Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2014
Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study.
Short-stem prostheses enable bone stock preserving total hip arthroplasty. However, little is known about the durability of this group of implants. The most common cause for implant failure is aseptic loosening. Early implant migration is supposed to be the best indicator for mechanical failure of femoral stems. The purpose of this study was to evaluate the migration pattern of a short stem implant and the influence of BMI, gender and femoral offset on implant migration. ⋯ The evaluated short stem prosthesis showed a migration pattern similar to clinical proven standard straight stem implants. The indication of short-stem prostheses should be critically evaluated in obese and female patients.
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Arch Orthop Trauma Surg · Jul 2014
Risk factors for heterotopic ossification and spur formation after total knee arthroplasty.
The present study investigated the incidence and risk factors of heterotopic ossification (HO) after implantation of knee prosthesis. ⋯ Our study has revealed that patients with rheumatoid arthritis are at lower risk of HO than patients with osteoarthritis. An impairment of wound healing would appear to promote the development of a HO. Notching and hypertrophic arthrosis are highly likely to be associated with the development of a bony spur in the ventral contact area of the prosthesis.
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Arch Orthop Trauma Surg · Jul 2014
Case ReportsTwo cases of pisiform bone impingement syndrome after proximal row carpectomy.
Proximal row carpectomy (PRC) is an established surgical procedure used to treat post-traumatic osteoarthritis of the wrist with sparing of the midcarpal joint and advanced aseptic necrosis such as lunatomalacia. Proximalization of the distal carpal row following PRC may lead to secondary problems such as radiocarpal impingement. ⋯ The CT scan revealed clear osteolysis consistent with a pisiform bone impingement on the ulnar styloid process in both the cases, and also on the hamate in one patient. An impingement syndrome of this nature has not previously been described and should be kept in mind when patients report ulnocarpal symptoms after PRC.
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Arch Orthop Trauma Surg · Jul 2014
Feasibility of arthroscopic 3-dimensional, purely autologous chondrocyte transplantation for chondral defects of the hip: a case series.
The purpose of this retrospective study was to describe technical aspects of arthroscopic, purely autologous chondrocyte transplantation of the hip and to report short-term data of the postoperative outcome in a consecutive series of patients. ⋯ Level IV, retrospective study.
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Arch Orthop Trauma Surg · Jul 2014
Case ReportsMRI does not detect acetabular osteolysis around metal-on-metal Birmingham THA.
Osteolysis has not been recognized as a common failure mode of the Birmingham modular metal-on-metal (MoM) total hip arthroplasty (THA). The clinical value of metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) to assess the periprosthetic soft tissue is well documented; however, the appropriate image modalities to detect periacetabular osteolysis remain unclear. Eleven patients with periacetabular osteolysis within 3-6 years after uncemented Birmingham modular MoM THA with a synergy stem are presented. All 11 patients received corresponding standardized AP pelvis radiographs, high-quality MARS MRIs and CT scans with a metal artifact reduction sequence. While periacetabular osteolysis around MoM THA was not detected on MARS MRI in ten patients, CT imaging identified osteolysis in all patients. Periacetabular osteolysis appears to be a failure mechanism of the Smith & Nephew Birmingham MoM THA. ⋯ MRI is not a sensitive test to identify periacetabular osteolysis. The authors recommend CT for the screening of implants with this failure mode. Our study suggests that patients with a Birmingham modular MoM THA are at increased risk to develop acetabular osteolysis and should be carefully monitored for this failure mode.