Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2014
Prospective quantitative assessment of spinal range of motion before and after minimally invasive surgical treatment of vertebral body fractures.
Randomized clinical trials have generated doubts regarding the therapeutic effectiveness of spinal kyphoplasty to reduce pain and improve quality of life in patients with vertebral fractures. There is a paucity of data on the influence of kyphoplasty on spinal range of motion. To quantify early postoperative changes following kyphoplasty in spinal motion, a noninvasive, radiation-free measurement method was used and results related to clinical and radiological parameters. ⋯ Significant clinical and radiological improvement following kyphoplasty supports the rational for cement augmentation in patients with pathological vertebral body fractures. To the knowledge of the authors, no prior study has assessed the influence of preservation and improvement of spinal range of motion on clinical outcome following kyphoplasty.
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Arch Orthop Trauma Surg · Aug 2014
Case ReportsA detached arthroscopic lens within the shoulder joint: a case report.
Shoulder arthroscopy has become a common procedure in today's orthopedic practice. The safety of this procedure has been well established, but there are some complications associated with every surgical procedure both minor and major. In the present era, with advanced arthroscopic instruments, it is rare to encounter the problem of instrument breakage during arthroscopic surgery. ⋯ We performed shoulder arthroscopy again and removed the detached lens arthroscopically. This case warrants the need for the surgeon and the operating room staff to be well acquainted with the arthroscopic instruments and to check the instruments properly before and after the completion of the procedure. If the operating room staff would have identified the damage to the scope, encountered during the primary operation, we could have avoided the second procedure to remove the lens.
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Arch Orthop Trauma Surg · Aug 2014
Degradation of poly-D-L-lactide (PDLLA) interference screws (Megafix ®).
Interference screw fixation is a standard procedure in anterior cruciate ligament (ACL) replacement. Aim of this study was to evaluate the degradation process of Poly-D-L-lactide (PDLLA) interference screws used for tibial ACL graft fixation. ⋯ After 22 months, a PDLLA screw may not interfere with ACL revision surgery. Regarding the degradation process of PDLLA screws, we noted three different phases. Furthermore, the degradation process observed by MRI resembles to that described by animal studies. The PDLLA screws fully absorb and are partially replaced by bone. The degradation process in humans seems to be longer than that described in animals.
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Arch Orthop Trauma Surg · Aug 2014
Failure of bulk bone grafts after total hip arthroplasty for hip dysplasia.
Bulk bone grafts are used in total hip arthroplasty (THA) when adequate acetabular cup coverage cannot be achieved. Data from literature show mainly good short-term and mid-term results with contradictory long-term results. The aim of this study was to investigate acetabular cup stability and graft integrity after dysplastic adult hip reconstruction with total hip endoprosthesis and bulk bone graft for acetabular deficiency. ⋯ Results of this study show significant decrease in acetabular cup stability when either autograft or allograft is used for cemented acetabular reconstruction of dysplastic hip. Further, allografts showed twice as rapid failure as autografts. Although these results contradict both good short-term and long-term results in published literature, they present warning for future use of free bulk bone grafts in reconstructive hip surgery.