Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2001
Preoperative radiotherapy without femoral shielding for prevention of heterotopic ossification in hydroxyapatite-coated hip prostheses.
Twenty-seven consecutive patients at high risk of developing heterotopic ossifications (HO) after implantation of a hydroxyapatite (HA)-coated hip prosthesis were irradiated with a single dose of 7 Gy, at least 4 h before the operation. The femoral stem was not shielded during radiotherapy (RT). ⋯ We conclude that single-dose, preoperative RT for HA-coated hip prosthesis can effectively inhibit HO. Not blocking the femoral stem does not result in prosthesis migration.
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Droopy shoulder syndrome (DSS) is characterized by a depression of the shoulders that stretches the brachial plexus, thus causing pain without any signs of neurological impairment. We describe ten patients with DSS; all had been treated for different diagnoses before. ⋯ All patients responded well to conservative treatment in 2-10 weeks. DSS must be kept in mind in the differential diagnosis of pain in the cervical-shoulder region, to prevent unnecessary medication.
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Arch Orthop Trauma Surg · May 2001
Randomized Controlled Trial Clinical TrialPostoperative analgesic value of the intra-articular instillation of bupivacaine and morphine after arthroscopic knee surgery.
This prospective, randomized, double-blind study was carried out with 320 patients, subdivided into 4 groups of 80 patients each, who underwent arthroscopic knee surgery during the time period from March 1995 to February 1997. Each of the 4 groups received a different solution: 15 ml of bupivacaine 0.5%, 5 mg of morphine in 15 ml of isotonic saline solution, 15 ml of bupivacaine 0.5% with epinephrine 0.0005%, or 15 ml of isotonic saline solution (control group). ⋯ Pain intensity was assessed with the visual analogue scale obtained from questioning patients at 2, 4, 8, 12, and 24 h postoperatively. In terms of reducing postoperative pain and decreasing the consumption of analgesics after arthroscopic knee surgery, bupivacaine 0.5% with epinephrine 0.0005% was found to be the most effective.
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Arch Orthop Trauma Surg · May 2001
Comparative StudyDistal femoral bone mineral density after total knee arthroplasty: a comparison with general bone mineral density.
The bone mineral density (BMD) of the distal femur may decrease after cemented total knee arthroplasty (TKA) as a result of the stress shielding effect of the femoral component. The purpose of the study was to determine the changes in BMD of the distal femur compared with those of the femoral necks and the lumbar spine after cemented TKA. BMD of two regions of interest in the distal femur, both femoral necks and the lumbar spine was measured with dual-energy X-ray absorptiometry in 10 patients (age range 41-80 years, mean 62 years) with 12 TKAs preoperatively and during follow-up for 1 year after surgery. ⋯ We found less than 1% difference in BMD of both femoral necks and the lumbar spine on average between the preoperative and 1 year follow-up measurements (not significant). A significant periprosthetic distal femoral bone resorption occurred after TKA. BMD of the femoral necks and lumbar spine did not differ 1 year after TKA.
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Arch Orthop Trauma Surg · May 2001
Comparative StudyOpen versus arthroscopic treatment of chronic rotator cuff impingement.
We report the results of 238 consecutive patients who underwent in total 261 acromioplasties because of chronic rotator cuff impingement. The procedure was performed either in conventional open technique (80) or arthroscopically (181). ⋯ Compared to the open technique, the arthroscopic procedure had a statistically significant superior result concerning outcome, operating time and hospital stay. Arthroscopic procedures performed by less experienced surgeons had inferior results.