Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2019
A novel preoperative scoring system for the indication of unicompartmental knee arthroplasty, as predictor of clinical outcome and satisfaction.
Proper patient selection is a crucial factor for the outcome of the unicompartmental knee arthroplasty (UKA). However, there is still not a clear consensus on which patients could benefit the utmost from a UKA. The purpose of this prospective study was to introduce a novel, preoperative, predictive score (Unicompartmental Indication Score, UIS) to aid proper patient selection in UKA. ⋯ Prospective study, II.
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Arch Orthop Trauma Surg · Jan 2019
The minimalinvasive direct anterior approach in aseptic cup revision hip arthroplasty: a mid-term follow-up.
The minimally invasive direct anterior approach (DAA) is an established approach for primary total hip arthroplasty (THA). The complication rates in hip revision arthroplasty are much higher in comparison with primary THA. A right positioning of the implants and a soft tissue, especially the abductors spearing approach, is important to get good functional results and low complication rates. The aim of this study was to show the clinical and radiological outcome of isolated revision hip arthroplasty of the cup by using the DAA. ⋯ The DAA represents a feasible option in hip revision arthroplasty. Anatomic reconstruction of the cup is reproducibly possible. Good medium-term results can also be achieved. Particularly in relation to dislocation, the complication rates are low. Due to the learning curve, the DAA should only be used in hip revision arthroplasty by those with sufficient experience in primary THA. Adequate data regarding stem revisions through the DAA are not available at the moment.
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Arch Orthop Trauma Surg · Jan 2019
Case ReportsDorsal buttress plate fixation for the treatment of fracture-dislocation of the fifth carpometacarpal joint with avulsion fracture of the hamate: a case report.
Fracture-dislocations of the fourth and fifth carpometacarpal (CMC) joints present a complex situation. Misdiagnosis and inadequate treatment may cause malunion and residual subluxation, which lead to painful arthritis and grip weakness. Open reduction along with internal fixation is the treatment of choice, but there is no consensus on an optimal treatment approach. ⋯ Six months postoperatively, bone union was achieved and the reduction of the fourth and fifth CMC joints was maintained. Range of motion of the fourth and fifth CMC joints was almost equal to that on the contralateral side. Dorsal buttress plating between the hamate and the capitate could be an alternative technique for the treatment of fracture-dislocation of the fifth CMC joint with avulsion fracture of the hamate.
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Arch Orthop Trauma Surg · Jan 2019
The survivorship of the link endo-rotational hinge total knee arthroplasty: 5-12-year follow-up of 100 patients.
There is a paucity of survival data reporting the medium to long-term outcome of the LINK® Endo-Model® rotational hinge total knee arthroplasty (ERH-TKA). Such information is essential when counselling patients and predictors of survival would help inform patients of their likely outcome. ⋯ The ERH-TKA has a good medium- to long-term survival rate but male patients are nearly twice as likely to undergo revision, compared to females, and should be made aware of this preoperatively.
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Arch Orthop Trauma Surg · Jan 2019
Cell-free cartilage repair in large defects of the knee: increased failure rate 5 years after implantation of a collagen type I scaffold.
Cartilage defects of the knee remain a challenging problem in orthopedic surgery despite the ongoing improvements in regenerative procedures such as the autologous chondrocyte transplantation. Due to the lack of donor-site morbidity and the single-stage procedure cell-free scaffolds are an interesting alternative to cell-based procedures. But as currently mid- and long-term data are lacking, the aim of the present study was to present mid-term clinical, radiological and histological results of a cell-free collagen type I scaffolds for cartilage repair. ⋯ The use of this cell-free collagen type I scaffold for large defects showed increased wear of the repair tissue and clinical failure in 18% of cases at 5-year follow-up.