Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2012
Review Comparative StudyTotal hip arthroplasty: to cement or not to cement the acetabular socket? A critical review of the literature.
The optimal method for acetabular socket fixation remains controversial. We present a critical analysis of the current evidence from a systemic literature review of comparative studies, long-term case series, prior literature reviews, meta-analysis, and national arthroplasty registry data for cemented and uncemented acetabular components to determine the respective survivorship rates, overall risk of re-operation, dislocation rates, and wear-related complications. Using contemporary techniques, both cemented and uncemented sockets can yield good long-term results, but our evaluation suggests that the overall/all cause re-operation risk is lower for cemented fixation. Until and unless crosslinked polyethylene (PE) liners or alternative bearings can prove to yield superior outcome in the future, the cemented PE cup remains the gold standard, in all age groups, by which every acetabular component should be compared.
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Arch Orthop Trauma Surg · Mar 2012
Comparative StudyInterdisciplinary inter-observer agreement and accuracy of MR imaging of the shoulder with arthroscopic correlation.
Differences between radiologists and orthopaedic surgeons in the interpretation of MR images of the shoulder joint are experienced in daily clinical practice. This study set out to evaluate the inter-observer agreement between radiologists and orthopaedic surgeons in assessing pathology on MR imaging of the shoulder joint. Also, we determined the accuracy of the observers with arthroscopy as the standard of reference. ⋯ The orthopaedic surgeon and radiologists differed in their interpretation of what defines a Bankart lesion and what defines a ligamentous lesion. The orthopaedic surgeon was significantly more accurate in assessing impingement.
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The current study was designed to evaluate the rate of osteolysis and the clinical and functional outcomes in patients who underwent mini-open rotator cuff repairs using first generation bioabsorbable suture anchors. Our hypothesis was that patients with osteolysis noted on post-repair MRI would have an accompanying decrease in functional and clinical patient outcomes when compared with patients who did not have osteolysis evident on post-repair MRI. ⋯ Although, we found a high rate of osteolysis after rotator cuff repair with bioabsorbable anchors, these results did not change the clinical outcomes after rotator cuff repair. Recurrent tears were not significantly different in both groups and are comparable to rerupture rates in prior studies. More studies are needed to verify the effect of osteolysis over the long term.
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Arch Orthop Trauma Surg · Mar 2012
Comparative StudyValue of magnetic resonance arthrography in post-traumatic anterior shoulder instability prior to arthroscopy: a prospective evaluation of MRA versus arthroscopy.
This prospective study was designed to evaluate the value of magnetic resonance arthrography (MRA) after traumatic anterior shoulder instability prior to arthroscopy. ⋯ In patients with post-traumatic anterior glenohumeral instability MRA shows many lesions that can not be confirmed by arthroscopy and therefore do not have therapeutical consequences. On the other hand some labral lesions which do need surgical treatment are not detected on MRA. At least from this study, it can be concluded that MRA has limited value prior to the arthroscopic treatment of post-traumatic shoulder instability.
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Arch Orthop Trauma Surg · Mar 2012
Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players.
Muscle injuries are very common in athletes. Depending on the type of sport, muscle injuries represent approximately 9-54% of total injuries. The rectus femoris muscle is very important in specific sports, such as soccer and American football, because it is the muscle involved in movements, such as sprinting and kicking the ball. Therefore, we believe that these disabling injuries need special and prompt treatment to enable athletes to return to their sporting activities. ⋯ Surgical treatment has a lower recurrence rate in our hands; we believe that surgical treatment is indicated in these cases, for a complete functional recovery for professional soccer players.