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Clinics in Orthopedic Surgery

Seok Min Hwang, In Seok Son, Pei Juin Yang, Min Seok Kang
The approach we suggest was developed for cases in which the fourth and fifth lumbar and first sacral spinal nerves were affected in lumbar degenerative disc disease. Retrodiscal transforaminal epidural injection is known to be very effective for lumbar radiculopathy because of excellent access to primary pathology; however, access below L5 is often restricted by the anatomic characteristics of the L5-S1. In the translateral recess approach (TLR), proper final needle placement (i.e., in the axillary portion between the exiting and traversing nerve roots) can be achieved by setting the direction of the needle laterally and superiorly from the distal tip of the infra-adjacent spinous process toward the medial wall of the pedicle and neural foramen of the given level without neural injury...
March 2019: Clinics in Orthopedic Surgery
Kyungtai Lee, Hyuk Jegal, Heewoong Chung, Younguk Park
Background: This study assessed the average time to return to training and official game participation after modified Broström operation (MBO) in elite athletes. Methods: Sixty athletes diagnosed with lateral ankle instability underwent MBO from October 2011 to December 2013. Their average age was 19.3 years, and the average follow-up time was 28.8 months. We measured the time sequence of three phases of rehabilitation: start of personal training, start of team training, and start of the first official game after recovery...
March 2019: Clinics in Orthopedic Surgery
Jin Rok Oh, Doo Sup Kim, Jun Seop Yeom, Sang Kyu Kang, Yun Tae Kim
Background: We sought to estimate the ultimate tensile strength after metacarpal shaft fracture repair in adults using three operative fixation methods: plate fixation, Kirschner wire (K-wire) fixation, and intramedullary headless compression screw fixation. We also compared the advantages and disadvantages of each operative technique. Methods: We acquired 30 metacarpal bones from four Korean adult cadavers without trauma, operative history, or deformities. The 30 metacarpal bones were divided into ten groups consisting of three metacarpal bones each with matching sizes and lengths...
March 2019: Clinics in Orthopedic Surgery
Sung-Min Rhee, Jeong Dong Lee, Yong Bok Park, Jae Chul Yoo, Joo Han Oh
Background: Despite the growing use of reverse shoulder arthroplasty (RSA), it is associated with relatively frequent complications and uncertain clinical outcomes. We investigated radiological factors affecting clinical outcomes of RSA in the Korean population. Methods: We evaluated physical findings, radiographic findings, visual analog scale scores for pain and satisfaction, and several functional scores in 179 consecutive patients who underwent RSA at two centers between 2008 and 2014...
March 2019: Clinics in Orthopedic Surgery
Tae Kang Lim, Whang Kyun Oh
Background: Arthroscopic stabilization of torn coracoclavicular (CC) ligaments gained popularity recently. However, loss of reduction after the operation and complications unique to this technique involving tunnel placement through the distal clavicle and coracoid process are concerns. The purpose of this study was to report intraoperative and early postoperative complications associated with this procedure. Methods: This study retrospectively evaluated 18 consecutive patients who had undergone arthroscopic stabilization for torn CC ligaments between 2014 and 2015...
March 2019: Clinics in Orthopedic Surgery
Seung Myung Wi, Hui Jong Lee, Sam Yeol Chang, Oh Hyo Kwon, Choon-Ki Lee, Bong-Soon Chang, Hyoungmin Kim
Background: In lumbar spinal stenosis, spinous process-splitting decompression has demonstrated good clinical outcomes with preservation of the posterior ligamentous complex and paraspinal muscles in comparison to conventional laminectomy, but the radiological consequence and clinical impact of the split spinous processes have not been fully understood. Methods: Seventy-three patients who underwent spinous process-splitting decompression were included. The bone union rate and pattern were evaluated by computed tomography performed 6-18 months after surgery and compared among subgroups divided according to the number of levels decompressed and the extent of spinous process splitting...
March 2019: Clinics in Orthopedic Surgery
Dae Moo Shim, Tae Gyun Kim, Jun Sung Koo, Young Ho Kwon, Chang Su Kim
Background: Buttock pain is common, and there are no fixed guidelines for its diagnosis and treatment. This study compared a selective nerve root block and a facet joint block for patients with degenerative spinal disease and buttock pain. Methods: Patients with degenerative spinal disease who presented with buttock pain, received a selective nerve root block (group A) or a facet joint block (group B) from June 2017 to September 2017, and were able to be followed up for more than 3 months were prospectively enrolled...
March 2019: Clinics in Orthopedic Surgery
Dae-Jung Choi, Ju-Eun Kim
Background: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI)...
March 2019: Clinics in Orthopedic Surgery
Rajesh Navin Maniar, Prashant Pradhan, Nishit Bhatnagar, Adit Maniar, Rohan Bidwai, Pranav Bindal
Background: Postoperative suction drains are used after total knee arthroplasty to avoid intra-articular hematoma formation although they can increase blood loss due to a negative suction effect. The use of tranexamic acid to reduce blood loss may nullify this. The aim of this study was to compare outcomes in patients undergoing total knee arthroplasty with or without drains and to analyze whether the drain's diameter also has an impact. Methods: This is a prospective randomized study of patients undergoing unilateral total knee arthroplasty performed by a single surgeon...
March 2019: Clinics in Orthopedic Surgery
Dhong Won Lee, Jae Chan Shim, Sang Jin Yang, Seung Ik Cho, Jin Goo Kim
Background: This study aimed to determine the effects of single semitendinosus tendon (ST) harvesting for anterior cruciate ligament (ACL) reconstruction by comparing outcomes of single ST and semitendinosus-gracilis tendon (ST-G) harvesting. Methods: ACL reconstruction with ST-G harvesting (D group, n = 60) or single ST harvesting (S group, n = 60) were included according to inclusion criteria. Subjective assessments included subjective International Knee Documentation Committee score, Lysholm score, and Tegner activity scale score...
March 2019: Clinics in Orthopedic Surgery
Akshay Mehta, Charles C Lin, Ronald A Campbell, Garwin Chin, Michelle H McGarry, Thay Q Lee, Gregory J Adamson
Background: The purpose of this study was to compare the tibial tunnel aperture contact characteristics simulating an anteromedial and transtibial anterior cruciate ligament (ACL) tunnel preparation. Methods: Seven matched pairs of cadaveric knees were tested. From each knee, a 10-mm quadriceps ACL graft was prepared. The native ACL was arthroscopically removed and tibial tunnels were drilled. In one knee, a transtibial technique was performed with femoral tunnel drilling approached through the tibial tunnel...
March 2019: Clinics in Orthopedic Surgery
Yuta Kubota, Nobuhiro Kaku, Tomonori Tabata, Hiroaki Tagomori, Hiroshi Tsumura
Background: Navigation systems are an effective tool to improve the installation accuracy of the cup in primary total hip arthroplasty. This study aimed to evaluate the efficacy of a computed tomography-based navigation system in achieving optimal installation accuracy of implants in revision total hip arthroplasty and to clarify the usefulness of the navigation system. Methods: We conducted a retrospective study of 23 hips in 23 patients who underwent revision total hip arthroplasty using a computed tomography-based navigation system; the control group comprised 33 hips in 33 patients who underwent revision total hip arthroplasty without a navigation system...
March 2019: Clinics in Orthopedic Surgery
Eui Yub Jung, In Taek Oh, Sang Yeup Shim, Byung Ho Yoon, Yerl Bo Sung
Background: The purpose of this study was to evaluate the quantitative association between the degree of reduction and the position of the blade of the proximal femoral nail antirotation (PFNA) in intertrochanteric hip fractures. Methods: From March 2009 to April 2015, 530 patients treated with PFNA for intertrochanteric hip fractures were retrospectively reviewed. Patients were divided into a valgus reduced group (group 1) and a non-valgus reduced group (group 2), and the "valgus reduced" was defined as valgus reduction over 5°...
March 2019: Clinics in Orthopedic Surgery
Jae-Won Lee, Deuk-Soo Hwang, Chan Kang, Jung-Mo Hwang, Hyung-Jin Chung
Background: The purpose of this study is to report the long-term follow-up results of arthroscopic repair of acetabular labral tears with femoroacetabular impingement (FAI). Methods: Of 45 patients who underwent arthroscopic labral repair under the diagnosis of acetabular labral tears with FAI from January 2008 to December 2010 and met our inclusion criteria, 41 patients who were available for a long-term follow-up were included in the analysis. We compared the long-term follow-up results with the previously reported short-term follow-up results of the same patients...
March 2019: Clinics in Orthopedic Surgery
Guen Young Lee, Sujin Kim, Suk-Ho Baek, Eui-Chan Jang, Yong-Chan Ha
Background: We investigated sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) and computed tomography arthrography (CTA), on the basis of arthroscopic findings, to diagnose acetabular labral tears and chondral lesions. Methods: We retrospectively reviewed the results of MRI and subsequent CTA in 36 hips that underwent arthroscopic surgery (33 patients; 17 males [17 hips] and 16 females [19 hips]; average age, 35 years). All patients had positive impingement test results and groin pain...
March 2019: Clinics in Orthopedic Surgery
Yong-Han Cha, Young-Kyun Lee, Kyung-Hoi Koo, Chankuk Wi, Kyung-Hag Lee
Background: The purpose of this study was to investigate the difference in mortalilty rate between cardiovascular disease (CVD) patients and non-CVD patients after hip fracture surgery performed in elderly patients. In addition, we compared the effect of CVD medication on mortality after hip fracture surgery. Methods: Patients who underwent surgery for femoral intertrochanteric or neck fracture from January 2003 to December 2013 were enrolled in this study. After applying exclusion criteria, we categorized patients into group I (833 patients, non-CVD group) and group II (811 patients, CVD group)...
March 2019: Clinics in Orthopedic Surgery
Yong-Han Cha, Jun-Il Yoo, Seok-Young Hwang, Kap-Jung Kim, Ha-Yong Kim, Won-Sik Choy, Sun-Chul Hwang
Background: The purpose of this systematic review was to investigate various fixation methods or implants used in the treatment of Pauwels type III femoral neck fractures. Methods: PubMed Central, OVID Medline, Cochrane Collaboration Library, Web of Science, Embase, and AHRQ databases were searched to identify relevant studies published until August 2017 with English language restriction. Studies were selected on the basis of the following inclusion criteria: biomechanical study of Pauwels type III femoral neck fractures and the use of dynamic hip screw (DHS) or multiple screw fixation or other devices for fixation of the fracture...
March 2019: Clinics in Orthopedic Surgery
Ju-Eun Kim, Dae-Jung Choi
Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention...
December 2018: Clinics in Orthopedic Surgery
Sang Bum Kim, Youn Moo Heo, Cheol Mog Hwang, Tae Gyun Kim, Jee Young Hong, You Gun Won, Chang Uk Ham, Young Ki Min, Jin Woong Yi
Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis...
December 2018: Clinics in Orthopedic Surgery
Emrah Caliskan, Evrim Karadag Saygi, Zeynep Kardelen Gencer, Hizir Kurtel, Bulent Erol
Background: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. Methods: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study...
December 2018: Clinics in Orthopedic Surgery
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