Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2012
Total hip replacement in patients with history of illicit injecting drug use.
A history of illicit injecting drug use makes indication of total hip arthroplasty (THA) in patients with end stage hip osteoarthritis difficult, as the risk of infection with colonized strains is multiplied if the patient continues to inject or inhale illicit drugs. ⋯ We use this unacceptable high failure rate as evidence when counseling patients and their health care professionals about the appropriate treatment of osteoarthritis in patients with a history of illicit drug use. Furthermore, we support the request of hair analysis for drugs documenting abstinence of at least 1 year before indicating THA.
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Arch Orthop Trauma Surg · Jul 2012
Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid.
The Epoca-Reconstruction-(Reco)®-Glenoid has been developed to treat patients with cuff-tear-arthropathy. The glenoid component of this system has a hemispheric shape that canopies the humeral head. This design is believed to provide a stable fulcrum and restore normal deltoid function. The purpose of this study was to analyse strengths and disadvantages of the Epoca-Reco®-Glenoid in cuff-tear-arthropathy patients. Changes in functional outcome using Constant-Murley-Scoring(CMS), CMS sub-scoring parameters and radiological outcome were analysed. For this purpose, a classification for radiologic lucency was proposed. Diverging results, influencing factors and alternative treatment options have been discussed to analyse weaknesses and enhance future development of this arthroplastic model. ⋯ The semi-constraint reconstruction glenoid prosthesis model in cuff-tear-arthropathy patients significantly improves shoulder function, however, it yields controversial results, with satisfactory results in male and poor results in female patients. Revision rate of the female cohort and loosening of the glenoid component in this short-term follow-up is of concern. Further investigations taking BMD, osteopenic conditions and influence of surface area in smaller individuals into consideration are recommended, to determine whether this is the underlying cause of the inferior results in females.
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Arch Orthop Trauma Surg · Jul 2012
Clinical TrialDetermination of cephazolin, ceftazidime, and ceftriaxone distribution in nucleus pulposus.
The intervertebral disc is the largest avascular structure in the adult body and minimal blood flow through capillary beds only supplying the outer regions of the disc, which relies on the passive diffusion as a major factor for nutrition and uptake of molecules, including antibiotics. This study is to detect the serum and nucleus pulposus (NP) levels of cephazolin, ceftazidime, and ceftriaxone and to assess this antibiotic permeability into the intervertebral disc. ⋯ The antibiotics of cephazolin, ceftazidime, and ceftriaxone had concentration in the NP tissue, which was higher than the stated MIC. Ceftazidime had highest penetration in to NP tissue, and ceftriaxone had the lowest penetration in to NP tissue.
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Arch Orthop Trauma Surg · Jul 2012
Augmentative locking compression plate fixation for the management of long bone nonunion after intramedullary nailing.
Intramedullary nailing is widely used in the treatment of long bone fractures. But some patients suffer from nonunion after receiving intramedullary nailing. This paper investigates the methods and effects of locking compression plate (LCP) in the treatment of long bone nonunion after intramedullary nailing. ⋯ LCP can be used for the treatment of long bone nonunion after intramedullary nailing for its convenience, minimal invasion and curative effect.
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Arch Orthop Trauma Surg · Jul 2012
Small differences between anatomical and mechanical sagittal femur axes: a radiological and navigated study of 50 patients.
The purposes of the study were to define the orientation of the anatomical and mechanical axes of the femur on the lateral plane on long leg X-rays including the femoral head, and to compare these results to the intra-operative measurement of the mechanical axis by a nonimage-based navigation system. ⋯ The differences observed are small and have probably little clinical relevance. The distal cortical axis may be the best compromise. The navigation system allows measuring accurately the orientation of the distal femoral resection in the sagittal plane.