Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2020
Total hip arthroplasty following acetabular fracture: a clinical and radiographic outcome analysis of 67 patients.
Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures. ⋯ The decrease of the interval between injury and arthroplasty was associated with increasing patient age (p = 0.001) and surgical treatment of the acetabular fracture (p = 0.04). Complex fracture patterns were accompanied by acetabular bone defects more often than simple patterns (p = 0.03). Overall, arthroplasty due to posttraumatic osteoarthritis after acetabular fracture resulted in decreased overall survival rates and poorer clinical outcome as compared to primary arthroplasty.
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Arch Orthop Trauma Surg · Mar 2020
The entry point of intramedullary tibia cutting guide should vary according to the individual tibia morphology in TKA.
In total knee arthroplasty (TKA) using the intramedullary tibial cutting guide (IMTCG), the positioning of the IMTCG is important for accurate tibial bone resection. The aim of this study was to evaluate the ideal entry point of IMTCG and affecting radiologic factors. ⋯ The ideal entry point of IMTCG should vary according to the individual tibial morphology.
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Arch Orthop Trauma Surg · Mar 2020
Corrective osteotomies of femur and tibia: which factors influence bone healing?
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing. ⋯ Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.
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Arch Orthop Trauma Surg · Mar 2020
Analysis of computed tomography-based infra-acetabular morphometry to assess the feasibility of infra-acetabular screws.
The number of pelvic fractures based on osteoporosis has been increasing. The infra-acetabular screw (IAS), which connected both osseous columns, is a safe method of screw placement going through the infra-acetabular corridor (IAC). However, the specifics of the anatomy of IAC have been far from completely understood, especially in the Asian population. The purpose of our study was to reveal the details of the IAC using computed tomography (CT) data. ⋯ Surgeons should pay attention to the fact that over 20% of IACs are not feasible for infra-acetabular screw placement even with the perfect reduction of fragments when treating acetabular fractures.
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Arch Orthop Trauma Surg · Mar 2020
Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU).
Focal cartilage defects of the knee are often treated with arthroscopic debridement. Existing literature discussing the benefit of debridement for small articular cartilage lesions is scarce, especially if the debridement was not part of a combined operative cartilage procedure including meniscal and ligament repair. The purpose of this study was to examine the patients´ benefit after arthroscopic debridement for the treatment of isolated focal chondral defects with or without partial meniscus resection. ⋯ An overall benefit of arthroscopic debridement for focal cartilage lesions of the knee could be conducted. Isolated cartilage defects seem to benefit from debridement irrespectively of size. In patients with large cartilage defects (> 2 cm2) and concurrent meniscal pathology expectation to improvement should be humbled. Effective reduction of pain by arthroscopic debridement remains unclear.