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EFORT Open Reviews

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https://read.qxmd.com/read/30993012/plaster-splint-brace-tape-or-functional-mobilization-after-first-time-patellar-dislocation-what-s-the-evidence
#1
REVIEW
Daan Vermeulen, Mara Rosa van der Valk, Laurens Kaas
With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation.Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100 000 per year in adolescents...
March 2019: EFORT Open Reviews
https://read.qxmd.com/read/30993011/manipulation-under-anaesthesia-for-frozen-shoulders-outdated-technique-or-well-established-quick-fix
#2
REVIEW
Tim Kraal, Lijkele Beimers, Bertram The, Inger Sierevelt, Michel van den Bekerom, Denise Eygendaal
Manipulation under anaesthesia (MUA) for frozen shoulder (FS) leads to a considerable increase in range of motion and Oxford shoulder score, a significant reduction in pain and around 85% satisfaction.A clearly defined indication for MUA in FS patients cannot be extracted from this review or the available literature. The associating criteria before proceeding to MUA vary widely.All but one study in this review lacked a control group without intervention. Therefore, firm conclusions about the role of MUA in the treatment of FS cannot be drawn from the current literature...
March 2019: EFORT Open Reviews
https://read.qxmd.com/read/30993010/osteonecrosis-of-the-femoral-head-pathophysiology-and-current-concepts-of-treatment
#3
REVIEW
Daniel Petek, Didier Hannouche, Domizio Suva
Osteonecrosis of the femoral head is a disabling pathology affecting a young population (average age at treatment, 33 to 38 years) and is the most important cause of total hip arthroplasty in this population. It reflects the endpoint of various disease processes that result in a decrease of the femoral head blood flow.The physiopathology reflects an alteration of the vascularization of the fine blood vessels irrigating the anterior and superior part of the femoral head. This zone of necrosis is the source of the loss of joint congruence that leads to premature wear of the hip...
March 2019: EFORT Open Reviews
https://read.qxmd.com/read/30993009/silastic-replacement-of-the-first-metatarsophalangeal-joint-historical-evolution-modern-concepts-and-a-systematic-review-of-the-literature
#4
REVIEW
Haroon Majeed
Silastic implants for the first metatarsophalangeal joint (MTPJ) have been in use for over 50 years. Initial reports were associated with high failure rates leading to development of new designs that are currently in use.The aim of this article is to review the historical evolution and the outcomes of silastic implants for the treatment of end-stage OA of the first MTPJ. Databases were searched for studies reporting the outcomes of silastic implants for the first MTPJ. Various relevant search terminologies were used...
March 2019: EFORT Open Reviews
https://read.qxmd.com/read/30993008/the-assessment-of-instability-in-the-osteoarthritic-knee
#5
REVIEW
David T Wallace, Philip E Riches, Frédéric Picard
Patient-reported instability is a common complaint amongst those with knee arthritis.Much research has examined the assessment of self-reported instability in the knee; however, no definitive quantitative measure of instability has been developed.This review focuses on the current literature investigating the nature of self-reported instability in the arthritic knee and discusses the possibilities of further investigation. Cite this article: EFORT Open Rev 2019;4:70-76. DOI: 10.1302/2058-5241.4.170079.
March 2019: EFORT Open Reviews
https://read.qxmd.com/read/30931151/comparison-of-revision-rates-and-radiographic-observations-of-long-and-short-uncoated-and-coated-humeral-stem-designs-in-total-shoulder-arthroplasty
#6
REVIEW
Arnaud Godenèche, Jérôme Garret, Johannes Barth, Aude Michelet, Laurent Geais
There is no consensus on outcomes of long versus short and uncoated versus coated uncemented stems in total shoulder arthroplasty (TSA).We reviewed the literature to compare revision rates and adverse radiographic observations at ⩾ 2 years of various uncemented humeral stem designs.We performed an electronic PubMed search for studies on uncemented primary TSA that reported one or more of the following observations at ⩾ 2 years for distinct stem designs: stem revision; subsidence; stress shielding; radiolucent lines; and humeral loosening...
February 2019: EFORT Open Reviews
https://read.qxmd.com/read/30931150/dupuytren-s-disease-where-do-we-stand
#7
REVIEW
Rita Grazina, Sérgio Teixeira, Renato Ramos, Henrique Sousa, Andreia Ferreira, Rui Lemos
Dupuytren's disease is a fibroproliferative disease that involves collagen deposition, leading to hand contractures that ultimately affect hand mobility and grip strength.It is a benign disorder but can cause high morbidity by limiting daily activities.Many factors have been proposed for its aetiology: namely genetics, smoking, alcohol intake and diabetes. However, there is still controversy as to the main aetiological cause of the disease.Treatment is not yet uniform around the world and still varies with the surgeon's experience and preference...
February 2019: EFORT Open Reviews
https://read.qxmd.com/read/30931149/rotator-cable-and-rotator-interval-anatomy-biomechanics-and-clinical-importance
#8
REVIEW
Gazi Huri, Mehmet Kaymakoglu, Nickolas Garbis
The rotator cable and rotator interval are among the most recent topics of interest in current shoulder literature. Most of the research has been published in the last two decades and our understanding about the importance of these anatomical structures has improved with biomechanical studies, which changed the pre- and intra-operative approaches of shoulder surgeons to rotator cuff tears in symptomatic patients.The rotator cable is a thick fibrous bundle that carries the applied forces to the rotator cuff like a 'suspension bridge'...
February 2019: EFORT open reviews
https://read.qxmd.com/read/30931148/a-systematic-review-and-meta-analysis-of-trainee-versus-consultant-surgeon-performed-elective-total-hip-arthroplasty
#9
REVIEW
Prashant Singh, Suroosh Madanipour, Andreas Fontalis, Jagmeet Singh Bhamra, Hani B Abdul-Jabar
Total hip arthroplasty (THA) is one of the most commonly performed orthopaedic procedures. Some concern exists that trainee-performed THA may adversely affect patient outcomes. The aim of this meta-analysis was to compare outcomes following THA performed by surgical trainees and consultant surgeons.A systematic search was performed to identify articles comparing outcomes following trainee- versus consultant-performed THA. Outcomes assessed included rate of revision surgery, dislocation, deep infection, mean operation time, length of hospital stay and Harris Hip Score (HHS) up to one year...
February 2019: EFORT Open Reviews
https://read.qxmd.com/read/30931147/arthroscopic-treatment-of-total-knee-arthroplasty-complications
#10
REVIEW
Carlos A Encinas-Ullán, E Carlos Rodríguez-Merchán
The most frequent indications for arthroscopy in patients with total knee arthroplasty (TKA) are soft-tissue impingement, arthrofibrosis (knee stiffness), periprosthetic infection and removal of free bodies or cement fragments.When performing a knee arthroscopy in a patient with a symptomatic TKA, look for possible free/retained bone or cement fragments, which can be anywhere in the joint.Patellar tracking should be evaluated and soft-tissue impingement under the patella or between the femoral and tibial prosthetic components should be ruled out...
February 2019: EFORT Open Reviews
https://read.qxmd.com/read/30800477/slap-lesions-current-controversies
#11
Filippo Familiari, Gazi Huri, Roberto Simonetta, Edward G McFarland
Knowledge of the pertinent anatomy, pathogenesis, clinical presentation and treatment of the spectrum of injuries involving the superior glenoid labrum and biceps origin is required in treating the patient with a superior labrum anterior and posterior (SLAP) tear.Despite the plethora of literature regarding SLAP lesions, their clinical diagnosis remains challenging for a number of reasons.First, the diagnostic value of many of the available physical examination tests is inconsistent and ambiguous.Second, SLAP lesions most commonly occur concomitantly with other shoulder injuries...
January 2019: EFORT Open Reviews
https://read.qxmd.com/read/30800476/morton-s-interdigital-neuroma-instructional-review
#12
Nikolaos Gougoulias, Vasileios Lampridis, Anthony Sakellariou
The terminology 'Morton's neuroma' may represent a simplification of the clinical condition as the problem may not be a benign tumour of the nerve, but neuropathic foot pain associated with the interdigital nerve.Foot and ankle pathomechanics leading to metatarsalgia, clinical examination and differential diagnosis of the condition and imaging of the condition, for differential diagnosis, are discussed.Nonoperative management is recommended initially. Physiotherapy, injections (local anaesthetic, steroid, alcohol), cryotherapy, radiofrequency ablation and shockwave therapy are discussed...
January 2019: EFORT open reviews
https://read.qxmd.com/read/30800475/the-role-of-alpha-defensin-in-prosthetic-joint-infection-pji-diagnosis-a-literature-review
#13
Tommaso Bonanzinga, Matteo Carlo Ferrari, Giuseppe Tanzi, Filippo Vandenbulcke, Akos Zahar, Maurilio Marcacci
Prosthetic joint infection (PJI) management is not standardized worldwide and the outcome is frequently unsatisfactory.More and more arthroplasties are now being performed. An increasing number of highly virulent and antibiotic-resistant bacteria and an ageing population of patients presenting with many comorbidities make it necessary to focus on this important topic.Diagnosis of PJI remains challenging because the clinical signs and symptoms and elevation of systemic biomarkers (C-reactive protein, erythrocyte sedimentation rate) may be unclear...
January 2019: EFORT open reviews
https://read.qxmd.com/read/30800474/fractures-of-the-proximal-ulna-current-concepts-in-surgical-management
#14
Sebastian Siebenlist, Arne Buchholz, Karl F Braun
Fractures of the proximal ulna range from simple olecranon fractures to complex Monteggia fractures or Monteggia-like lesions involving damage to stabilizing key structures of the elbow (i.e. coronoid process, radial head, collateral ligament complex).In complex fracture patterns a computerized tomography scan is essential to properly assess the injury severity.Exact preoperative planning for the surgical approach is vital to adequately address all fracture parts (base coronoid fragments first).The management of olecranon fractures primarily comprises tension-band wiring in simple fractures as a valid treatment option, but modern plate techniques, especially in comminuted or osteoporotic fracture types, can reduce implant failure and potential implant-related soft tissue irritation...
January 2019: EFORT Open Reviews
https://read.qxmd.com/read/30697443/the-role-of-bone-in-glenohumeral-stability
#15
Giovanni Di Giacomo, Luigi Piscitelli, Mattia Pugliese
Shoulder stability depends on several factors, either anatomical or functional. Anatomical factors can be further subclassified under soft tissue (shoulder capsule, glenoid rim, glenohumeral ligaments etc) and bony structures (glenoid cavity and humeral head).Normal glenohumeral stability is maintained through factors mostly pertaining to the scapular side: glenoid version, depth and inclination, along with scapular dynamic positioning, can potentially cause decreased stability depending on the direction of said variables in the different planes...
December 2018: EFORT Open Reviews
https://read.qxmd.com/read/30697442/management-of-symptomatic-degenerative-low-grade-lumbar-spondylolisthesis
#16
Nick Evans, Michael McCarthy
Degenerative low-grade lumbar spondylolisthesis is the most common form of spondylolisthesis.The majority of patients are asymptomatic and do not require surgical intervention.Symptomatic patients present with a combination of lower back pain, radiculopathy and/or neurogenic claudication and may warrant surgery if non-operative measures fail.There is widespread controversy regarding the indications for surgery and appropriate treatment strategies for patients with this type of spondylolisthesis.This article provides a comprehensive evidence-based review of the available literature to support the management of degenerative low-grade spondylolisthesis...
December 2018: EFORT Open Reviews
https://read.qxmd.com/read/30697441/what-is-a-balanced-knee-replacement
#17
Lucy C Walker, Nick D Clement, Kanishka M Ghosh, David J Deehan
For multifactorial reasons an estimated 20% of patients remain unsatisfied after total knee arthroplasty (TKA).Appropriate tension of the soft tissue envelope encompassing the knee is important in total knee arthroplasty and soft tissue imbalance contributes to several of the foremost reasons for revision TKA, including instability, stiffness and aseptic loosening.There is debate in the literature surrounding the optimum way to achieve balancing of a total knee arthroplasty and there is also a lack of an accepted definition of what a balanced knee replacement is...
December 2018: EFORT Open Reviews
https://read.qxmd.com/read/30595846/percutaneous-fixation-of-thoracolumbar-vertebral-fractures
#18
Amer Sebaaly, Maroun Rizkallah, Guillaume Riouallon, Zhi Wang, Pierre Emmanuel Moreau, Falah Bachour, Ghassan Maalouf
Surgical treatment of patients with thoracolumbar vertebral fracture without neurological deficit is still controversial.Management of vertebral fracture with percutaneous fixation was first reported in 2004.Advantages of percutaneous fixation are: less tissue dissection; decreased post-operative pain; decreased bleeding and operative time (depending on the steep learning curve); better screw positioning with fluoroscopy compared with an open freehand technique; and a decreased infection rate.The limitations of percutaneous fixation of vertebral fractures include increased radiation exposure to the patient and the surgeon, together with the steep learning curve for this technique...
November 2018: EFORT Open Reviews
https://read.qxmd.com/read/30595845/acetabular-retroversion-diagnosis-and-treatment
#19
Bruno Direito-Santos, Guilherme França, Jóni Nunes, André Costa, Eurico Bandeira Rodrigues, A Pedro Silva, Pedro Varanda
Acetabular retroversion (AR) consists of a malorientation of the acetabulum in the sagittal plane. AR is associated with changes in load transmission across the hip, being a risk factor for early osteoarthrosis. The pathophysiological basis of AR is an anterior acetabular hyper-coverage and an overall pelvic rotation.The delay or the non-diagnosis of AR could have an impact in the overall management of femoroacetabular impingement (FAI). AR is a subtype of (focal) pincer deformity.The objective of this review was to clarify the pathophysiological, diagnosis and treatment fundaments inherent to AR, using a current literature review...
November 2018: EFORT Open Reviews
https://read.qxmd.com/read/30595844/arthroscopic-repair-of-the-meniscus-surgical-management-and-clinical-outcomes
#20
Alfonso Vaquero-Picado, E Carlos Rodríguez-Merchán
From the biomechanical and biological points of view, an arthroscopic meniscal repair (AMR) should always be considered as an option. However, AMR has a higher reoperation rate compared with arthroscopic partial meniscectomy, so it should be carefully indicated.Compared with meniscectomy, AMR outcomes are better and the incidence of osteoarthritis is lower when it is well indicated.Factors influencing healing and satisfactory results must be carefully evaluated before indicating an AMR.Tears in the peripheral third are more likely to heal than those in the inner thirds...
November 2018: EFORT Open Reviews
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