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Archives of Orthopaedic and Trauma Surgery

Giovanni Balato, Vincenzo de Matteo, Tiziana Ascione, Sigismondo Luca Di Donato, Cristiano De Franco, Francesco Smeraglia, Andrea Baldini, Massimo Mariconda
INTRODUCTION: Two methods are currently available for the assay of α-defensin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test. We aimed to assess the diagnostic accuracy of synovial fluid α-defensin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection. MATERIALS AND METHODS: We searched (from inception to May 2018) MEDLINE, Scopus, EMBASE, Web of Science, and Cochrane for studies on α-defensin in the diagnosis of periprosthetic joint infection (PJI)...
July 12, 2019: Archives of Orthopaedic and Trauma Surgery
Han-Jun Lee, Yong-Beom Park, Dong-Hoon Lee, Kyu-Hwang Kim, Dae Woong Ham, Seong Hwan Kim
INTRODUCTION: To evaluate the incidence and risk factors of postoperative hyperextension after mobile-bearing total knee arthroplasty (TKA) and its clinical outcomes. MATERIALS AND METHODS: This retrospective case-control study included 387 knees of primary TKA patients after a 5-year follow-up. The clinical outcomes and radiographs including posterior condylar offset (PCO), femur and tibial slope angle and its discrepancy were evaluated. The patients were divided into two groups (group 1: non-hyperextension, group 2: hyperextension)...
July 12, 2019: Archives of Orthopaedic and Trauma Surgery
F E Rowan, S S Huq, F S Haddad
PURPOSE: The role for extra-articular procedures in addition to ACL reconstruction to restore rotational stability is debated. We use lateral extra-articular tenodesis (LEAT) for patients that meet criteria. Our null hypothesis was that there would be no difference between two groups of patients that were treated with ACL reconstruction alone or ACL reconstruction with LEAT according to criteria. METHODS: A prospectively collected database of patients that were treated primarily according to the presence of a high-grade pivot shift with LEAT at the time of ACL reconstruction was propensity-matched with a group of patients that underwent ACL reconstruction alone...
July 11, 2019: Archives of Orthopaedic and Trauma Surgery
Haruhisa Kanaya, Makoto Enokida, Kazutake Uehara, Masaru Ueki, Hideki Nagashima
OBJECTIVES: The Gekkou-drill® is an industrial drill that is highly efficient due to reduced cutting resistance resulting from its characteristic drill point shape. In this experiment, we compared the degree of thermal damage to bone tissue caused by conventional medical drills and these same drills with Gekkou modifications. METHODS: Holes were created in the tibias of living pigs using two different 3.2-mm diameter drills and their modified versions. Regarding the drilling parameters, the thrust force was 10 N and the drilling speeds were 800 revolutions per minute (rpm) and 1500 rpm...
July 9, 2019: Archives of Orthopaedic and Trauma Surgery
Annan Hu, Chi Sun, Yun Liang, Houlei Wang, Xilei Li, Jian Dong
INTRODUCTION: Middle- and long-term outcomes of multi-segmental lumbar spinal stenosis treated with Dynesys stabilization (DS) have rarely been reported. Older age and multi-segmental degeneration may be positive factors in achieving satisfactory outcomes following DS. The present study aimed to compare the middle- and long-term outcomes of DS with lumbar fusion for treatment of multi-segmental lumbar spinal stenosis (ms-LSS) in elderly patients. MATERIALS AND METHODS: This study retrospectively analyzed patients with ms-LSS treated by DS or lumbar fusion from January 2011 to April 2013...
July 9, 2019: Archives of Orthopaedic and Trauma Surgery
Jae-Woo Cho, Hoe Jeong Chung, Beom-Soo Kim, Do-Hyun Yeo, Jong-Hyeop Song, Chang-Wug Oh, Cyril Mauffrey, Won-Tae Cho, Jong-Keon Oh
PURPOSE: The purposes of the study were to introduce surgical technique of fragment-specific fixation technique using multiple 2.7-mm variable-angle locking compression plates (VA LCPs) in comminuted posterior wall acetabular fractures and reported its clinical results. PATIENTS AND METHODS: Among the 68 patients, 23 with comminuted posterior wall factures with ≥ 3 fragments in the CT scan and no column involvement with a minimum follow-up duration of 12 months were enrolled in this study...
July 8, 2019: Archives of Orthopaedic and Trauma Surgery
Jun-Il Yoo, Hojin Jeong, Jaeboem Na, Sang-Youn Song, Jung-Taek Kim, Yong-Han Cha, Chan Ho Park
INTRODUCTION: When locking intramedullary nails, inserting the distal interlocking screw accurately and quickly with less radiation exposure is very important. The purpose of this randomized control study was to compare radiation exposure and accuracy of distal locking screws between free-hand fluoroscopic guidance and the use of a distal targeting system (DTS). MATERIALS AND METHODS: Inclusion criteria of this study were patients older than 60 years who need an intramedullary nailing due to unstable intertrochanteric and subtrochanteric fracture...
July 5, 2019: Archives of Orthopaedic and Trauma Surgery
Falko Schwarz, Aaron Lawson McLean, Anna Luisa Steinberg, Christian Ewald, Rolf Kalff, Albrecht Waschke
INTRODUCTION: Kyphoplasty is an established method of treating osteoporotic vertebral body compression fractures. In recent years, several techniques to enhance the efficiency and outcomes of this surgery have been developed and implemented in clinical practice. In the present study, we assess the impact of two new access instruments on overall operation time and the administered dose area product in comparison with the standard access instrument used in our clinical practice. The two newer comparator devices have been designed with the intention of streamlining intraoperative workflow by omitting several procedural steps...
July 5, 2019: Archives of Orthopaedic and Trauma Surgery
Kwang Yun Song, In Jun Koh, Man Soo Kim, Nam Yong Choi, Ji Hwan Jeong, Yong In
PURPOSE: Lateral hinge fracture (LHF) during a medial opening-wedge high tibial osteotomy (MOWHTO) is considered to be the main cause of instability, further displacement, loss of correction, malunion, and nonunion. The purposes of this study were to evaluate whether the incidence of LHFs during MOWHTOs has decreased as the number of cases performed over time has increased, and whether the radiographic and clinical outcomes of patients with LHFs were worse than those of patients without LHFs...
July 4, 2019: Archives of Orthopaedic and Trauma Surgery
Armin Keshmiri, Philip Schöttle, Carolin Peter
PURPOSE: Trochlear dysplasia is one of the most important pathomorphologies predisposing to patellofemoral instability. The development of the trochlea groove is not well understood so far. We hypothesized that the underlying pathology of trochlear dysplasia is a medial hypoplasia. METHODS: 110 magnetic resonance imaging (MRI) scans from adult knees, 55 with and 55 without trochlear dysplasia were analyzed. On the axial and sagittal T2 MRI sequences, the height (h), width (w) and depth (d) of the medial (MC) and lateral femoral condyle (LC) as well as the depth of the trochlea groove (dTG) were measured using a three-dimensional measuring algorithm...
July 2, 2019: Archives of Orthopaedic and Trauma Surgery
Nicola Oehler, Julia Kristin Ruby, André Strahl, Rainer Maas, Wolfgang Ruether, Andreas Niemeier
INTRODUCTION: Hip abductor tendinopathies are becoming increasingly recognized as clinically relevant disorders. However, knowledge about prevalence of abductor tendinopathies and associated disorders of adjacent hip articular and periarticular structures is limited. In this context, the relative diagnostic value of 1.5-T vs. 3.0-T MRI magnets has not been studied yet. MATERIALS AND METHODS: Pelvic MRI scans of 1000 hips from 500 consecutive unselected patients (341 in 3...
June 26, 2019: Archives of Orthopaedic and Trauma Surgery
Laurent Audigé, Lukas Graf, Matthias Flury, Marco M Schneider, Andreas M Müller
INTRODUCTION: Shoulder arthroplasty for proximal humerus fracture sequelae is known to provide significant patient improvement, yet this outcome varies with time, prosthesis type, and fracture sequelae. We outline the expected course of postoperative shoulder pain and function in patients with anatomical (ASA) or reverse (RSA) shoulder arthroplasty following different fracture sequelae. MATERIALS AND METHODS: Of 111 consecutive patients from our local shoulder arthroplasty registry, 32 underwent ASA for Boileau type 1 sequelae and 77 RSA patients were identified with Boileau types I, III, and IV...
June 24, 2019: Archives of Orthopaedic and Trauma Surgery
Kaiser Peter, Haug Luzian, Gabl Markus, Rudisch Ansgar, Klauser Andrea, Rohit Arora
INTRODUCTION: The aim of our study was the assessment of the mid-term outcome of patients treated with a pediculated extensor retinaculum flap for extensor carpi ulnaris (ECU) tendon subluxation including postoperative tendon stability control. MATERIALS AND METHODS: Twelve patients treated with an extensor retinaculum flap for symptomatic ECU tendon instability were retrospectively evaluated. Follow-up examinations included functional and radiologic assessment...
June 20, 2019: Archives of Orthopaedic and Trauma Surgery
Austin T Fragomen, David Wellman, S Robert Rozbruch
INTRODUCTION: The magnetic intramedullary (IM) compression nail is capable of providing sustained compression for the treatment of nonunions of long bones. This ability was previously only possible with the use of external fixation. We asked the following questions: How effective is the IM compression nail at achieving union? How do we know when adequate compression has been attained? Which types of nonunions are good candidates for this treatment? MATERIALS AND METHODS: Fourteen patients with nonunions of the tibia (5) or femur (9) were treated with the PRECICE IM compression nail...
June 19, 2019: Archives of Orthopaedic and Trauma Surgery
Marvin Minkus, Julia Wolke, Pit Fischer, Markus Scheibel
BACKGROUND: The coracoid transfer represents a treatment option for patients with recurrent shoulder instability. Only a few studies exist about the complication rate of the coracoid transfer as a revision surgery following failed soft tissue stabilization. The purpose of this study was to analyze the results and complication rate after coracoid transfer as a revision surgery. METHODS: In this study 38 patients (4 females, 34 males, mean age 27 years) were included of whom 29 patients were available for follow-up after a mean of 27 months...
June 18, 2019: Archives of Orthopaedic and Trauma Surgery
Nina Wuertele, Johannes Beckmann, Malin Meier, Jochen Huth, Wolfgang Fitz
INTRODUCTION: Correct femoral rotational alignment in total knee arthroplasty (TKA) is important for femoropatellar knee kinematics as well as for the overall clinical success. The goal of the present study was to evaluate how accurately standard instruments of various manufacturers with specific rotational settings in posterior referencing restore the posterior femoral condylar anatomy and allow a rotational alignment which matches a particular anatomic rotational landmark on CT. METHODS: The anatomical transepicondylar axis (aTEA) and the posterior condylar line (PCL) were identified and the angle formed by these two axes was measured on 100 consecutive CT scans of knees...
June 17, 2019: Archives of Orthopaedic and Trauma Surgery
Yuta Mochizuki, Takao Kaneko, Keisuke Kawahara, Shinya Toyoda, Hiroyasu Ikegami, Yoshiro Musha
HYPOTHESIS: The purpose of the present study was described as the arthroscopically assisted procedure that uses a synthetic conoid ligament reconstruction using Zip Tight (Zimmer biomet, Warsaw, USA) and fracture-site fixation with K-wire. Our hypothesis was that this technique provided a satisfactory functional outcome with minimum complication. METHODS: 45 patients underwent operation to treat fractures of the distal clavicle between January 2014 and May 2017...
June 17, 2019: Archives of Orthopaedic and Trauma Surgery
Hussein Abdelaziz, Oury M Balde, Mustafa Citak, Thorsten Gehrke, Ahmed Magan, Carl Haasper
INTRODUCTION: The Kellgren-Lawrence score helps the orthopedic surgeon to classify the severity of knee osteoarthritis (OA) before total knee arthroplasty (TKA). There might be a discrepancy between subjective complaints of the patients and radiologically visible changes of the knee joint in many cases. In this context, we performed a prospective clinical study to compare the preoperative degree of knee OA using the Kellgren-Lawrence score with the intraoperative extent of cartilage damage during primary TKA...
June 17, 2019: Archives of Orthopaedic and Trauma Surgery
Young Hwan Park, Jong Hyub Song, Tae Jin Kim, Seong Hyun Kang, An Seong Chang, Hak Jun Kim
INTRODUCTION: The use of evaporative coolants in the management of acute musculoskeletal injury has received increasing attention recently. However, its efficacy compared with conventional cryotherapy in treating injured human subjects remains unclear. The purpose of this study is to compare the efficacy of evaporative coolants with that of ice packs in preoperative management of edema and pain in patients with an ankle fracture. MATERIAL AND METHODS: Sixty-three patients in need of surgical treatment for ankle fracture were randomly assigned to either an evaporative coolant group or an ice pack group...
June 15, 2019: Archives of Orthopaedic and Trauma Surgery
Xianyue Shen, Jianlin Xiao, Yuhui Yang, Tong Liu, Shangjun Chen, Zhongli Gao, Jianlin Zuo
OBJECTIVE: The aim of the present study was to compare the morphometric differences between patients with or without anterior cruciate ligament (ACL) injury, and identify the anatomic risk factors associated with ACL injury in active individuals. METHODS: The knee joint magnetic resonance images (MRI) of 100 subjects were included in this study. Data from the ACL-injured group (50 patients) and matched controls (50 subjects) were obtained from the same hospital...
June 12, 2019: Archives of Orthopaedic and Trauma Surgery
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