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
Relationship between spinal sagittal alignment and acetabular coverage: a patient-matched control study.
The significance of the relationship between the spine and hip joints has been frequently discussed. However, the relationship between acetabular coverage and spinal sagittal alignment has not been fully elucidated as previous studies did not adequately control for factors that might affect the spinopelvic alignment. The aim of this study was to elucidate the impact of acetabular coverage on spinal sagittal alignment by comparing patient groups matched on sex, age, and the presence of hip and anterior impingement pain. ⋯ The SS and LL were greater in patients with DDH than in patients with hip pain, but without DDH. Patients with DDH might show lumbar hyperlordosis to rotate the pelvis anteriorly, increasing the anterosuperior acetabular coverage.
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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
Mid-term clinical results of an arthroscopic glenoid rim reconstruction technique for recurrent anterior shoulder instability.
Glenoid bone loss in recurrent anterior instability of the shoulder needs to be addressed to restore joint stability. Over the last years, several arthroscopic methods have been described to treat this condition. However, no clinical mid-term results have been presented for arthroscopic iliac crest bone grafting procedures. ⋯ The all-arthroscopic glenoid reconstruction using iliac crest grafts shows good functional results with a recurrence rate of 9%. At final follow-up 42 months after surgery, our patients showed low pain levels and acceptable complications.
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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.