Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2013
Meta Analysis Comparative StudyComparison between posterior lumbar interbody fusion and posterolateral fusion with transpedicular screw fixation for isthmic spondylolithesis: a meta-analysis.
Primary aim of this study was to compare long-term pain relief and quality of life in adults with isthmic spondylolisthesis (IS) who were treated with posterior lumbar interbody fusion (PLIF) and posterolateral fusion (PLF). Secondary aim was to compare the fusion and infection rates of PLIF- or PLF-treated groups. ⋯ The majority of PLIF- and PLF-treated adults with low-grade IS experienced long-term pain relief to a similar extent in most studies. PLIF treatment provided significantly better fusion rates than PLF treatment. This meta-analysis indicates that the use of separate, well-defined scales for pain relief and functional outcomes are needed in studies of PLF or PLIF-treated patients.
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Arch Orthop Trauma Surg · Dec 2013
ReviewRehabilitation after posterior cruciate ligament reconstruction: a review of the literature and theoretical support.
The purpose of this study was to conduct a literature review of studies that have addressed rehabilitation after posterior cruciate ligament (PCL) reconstruction. In particular, we intended to perform categorical analysis and discuss some critical points. ⋯ The review showed that flexion of 90° was allowed at around 6 weeks and prone passive flexion exercise or supine passive ROM exercise with posterior support was used to prevent a posteriorly directed force. Most authors used non-weight bearing or partial weight bearing in their rehabilitation programs, however it may be possible to perform active weight bearing in full extension or early flexion grades as soon as the soft tissue situation allows. Co-strengthening exercises could be recommended because these exercises produce co-contraction between the quadriceps and hamstring muscles with little posterior shear force.
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Arch Orthop Trauma Surg · Dec 2013
Randomized Controlled Trial Comparative StudyIncreased post-operative ischemia in the femoral head found by microdialysis by the posterior surgical approach: a randomized clinical trial comparing surgical approaches in hip resurfacing arthroplasty.
Hip resurfacing arthroplasty (HRA) is associated with osteonecrosis of the femoral head and femoral neck fracture, which may be caused by a decrease in the perfusion of the bone initiated at surgery. Several studies have demonstrated a decreased blood flow during surgery depending on the choice of surgical approach. We investigated the effect of the surgical approach on the blood flow and metabolism in the femoral head and neck in HRA by Laser Doppler flowmetry (LDF) and microdialysis. ⋯ HRA in the posterior approach results in increased post-operative ischemia in the femoral head and neck although during surgery, no difference in the blood flow was found. Still, the antero-lateral approach also causes considerable ischemia and other possible explanations, such as damage to the retinacular vessels during surgery or altered microcirculation because of heating from the cementation process, needs to be investigated.
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Arch Orthop Trauma Surg · Dec 2013
Comparative StudyEarly loosening of a press-fit cup with ceramic-on-ceramic articulation: our early results.
In this study, we present the short-term results of the Selexys TH+ cup with the Ceramys inlay which is a press-fit cup with a ceramic-on-ceramic articulation. (Mathys, Bettlach, Switzerland). We compared the results with a retrospective-matched control group with a Delta PF cup (Lima, Udine, Italy), which is also a press-fit cup with a ceramic-on-ceramic articulation. ⋯ The Selexys TH+ cup combined with the Ceramys ceramic-on-ceramic inlay coupling show an unacceptable high early revision rate. Therefore, we advice against using this combination.
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Arch Orthop Trauma Surg · Dec 2013
Case ReportsNon surgically managed anteromedial coronoid fractures in posteromedial rotatory instability: three cases with 2 years follow-up.
Varus posteromedial rotatory instability refers to one of the complex elbow fracture-dislocation caused by anteromedial coronoid fracture with disruption of lateral collateral ligament (LCL). Recent clinical and biomechanical studies have demonstrated that this unstable complex injury resulted in incongruence of joint, which could lead to early posttraumatic arthritis. ⋯ This case series describes three patients with anteromedial coronoid fracture who were managed conservatively with excellent outcomes. This report suggests that anteromedial coronoid fracture associated with posteromedial rotatory instability might be treated using conservative treatment in selective cases when anteromedial coronoid fracture is minimally displaced and there is no evidence of elbow subluxation.