Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · May 2014
Randomized Controlled TrialAdministration of enoxaparin 24 h after total knee arthroplasty: safer for bleeding and equally effective for deep venous thrombosis prevention.
The purpose of this study was to determine the safety and effectiveness, as assessed by risk of bleeding and incidence of deep venous thrombosis (DVT), of administering delayed low-molecular-weight heparin (LMWH) after total knee arthroplasty. ⋯ After total knee arthroplasty, LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT.
-
Arch Orthop Trauma Surg · May 2014
Joint gap measurement in total knee arthroplasty using a tensor device with the same articulating surface as the prosthesis.
We developed a new tensor to measure the joint gap throughout knee flexion during total knee arthroplasty (TKA). This tensor has the same articular shape as that of the tibial liner, including the post structure and the curvature of femorotibial articular surface, to measure the gap intraoperatively under the same conditions as after TKA. The present study aimed to examine the precision of the new tensor for gap measurement after implantation. ⋯ The new tensor provides precise and reproducible measurements. Although the joint gap before implantation was parallel and equal at extension and 90° flexion, the joint gap after implantation was variable throughout knee flexion. This feature of the gap should be considered during the operation.
-
Arch Orthop Trauma Surg · May 2014
Observational StudyFunctional and radiological outcomes of semi-rigid dynamic lumbar stabilization adjacent to single-level fusion after 2 years.
To prospectively evaluate the functional and radiological outcomes of Isobar semi-rigid dynamic posterior stabilization adjacent to single-level fusion up to and including 24 months postoperatively. ⋯ Patients with single-level DLDI and mild adjacent level degeneration treated with Isobar stabilization show a clinical improvement after 2 years. However, disc degeneration at the index and adjacent levels seems to continue despite using semi-rigid dynamic stabilization.
-
Arch Orthop Trauma Surg · May 2014
Vertebral body replacement with PEEK-cages after anterior corpectomy in multilevel cervical spinal stenosis: a clinical and radiological evaluation.
A growing number of industrially manufactured implants have been developed in the last years for vertebral replacement in anterior cervical corpectomy and fusion (ACCF). Polyetheretherketone (PEEK)-cages are used in many centers, but outcome reports are scarce. This study assesses the clinical and radiological outcome after one- or two-level ACCF by the use of a PEEK-cage augmented by a plate-screw osteosynthesis. ⋯ Anterior corpectomy and fusion by a PEEK-cage and plate-screw osteosynthesis resulted in clinical improvement in all patients. Bony fusion was achieved in all patients in the long run. PEEK cages are allegedly less rigid than other xenografts. Similar to those, however, their use bears the risk of early cage-dislocation and subsidence. A comparison of industrial xenografts and autologous bone implants is required to challenge the different fusion techniques.
-
Arch Orthop Trauma Surg · May 2014
Tibial tubercle osteotomy with absorbable suture fixation in revision total knee arthroplasty: a report of 23 cases.
Tibial tubercle osteotomy (TTO) is a well-known technique for improving exposure in difficult total knee arthroplasty (TKA). We have performed 23 revision TKAs with TTO. The tibial tubercle was fixated with only absorbable sutures afterwards. The aim of this study is to report on the clinical results and complications of this procedure. ⋯ Tibial tubercle osteotomy with only absorbable suture fixation is a reliable and simple method of fixation and provides adequate stability. It is a straightforward surgical technique which is less time-consuming and expensive compared with screw and cerclage wire fixation and no hardware removal will be necessary. Therefore, this method is a beneficial technique for the enhancement of surgical exposure in difficult revision TKA.