Archives of Orthopaedic and Trauma Surgery

Elisabeth Boehm, Marvin Minkus, Philipp Moroder, Markus Scheibel
INTRODUCTION: Donor site morbidity constitutes the most prevalent source of complications during anatomic glenoid reconstruction. Therefore, the aim of this study was to evaluate the clinical and radiologic results of arthroscopic anatomic glenoid reconstruction using an allogenic, tricortical iliac crest bone graft for glenoid bone loss in recurrent anterior shoulder instability. MATERIALS AND METHODS: Ten patients [one female/nine male, mean age 31.9 years (range, 26-40)] underwent allogenic iliac crest bone grafting and were evaluated clinically [range of motion, subscapularis tests, apprehension sign, Constant score (CS), Rowe score (RS), Walch-Duplay score (WD), Western Ontario Shoulder Instability Index (WOSI), Subjective Shoulder Value (SSV)] and radiographically [3-dimensional computed tomography (CT) scans]...
February 24, 2020: Archives of Orthopaedic and Trauma Surgery
Karl Stoffel, Michael Blauth, Alexander Joeris, Andrea Blumenthal, Elke Rometsch
INTRODUCTION: Hip arthroplasty (HA) is commonly performed to treat various hip pathologies. Its volume is expected to rise further due to the increasing age of the population. Complication rates are low; however, periprosthetic femoral fractures (PFF) are a rare, albeit serious, complication with substantial economic impact. While current guidelines propose revision with long-stemmed prostheses for all Vancouver B2 and B3 PFF, some recent research papers suggest that open reduction with internal fixation (ORIF) could lead to an equivalent outcome...
February 21, 2020: Archives of Orthopaedic and Trauma Surgery
Filippo Migliorini, Andromahi Trivellas, Giorgia Colarossi, Jörg Eschweiler, Markus Tingart, Björn Rath
INTRODUCTION: The MPFL reconstruction is performed either via a single-bundle (SB) or double-bundle (DB) procedure. The purpose of this study is to perform a systematic review comparing SB versus DB graft for recurrent patellofemoral instability, to summarize current evidence, and to clarify the role of both techniques. We focused on clinical scores, physical examination, complications, revision surgeries, and failures. MATERIAL AND METHODS: In May of 2019 the main online databases were accessed...
February 21, 2020: Archives of Orthopaedic and Trauma Surgery
André Busch, Marcus Jäger, Stefan Klebingat, Josef Baghdadi, Thilo Flörkemeier, Felix Hütter, Thomas M Grupp, Marcel Haversath
BACKGROUND: Progressive oxidation of highly cross-linked ultra-high molecular weight (UHMPWE-X) liners is considered to be a risk factor for material failure in THA. Antioxidants such as vitamin E (alpha-tocopherol) (UHMWPE-XE) were supplemented into the latest generation of polyethylene liners. To prevent inhomogenous vitamin E distribution within the polymer, blending was established as an alternative manufacturing process to diffusion. The purpose of the present study was to investigate the in vivo wear behavior of UHMWPE-XE in comparison with conventional UHMWPE-X liners using virtual CAD-based radiographs...
February 12, 2020: Archives of Orthopaedic and Trauma Surgery
Antonio Leiva-Gea, Francisco Borja Delgado-Rufino, Alfonso Queipo-de-Llano, Jorge Mariscal-Lara, Maximiano Lombardo-Torre, Felipe Luna-González
INTRODUCTION: Surgical lengthening and angular correction of the limbs are an option for treating the orthopedic clinical manifestations in patients with achondroplasia. This study assesses a staged limb lengthening protocol, performing simultaneous bilateral lengthening of the femur and tibia (stage I [S1]), and humeral lengthening (stage II [S2]). MATERIALS AND METHODS: Twenty-one achondroplastic patients were included in this study, and 106 segments (34 femurs, 34 tibias and 38 humeri) were lengthened...
February 11, 2020: Archives of Orthopaedic and Trauma Surgery
Jens Everding, Josef Stolberg-Stolberg, Jan Pützler, Steffen Roßlenbroich, Sabine Ochman, Michael Raschke
INTRODUCTION: Non-union is a regular complication of arthrodeses. Standard treatment includes revision surgery with frequent need for re-revision due to persistent non-union. Particularly patients with concomitant diseases are at risk of secondary complications. There is a need for evaluation of alternative treatment options. The aim of this study is to provide first evidence on union-rate and pain course after focussed extracorporeal shock-wave therapy of arthrodesis non-unions. PATIENTS AND METHODS: In a retrospective single-centre study, 25 patients with non-union following arthrodesis received one session of focussed extracorporeal shock-wave therapy (energy flux density 0...
February 8, 2020: Archives of Orthopaedic and Trauma Surgery
Georg Hauer, Gerwin A Bernhardt, Gloria Hohenberger, Lukas Leitner, Paul Ruckenstuhl, Andreas Leithner, Gerald Gruber, Patrick Sadoghi
PURPOSE: Our aim was to assess the outcome with respect to cumulative revision rates of unicompartmental knee arthroplasty (UKA) by comparing published literature and arthroplasty registry data. Our hypothesis was that there is a superior outcome of UKA described in dependent clinical studies compared to independent studies or arthroplasty registers. METHODS: A systematic review of all clinical studies on UKA in the past decade was conducted with the main endpoint revision rate...
February 8, 2020: Archives of Orthopaedic and Trauma Surgery
Wei Jie Tan, Ernest Beng Kee Kwek
INTRODUCTION: Open fractures are associated with high rates of complication, morbidity and high economic costs. To improve outcomes, an open extremity fracture clinical pathway that protocolized surgical management and encouraged multidisciplinary collaboration was implemented in our institution. This study evaluates the clinical outcomes before and after the implementation of the pathway. METHODOLOGY: Retrospective review of open tibial and femur fractures covering the 2 year periods before and after pathway implementation was conducted...
February 8, 2020: Archives of Orthopaedic and Trauma Surgery
Jun-Ki Moon, Jae Youn Yoon, Chul-Ho Kim, Sun Hyung Lee, Aditya L Kekatpure, Jun Seong Lee, Pil Whan Yoon
INTRODUCTION: We aimed to present the clinical outcomes of multiple drilling and multiple matchstick-like bone allograft for large osteonecrotic lesions of the femoral head as a joint-preserving surgery. MATERIALS AND METHODS: Between March 2014 and March 2018, 57 patients (77 hips) who underwent multiple drilling and multiple matchstick-like bone allograft for large lesions (≥ 30%) in osteonecrosis of the femoral head (ONFH) were included. Harris hip scores (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were obtained preoperatively and at the latest follow-up...
February 7, 2020: Archives of Orthopaedic and Trauma Surgery
Xuedong Sun, Jun Wang, Zheng Su
BACKGROUND: This study was performed to compare the clinical and radiographic outcomes of total knee arthroplasty (TKA) following high tibial osteotomy (HTO) versus primary TKA. METHODS: Relevant trials were identified via a search of Ovid, PubMed and the Cochrane Central Register of Controlled Trials from inception to 10 January 2019. A meta-analysis was performed to compare postoperative outcomes between revising HTO to TKA (RHTO) and primary TKA (PTKA) with respect to Knee Society Score (KSS), 10-year survival rate, operative time, flexion and extension angle, infection rate and radiographic results...
January 30, 2020: Archives of Orthopaedic and Trauma Surgery
M Wenning, A H Heitner, M Mauch, D Gehring, C Ramsenthaler, J Paul
INTRODUCTION: Ruptures of the anterior cruciate ligament (ACL) can be accompanied by meniscal lesions. Generally, the rehabilitation protocols are altered by meniscal repair. Therefore, the aim of this study was to investigate the effect of meniscal repair on the early recovery of thigh muscle strength in ACL reconstruction (ACLR). MATERIALS AND METHODS: We performed a matched cohort analysis of n = 122 isolated ACLR (CON) compared to n = 61 ACLR with meniscal repair (ACLR + MR)...
January 29, 2020: Archives of Orthopaedic and Trauma Surgery
Mathieu Thaunat, Gaspard Fournier, Padhraig O'Loughlin, Biova Teko Kouevidjin, Gilles Clowez, Matteo Borella, Jean-Marie Fayard, Bertrand Sonnery-Cottet
INTRODUCTION: The failure rate of meniscal repair remains significant, especially for bucket-handle tears. This study aimed to evaluate the clinical outcomes, failure rate and risk factors for failure of bucket-handle medial meniscal tear repairs performed during ACL reconstruction. MATERIALS AND METHODS: A retrospective analysis of prospectively collected data was performed on a consecutive series of 96 ACL reconstructions with meniscal arthroscopic suture of a bucket-handle tear of the medial meniscus with a minimum 2 year follow-up...
January 28, 2020: Archives of Orthopaedic and Trauma Surgery
George A Konstantinidis, Troy Smithers, Thin Foo Hong
INTRODUCTION: Acromion fractures are rare and difficult to treat. There is no consensus on type of fixation. Due to the rarity of the injury, it is difficult to compare different techniques of osteosynthesis. OBJECTIVES: The aim of this study was to present the long-term results of an alternative method of plating Ogawa type IIB meta-acromion fractures and to review the literature. DESIGN: Retrospective study. MATERIALS AND METHODS: We present a case series of 11 consecutive patients with displaced Ogawa type IIB meta-acromion fracture, treated with open reduction internal fixation using a 3...
January 27, 2020: Archives of Orthopaedic and Trauma Surgery
Jonathan D Bartlett, John E Lawrence, Matthew Yan, Borna Guevel, Max E Stewart, Emmanuel Audenaert, Vikas Khanduja
INTRODUCTION: Decreases in trainees' working hours, coupled with evidence of worse outcomes when hip arthroscopies are performed by inexperienced surgeons, mandate an additional means of training. Though virtual reality simulation has been adopted by other surgical specialities, its slow uptake in arthroscopic training is due to a lack of evidence as to its benefits. These benefits can be demonstrated through learning curves associated with simulator training-with practice reflecting increases in validated performance metrics...
January 27, 2020: Archives of Orthopaedic and Trauma Surgery
Lizzy Weigelt, Julian Hasler, Andreas Flury, Dimitris Dimitriou, Naeder Helmy
BACKGROUND: Direct fixation of posterior malleolar fractures has been shown to lead to higher accuracy of fracture reduction compared to an indirect anterior to posterior fixation but lacks long-term clinical results. This study shows the mid- to long-term clinical and radiological outcome after direct fixation of the posterior malleolus through a posterolateral approach. MATERIALS AND METHODS: Thirty-six patients with an ankle fracture including a posterior malleolar fragment (23 × AO-44C, 12 × AO-44B, 1 × unclassifiable) treated with direct fixation of the fragment through a posterolateral approach were retrospectively evaluated...
January 25, 2020: Archives of Orthopaedic and Trauma Surgery
David Rabago, Kenneth Dean Reeves, Gastón Andrés Topol, Leandro Ariel Podesta, An-Lin Cheng, Bradley D Fullerton
No abstract text is available yet for this article.
January 25, 2020: Archives of Orthopaedic and Trauma Surgery
T M Tiefenboeck, J Zeilinger, M Komjati, C Fialka, S Boesmueller
BACKGROUND: The shoulder is the joint most prone to dislocating in the human body and accounts for 45% of all dislocations. In addition to ruptures of the soft tissue and bony injuries, lesions to vascular structures as well as the brachial plexus and its corresponding nerves might occur. With an incidence of up to 65%, nerve lesions are frequently reported after shoulder dislocations. The aim of this study is to obtain information on epidemiology, diagnostics, treatment and duration until remission or late sequelae after shoulder dislocation and concomitant nerve injury in a large patient cohort...
January 24, 2020: Archives of Orthopaedic and Trauma Surgery
Jun-Seob Song, Ki-Taek Hong, Na-Min Kim, Han-Soo Park, Nam-Hong Choi
INTRODUCTION: This study aimed to investigate the clinical outcomes after human umbilical cord blood-derived mesenchymal stem cell (hUCB-MSC) implantation for medial compartment (MC) osteoarthritis of the knee. MATERIALS AND METHODS: Inclusion criteria were patients older than 60 years, with a kissing lesion of the MC, a full-thickness chondral defect ≥ 4 cm2 of the medial femoral condyle (MFC), and a varus deformity ≥ 3° on a long cassette scanogram...
January 24, 2020: Archives of Orthopaedic and Trauma Surgery
Ajay C Kanakamedala, Andrew J Sheean, Michael J Alaia, James J Irrgang, Volker Musahl
AIM: There is a shortage of high-level evidence regarding periarticular fractures affect outcomes after MLKIs. The purpose of this study was to determine whether concomitant periarticular fractures with mutliligament knee injuries (MLKIs) predict worse patient-reported outcomes (PROMs) when compared to MLKIs without concomitant periarticular fractures after surgical repair and/or reconstruction. MATERIALS AND METHODS: Medical records of patients who sustained MLKIs from January 1, 2009 to June 1, 2014 were retrospectively reviewed...
January 24, 2020: Archives of Orthopaedic and Trauma Surgery
Jan Theopold, Stefan Schleifenbaum, Alexander Georgi, Michael Schmidt, Ralf Henkelmann, Georg Osterhoff, Pierre Hepp
PURPOSE: Numerous techniques have been described for the tibial-sided graft preparation in anterior cruciate ligament (ACL) reconstruction. The use of less suture material for graft preparation is thought to improve ingrowth and to reduce the risk for infection. At the same time, the suture construct should be strong enough to resist the surgeon's pull during tensioning of the transplant. METHODS: In total, 39 fresh-frozen procine deep flexor tendons were used and prepared as four-strand grafts...
January 24, 2020: Archives of Orthopaedic and Trauma Surgery
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