Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Rotationplasty--surgical treatment modality after failed limb salvage procedure.
Twelve patients aged between 10.9 and 64.7 (mean 28.5) years with a malignant tumour of the knee region underwent a rotationplasty after failed primary limb salvage procedure. The reasons for failure which finally lead to surgery were recurrent infection in 10 patients and local recurrence of the tumour in 2. The number of operations before the rotationplasty was performed was between 2 and 23 (mean 6.7). ⋯ Concerning the health-related quality-of-life, the mean score in physical functioning was 76.3 in the group with a rotationplasty versus 50.0 in the group of amputees. Patients with a rotationplasty reached a higher score of global health status (77.1 vs 58.3). Based on the present results we are convinced that rotationplasty can be recommended as a treatment option after a failed limb salvage procedure.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyInnervation of nociceptors in the menisci of the knee joint: an immunohistochemical study.
Using histology, we studied the innervation of nociceptors in the medial and lateral menisci of the knee joint. Specimens examined were taken from 16 patients during arthroplasty. The patients were 6 men and 10 women, with ages ranging from 14 to 76 years (mean 56 years). ⋯ Nerve fibers positive for SP were also detected in the menisci, but were fewer in number. Their branches also were fewer, oriented radially and paralleling blood vessels. This study showed that some of the pain in cases of meniscal tear could originate in the meniscus itself, especially with peripheral tears that may be accompanied by bleeding.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyMortality after total knee arthroplasty in patients with osteoarthrosis and rheumatoid arthritis.
Total knee arthroplasty (TKA) is a widely used procedure in the treatment of severe destruction of the knee joint because of osteoarthrosis (OA) or rheumatoid arthritis (RA). The aim of this study was to explore whether there is an increased mortality in patients after TKA with the underlying diagnosis OA or RA compared with the general population. We studied a consecutive series of 422 primary TKAs with a hinged Blauth prosthesis in 330 patients (OA: 208 patients, 175 women, 33 men; RA: 122 patients, 109 women, 13 men) with a mean follow-up of 6 years (range 0-20 years). ⋯ SMRs of patients suffering from RA showed a clear shortening of the life span (women: 2.92, 95% CI 2.17-3.85; men: 3.09, 95% CI 1.0-7.19). In spite of the risk of intra- and perioperative complications and further operative procedures necessary because of late complications, the implantation of a knee prosthesis per se does not necessarily significantly reduce the life expectancy in patients with OA. Patients with RA who require the implantation of a total knee prosthesis obviously represent a high-risk group with a high mortality rate.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsMagnetic resonance imaging of growth plate injuries: the efficacy and indications for surgical procedures.
In 23 patients with growth plate injuries, magnetic resonance imaging (MRI) studies were performed a total of 31 times to evaluate the physis which showed plain radiographic evidence of possible damage. Fourteen patients clinically showed growth arrest, and 10 patients required a Langenskiold operation. ⋯ We propose that the merging shape of the arrest line with calcification of the provisional zone of the metaphysis shown by MRI indicates poor viability of the physis. MRI provided useful information on the appearance of the growth plate and changes in the metaphysis, both of which affected the prognosis and the results of the surgical procedures.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsIsolated palmar dislocation of the fifth carpometacarpal joint diagnosed by stress X-rays.
Isolated palmar ulnar dislocation of the fifth carpometacarpal (CMC) joint is a rare injury which often yields only subtle radiographic findings that may be easily overlooked, especially when there is no associated fracture. We reported a case of an isolated palmar dislocation of the fifth CMC joint, diagnosed correctly by means of simple stress X-rays (traction and axial compression stress views). This method proved to be useful and needs no special equipment.