Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2014
Physiologic bone remodeling in medial aspect of proximal tibia after under-release of medial soft tissue during total knee arthroplasty.
This study was undertaken to investigate the incidence and to identify predictors of physiologic remodeling in the medial aspect of the proximal tibia in varus knees after total knee arthroplasty (TKA). ⋯ In some varus knees showing physiologic bone remodeling in the medial aspect of the proximal tibia after TKA, prostheses thickness showed a strong tendency to be larger than the medial extension gap after bone cutting.
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Arch Orthop Trauma Surg · Jun 2014
Complications of hip fracture surgery on patients receiving clopidogrel therapy.
Clopidogrel (Plavix(®)) may influence patient safety during fracture surgery. Our study examines the incidence of complications for patients undergoing hemiarthroplasty on clopidogrel therapy. ⋯ The optimal treatment for hip fracture patients on antiplatelet therapy is unclear. However, in this study there appears to be no significant difference with regards to bleeding and bleeding related wound complications, suggesting it is safe to proceed with hemiarthroplasty for patients receiving clopidogrel.
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Arch Orthop Trauma Surg · Jun 2014
Osteochondral transplantation for the treatment of osteochondral defects at the talus with the Diamond twin system(®) and graft harvesting from the posterior femoral condyles.
The aim of this study is to analyze clinical results after osteochondral cylinder transplantation for osteochondral defects at the medial or lateral talar dome using the Diamond twin system (Karl Storz). We hypothesize that grafts harvesting from the posterior femoral condyles are associated with less donor site morbidity than reported by previous studies. ⋯ The donor site morbidity after graft harvesting from the posterior aspects of the femoral condyles is lower than previously reported.
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Arch Orthop Trauma Surg · Jun 2014
The T-line as an intraoperative landmark for reproducing the native femoral anteversion during hip arthroplasty.
Three-dimensional computed tomographic (CT)-based preoperative planning for total hip arthroplasty (THA) enabled us to evaluate the cut surface of the femoral neck osteotomy. When we planned the stem placement in 20° of anteversion, we noticed that the line connecting the trochanteric fossa and the middle of the medial cortex of the femoral neck (T line) was coincident with the component torsion in many cases. We attempted to evaluate the accuracy of the T line for reproducing the native femoral anteversion during THA comparing it with the midcortical line, the reference guide previously reported by Suh. ⋯ Aligning the stem parallel to the T line on the cut surface provides a good reproduction of the femoral anteversion. The T line can be an useful intraoperative reference guide for the anteversion of the femoral component in THA for patients without severe hip deformity.
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Arch Orthop Trauma Surg · Jun 2014
Gap measurement in posterior-stabilized total knee arthroplasty with or without a trial femoral component.
To investigate the effects of a trial femoral component on the intraoperative joint gap and intraoperative joint gap kinematics throughout the range of knee motion in minimally invasive surgery-total knee arthroplasty (MIS-TKA) with the gap technique. ⋯ The trial femoral component influenced the intraoperative gap measurements, and increased the intraoperative gap difference. The joint gap kinematics with the trial femoral component were not constant throughout the range of knee motion, even if the appropriate joint gaps in extension and flexion were achieved. For acquisition of constant stability throughout the knee motion, the present results should be taken into account by surgeons performing MIS-TKA with the gap technique.