Archives of orthopaedic and trauma surgery
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Freeze-dried human bone allograft is used clinically as an adjunct to autologous bone graft. When freeze-dried human bone allograft is demineralized, the allograft is osteoinductive, since it causes bone to form heterotopically. Both types of allograft are also used alone, such as in spinal fusions, critical size defects, and periodontal therapy. ⋯ In the demineralized, freeze-dried bone from donors younger than 42 years of age, the bone induction score and new bone area were significantly higher than in the other batches of bone graft, and the area of residual particles was reduced. Both demineralized and nondemineralized bone graft from patients older than 70 years of age were encapsulated in dense, fibrous connective tissue. These results may help explain the observed differences in clinical outcome when demineralized, freeze-dried bone graft or nondemineralized, freeze-dried bone graft from different donors is used in bone regeneration applications.
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Arch Orthop Trauma Surg · Nov 2001
A minimally invasive percutaneous technique of intramedullary nail insertion in an animal model of fracture healing.
Previous animal models of fracture repair have been shown to be reproducible but are often time-inefficient. We present a minimally invasive percutaneous technique for retrograde insertion of intramedullary pins in a model of rat femoral fracture healing. Forty Sprague-Dawley rats were divided into 3 groups: no fracture (n = 6), no fracture but pinned (n = 6), and fractured and pinned (n = 24). ⋯ The mean fluoroscopic time for the last 15 procedures was 4.2 s (standard deviation 1.2 s). No patellar tendon ruptures or bleeding complications were seen in the postoperative period. The course of fracture healing was not altered by this new percutaneous technique of pin insertion.
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Arch Orthop Trauma Surg · Nov 2001
Case ReportsDeep soft-tissue leiomyoma of the popliteal fossa in a 14-year-old girl.
This is the first case report of a deep soft-tissue leiomyoma with intraarticular localization within the knee joint. A 14-year-old girl presented with a painless mass in the dorsal aspect of her knee which she had noticed some 9 months earlier. ⋯ The final diagnosis was established immunohistologically. Although this is a very rare tumor, it has to be considered in the differential diagnosis for soft-tissue swellings of the popliteal fossa.
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Arch Orthop Trauma Surg · Nov 2001
Comparative StudyRupture of the patellar tendon: a review of 68 cases and a retrospective study of 29 ruptures comparing two methods of augmentation.
Rupture of the patellar tendon is a rare injury requiring acute repair to reestablish knee extensor continuity and to allow early motion. Different pathomechanisms have been postulated, and multiple techniques for repair have been described in the literature. Firstly, the current study reviews the epidemiology, pathomechanism, and risk factors. ⋯ To avoid reoperation for removal of the cerclage wire, a PDS cord can be used. The infection rate seems to be higher in the PDS group. A larger prospective study group is necessary to determine whether this phenomenon can be reproduced.
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Arch Orthop Trauma Surg · Nov 2001
Comparative Study Clinical TrialBlood loss in anterior cruciate ligament (ACL) reconstruction with and without intercondylar notchplasty: does it affect the clinical outcome?
Blood loss is associated with any surgical procedure and should be reduced wherever possible. It was our impression that notchplasty adds to the amount of postoperative bleeding after anterior cruciate ligament (ACL) reconstruction. With posterior placement of the tibial tunnel, notchplasty is optional in many cases. ⋯ The serum hematocrit (Hct) decrease was 9.7% in group I and 7.4% in group II (p < 0.001). At 12 months after surgery, the IKDC and Lysholm score evaluations and the KT-1000 arthrometer measurements revealed no clinical differences between the notchplasty and non-notchplasty groups. Despite a 30% increase in blood loss, notchplasty has been shown to be a useful procedure to prevent graft impingement without negative side-effects.