Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2001
Case ReportsTreatment and clinical management of recurrent knee empyema due to methicillin-resistant Staphylococcus aureus (MRSA) after total knee replacement.
We describe a patient with recurrent knee empyema and associated complications caused by methicillin-resistant Staphylococcus aureus (MRSA) after total knee replacement and the difficulties and limited options in its clinical management.
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Arch Orthop Trauma Surg · Jun 2001
Knee and ankle: human joints with different susceptibility to osteoarthritis reveal different cartilage cellularity and matrix synthesis in vitro.
Clinical experience shows that symptoms and pathological changes of primary osteoarthritis (OA) are more frequent and severer in the knee than in the ankle joint. The different anatomy of both weight-bearing joints implies that biomechanical differences may contribute to their varying susceptibility to OA. This study aims at elucidating other non-biomechanical factors to explain these fundamental differences in secondary OA prevalence. ⋯ In addition, cartilage from the ankle joint is significantly more cellular than cartilage from the knee joint. In general, ankle chondrocytes synthesize more proteoglycans (PGs) and collagens than knee chondrocytes, and deep zone chondrocytes more than superficial zone chondrocytes. The biochemical properties of chondrocytes of the ankle and knee joints differ significantly and might play an important role in the pathogenesis of OA.
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Arch Orthop Trauma Surg · Jun 2001
Correlation between the Q angle and the patella position: a clinical and axial computed tomography evaluation.
The purpose of this study was to evaluate the significance of the Q angle with respect to the patella position. Fifty-six knee joints of 34 patients (15 bilateral) with chronic patellofemoral pain were prospectively evaluated. All patients were examined by the same orthopaedic surgeon (R. ⋯ Similar results were found in patients with pain only on one side. In conclusion, there is no significance between the Q angle and the position of patella. The diagnostic relevance of the Q angle could not be established.
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Arch Orthop Trauma Surg · Jun 2001
Functional results after anterior cruciate ligament reconstruction using the patellar ligament bone-tendon-bone technique.
This study evaluates the outcome after surgical repair of the cruciate ligament in 129 patients (physical examination plus questionnaire) and another 49 patients (questionnaire only) after a mean interval of 3.2 years. A modified Lysholm score and the OAK score together with KT 1000 arthrometry were used. ⋯ The overall OAK objective score was good or excellent in 81%. Elongation as measured by KT 1000 arthrometry was 1.0 mm (67 N) and 1.2 mm (90 N) on average compared with the contralateral knee.
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Low tibial osteotomy is one of the significant advances of ankle reconstruction techniques that has been made recently in an effort to halt arthritis in its early stages and leave fusion as the last, not the only, alternative treatment of ankle arthritis. From 1989 to 1995, we performed 18 low tibial osteotomies which included 6 cases of post-traumatic arthritis and 12 cases of degenerative arthritis. The ages of the 7 male and 11 female patients ranged from 18 to 78 years with an average of 41.9 years. ⋯ Complications included one case of late infection and two cases of implant failure, none of which led to nonunion. The indication for low tibial osteotomy is the intermediate stage of moderate ankle arthritis with a medial joint lesion and intact lateral facet. Using pressure redistribution on the joint surface, this procedure is an alternative treatment for ankle arthritis which may save an arthritic ankle from the fate of fusion or at least postpone fusion surgery.