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EFORT Open Reviews

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https://www.readbyqxmd.com/read/29657851/kinematic-alignment-technique-for-total-hip-and-knee-arthroplasty-the-personalized-implant-positioning-surgery
#1
Charles Rivière, Stefan Lazic, Loïc Villet, Yann Wiart, Sarah Muirhead Allwood, Justin Cobb
Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality.Technological improvements and a better understanding of joint kinematics have facilitated the progression to 'personalized' implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined.By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657850/hamstring-autograft-size-importance-in-anterior-cruciate-ligament-repair-surgery
#2
Francisco Figueroa, David Figueroa, João Espregueira-Mendes
Graft size in hamstring autograft anterior cruciate ligament (ACL) surgery is an important factor directly related to failure. Most of the evidence in the field suggests that the size of the graft in hamstring autograft ACL reconstruction matters when the surgeon is trying to avoid failures.The exact graft diameter needed to avoid failures is not absolutely clear and could depend on other factors, but newer studies suggest than even increases of 0.5 mm up to a graft size of 10 mm are beneficial for the patient...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657849/talar-process-fractures-an-overview-and-update-of-the-literature
#3
Haroon Majeed, Donald J McBride
Fractures of the lateral and the posterior processes of the talus are uncommon and frequently missed because of a low level of suspicion and difficulty in interpretation on plain radiographs. Missed fractures can lead to persistent pain and reduced function.Lateral process fractures are usually a consequence of forced dorsiflexion and inversion of fixed pronated foot. These are also commonly known as snowboarder's fractures.The posterior process of the talus is composed of medial and lateral tubercles, separated by the groove for the flexor hallucis longus tendon...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657848/medial-subvastus-versus-the-medial-parapatellar-approach-for-total-knee-replacement-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
James R Berstock, James R Murray, Michael R Whitehouse, Ashley W Blom, Andrew D Beswick
Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) in time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 to 2.3), visual analogue score for pain on day one (0.8 points on a scale out of 10, 95% CI 0.2 to 1.4) and total range of knee movement at one week (7°, 95% CI 3.2 to 10.7). The subvastus approach also resulted in fewer lateral releases (odds ratio 0...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657847/axillary-nerve-injury-associated-with-glenohumeral-dislocation-a-review-and-algorithm-for-management
#5
Duncan Avis, Dominic Power
Axillary nerve injury is a well-recognized complication of glenohumeral dislocation. It is often a low-grade injury which progresses to full recovery without intervention. There is, however, a small number of patients who have received a higher-grade injury and are less likely to achieve a functional recovery without surgical exploration and reconstruction.Following a review of the literature and consideration of local practice in a regional peripheral nerve injury unit, an algorithm has been developed to help identification of those patients with more severe nerve injuries...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657846/reverse-total-shoulder-arthroplasty
#6
Filippo Familiari, Jorge Rojas, Mahmut Nedim Doral, Gazi Huri, Edward G McFarland
Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657845/long-term-bone-remodelling-around-legendary-cementless-femoral-stems
#7
Charles Rivière, Guido Grappiolo, Charles A Engh, Jean-Pierre Vidalain, Antonia-F Chen, Nicolas Boehler, Jihad Matta, Pascal-André Vendittoli
Bone remodelling around a stem is an unavoidable long-term physiological process highly related to implant design. For some predisposed patients, it can lead to periprosthetic bone loss secondary to severe stress-shielding, which is thought to be detrimental by contributing to late loosening, late periprosthetic fracture, and thus rendering revision surgery more complicated.However, these concerns remain theoretical, since late loosening has yet to be documented among bone ingrowth cementless stems demonstrating periprosthetic bone loss associated with stress-shielding...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657844/spine-hip-relations-in-patients-with-hip-osteoarthritis
#8
Charles Rivière, Stefan Lazic, Louis Dagneaux, Catherine Van Der Straeten, Justin Cobb, Sarah Muirhead-Allwood
Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome.Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs.By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes.An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual's SHR, and use of the transverse acetabular ligament to adjust the cup positioning...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657843/impingement-around-the-hip-beyond-cam-and-pincer
#9
Niels Hendrik Bech, Daniel Haverkamp
In this review, we bring to the attention of the reader three relatively unknown types of hip impingement. We explain the concept of low anterior inferior iliac spine (AIIS) impingement, also known as sub-spine impingement, ischio-femoral impingement (IFI) and pelvi-trochanteric impingement. For each type of impingement, we performed a search of relevant literature.We searched the PubMed, Medline (Ovid) and Embase databases from 1960 to March 2016. For each different type of impingement, a different search strategy was conducted...
February 2018: EFORT open reviews
https://www.readbyqxmd.com/read/29657842/repair-of-syndesmosis-injury-in-ankle-fractures-current-state-of-the-art
#10
May Fong Mak, Richard Stern, Mathieu Assal
Conventional treatment of syndesmosis injuries in rotationally unstable ankle fractures is associated with an unacceptably high rate of malreduction, and this has led to a paradigm shift in the approach to a newer concept of anatomical repair.In the anatomical approach, the principle is to 'directly fix what is broken and repair what is torn'. The approach is effective in reducing the rate of syndesmosis malreduction, increasing the biomechanical strength of syndesmosis fixation and avoiding the need for trans-syndesmotic fixation and its secondary removal...
January 2018: EFORT open reviews
https://www.readbyqxmd.com/read/29657841/locked-posterior-dislocation-of-the-shoulder-a-systematic-review
#11
Ozgur Basal, Recep Dincer, Bulent Turk
Locked posterior dislocation of the shoulder is very rare. Seizures and trauma are the most common causes of this injury.There is no current benchmark treatment strategy for these rare cases.This study has shown that reconstruction of the shoulder joint in an anatomical way in acute and chronic cases up to 16 weeks provides good results.The purpose of this study is to evaluate the results of different treatment procedures with outcomes and to compare the results of the same procedures in acute and chronic cases...
January 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657840/third-generation-pure-alumina-and-alumina-matrix-composites-in-total-hip-arthroplasty-what-is-the-evidence
#12
Didier Hannouche, Matthieu Zingg, Hermes Miozzari, Remy Nizard, Anne Lübbeke
Wear, corrosion and periprosthetic osteolysis are important causes of failure in joint arthroplasty, especially in young patients.Ceramic bearings, developed 40 years ago, are an increasingly popular choice in hip arthroplasty. New manufacturing procedures have increased the strength and reliability of ceramic materials and reduced the risk of complications.In recent decades, ceramics made of pure alumina have continuously improved, resulting in a surgical-grade material that fulfills clinical requirements...
January 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657839/current-concepts-for-aligning-knee-implants-patient-specific-or-systematic
#13
REVIEW
Charles Rivière, Stefan Lazic, Oliver Boughton, Yann Wiart, Loic Vïllet, Justin Cobb
Mechanical or anatomical alignment techniques create a supposedly 'biomechanically friendly' but often functionally limited prosthetic knee.Alternative techniques for alignment in total knee arthroplasty (TKA) aim at being more anatomical and patient-specific, aiming to improve functional outcomes after TKA.The kinematic alignment (KA) technique for TKA has shown good early clinical outcomes. Its role in extreme anatomical variation remains to be defined.The restricted KA technique for TKA might be a reasonable option for patients with extreme anatomical variation...
January 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29387472/return-to-sport-after-total-or-unicompartmental-knee-arthroplasty-an-informative-guide-for-residents-to-patients
#14
Louis Dagneaux, Julien Bourlez, Benjamin Degeorge, François Canovas
Knee arthroplasty survival rate - either UKA or TKA - is currently 95%, greater than it was ten years ago, but has not been specifically evaluated in very active patients practicing sport at a high intensity.The terms and conditions of return to physical activities are decided by the surgeon, the rehabilitation or Sports Medicine doctor, who needs to make sure that postoperative rehabilitation has been conducted optimally. Specifically, range of movement must be complete, muscular strengthening has to be sufficient and balance must be recovered by proprioception...
December 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29387471/subscapularis-tendon-tears-management-and-arthroscopic-repair
#15
Brett A Lenart, Jonathan B Ticker
Tears of the subscapularis tendon have been under-recognised until recently. Therefore, a high index of suspicion is essential for diagnosis.A directed physical examination, including the lift-off, belly-press and increased passive external rotation can help identify tears of the subscapularis.All planes on MR imaging should be carefully evaluated to identify tears of the subscapularis, retraction, atrophy and biceps pathology.Due to the tendency of the tendon to retract medially, acute and traumatic full-thickness tears should be repaired...
December 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29387470/arthroscopic-remplissage-is-it-still-an-option
#16
Mohamed G Morsy
Posterolateral humeral head defects can be large and engage on the anterior glenoid, and they usually contribute to anterior shoulder instability in 40% to 90% of cases.The purpose of this study is to evaluate the results of the largest series of patients who underwent arthroscopic remplissage with Bankart repair for recurrent anterior shoulder instability due to associated Bankart lesions, with large and engaging (> 25% involvement) humeral Hill-Sachs defects (HSDs).A total of 51 patients underwent arthroscopic Bankart repair with remplissage technique for the treatment of recurrent anterior glenohumeral instability with large and medial HSDs...
December 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29387469/development-of-a-german-fracture-register-to-assess-current-fracture-care-and-improve-treatment-quality-a-feasibility-study
#17
Marc Beirer, Chlodwig Kirchhoff, Peter Biberthaler
Continuous evaluation of current treatment methods is crucial in orthopaedic trauma surgery.Existing fracture registries substantially contribute to improving fracture care and quality of life in trauma patients.Currently there is no universal German fracture register recording the patient-centred outcome of non-surgical as well as surgical fracture treatment in all anatomical regions.Conclusions regarding nationwide fracture treatment and quality of care are only significant to a limited extent. Cite this article: EFORT Open Rev 2017;2:474-477...
December 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29218232/the-role-of-neurectomy-in-the-management-of-spasticity-of-the-upper-limb
#18
Petros Mikalef, Dominic Power
Neurectomy is one of the treatments available to the surgeon treating patients with spasticity of the upper limb.Its popularity has increased in recent years.Accurate knowledge of the anatomical variations of the terminal branches to the muscles is required in order to achieve a successful outcome.Although the anatomy has been thoroughly studied, there are still controversies regarding the percentage of the nerve to be resected for a successful result, and also regarding the terminology that has been used in the literature to describe the procedure...
November 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29218231/indications-for-hydrodilatation-for-frozen-shoulder
#19
S Rymaruk, C Peach
Frozen shoulder causes significant functional disability and pain in a population group constituted by patients who are often middle-aged and working.Frozen shoulder remains poorly understood. The available literature is limited and often prone to bias.A rapid, non-surgical and cost-effective treatment that reduces pain and restores function is an attractive option.Hydrodilatation is a potential first-line treatment of frozen shoulder in secondary care. Cite this article: EFORT Open Rev 2017;2:462-468. DOI: 10...
November 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29218230/spondylodiscitis-revisited
#20
Andreas F Mavrogenis, Panayiotis D Megaloikonomos, Vasileios G Igoumenou, Georgios N Panagopoulos, Efthymia Giannitsioti, Antonios Papadopoulos, Panayiotis J Papagelopoulos
Spondylodiscitis may involve the vertebral bodies, intervertebral discs, paravertebral structures and spinal canal, with potentially high morbidity and mortality rates.A rise in the susceptible population and improved diagnosis have increased the reported incidence of the disease in recent years.Blood cultures, appropriate imaging and biopsy are essential for diagnosis and treatment.Most patients are successfully treated by conservative means; however, some patients may require surgical treatment.Surgical indications include doubtful diagnosis, progressive neurological deficits, progressive spinal deformity, failure to respond to treatment, and unresolved pain...
November 2017: EFORT Open Reviews
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