Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2013
Comparative StudyX-treme CT analysis of cancellous bone at the rotator cuff insertion in human individuals with osteoporosis: superficial versus deep quality.
Rotator cuff (RC) repair-especially in the elderly population-is problematic since the patients suffer to a high extent from bone mineral density loss at the reattachment site. Therefore, the study was primarily driven by the question whether it is possible to reach more or qualitatively better cancellous bone and thus a more stable postoperative result if anchors with greater length are used for RC repair and/or the conventional anchors are screwed deeper into the bone. In anatomical terms, the question is raised whether cancellous bone is of better quality close to or far off the RC enthesis. ⋯ Our data show that cancellous bone presents with decreasing bone quality when analyzing increasingly deeper portions of the bone cylinders of the GT and LT starting at the articular surface. This information seems to be crucial for shoulder surgeons, especially when treating elderly patients. Our results clearly prove that screwing in anchors to a deeper extent will not improve stability, since the deeper bone stock is of worse quality.
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Arch Orthop Trauma Surg · Mar 2013
Risk factors for failed two-stage procedure after chronic posttraumatic periprosthetic hip infections.
The aim of the study was to identify risk factors of failed two-stage procedures in cases of chronic posttraumatic periprosthetic hip infections. ⋯ A reduced general state of health, a high BMI and highly resistant pathogens are the main risk factors for a failed two-stage procedure after chronic posttraumatic periprosthetic hip infections. Therefore, different treatment strategies are required for a defined subgroup of patients.
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Arch Orthop Trauma Surg · Mar 2013
Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.
The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. ⋯ The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.
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Arch Orthop Trauma Surg · Mar 2013
Individual and team training with first time users of the Pelvic C-Clamp: do they remember or will we need refresher trainings?
Pelvic ring injuries with associated hemorrhage from the presacral venous plexus are major contributors to morbidity and mortality in trauma patients. The Pelvic C-Clamp is an often discussed, yet seldom used device for both skeletal and hemodynamic stabilization. In a recent study we have addressed this issue and have stressed the importance of regular training sessions with the device. This study is aimed as an extended follow up with a special focus on how trained skills are retained over time. ⋯ The majority of 57 pins were placed in the safe area within 6 min after one single training session. This reproduces the Australian data and supports the theory that adequately educated and skilled physicians should be able to handle the device properly. The data from the re-evaluation suggest that repeating the training session with the device improves performance.