Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2018
ReviewIntralesional vs. extralesional procedures for low-grade central chondrosarcoma: a systematic review of the literature.
Chondroid lesions are very common bone tumors. In most cases, they are benign enchondromas (EC) and, in a minor percentage, chondrosarcomas (CSs), the malignant counterpart. In the latter cases, surgery is the mainstay treatment, because they are chemo- and radio-resistant unless dedifferentiation occurs. If resection is recognized as the gold standard for intermediate-, high-grade tumors, and for low-grade chondrosarcoma (LG-CS) located in the spine and pelvis to reduce the risk of local recurrence, there is still no consensus in literature on the treatment of central low-grade chondrosarcoma (cLG-CS) located in the limbs. Our aim is to perform a review of literature on evidence supporting this approach or not. ⋯ The absence of a preoperative histological diagnosis and the lack of a scientific method to conduct the studies do not sufficiently support curettage for low-grade chondrosarcomas. In the absence of this, resection must be considered a general rule for every malignancy. In our opinion, based on the low biological growth rate of low-grade chondrosarcoma, every chondromatous lesion can be followed-up. Biopsies must be performed based on clinical and radiological suspicions such as pain, scalloping or increase in size, rather than on performing a PET scan to evidence more informative high metabolic areas.
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Arch Orthop Trauma Surg · Jul 2018
Observational StudyFTFA change under valgus stress force radiography is useful for evaluating the correctability of intra-articular varus deformity in UKA.
The aim of this observational study was to investigate the postoperative alignment change with Oxford unicompartmental knee arthroplasties (UKA), and clarify whether femoro-tibial facet angle (FTFA) is useful for evaluating alignment correctability with UKA. ⋯ FTFA change under valgus stress force was useful for evaluating the correctability of UKA. It could reflect intra-articular varus deformity. Intra-articular varus deformity not corrected under valgus stress would result in varus after UKA. However, intra-articular deformity which could be overcorrected under valgus stress would have a tendency to valgus after Oxford UKA.
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Arch Orthop Trauma Surg · Jul 2018
ReviewApplication and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.
The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. ⋯ For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as moderate responsiveness in patients with upper extremity conditions.
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Arch Orthop Trauma Surg · Jul 2018
Periprosthetic acetabular radiolucency progression in mid-term follow-up of the articular surface replacement hip system.
Recent registry studies show that aseptic loosening secondary to osteolysis is the second leading cause of hip implant failure in patients implanted with metal-on-metal (MoM) bearings. The primary aim of our study was to report on the progression of acetabular osteolysis during mid-term follow-up in patients treated with MoM hip resurfacing arthroplasty (HRA) and MoM total hip arthroplasty (THA). The secondary aim was to identify independent predictors of osteolytic lesion progression. ⋯ We suggest that physicians of patients implanted with ASR HRA implants closely monitor patients with higher chromium levels and lower version angles, as they are at increased risk for osteolytic lesion progression, and we recommend annual radiographic follow-up on all patients with ASR implants.
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Arch Orthop Trauma Surg · Jul 2018
ReviewMetaphyseal sleeves in total knee arthroplasty revision: complications, clinical and radiological results. A systematic review of the literature.
Total knee arthroplasty revision (TKAr) is increasing of relevance in orthopaedic surgeon daily practice and will become more and more relevant in the future. The aim of this study is to summarize indications, complications, clinical and radiological mid-term results of metaphyseal sleeves in management of bone defects in TKAr. ⋯ Metaphyseal sleeves represent a viable option in management of types IIb and III AORI bone defects in TKAr. Further high-quality log-term studies would better clarify complications, clinical and radiological results of this promising technique in total knee arthroplasty revision.