Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2018
Biomechanical performance of the Actifit® scaffold is significantly improved by selection of irrigation fluid.
Clinical reports on meniscal scaffolds seem promising, albeit relatively paucity exists regarding their biomechanical behavior. The aim of the study is to delineate the impact of differing suture materials and the type as well as the temperature of the irrigation fluid on the pull-out strength of a polyurethane meniscal scaffold (Actifit®). ⋯ This study underlines the potential to improve pull-out strength during implantation of an Actifit® scaffold by alteration of the type of irrigation fluid. Lactated Ringer solution provided the highest construct stability in regard to load-to-failure testing and should be considered whenever implantation of a polyurethane meniscal scaffold is conducted.
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Arch Orthop Trauma Surg · Apr 2018
Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty.
In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA. ⋯ All patients showed malformations, especially high prevalences were found for CAM-deformity, coxa profunda and acetabular retroversion. Identifying these malformations is fairly simple and recognizing the high prevalence may help surgeons avoid pitfalls during implant positioning in THA surgery. Further, focus on hip malformations may facilitate correct referral to joint-preserving surgery before OA develops.
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Arch Orthop Trauma Surg · Apr 2018
Femoral component alignment in unicompartmental knee arthroplasty leads to biomechanical change in contact stress and collateral ligament force in knee joint.
In recent years, the popularity of unicompartmental knee arthroplasty (UKA) has increased. However, the effect of femoral component positioning in UKA continues to invite a considerable debate. The purpose of this study involved assessing the biomechanical effect of mal-alignment in femoral components in UKA under dynamic loading conditions using a computational simulation. ⋯ The results of the study confirm the importance of conservation in post-operative accuracy of the femoral component since the valgus and varus femoral malalignments affect the collateral ligament and lateral compartment, respectively. Our results suggest that surgeons should avoid valgus malalignment in the femoral component and especially malalignment exceeding 9°, which may induce higher medial collateral ligament forces.
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Arch Orthop Trauma Surg · Apr 2018
Posterolateral tibial plateau fractures, how to buttress? Reversed L posteromedial or the posterolateral approach: a comparative cadaveric study.
The selection of a surgical approach for buttressing posterolateral tibial plateau fractures is controversial. ⋯ The PL approach provides better access for buttressing the posterolateral tibial plateau fracture than the R-PM approach. With the R-PM approach, the blind area on the lateral plateau which can be accessed only by the PL approach starts approximately at 43.72% and ends at 81.41% of the lateral tibial plateau width. When a fracture is located in this zone, the posterolateral approach is recommended.
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Arch Orthop Trauma Surg · Apr 2018
Is there a relationship between the load distribution on the tibial plateau and hip knee ankle angle after TKA?
This study asked whether differences in coronal alignment after total knee arthroplasty (TKA) affect the load distribution on the tibial plateau. The aim of this study was to investigate the correlation between coronal alignment and the load distribution on the tibial plateau after TKA, using three-dimensional multi-detector-row-computed tomography (3D-MDCT). ⋯ Therapeutic study, Level III.