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Archives of Orthopaedic and Trauma Surgery | Page 2

Lauren J Seo, Jonathan Gabor, David Novikov, James E Feng, Ran Schwarzkopf, Jonathan M Vigdorchik
BACKGROUND: Patients with developmental dysplasia of the hip (DDH) require special surgical considerations for total hip arthroplasty (THA). Despite the difficulties posed by the population's anatomical abnormalities, few large evaluations of postoperative outcomes exist. This study seeks to characterize outcomes following primary THA among patients diagnosed with DDH. METHODS: A retrospective review was conducted at a tertiary care center on all THA patients between June 2011 and March 2018...
April 2, 2019: Archives of Orthopaedic and Trauma Surgery
Kilian Rueckl, Diego J Alcaide, Bernhard Springer, Stefan Rueckl, Maximilian F Kasparek, Friedrich Boettner
INTRODUCTION: Malpositioning of the cup in total hip arthroplasty (THA) is associated with dislocation, early polyethylene wear, and impingement. The direct anterior approach (DAA) THA allows for intraoperative fluoroscopy imaging (IF). The current study investigates the following research hypotheses: (1) intraoperative measurements of radiographic cup inclination (RI) are reliable and reproducible. (2) A correction factor can compensate for the complex parallax effects when using IF...
April 1, 2019: Archives of Orthopaedic and Trauma Surgery
Michal Zídka, Valér Džupa
PURPOSE OF THE STUDY: Outpatient treatment of hip dysplasia in newborns has excellent results. A combination of general screening with early treatment with a functional abduction device works well. Treatment with the Frejka pillow and the Pavlik harness is frequently used in our region. The aim of the study is to compare efficiency and treatment duration, related to the brace used, and to prove that the choice of an abduction device implies parental compliance with the treatment protocol...
April 1, 2019: Archives of Orthopaedic and Trauma Surgery
Konstantinos Anagnostakos, Christof Meyer
INTRODUCTION: In the past 10 years an increasing number of studies about partial two-stage exchange arthroplasty in the management of periprosthetic hip infections have been published. The aim of the present work was to systematically review the current knowledge about this procedure, and critically verify the success as well as the complications of this treatment option. MATERIALS-METHODS: A literature search was performed through PubMed until June 2018. Search terms were "partial two stage hip" and "partial retention hip", and "retaining well fixed hip"...
March 29, 2019: Archives of Orthopaedic and Trauma Surgery
Alexander Maslaris, Frank Layher, Matthias Bungartz, Timo Zippelius, Emmanouil Liodakis, Olaf Brinkmann, Georg Matziolis
BACKGROUND: Easy revisability is gaining increasingly in importance. The removal of well-fixed cemented stems is very demanding and is often associated with increased operative morbidity. Implant design may be here a decisive impact factor, and the best way to ascertain it is experimentally. Aim of this study is to assess different cemented stems of established knee revision implants in regard to their removal capability. METHODS: Based on their sagittal profile, five stem extensions from known manufacturers were divided in conical, conical-cylindrical and cylindrical designs...
March 29, 2019: Archives of Orthopaedic and Trauma Surgery
R L Roerdink, A W Plat, R P van Hove, A C A P Leenders, B C van der Zwaard
INTRODUCTION: Wound leakage has been shown to increase the risk of prosthetic joint infections (PJIs) in primary total hip (THA) and knee arthroplasty (unicondylar and total knee arthroplasty; KA). The aim of this study is to determine whether the addition of a continuous subcuticular bonding stitch to a conventional three-layer closure method reduces the incidence of prolonged wound leakage and PJIs after THA and KA. MATERIALS AND METHODS: This retrospective cohort study included all patients receiving a THA or KA...
March 25, 2019: Archives of Orthopaedic and Trauma Surgery
Florian Wichlas, Serafim Tsitsilonis, Michela Delli Guanti, Gino Strada, Christian Deininger
PURPOSE: Developing a guideline for orthopedic trauma surgeons working in civilian trauma hospitals in low-income countries. METHODS: This is a retrospective data analysis in a non-governmental organizational trauma hospital in Sierra Leone, Africa. Trauma victims (282), with 349 fractures, were admitted to the hospital 10/2015-01/2016. The incidence of open and closed fractures and the use of implants were evaluated. RESULTS: The most common fractures were open and closed tibial shaft fractures and closed femoral shaft fractures in adults, and closed supracondylar humerus fractures in children...
March 25, 2019: Archives of Orthopaedic and Trauma Surgery
Niklas Biermann, Wolf Christian Prall, Wolfgang Böcker, Hermann Otto Mayr, Florian Haasters
INTRODUCTION: Secondary dislocation due to loss of fixation is the most common complication after plate fixation of proximal humeral fractures. A wide range of different techniques for augmentation has been described to improve the primary and secondary stability. Nevertheless, comparative analyses on the specific advantages and limitations are missing. Therefore, the aim of the present article was to systematically review and evaluate the current biomechanical and clinical studies. MATERIALS AND METHODS: The databases of PubMed and EMBASE were comprehensively searched for studies on augmentation techniques for proximal humeral fractures using defined search terms...
March 22, 2019: Archives of Orthopaedic and Trauma Surgery
Themistoklis Tzatzairis, Georgios I Drosos, Theodosia Vogiatzaki, Konstantinos Tilkeridis, Athanasios Ververidis, Konstantinos Kazakos
BACKGROUND: Tranexamic acid (TXA) is widely used in the orthopedic field and particularly in total knee arthroplasty (TKA). Its efficacy and safety in reducing the blood loss in TKA have been well-documented in the current literature. Little data regarding TKA without tourniquet and TXA exist. Our aim is to compare three different dosages of intravenous (IV) TXA in TKA without tourniquet. MATERIALS AND METHODS: A total of 180 patients undergoing TKA for knee osteoarthritis were stratified in three equal groups...
March 22, 2019: Archives of Orthopaedic and Trauma Surgery
Julio Urrutia, Pablo Besa, Cristobal Piza
INTRODUCTION: Vertebral compression fractures (VCF) are frequently asymptomatic; incidental diagnosis is a valuable opportunity to identify low bone mass and to start treatment. We aimed to determine the proportion of patients over 60 years old evaluated with chest plus abdominal and pelvic computed tomography (CT) scans, allowing visualization of the entire thoraco-lumbar spine, who incidentally present VCF. MATERIALS AND METHODS: We evaluated 300 patients over 60 years old who under went chest plus abdominal and pelvic CT scans...
March 21, 2019: Archives of Orthopaedic and Trauma Surgery
James W A Fletcher, Markus Windolf, Leonard Grünwald, R Geoff Richards, Boyko Gueorguiev, Peter Varga
BACKGROUND: The aim of this study was to identify the effect of screw length on predictions of fixation failure in three-part proximal humeral fractures using a finite element-based osteosynthesis modelling toolkit. METHODS: A mal-reduced unstable three-part AO/OTA 11-B3.2 fracture with medial comminution was simulated in forty-two digitally processed proximal humeri covering a spectrum of bone densities and fixed with the PHILOS plate using three distal and six proximal locking screws...
March 20, 2019: Archives of Orthopaedic and Trauma Surgery
Alex E Ward
INTRODUCTION: All the surgeries carry risks, which may lead to readmission at a later date. At present, there is limited Trauma and Orthopaedic (T&O) specific data in the literature. As a result, a prospective regional service evaluation aimed to discover the current complication and readmission rates across all T&O procedures and identify any factors associated with these outcomes. METHODS: Data were collected at six sites across Yorkshire and Humber for all T&O procedures during October 2016...
March 20, 2019: Archives of Orthopaedic and Trauma Surgery
Raja Bhaskara Rajasekaran, Dheenadhayalan Jayaramaraju, Dhanasekara Raja Palanisami, Devendra Agraharam, Ramesh Perumal, Arun Kamal, Shanmuganathan Rajasekaran
BACKGROUND: Recalcitrant distal femur nonunions (RDFN) are a challenge in management due to factors including poor bone stock, multiple surgeries, metaphyseal bone loss, and joint contractures. There are no specific guidelines in the management of cases of RDFN. Based on our experience, we devised an algorithm and we present the results of 62 cases of RDFN managed following it. MATERIALS AND METHODS: Our algorithm was formulated after analyzing 34 cases of RDFN and it involved four factors which were hypothesized to influence outcomes namely: distal femoral bone stock, extent of medial void, alignment of the fracture, and stability of fixation...
March 20, 2019: Archives of Orthopaedic and Trauma Surgery
Christian Egloff, Lukas Huber, Markus Wurm, Geert Pagenstert
The shared first authorship of Christian Egloff, MD and Lukas Huber was always planned and correctly acknowledged.
March 20, 2019: Archives of Orthopaedic and Trauma Surgery
Oliver E Bischel, J Nadorf, S B Klein, S Gantz, E Jakubowitz, J P Kretzer, J Arnholdt, J B Seeger
INTRODUCTION: High loosening rates after distal femoral replacement may be due to implant design not adapted to specific anatomic and biomechanical conditions. MATERIALS AND METHODS: A modular tumor system (MUTARS® , Implantcast GmbH) was implanted with either a curved hexagonal or a straight tapered stems in eight Sawbones® in two consecutively generated bone defect (10 cm and 20 cm proximal to knee joint level). Implant-bone-interface micromotions were measured to analyze main fixation areas and to characterize the fixation pattern...
March 18, 2019: Archives of Orthopaedic and Trauma Surgery
Gonzalo Luengo-Alonso, Maria Mellado-Romero, Shai Shemesh, Luis Ramos-Pascua, Juan Pretell-Mazzini
BACKGROUND: Denosumab is a human monoclonal antibody (mAb) that specifically inhibits tumor-associated bone lysis through the RANKL pathway and has been used as neoadjuvant therapy for giant-cell tumor of bone (GCTB) in surgical as well as non-surgical cases. The purpose of this systematic review of the literature, therefore, is to investigate: (1) demographic characteristics of patients affected by GCTBs treated with denosumab and the clinical impact, as well as, possible complications associated with its use (2) oncological outcomes in terms of local recurrence rate (LRR) and development of lung metastasis, and (3) characteristics of its treatment effect in terms of clinical, radiological, and histological response...
March 15, 2019: Archives of Orthopaedic and Trauma Surgery
Li Baogui, Chen Juwen
OBJECTIVE: For odontoid fractures, surgical treatment approaches including anterior odontoid screw fixation approach and the posterior C1-C2 arthrodesis approach are generally adopted in practice. However, the choice of different surgical procedures remains controversial. In addition to surgical technique, the fusion rate is an important factor contributing to the clinical efficacy. Therefore, this study was aimed to investigate the discrepancy in fusion rate between these two surgical approaches through synthesizing the currently available evidence on the topic...
March 15, 2019: Archives of Orthopaedic and Trauma Surgery
Richard J Holleyman, David J Deehan, Lucy Walker, Andre Charlett, Julie Samuel, Mark D F Shirley, Paul N Baker
INTRODUCTION: This study aimed to (1) report the rates of resistance against a variety of antibiotics for pure Staphylococcal infections, and (2) examine the impact of ALBC use at primary surgery has on resistance patterns for patients undergoing first-time revision of primary hip and knee arthroplasty for indication of infection. MATERIALS AND METHODS: Data from the National Joint Registry database for England and Wales were linked to microbiology data held by Public Health England to identify a consecutive series of 258 primary hip and knee arthroplasties performed between April 2003 and January 2014 that went on to have a revision for Staphylococcal deep periprosthetic infection...
March 15, 2019: Archives of Orthopaedic and Trauma Surgery
Allen J Tsai
BACKGROUND: Total joint arthroplasty (TJA) is a major orthopedic procedure associated with substantial morbidity and mortality. Never events (NEs) are harmful hospital-acquired conditions (HACs) that are preventable. METHODS: Information on hospital admissions with TJA was collected from the National Inpatient Sample (NIS) from 2003 to 2012. NIS was queried to identify NE applicable to TJA patients based on the HAC definition listed by the Centers for Medicare and Medicaid Services (CMS)...
March 14, 2019: Archives of Orthopaedic and Trauma Surgery
Wiktor Urbanski, Rafał Zaluski, Anis Kokaveshi, Silvester Aldobasic, Grzegorz Miekisiak, Piotr Morasiewicz
INTRODUCTION: Surgical management of adolescent idiopathic scoliosis in spite of usually favourable outcomes is still a major operation. Therefore, efforts are being undertaken to minimalize the procedure, reduce the surgical trauma and postoperative convalescence. The study was designed to compare posterior minimal invasive surgery using navigation based on intraoperative 3D imaging and standard open instrumented fusion in Lenke 5C idiopathic scoliosis treatment. MATERIALS AND METHODS: From eight patients with Lenke 5C curves planned for posterior correction and instrumented fusion, four were treated with minimally invasive and four had open procedure...
March 14, 2019: Archives of Orthopaedic and Trauma Surgery
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