Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2018
Do patient-specific instruments (PSI) for UKA allow non-expert surgeons to achieve the same saw cut accuracy as expert surgeons?
High-volume unicompartmental knee arthroplasty (UKA) surgeons have lower revision rates, in part due to improved intra-operative component alignment. This study set out to determine whether PSI might allow non-expert surgeons to achieve the same level of accuracy as expert surgeons. ⋯ In a sawbone model, PSI allowed inexperienced surgeons to achieve more accurate saw cuts, equivalent to expert surgeons, and thus has the potential to reduce revision rates. The next test will be to determine whether these results can be replicated in a clinical trial.
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Arch Orthop Trauma Surg · Nov 2018
Review Meta AnalysisBetter rotational control but similar outcomes with the outside-in versus the transtibial drilling technique for anterior cruciate ligament reconstruction: a systematic review of comparative trials.
This study was a systematic review comparing the clinical outcomes of using the transtibial (TT) versus the outside-in (OI) technique for anterior cruciate ligament (ACL) reconstruction. ⋯ Therapeutic study (systematic review), Level III.
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Arch Orthop Trauma Surg · Nov 2018
Range of motion, postoperative rehabilitation and patient satisfaction in MCP and PIP joints affected by Dupuytren Tubiana stage 1-3: collagenase enzymatic fasciotomy or limited fasciectomy? A clinical study in 52 patients.
In Switzerland, collagenase Clostridium histolyticum therapy (CCH) for Dupuytren's disease was introduced in 2011. This study analyzes possible differences between CCH and limited fasciectomy (LF) in terms of range of motion, patient satisfaction and postoperative rehabilitation. ⋯ Level III.
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Arch Orthop Trauma Surg · Nov 2018
Preliminary results of a novel spacer technique in the management of septic revision hip arthroplasty.
Mechanical failure due to dislocation, fracture and acetabular wear is a major complication associated with the use of spacers in the management of periprosthetic joint infection (PJI). We have developed a novel custom-made spacer in the setting of two-stage septic revision hip arthroplasty and present the preliminary results of our technique. ⋯ The ENDO spacer surgical technique is a feasible option in the treatment of periprosthetic joint infection (PJI), with a low dislocation rate. Furthermore, it allows early mobilization with the possibility of full-weight bearing.
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Arch Orthop Trauma Surg · Nov 2018
Learning curve analysis of 3D-fluoroscopy image-guided pedicle screw insertions in lumbar single-level fusion procedures.
The implementation of 3D-navigation in the operating theater is reported to be complex, time consuming, and radiation intense. This prospective single-center cohort study was performed to objectify these assumptions by determining navigation-related learning curves in lumbar single-level posterior fusion procedures using 3D-fluoroscopy for real-time image-guided pedicle screw (PS) insertions. ⋯ In newly inaugurated O-arm based image-guidance, lumbar PS insertions can be performed at constantly high accuracy, even without prior experience in navigated techniques. Navigation-related time demand decreases considerably due to accelerating workflow preceding skin incision. Procedural 3D-radiation dose is reducible to a fraction (13.2%) of a lumbar diagnostic non-contrast-enhanced computed tomography scan's radiation dose.