Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2012
Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study.
To assess health-related quality of life (HRQOL) in a prospective study with 7 years of follow-up in 49 consecutive patients who underwent a total joint replacement because of osteoarthritis. ⋯ The improvements observed in HRQOL at short term after surgery, are at least maintained over a 7-year follow-up period.
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Arch Orthop Trauma Surg · Nov 2012
Case ReportsIs augmentation a possible salvage procedure after lateral migration of the proximal femur nail antirotation?
Failed fracture fixation of proximal femur fractures in the elderly usually results in prosthetic replacement. In case of the proximal femur nail antirotation (PFNA), during lateral blade migration or periimplant fracture at the femoral shaft, the femoral head remains intact and therefore a joint preserving procedure might be performed. However, implant anchorage in the femoral head after the second blade implantation generally results in reduced anchorage in the remaining cancellous bone. Therefore, we hypothesize that in the above mentioned cases augmentation of the PFNA blade could be a treatment option before prosthetic surgery has to be performed. ⋯ Augmentation of simulated blade exchange after lateral blade migration demonstrated a good anchorage. There was superior rotational stability in the revised case and no inferiority during pull out for the investigated specimens. Furthermore, augmentation could compensate for destroyed trabeculae and poor bone stock. It could furthermore be an option when a failed implant has to be replaced by a long PFNA in case of shaft fracture at the tip of the implant to increase anchorage in the femoral head. From a biomechanical point of view, reosteosynthesis and augmentation in selected cases of PFNA revision could be an alternative to initial prosthetic replacement. In the case of cut-out or medial implant protrusion, the suggested salvage technique is not feasible.
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Arch Orthop Trauma Surg · Nov 2012
Osteodensitometry measurements of periprosthetic bone using dual energy X-ray absorptiometry following total knee arthroplasty.
The present study investigates the reaction of bone density as well as the possible factors influencing this reaction following a cement-free total knee arthroplasty (TKA). ⋯ Finally, results achieved in the present study demonstrate that the fundamental classification in defined ROI proved to be functional and effective.
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Arch Orthop Trauma Surg · Nov 2012
The influence of the femoral force application point on tibial cementing pressure in cemented UKA: an experimental study.
Aseptic loosening is the major cause for implant failure in cemented unicompartmental knee arthroplasty (UKA). Central positioning of the femoral pressure during the tibial cementation process is recommended to achieve equal pressure and a good cementation result. The aim of this study was to verify the central position of the femoral force application point (FFAP) at 45° flexion of the knee and to investigate the influence of ligament tension and cement penetration pressure (CPP) for UKA. ⋯ The central position of the FFAP for the investigated cemented UKA with single radius femoral component at 45° flexion of the knee could be confirmed. A flexion angle of <45° does not influence the position of the FFAP significantly. More than 45° of flexion should be avoided because the FFAP shifts backwards significantly and may cause increased pressures posteriorly and therefore tilting of the component occurs during the cementation process.
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Arch Orthop Trauma Surg · Nov 2012
High incidence of tunnel widening after anterior cruciate ligament reconstruction with transtibial femoral tunnel placement.
This study evaluated the incidence, amount, morphology and clinical significance of bone tunnel widening (TW) at a mean 5-year period after anterior cruciate ligament reconstruction (ACLR) with a transtibial drilling technique. ⋯ This study demonstrates that considerable TW occurs in virtually all patients in the mid term after ACLR using a transtibial drilling technique with 'high' femoral tunnel positions. Yet, neither amount nor morphology or tunnel position does affect knee stability or function.