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Mobilizing with femoral line

Chahine Assi, Nadim Kheir, Camille Samaha, Pascal Kouyoumjian, Kaissar Yammine
INTRODUCTION: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH...
2018: SICOT-J
S Parratte, M Ollivier, J-N Argenson
Relatively poor results have been reported with open reduction and internal fixation of complex fractures around the knee in elderly osteoporotic patients, and primary total knee arthroplasty (TKA) has been proposed as an alternative solution. While limiting the number of procedures, it meets two prerequisites: (1) to save the patient's life, thanks to early weight-bearing, to limit decubitus complications; and (2) to save knee function and patient autonomy, thanks to early knee mobilization. There are 3 main indications: complex articular fractures in elderly patients with symptomatic osteoarthritis prior to fracture; complex articular fractures of the tibial plateau in elderly patients whose bone quality makes internal fixation hazardous; and major destruction of the distal femur in younger patients...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
André Ferreira, Jean-Louis Prudhon, Régis Verdier, Jean-Marc Puch, Loys Descamps, Guy Dehri, Marcel Remi, Jacques H Caton
INTRODUCTION: The dual-mobility cup (DMC) was introduced in 1979. Due to lack of referenced publications, this interesting and innovating concept was ignored during close to 20 years. However, 180 studies (level III or IV) have now been published. Evidence-based medicine is based on level I studies. Over the past three decades, the role of national registries developed with the intention of surveying orthopaedic implants. In 2012, we developed, registered, and implemented a specific database for contemporary DMC...
March 2017: International Orthopaedics
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
Philippe Hernigou, Matthieu Trousselier, François Roubineau, Charlie Bouthors, Charles Henri Flouzat Lachaniette
BACKGROUND: Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation. QUESTION/PURPOSES: (1) What is the cumulative risk of dislocation in patients with obesity after THA in the absence of a dual-mobility or constrained liner, and is this related to component positioning? (2) Does bariatric surgery before undergoing THA decrease dislocation risk in patients with obesity? (3) Are dual-mobility and constrained liners efficient in preventing dislocation in patients with obesity? METHODS: At our university-based practice, all surgeons adhered to the following treatment approaches: Before 2000 no dual-mobility implants or constrained liners were used for primary THAs...
October 2016: Clinical Orthopaedics and related Research
Atsushi Takahashi, Takehiko Sugita, Toshimi Aizawa, Daisuke Chiba, Masayuki Kamimura, Takashi Aki, Eiji Itoi
BACKGROUND: During total knee arthroplasty (TKA), excision of the popliteus tendon leads to extensive static gaps and reduced mobility. The purpose of this study was to determine the positional relationship between the femoral insertion of the popliteus tendon and the bone cutting lines of various TKA systems. METHODS: This study included 21 cadaveric right femurs presenting no macroscopic deformity. The lateral image of the femur and the template of the femoral component were overlaid to determine the preservation/excision of the popliteus tendon insertion...
November 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
R Hube, T Pfitzner, P von Roth, H O Mayr
OBJECTIVE: Surgical technique for primary and revision total knee arthroplasty to reconstruct bone defects with metal augments and reproducible positioning of the implant at the right joint line. INDICATIONS: Primary and revision total knee arthroplasty with bone defects. CONTRAINDICATIONS: Complete destruction of the metaphysis. SURGICAL TECHNIQUE: Implantation of revision components performed in three consecutive steps: first, positioning of the tibia component at correct height and rotation; second, determination of the posterior joint line in flexion through the size and correct rotation of the femoral implant; third, determination of the distal joint line by use of positioning of the femoral component...
February 2015: Operative Orthopädie und Traumatologie
Xavier Normand, Jean-Louis Pinçon, Jean-Marie Ragot, Régis Verdier, Thierry Aslanian
One of the main factors affecting the survival of a total knee arthroplasty (TKA) is the fixation method. The constraints placed on the bone-implant interface of a mobile-bearing TKA must be taken in account during the design and evaluation phases. For more than two decades, calcium phosphate ceramics, particularly hydroxyapatitis, have been used in Europe to accelerate the bone integration of cementless implants. A prospective study of patients continuously recruited by three senior surgeons at three French private hospitals has been carried out...
February 2015: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Fei Luo, Jie Shen, Jianzhong Xu, Shiwu Dong, Qiang Huang, Zhao Xie
OBJECTIVE: AO/OTA 31-A3 intertrochanteric femoral fractures have completely different fracture line directions and biomechanical characteristics compared with other types of intertrochanteric fractures. The choice of the fixation method has been a focus of dispute among orthopedic trauma surgeons. The purpose of this study was to review the outcomes of these fractures treated with a percutaneous compression plate at our institute. METHOD: Seventeen patients with AO/OTA 31-A3 intertrochanteric femoral fractures were treated with a percutaneous compression plate at our institute from January 2010 to December 2011...
January 2014: Clinics
Fred Mullins, Mohammad Anwarul Huq Mian, Dana Jenkins, Claus Brandigi, Joseph R Shaver, Bruce Friedman, Badrul Alam, Meyer Schwartz, Zaheed Hassan
Early mobilization and deep venous thrombosis (DVT) prophylaxis have been shown to reduce the incidence of DVT and pulmonary embolism among hospitalized patients, yet thromboembolic complications remain a great concern, especially to those who remain immobilized for an extended period of time. There are many risk factors associated with the development of thromboembolism, especially DVT. The main objective of this retrospective study is to estimate the occurrence of DVT in burn patients and to investigate some burn-related risk factors...
May 2013: Journal of Burn Care & Research: Official Publication of the American Burn Association
W Petersen, P Forkel, A Achtnich, S Metzlaff, T Zantop
OBJECTIVE: Restore the knee stability by ACL reconstruction of the anterior cruciate ligament. INDICATION: Acute and chronic functional instability with rupture of the anterior cruciate ligament giving way phenomena, acute rupture of the anterior cruciate ligament with concomitant meniscus repair. CONTRAINDICATIONS: Local infection in the knee joint, local soft tissue damage, lack of cooperation of the patient. SURGICAL TECHNIQUE: The operation begins with the examination under anesthesia...
April 2013: Operative Orthopädie und Traumatologie
(no author information available yet)
UNLABELLED: In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home...
2008: Ontario Health Technology Assessment Series
M Tall, I Ouedraogo, A Nd Kasse, B J D Tekpa, G Bonkoungou, S Belem, M F Toe, S C Da
INTRODUCTION: In developing countries, malunion, after diaphyseal femur fractures initially untreated by internal fixation, is not rare. Their difficult management contrasts with the deficiency of the technical operating room facilities. PATIENTS AND METHODS: Our prospective study, conducted over a 1-year period, reports 16 open osteotomies fixed using Küntscher intramedullary nailing in patients who presented malunion of the femoral diaphysis. Twelve males and four females (mean age, 34...
November 2012: Orthopaedics & Traumatology, Surgery & Research: OTSR
R Vaidya, B Oliphant, R Jain, K Nasr, R Siwiec, N Onwudiwe, A Sethi
Anterior external fixation for pelvic fractures has been the standard for acute stabilization but definitive treatment often leads to pin tract infection, is uncomfortable, and limits patient mobility. We recently developed a subcutaneous anterior pelvic fixator which addresses these issues (INFIX). The objective of this study is to introduce the Bikini Area and Bikini Line as the subcutaneous anatomical location where this apparatus is placed. A study was preformed on eight cadaveric specimens to define the location of the subcutaneous device with respect to anatomic structures...
April 2013: Clinical Anatomy
M Rudert, B M Holzapfel, H Pilge, H Rechl, R Gradinger
OBJECTIVE: Treatment of tumors of the pelvic girdle by resection of part or all of the innominate bone with preservation of the extremity. Implantation and stable fixation using a custom-made megaprosthesis to restore painless joint function and loading capacity. The surgical goal is to obtain a wide surgical margin and local tumor control. INDICATIONS: Primary bone and soft tissue sarcomas, benign or semi-malignant aggressive lesions, metastatic disease (radiation resistance and/or good prognosis)...
July 2012: Operative Orthopädie und Traumatologie
G Spahn, H M Klinger, P Harth, G O Hofmann
AIM: High tibial osteotomy (HTO) has been established as an effective method for the treatment of unicondylar knee osteoarthritis. This study was undertaken to quantify the potential for restoration of cartilage lesions or defects after HTO in relation to different cartilage treatment modalities. Control arthroscopy was undertaken to identify the cartilage lesions within the knee joint 1.5 years after medial opening wedge osteotomy. MATERIAL AND METHOD: A total of 135 patients (72 male and 63 female) had undergone medial-opening high tibial osteotomy and arthroscopy...
June 2012: Zeitschrift Für Orthopädie und Unfallchirurgie
Sarah K Gray, Meghan E McGee-Lawrence, Jennifer L Sanders, Keith W Condon, Chung-Jui Tsai, Seth W Donahue
Duchenne muscular dystrophy (DMD) is an X-linked neuromuscular disease that has deleterious consequences in muscle and bone, leading to decreased mobility, progressive osteoporosis, and premature death. Patients with DMD experience a higher-than-average fracture rate, particularly in the proximal and distal femur and proximal tibia. The dystrophin-deficient mdx mouse is a model of DMD that demonstrates muscle degeneration and fibrosis and osteoporosis. Parathyroid hormone, an effective anabolic agent for post-menopausal and glucocorticoid-induced osteoporosis, has not been explored for DMD...
September 2012: Bone
Kristina Hölig, Matthias Blechschmidt, Michael Kramer, Kristin Zimmer, Frank Kroschinsky, Kirsten Poppe-Thiede, Martin Bornhäuser, Gerhard Ehninger
BACKGROUND: Peripheral blood stem cell (PBSC) collection is accepted as a routine procedure in related and unrelated healthy donors worldwide. Venous access can be accomplished by peripheral veins or a central venous catheter (CVC). STUDY DESING AND METHODS: We compared efficacy and tolerability of 40 PBSC collections via CVC with 6267 PBSC collections via peripheral veins in healthy allogeneic donors. Results of the leukapheresis procedures and side effects in the donors were evaluated...
December 2012: Transfusion
C Schnurr, I Stolzenberg, J Nessler, P Eysel, P König
OBJECTIVE: Implantation of a total knee arthroplasty with a correct mechanical axis, a rectangular joint gap and a reconstructed joint line by use of an imageless computer navigation device INDICATIONS: Symptomatic gonarthrosis if non operative treatment or joint preserving operations remains ineffective CONTRAINDICATIONS: Infections; soft tissue damage in the approach area; massive instability of the collateral ligaments SURGICAL TECHNIQUE: Medial parapatellar approach to the knee joint; diminution of the patella; fixation of the reference arrays in tibia and femur; registration of leg axis, ligament balance and surface of the knee joint by use of the navigation system; tibial resection perpendicular to the mechanical axis; ligament balancing to achieve a rectangular extension gap; femoral implant planning to maintain the original joint line and reconstruct an equal joint gap in extension and flexion; femora resection perpendicular to the mechanical axis; reconstruction of the rectangular flexion gap by rotation of the femoral resection; two stage cementing technique for fixation of the original implants; check of the final mechanical axis and symmetry of the joint gap over the whole range of motion; wound closure...
April 2012: Operative Orthopädie und Traumatologie
Barbara Biesalski, Bengü Yilmaz, Hans-Georg Buchholz, Nicole Bausbacher, Mathias Schreckenberger, Oliver Thews
Bone metastases are a major problem in several tumor entities affecting the therapeutic decision and the patient's prognosis. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are promising techniques for identifying bone tumors using gamma- or positron-emitting labeled radiotracers, but the same tracers if labeled with beta-emitters may also be used to apply therapeutic radionuclides for localized irradiation. For the tracer development specifically accumulating in osseous lesions, animal models of bone metastasis are needed...
May 2012: Nuclear Medicine and Biology
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