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Orthopaedic surgery

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https://www.readbyqxmd.com/read/28916991/higher-physical-activity-and-lower-pain-levels-before-surgery-predict-non-improvement-of-knee-pain-1%C3%A2-year-after-tka
#1
Nikolai Kornilov, Maren Falch Lindberg, Caryl Gay, Alexander Saraev, Taras Kuliaba, Leiv Arne Rosseland, Anners Lerdal
PURPOSE: The purpose of this study was to describe patterns of pain during the first year following total knee arthroplasty (TKA) and evaluate pre- and postoperative factors associated with pain and patient satisfaction at 1 year. It was hypothesized that more severe preoperative pain would be associated with more residual pain and lower patient satisfaction 1 year after surgery. METHODS: A longitudinal cohort study was performed with repeated measures of pain (0-10 numeric rating scale) and evaluation of other self-reported symptoms (Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Fatigue Severity Score), daily functioning (Lawton Instrumental Activities of Daily Living Scale), quality of life (EQ-5D-3L), knee function (KSS Knee and Function Score), perioperative and clinical characteristics (e...
September 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#2
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915523/-biologic-reconstruction-of-full-sized-cartilage-defects-of-the-hip-a-guideline-from-the-dgou-group-clinical-tissue-regeneration-and-the-hip-committee-of-the-aga
#3
Stefan Fickert, Matthias Aurich, Dirk Albrecht, Peter Angele, Lorenz Büchler, Michael Dienst, Christoph Erggelet, Jürgen Fritz, Christoph Gebhart, Hans Gollwitzer, Moritz Kindler, Christoph Lampert, Henning Madry, Gregor Möckel, Phillip Niemeyer, Jörg Schröder, Christian Sobau, Gunter Spahn, Wolfgang Zinser, Stefan Landgraeber
Background Symptomatic pre-arthritic deformities such as femoroacetabular impingement (FAI) or hip dysplasia often lead to localised cartilage defects and subsequently to osteoarthritis. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) and the hip committee of the AGA (German speaking Society for Arthroscopy and Joint Surgery) provides an overview of current knowledge of the diagnosis and surgical treatment of cartilage defects, in order to infer appropriate therapy recommendations for the hip...
September 15, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28913398/total-femur-arthroplasty-for-revision-hip-failure-in-osteogenesis-imperfecta-limits-of-biology
#4
Pablo Sanz-Ruiz, Manuel Villanueva-Martinez, Jose Antonio Calvo-Haro, Esther Carbó-Laso, Javier Vaquero-Martín
Osteogenesis imperfecta (OI) is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals-thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28904652/-role-of-trauma-damage-control-orthopaedic-in-polytraumas-a-case-of-pelvic-disjunction-associated-with-hip-dislocation-with-vascular-injury
#5
Tarik Madani, El Mehdi El Alouani, Younes Mhammdi, Mohammed Kharmaz, Mohamed El Ouadghiri, Abdou Lahlou, Lamrani Moulay Omar, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
The knowledge of the pathophysiology of patients with severe trauma and the hemodynamic and inflammatory consequences of initial surgical management has led many surgeons to change their approach to the treatment of patients with severe polytraumas associated with lesions of the pelvis or of limbs by integrating the principles of sequential treatment or Trauma Damage Control Orthopaedic (TDCO). We report the case of a patient involved in a public road accident, admitted to hospital in a state of shock with pelvic disjunction and hip dislocation complicated by vascular injury in the same limb...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904636/the-orthopaedic-management-of-lower-limb-deformity-in-hypophosphataemic-rickets
#6
A Horn, J Wright, D Bockenhauer, W Van't Hoff, D M Eastwood
BACKGROUND: Many patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child. METHODS: Since 2005, 24 patients with X-LHPR have been referred to our orthopaedic unit for evaluation. All patients had standardised long leg radiographs that were analysed sequentially before and after surgery if any was performed...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904635/does-orthopaedic-surgery-improve-quality-of-life-and-function-in-patients-with-mucopolysaccharidoses
#7
N Williams, D Challoumas, D M Eastwood
PURPOSE: Mucopolysaccharidoses (MPS) are a group of rare lysosomal storage disorders associated with involvement of multiple organs along with a generalised skeletal dysplasia. Both haematopoetic stem cell transplant and enzyme replacement therapy have improved the outlook for patients while surgery remains high-risk and there is little information on clinical or functional outcome to justify many of the surgical procedures performed. This paper aims to summarise the orthopaedic surgical procedures in MPS patients for which quality of life (QoL) and functional data are available and to describe additional QoL and functional measurement tools of relevance to the assessment of orthopaedic outcomes in MPS...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28902741/the-influence-of-geography-time-and-payer-type-on-the-utilization-of-bone-morphogenetic-protein-bmp-between-2005-and-2015
#8
Sohrab S Virk, Frank M Phillips, Safdar N Khan
Bone morphogenetic protein (BMP) is a critical compound for endochondral bone formation and is used as a bone graft substitute to promote spinal fusion and fracture healing. We sought to identify rate, type, and applications of use of BMP in spinal fusion surgery during 2005 to 2015. The Medicare 5% national sample (SAF5) database and the Humana Orthopaedics database (HORTHO) were searched for patients who underwent spinal fusion with BMP. Rate of use over time and influence of geographic region and payer type on utilization of BMP during 2005 to 2015 were analyzed...
September 11, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28902606/an-evaluation-of-patient-risk-factors-to-determine-eligibility-to-undergo-orthopaedic-surgery-in-a-freestanding-ambulatory-center-a-survey-of-4-242-consecutive-patients
#9
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28902601/impact-of-diabetes-on-perioperative-complications-in-patients-undergoing-elective-total-shoulder-arthroplasty
#10
Siddharth Mahure, Brent Mollon, Mary Quien, Raj Karia, Joseph Zuckerman, Young Kwon
INTRODUCTION: Diabetes has been associated with negative outcomes following orthopaedic surgery. While previous studies have reported on diabetes-associated complications in shoulder arthroplasty, those cohorts were heterogeneous in terms of patient population, nature of elective surgery, and arthroplasty type. Given that the number of elective total shoulder arthroplasties (TSAs) performed has grown substantially in volume and is predicted to rise even further, it is important to recognize the role that diabetes may play in developing in-hospital complications within a more homogenous sample of patients undergoing elective TSA...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28899563/treating-osteomyelitis-of-major-limb-amputations-with-a-modified-lautenbach-technique
#11
Juliet M Clutton, Oliver Donaldson, Anthony Perera, Rhidian Morgan-Jones
INTRODUCTION: Major lower limb amputation significantly increases the energy cost of walking for patients. Complications such as osteomyelitis may require further surgery, and can lead to shortening of the stump. In these cases, the aim should be to treat infection without shortening the limb further. We present a series of patients with established osteomyelitis of the amputation stump, managed using a modified Lautenbach technique. METHOD: Six patients with either above or below knee amputations, in the practice of a single orthopaedic surgeon, were studied...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28898892/posterior-hemi-laminectomy-and-facetectomy-approach-for-the-treatment-of-dumbbell-shaped-schwannomas-in-the-subaxial-cervical-spine-a-retrospective-study-of-26-cases
#12
Yong Huang, Zuowei Wang, Zan Chen, Hao Wu, Fengzeng Jian
OBJECTIVE: It is difficult to completely and safely remove a tumor that is located in the subaxial cervical spine by using the posterior approach because of the anatomical characteristics. Previous reports regarding the total removal of subaxial schwannomas using the one-stage posterior approach are still limited. This study was to evaluate the feasibility and efficacy of treating the dumbbell-shaped schwannomas in the subaxial cervical spine using the one-stage posterior approach. METHODS: Patients with dumbbell-shaped schwannomas in the subaxial cervical spine were treated using the one-stage posterior approach...
September 12, 2017: European Neurology
https://www.readbyqxmd.com/read/28898867/cerebral-fat-embolism-clinical-presentation-diagnostic-steps-and-long-term-follow-up
#13
Juliane Dunkel, Christian Roth, Frank Erbguth, Wenke Dietrich, Monika Hügens-Penzel, Andreas Ferbert
OBJECTIVE: Symptomatic cerebral fat embolism (CFE) is a rare complication that occurs after a traumatic injury or orthopaedic surgery and is diagnostically challenging. No data is currently available concerning long-term follow-up. METHODS: We identified from medical records 9 patients with CFE and revised the clinical signs and the diagnostic process. We then analysed long-term follow-up data, targeting clinical course after discharge, neurological impairment, and current quality of life, using the Barthel index and the modified Rankin Scale...
September 12, 2017: European Neurology
https://www.readbyqxmd.com/read/28894692/case-report-infection-of-total-knee-arthroplasty-treated-with-one-stage-surgery-and-linezolid
#14
Adriana Macedo Dell'Aquila, Cesar Janovsky, Moises Cohen
Staphylococcus spp meticillin resistant infection can be treated with Linezolid. This is a case report of an orthopaedic implant infection in a 60 year-old male treated orally with Linezolid and Rifampicin for three months after one-stage arthroplasty. This is possible provided that platelet count is closely monitored throughout the course of treatment.
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28894690/management-of-asymptomatic-bacteriuria-urinary-catheters-and-symptomatic-urinary-tract-infections-in-patients-undergoing-surgery-for-joint-replacement-a-position-paper-of-the-expert-group-infection-of-swissorthopaedics
#15
REVIEW
Parham Sendi, Olivier Borens, Peter Wahl, Martin Clauss, Ilker Uçkay
In this position paper, we review definitions related to this subject and the corresponding literature. Our recommendations include the following statements. Asymptomatic bacteriuria, asymptomatic leukocyturia, urine discolouration, odd smell or positive nitrite sediments are not an indication for antimicrobial treatment. Antimicrobial treatment of asymptomatic bacteriuria does not prevent periprosthetic joint infection, but is associated with adverse events, costs and antibiotic resistance development. Urine analyses or urine cultures in asymptomatic patients undergoing orthopaedic implants should be avoided...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28893227/damage-control-surgery-experiences-from-a-level-i-trauma-center
#16
Bernhard Gasser, Thomas M Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer
BACKGROUND: There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both. METHODS: Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed...
September 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28893017/a-comparative-study-of-analgesic-effect-of-intrathecal-nalbuphine-and-fentanyl-as-adjuvant-in-lower-limb-orthopaedic-surgery
#17
Shagufta Naaz, Usha Shukla, Swati Srivastava, Erum Ozair, Adil Asghar
INTRODUCTION: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. AIM: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. MATERIALS AND METHODS: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28893015/comparison-of-efficacy-and-safety-of-unilateral-spinal-anaesthesia-with-sequential-combined-spinal-epidural-anaesthesia-for-lower-limb-orthopaedic-surgery
#18
Jyoti Sandeep Magar, Kishori Dhaku Bawdane, Rahul Patil
INTRODUCTION: Orthopaedic anaesthesia plan requires customi-zation as per patient's need for safe outcome. Sequential Combined Spinal Epidural Anaesthesia (Sequential CSEA) and Unilateral Single Shot Spinal anaesthesia (Unilateral SA), both have advantages over conventional spinal anaesthesia that they provide longer lasting block with less hypotension. AIM: To compare safety and efficacy of unilateral spinal anaesthesia with sequential combined spinal epidural anaesthesia for lower limb orthopaedic surgery ...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891440/a-systematic-review-of-mesenchymal-stem-cells-in-spinal-cord-injury-intervertebral-disc-repair-and-spinal-fusion
#19
Shujhat Khan, Pouya Mafi, Reza Mafi, Wasim Khan
Spinal surgery presents a challenge for both neurosurgery and orthopaedic surgery. Due to the heterogeneous differentiation potential of mesenchymal stem cells, there is much interest in the treatment of spine surgery. Animal and human trials focussing on the efficacy of mesenchymal stem cells in spinal cord injury, spine fusion and disc degeneration were included in this systematic review. Published articles up to January 2016 from MEDLINE, PubMed and Ovid were used by searching for specific terms. Of the 2595 articles found, 53 met the selection criteria and were included for analysis (16 on spinal cord injury, 28 on intervertebral disc repair and 9 on spinal fusion)...
September 7, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28891313/mid-sole-release-of-the-plantar-fascia-combined-with-percutaneous-drilling-of-the-calcaneus-for-treatment-of-resistant-heel-pain
#20
Ahmed Shawkat Rizk, Wael A Kandel, Eslam Abd Elshafi Tabl, Mahmoud I Kandil
BACKGROUND: Heel pain with or without calcaneal spur is a challenging problem. Once conservative measures have failed, surgery may be indicated; there has been debate about the best surgical procedure. Two standard operative procedures have been either releasing the plantar fascia or removing the spur with drilling of the calcaneus. In this study, we evaluated the results of percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia for treatment of resistant heel pain...
September 1, 2017: Foot & Ankle International
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