Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2012
Comparative StudyA comparative analysis between fixed bearing total knee arthroplasty (PFC Sigma) and rotating platform total knee arthroplasty (PFC-RP) with minimum 3-year follow-up.
Since the introduction of mobile bearing total knee designs nearly 30 years back, many studies have been done to evaluate its long-term result. Comparison with fixed bearing designs has been done in the past, but the studies were confounded by variables such as disease, surgeon, bone quality, pain tolerance, etc. We attempt to eliminate these variables in this study. ⋯ Our study demonstrated no advantage of the mobile-bearing arthroplasty over fixed bearing arthroplasty with regard to clinical results at short-term follow-up. However, longer follow-up is necessary to confirm whether these results are sustained.
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Arch Orthop Trauma Surg · Jun 2012
Analysis of hereditary and medical risk factors in Achilles tendinopathy and Achilles tendon ruptures: a matched pair analysis.
In Achilles tendon injuries, it is suggested that a pathological continuum might be evident from the healthy Achilles tendon to Achilles tendinopathy to Achilles tendon rupture. As such, risk factors for both tendinopathy and rupture should be the same. ⋯ Identifying risk factors associated with Achilles tendon disorders has a high clinical relevance regarding the development and implementation of prevention strategies and programs. This cross-sectional study identified a positive family history as a significant solitary risk factor for Achilles tendinopathy, increasing the risk fivefold. However, in this matched pair analysis excluding age, weight, height and gender as risk factors no further factor necessarily increases the risk for either Achilles tendinopathy or Achilles tendon rupture.
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Arch Orthop Trauma Surg · Jun 2012
Nociceptive sensory innervation of the posterior cruciate ligament in osteoarthritic knees.
Although the posterior cruciate ligament (PCL) is considered to contain not only proprioceptive but also nociceptive sensory fibers, there is a lack of information about nociceptive sensory innervation of the PCL. We hypothesized that the PCL has constant nociceptive sensory innervation, suggesting the possible source of osteoarthritic (OA) knee pain. ⋯ Our results showed that, in spite of a significant decrease in total innervation in OA knees, the PCLs have constant nociceptive sensory innervation. Although the relationship between the decrease in total innervations in the PCL and OA pathophysiology is still unclear, the PCL is the possible source of OA knee pain. Our results should be taken into account when examining the pain source of the OA knees and handling the PCL during total knee arthroplasty.
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Arch Orthop Trauma Surg · Jun 2012
Percutaneous cerclage wiring and minimally invasive plate osteosynthesis (MIPO): a percutaneous reduction technique in the treatment of Vancouver type B1 periprosthetic femoral shaft fractures.
Periprosthetic femoral fractures (PPFs) associated at or near a well-fixed femoral prostheses (Vancouver type-B1) present a clinical challenge due to the quality of the bone stock and instability of the fracture. ⋯ Percutaneous reduction of spiral, oblique or wedge-type B1 PPFs with percutaneous cerclage wiring combined with minimally invasive locking plate osteosynthesis provided satisfactory reduction, adequate stability and healing in nine patients. Our early results suggest that this reduction technique and fixation may be a useful solution for this growing challenge in orthopaedics. The authors caution that this technique must be done carefully to avoid serious complications, e.g., vascular injury.
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Arch Orthop Trauma Surg · Jun 2012
Review Case ReportsA novel method of image-based navigation in fracture surgery.
The treatment of three- and four-part fractures of the humeral head is still controversially discussed. Some advocate primary arthroplasty while the results of primary fixation seem to be superior if no necrosis of the humeral head develops. Today navigation is used in orthopaedic surgery mainly for interventions on the spine, the pelvis and arthroplasty. ⋯ In conclusion, the described technique allows an accurate fixation of the humeral head fracture as the guidance system (Surgix) ensures the "first try first hit" screw positioning. The new system was integrated in the workflow and supports the surgeon as an aiming device. The role of navigation system in enhancing minimally invasive surgery of the shoulder should be further explored.