topkar
Acromioclavicular (AC) joint injury is a frequent diagnosis after an acute shoulder trauma - often found among athletes and people involved in contact sports.This injury occurs five times more frequently in men than in women, with the highest incidence in the 20- to 30-year-old age group. Patients usually complain of pain and tenderness over the shoulder, particularly over the AC joint.Depending on the degree of injury, the clavicle may become prominent on the injured site.The original classification was described by Rockwood and Green according to the injured ligament complex and degree and direction of clavicular displacement...
July 2018: EFORT open reviews
Haroon Majeed, James Barrie, Wendy Munro, Donald McBride
The aim of this article is to systematically identify and analyse research evidence available to compare the outcomes of minimally invasive reduction and percutaneous fixation (MIRPF) versus open reduction and internal fixation (ORIF) for displaced intra-articular calcaneal fractures.Articles from 2000 to 2016 were searched through MEDLINE (PubMed), Cochrane Library, Embase, ScienceDirect, Scopus and ISI Web of Knowledge using Boolean logic and text words. Of the 570 articles identified initially, nine were selected including three randomized controlled trials and six retrospective comparative studies...
July 2018: EFORT Open Reviews
Stig Storgaard Jakobsen, Søren Overgaard, Kjeld Søballe, Ole Ovesen, Bjarne Mygind-Klavsen, Christian Andreas Dippmann, Michael Ulrich Jensen, Jens Stürup, Jens Retpen
Hip pain is highly prevalent in both the younger and the elderly population. In older patients, pain arising from osteoarthritis (OA) is most frequent, whereas in younger patients, non-degenerative diseases are more often the cause of pain. The pain may be caused by hip dysplasia and femoroacetabular impingement (FAI).Abnormal mechanics of the hip are hypothesized by some authors to cause up to 80% of OA in the hip. Therefore, correction of these abnormalities is of obvious importance when treating young patients with hip pain...
July 2018: EFORT Open Reviews
Carlos A Encinas-Ullán, E Carlos Rodríguez-Merchán
Tears of the medial collateral ligament (MCL) are the most common knee ligament injury.Incomplete tears (grade I, II) and isolated tears (grade III) of the MCL without valgus instability can be treated without surgery, with early functional rehabilitation.Failure of non-surgical treatment can result in debilitating, persistent medial instability, secondary dysfunction of the anterior cruciate ligament, weakness, and osteoarthritis.Reconstruction or repair of the MCL is a relatively uncommon procedure, as non-surgical treatment is often successful at returning patients to their prior level of function...
July 2018: EFORT Open Reviews
Farhan Syed, Anthony Ugwuoke
Total ankle arthroplasty offers a reasonable alternative to ankle arthrodesis in carefully selected patients.It is debatable whether rheumatoid arthritis patients have better outcomes compared with those who have ankle arthroplasty for either primary osteoarthritis or post-traumatic arthritis.Aseptic loosening and infection are the most common complications requiring revision.It is worth noting that some of the best survival rates are seen in the surgeon-designer case series.The uncemented mobile or fixed bearing prostheses have better outcomes compared with their older counterparts...
June 2018: EFORT Open Reviews
Andreas F Mavrogenis, Vasilios G Igoumenou, Thekla Antoniadou, Panayiotis D Megaloikonomos, George Agrogiannis, Periklis Foukas, Sotirios G Papageorgiou
Non-Langerhans cell histiocytosis (N-LCH) summarizes a group of rare diseases with different clinical presentations, pathogenesis and morphology. These include primary cutaneous N-LCH, cutaneous N-LCH with systemic involvement, and primary extracutaneous systemic forms with occasional cutaneous involvement.The juvenile (JXG) and non-juvenile xanthogranuloma (N-JXG) family of histiocytoses are N-LCH: the JXG family consisting of the JXG (cutaneous), xanthoma disseminatum (cutaneous and systemic) and Erdheim-Chester disease (ECD; systemic); and the N-JXG family consisting of the solitary reticulohistiocytoma (cutaneous), multicentric reticulohistiocytosis (cutaneous and systemic) and Rosai-Dorfman disease (RDD; systemic)...
June 2018: EFORT Open Reviews
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