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Posttraumatic osteoarthritis

Matthieu Ollivier, Sébastien Parratte, Ludovic Lino, Xavier Flecher, Sébastien Pesenti, Jean-Noël Argenson
BACKGROUND: Previously published studies reported benefits of computer-assisted surgery (CAS) in terms of radiographic implant position in TKA, but whether these improvements result in clinically important survival differences or functional differences that a patient might perceive at a minimum 10-year followup remains largely unknown. QUESTIONS/PURPOSES: We performed a prospective randomized trial and asked whether CAS (1) improved survival free from aseptic loosening; and (2) demonstrated any clear difference in patient-reported outcomes at latest followup using validated outcome measures at minimum 10-year followup...
January 2018: Clinical Orthopaedics and related Research
O Lorbach
IMPLANT DESIGNS: Within the last 50 years, implants for shoulder replacement have developed rapidly. Monobloc-stems in few sizes were changed to modular implant systems that allow for an individual adaption of the stem, as well as adaption of the humeral head component according to the specific anatomic situation of the patient. Moreover, stemless und short stem implants are available, which may highly simplify primary implantation, especially in posttraumatic cases as well as in revision cases with a need for removal or change of the implants...
March 6, 2018: Der Orthopäde
Tim R Beals, Robert Harris, Darryl A Auston
Intraarticular fractures carry a significant risk for posttraumatic osteoarthritis, and this risk varies across different joint surfaces of the lower extremity. These differences are likely due to the anatomic and biomechanical specifics of each joint surface. High-quality human studies are lacking to delineate the threshold articular incongruity that significantly increases risk for posttraumatic osteoarthritis and diminished clinical outcomes for many joint surfaces. Even with anatomic reduction of the articular surface, close attention must be paid to mechanical axis and joint stability to optimize outcomes...
April 2018: Orthopedic Clinics of North America
Michelle L Delco, Edward D Bonnevie, Hazel S Szeto, Lawrence J Bonassar, Lisa A Fortier
No disease-modifying osteoarthritis (OA) drugs are available to prevent posttraumatic osteoarthritis (PTOA). Mitochondria (MT) mediate the pathogenesis of many degenerative diseases, and recent evidence indicates that MT dysfunction is a peracute (within minutes to hours) response of cartilage to mechanical injury. The goal of this study was to investigate cardiolipin-targeted mitoprotection as a new strategy to prevent chondrocyte death and cartilage degeneration after injury. Cartilage was harvested from bovine knee joints and subjected to a single, rapid impact injury (24...
February 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Todd O McKinley, Greg E Gaski, Yoram Vodovotz, Benjamin T Corona, Timothy R Billiar
Multiply injured patients with severe extremity trauma are at risk of acute systemic complications and are at high risk of developing longer term orthopaedic complications including soft-tissue infection, osteomyelitis, posttraumatic osteoarthritis, and nonunion. It is becoming increasingly recognized that injury magnitude and response to injury have major jurisdiction pertaining to patient outcomes and complications. The complexities of injury and injury response that affect outcomes present opportunities to apply precision approaches to understand and quantify injury magnitude and injury response on a patient-specific basis...
March 2018: Journal of Orthopaedic Trauma
Yong He, Lianbo Xiao, Weitao Zhai, Maximilian F Kasparek, Guilin Ouyang, Friedrich Boettner
Background: Data on indication of Unicompartmental Knee Arthroplasty (UKA) in the Asian population are currently not available. The current paper evaluates patients undergoing knee replacement at a Chinese Orthopaedic Specialty Hospital to report the percentage of patients who meet radiographic and clinical indication criteria for UKA. Methods: Over a one-year period 463 consecutive patients (515 knees) underwent primary knee replacement surgery. Clinical data were recorded and preoperative radiographs were assessed...
2018: Open Orthopaedics Journal
Mitchell C Coleman, Jessica E Goetz, Marc J Brouillette, Dongrim Seol, Michael C Willey, Emily B Petersen, Hope D Anderson, Nathan R Hendrickson, Jocelyn Compton, Behnoush Khorsand, Angie S Morris, Aliasger K Salem, Douglas C Fredericks, Todd O McKinley, James A Martin
We tested whether inhibiting mechanically responsive articular chondrocyte mitochondria after severe traumatic injury and preventing oxidative damage represent a viable paradigm for posttraumatic osteoarthritis (PTOA) prevention. We used a porcine hock intra-articular fracture (IAF) model well suited to human-like surgical techniques and with excellent anatomic similarities to human ankles. After IAF, amobarbital or N -acetylcysteine (NAC) was injected to inhibit chondrocyte electron transport or downstream oxidative stress, respectively...
February 7, 2018: Science Translational Medicine
Erik A Wikstrom, Tricia Hubbard-Turner, Sophie Guderian, Michael J Turner
CONTEXT:   Ankle sprains are the most common orthopaedic injury that occurs during sport and physical activity. Many individuals who sprain their ankles develop chronic ankle instability (CAI), a condition characterized by recurrent injury, decreased physical activity, and decreased quality of life. These residual impairments are believed to persist for the remainder of the patient's life, in part due to the link between CAI and posttraumatic ankle osteoarthritis. However, this belief remains speculative due to the lack of long-term prospective investigations...
February 7, 2018: Journal of Athletic Training
Yasaman Safarpour, Bahman Jabbari
This review evaluates the existing level of evidence for efficacy of BoNTs in different pain syndromes using the recommended efficacy criteria from the Assessment and Therapeutic Subcommittee of the American Academy of Neurology. There is a level A evidence (effective) for BoNT therapy in post-herpetic neuralgia, trigeminal neuralgia, and posttraumatic neuralgia. There is a level B evidence (probably effective) for diabetic neuropathy, plantar fasciitis, piriformis syndrome, pain associated with total knee arthroplasty, male pelvic pain syndrome, chronic low back pain, male pelvic pain, and neuropathic pain secondary to traumatic spinal cord injury...
January 31, 2018: Toxicon: Official Journal of the International Society on Toxinology
Scott F M Duncan, Anthony A Smith, Kevin J Renfree, Ross M Dunbar, Marianne V Merritt
BACKGROUND: Most hand surgeons use a dorsal approach for proximal interphalangeal (PIP) joint implant arthroplasty. However, a volar approach offers the advantage of no disturbance to the extensor mechanism, thus allowing early initiation of active range of motion. We examined our results in patients who underwent PIP joint arthroplasty via a volar approach. METHODS: Using a retrospective chart review, we evaluated the outcomes of patients undergoing PIP joint arthroplasty through a volar approach between 2001 and 2005 by 3 fellowship-trained hand surgeons at our institution...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Morgan H Jones, Kurt P Spindler, Jack T Andrish, Charles L Cox, Warren R Dunn, Jeff Duryea, Carol L Duong, David C Flanigan, Braden C Fleming, Laura J Huston, Christopher C Kaeding, Matthew J Matava, Nancy A Obuchowski, Heidi L Oksendahl, Richard D Parker, Erica A Scaramuzza, Matthew V Smith, Carl S Winalski, Rick W Wright, Emily K Reinke
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction can effectively return athletes to the playing field, but they are still at risk of developing posttraumatic osteoarthritis (PTOA). No studies have used multivariable analysis to evaluate the predictors of radiographic PTOA in the lateral compartment of the knee at short-term follow-up after ACL reconstruction. PURPOSE: To determine the predictors of radiographic joint space narrowing in the lateral compartment 2 to 3 years after ACL reconstruction in a young, active cohort...
January 1, 2018: American Journal of Sports Medicine
Giulio Lauri, Marco Biondi, Giuliana Roselli, Prospero Bigazzi
Background  Wrist osteoarthritis is a common disease often resulting from malunited fractures of the distal radius. The primary treatment purpose is to provide pain relief, while maintaining strength and mobility whenever possible. In a patient presenting a posttraumatic degeneration of the wrist, deciding which surgical technique, which joints to sacrifice and which to preserve is crucial to optimizing the outcome. Case Description  We describe a 10-year follow-up of an osteoarticular allograft of the distal radius proposed to treat an isolated distal radius posttraumatic degeneration...
February 2018: Journal of Wrist Surgery
Keiko Amano, Janet L Huebner, Thomas V Stabler, Matthew Tanaka, Charles E McCulloch, Iryna Lobach, Nancy E Lane, Virginia B Kraus, C Benjamin Ma, Xiaojuan Li
BACKGROUND: Anterior cruciate ligament tears can lead to posttraumatic osteoarthritis. In addition to biomechanical factors, changes in biochemical profiles within the knee joint after injury and anterior cruciate ligament reconstruction (ACLR) may play a role in accelerating joint degeneration. Hypothesis/Purpose: It was hypothesized that cartilage matrix composition after ACLR is associated with the degree of inflammatory response after initial injury. This study evaluated the association between the inflammatory response after injury-as indicated by cytokine, metalloproteinase, and cartilage degradation marker concentrations in synovial fluid-and articular cartilage degeneration, measured by T1ρ and T2 quantitative magnetic resonance imaging up to 3 years after ACLR...
January 1, 2018: American Journal of Sports Medicine
Philipp R Heuberer, Georg Brandl, Leo Pauzenberger, Brenda Laky, Bernhard Kriegleder, Werner Anderl
BACKGROUND: Stemless shoulder arthroplasty is a fairly new concept. Clinical and radiological follow-up is essential to prove implant safety and concept. This prospective single-centre study was performed to evaluate the influence of radiological changes on clinical mid-term outcome following stemless humeral head replacement with hollow screw fixation. METHODS: Short- and mid-term radiological and clinical evaluations were performed in 73 consecutive shoulders treated mainly for idiopathic and posttraumatic osteoarthritis with stemless humeral head arthroplasty including 40 hemi- (HSA) and 33 total shoulder arthroplasties (TSA)...
January 22, 2018: BMC Musculoskeletal Disorders
Elliot R Row, Stephen Kottmeier, David E Komatsu, John T Watson, Clifford Jones
PURPOSE: We present a surgical strategy to manage multicolumnar tibial plateau fracture variants by addressing the predominant posterior fragment employing a Lobenhoffer approach in the prone position followed by supine patient repositioning for anterolateral column access. DESIGN: Multicenter retrospective analysis. SETTING: Three academic Level 1 trauma centers. PATIENTS/METHODS: Twenty-eight cases (28 patients/28 knees) met inclusion criteria between 2003 and 2014...
January 5, 2018: Journal of Orthopaedic Trauma
Joseph A Buckwalter V, Robert Westermann, Brian Mooers, Matthew Karam, Brian Wolf
Talus fractures with associated dislocations are rare but have high rates of complications, including avascular necrosis (AVN). Management of these injuries involves urgent surgical reduction and fixation, although there are no definitive data defining an operative time frame for preserving the blood supply and preventing complications. To determine the effect of time to surgical reduction of talus fractures and talus fracture-dislocations on rates of AVN and posttraumatic osteoarthritis (PTOA), we retrospectively reviewed talus fractures surgically managed at a level I trauma center during the 10-year period 2003 to 2013...
November 2017: American Journal of Orthopedics
Florian Baumann, Johannes Weber, Daniel Mahr, Martin Bäumlein, Maximilian Kerschbaum, Karolina Müller, Paavo Rillmann, Michael Nerlich, Markus Loibl
BACKGROUND: Evaluating patient-reported outcomes (PRO) in early osteoarthritis (OA) of the knee is difficult. Established measurement tools are focused on one of the two major patient groups in knee surgery: young, highly active patients, or older patients with advanced degenerative OA of the knee. Joint awareness in everyday life is a crucial criterion in measuring PRO. The purpose of this study was to validate a German version of the "Forgotten Joint Score" (FJS) in patients after surgical treatment of tibial plateau fractures...
December 2, 2017: Health and Quality of Life Outcomes
Markus Parkkinen, Jan Lindahl, Tatu J Mäkinen, Seppo K Koskinen, Antti Mustonen, Rami Madanat
PURPOSE: To determine factors influencing the development of posttraumatic osteoarthritis (OA) following medial tibial plateau fractures and to evaluate concomitant injuries associated with these fractures. MATERIALS AND METHODS: A chart review of patients with operatively treated medial tibial plateau fractures admitted to our Level I trauma centre from 2002 to 2008 was performed. Of 63 patients, 41 participated in a clinical and radiographic examination. The mean age was 47 years (range 16-78) and the mean follow-up time was 7...
February 2018: Injury
Noha M Eltawil, Saima Ahmed, Luke H Chan, A Hamish R W Simpson, Andrew C Hall
Objectives During arthroscopic or open joint surgery, articular cartilage may be subjected to mechanical insults by accident or design. These may lead to chondrocyte death, cartilage breakdown and posttraumatic osteoarthritis. We have shown that increasing osmolarity of routinely used normal saline protected chondrocytes against injuries that may occur during orthopedic surgery. Often several liters of irrigation fluid are used during an orthopedic procedure, which is usually kept at room temperature, but is sometimes chilled...
January 1, 2017: Cartilage
Michael Dujela, Christopher F Hyer, Gregory C Berlet
BACKGROUND: Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail. METHODS: A chart and radiographic review was performed. TTC fusions performed in patients with osteoarthritis, posttraumatic arthritis, or deformity correction with retrograde nail fixation were included...
November 1, 2017: Foot & Ankle Specialist
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