Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2015
Open debridement and prosthesis retention is a viable treatment option for acute periprosthetic joint infection after total knee arthroplasty.
Open debridement with prosthesis retention (ODPR) has been considered as a reasonable treatment option for acute periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). However, multiple recent studies have challenged this contention. This study was undertaken to determine the success rate of ODPR, whether the success rate was affected by the ODPR timing or by the microorganisms. ⋯ ODPR should be considered as a viable treatment option for acute PJI following TKA. The promptness of ODPR is of paramount importance for success of ODPR, rather than the causative organism type or virulence.
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Arch Orthop Trauma Surg · Jun 2015
Case ReportsBilateral locked anterior shoulder dislocation in a bench-pressing athlete: case report.
Chronic bilateral anterior shoulder dislocation is a rare entity. Treatment options range from conservative to surgical reduction. ⋯ Upon presentation, the patient had no pain with functional range of motion so he refused surgery. Conservative treatment could be an acceptable alternative to surgical intervention if pain and functional status are satisfactory.
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Arch Orthop Trauma Surg · Jun 2015
Case ReportsEvaluation and analysis of graft hypertrophy by means of arthroscopy, biochemical MRI and osteochondral biopsies in a patient following autologous chondrocyte implantation for treatment of a full-thickness-cartilage defect of the knee.
Graft hypertrophy represents a characteristic complication following autologous chondrocyte implantation (ACI) for treatment of cartilage defects. Although some epidemiological data suggest that incidence is associated with first-generation ACI using autologous chondrocyte implantation, it has also been reported in other technical modifications of ACI using different biomaterials. Nevertheless, it has not been described in autologous, non-periosteum, implant-free associated ACI. ⋯ No expression of collagen type X (a sign of chondrocyte hypertrophy), only slight changes of the subchondral bone and a nearly normal cell-matrix ratio suggest that tissue within the hypertrophic area does not significantly differ from intact and high-quality repair tissue and therefore seems not to cause graft hypertrophy. This is in contrast to the assumption that histological hypertrophy might cause or contribute to an overwhelming growth of the repair tissue within the transplantation site. Data presented in this manuscript might contribute to further explain the etiology of graft hypertrophy following ACI.
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Arch Orthop Trauma Surg · Jun 2015
Case ReportsA rare case of a punched nerve syndrome of the deep motor branch of the ulnar nerve.
Peripheral compression neuropathy of the ulnar nerve is a frequent condition, most likely encountered at the ulnar sulcus or the Guyon's canal. High-resolution ultrasound (HRUS) can often identify the site of injury. Primarily idiopathic, compression neuropathy can stem from a punched nerve syndrome, in which direct contact between an arterial branch and the nerve leads to compression. ⋯ HRUS is a viable method to demonstrate a punched nerve syndrome. In conjunction with clinical presentation, even unlikely sites of compression such as the deep motor branch of the ulnar nerve can be identified.
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Arch Orthop Trauma Surg · Jun 2015
Fracture reduction with positive medial cortical support: a key element in stability reconstruction for the unstable pertrochanteric hip fractures.
To introduce the concept of fracture reduction with positive medial cortical support and its clinical and radiological correlation in geriatric unstable pertrochanteric fractures. ⋯ Fracture reduction with nonanatomic positive medial cortical support allows limited sliding of the head-neck fragment to contact with the femur shaft and achieve secondary stability, providing a good mechanical environment for fracture healing.