Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2013
Biomechanical evaluation of the primary stability of pedicle screws after augmentation with an innovative bone stabilizing system.
In today's aging population, diminished bone quality often affects the outcome of surgical treatment. This occurs especially when surgical implants must be fixed to bone, as it occurs when lumbar fusion is performed with pedicle screws. Besides Polymethylmethacrylate (PMMA) injection, several techniques have been developed to augment pedicle screws. The aim of the current study was to evaluate the primary stability of an innovative system (IlluminOss™) for the augmentation of pedicle screws in an experimental cadaveric setup. IlluminOss™ is an innovative technology featuring cement with similar biochemical characteristics to aluminum-free glass-polyalkenoate cement (GPC). ⋯ Based on these data, we conclude the IlluminOss™ system can be used to augment primary screw stability regarding axial traction, compared to native screws. The IlluminOss™ monomer offers ease of control for use in biological tissues. In contrast to PMMA, no relevant heat is generated during the hardening process and there is no risk of embolism. Further studies are necessary to evaluate the usefulness of the IlluminOss™ system in the in vivo augmentation of pedicle screws in the future.
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Arch Orthop Trauma Surg · Nov 2013
Combined arthroscopic synovectomy and radiosynoviorthesis in the treatment of chronic non-specific synovitis of the knee.
Chronic non-specific synovitis has a higher recurrence rate with arthroscopic synovectomy due to the insufficient removal of all pathological tissues. Neither has radiosynoviorthesis been sufficiently effective in treatment in contrast to cases of chronic specific synovitis such as rheumatoid arthritis. This study aimed to investigate the efficiency of combined arthroscopic and radionuclide synovectomy in chronic non-specific synovitis of the knee with the evaluation of clinical and radiological results. ⋯ The combination of arthroscopic subtotal synovectomy and radiosynoviorthesis can be an effective treatment modality for chronic non-specific synovitis of the knee.
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Arch Orthop Trauma Surg · Nov 2013
Reconstruction of skin avulsion injuries of the upper extremity with integra(®) dermal regeneration template and skin grafts in a single-stage procedure.
Management of skin avulsion injuries of the upper extremity may require coverage with large flaps or skin autografts. Cutaneous grafting is frequently combined with artificial skin to optimize the final functional and cosmetic result. The conventional use of bilaminated dermal substitutes consists of a two-stage procedure and requires long immobilization of the operated area. The purpose of this retrospective study is to evaluate the impact of a dermal regeneration template immediately covered by skin grafts in a one-step procedure for reconstructing skin avulsion injuries of the hand and forearm. ⋯ The use of Integra(®) Single Layer dermal substitute and immediate skin overgrafting consists an alternative reconstructive option for managing extended skin avulsion injuries of the upper extremity; it reduces postoperative immobilization, minimizes donor site morbidity and provides good functional and esthetic results in a single surgical procedure.
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Arch Orthop Trauma Surg · Nov 2013
Surgical approach and prosthesis fixation in hip arthroplasty world wide.
Hip arthroplasty is one of the most common and successful surgical procedures worldwide. Component design and materials as well as surgical techniques constantly evolve. There is no consensus among surgeons regarding the ideal surgical approach and method of fixation. ⋯ The most common surgical approaches in use in hip arthroplasty are posterior and lateral. Anterior approach is used by a minority of orthopedic surgeons for that purpose. Cementing hip prosthesis is falling out of favor among orthopedic surgeons worldwide. The trend toward un-cemented hip arthroplasty is not well supported in the current literature.
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Arch Orthop Trauma Surg · Nov 2013
Incidental dural tear in lumbar spinal decompression and discectomy: analysis of a nationwide database.
An incidental dural tear (DT) is one of the most common intraoperative complications in lumbar spine surgery. The purpose of this study was to report the incidence of DT in lumbar spinal decompression (LSD) and lumbar discectomy (LD), risk factors, and patient outcomes on a national level. ⋯ The incidence of DT was higher in LSD (6.3 %) than in LD (1.9 %), based on a national database. The effect of DT on in-hospital morbidity and mortality and health care burdens was more significant in LSD than in LD.