Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2022
ReviewPeriprosthetic fractures after medial unicompartmental knee arthroplasty: a narrative review.
On rare occasions, fractures of the tibial plateau may occur after uni-compartmental knee arthroplasty (UKA) and account for 2% of total UKA failures. The purpose of this narrative review is to identify and discuss potential risk factors that might lead to prevention of this invalidating complication. ⋯ Peri-prosthetic fracture is a rare, but troublesome event, which can lead to implant failure and revision surgery. Better knowledge of the multifactorial risk factors in association with a thorough surgical technique is key for prevention.
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Arch Orthop Trauma Surg · Aug 2022
Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate.
The guidelines regarding rehabilitation after pediatric anterior cruciate ligament reconstruction (ACLR) are sparse. The aim of the study was to retrospectively describe the long-term outcome regarding further surgery and with special emphasis on the revision rate after two different postoperative rehabilitation programs following pediatric ACLR. ⋯ Case-control study, Level III.
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Arch Orthop Trauma Surg · Aug 2022
Randomized Controlled TrialBiomechanical evaluation of interference screw fixation techniques for distal radioulnar ligament reconstruction: a cadaveric experimental study.
In the reconstruction of distal radioulnar ligaments (DRULs), interference screws can be used for antegrade or retrograde fixation of grafts to the ulna. However, the biomechanics of interference screw fixation are currently unknown. This study aimed to determine the biomechanical effects of these two fixations on the distal radioulnar joint (DRUJ) in a cadaveric model and to investigate the appropriate initial tension. ⋯ Compared with retrograde fixation, the antegrade fixation of interference screws may be a more reliable surgical technique, as it shows a higher failure load and stability. In addition, to avoid the risk of potential arthritis caused by anterograde fixation, we propose an equation to determine the appropriate initial tension in DRUL reconstruction.
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Arch Orthop Trauma Surg · Aug 2022
Comparative StudyHigher sensitivity with the lever sign test for diagnosis of anterior cruciate ligament rupture in the emergency department.
The objective of this study was to assess the diagnostic value of the "lever sign test" to diagnose ACL rupture and to compare this test to the two most commonly used, the Lachman and anterior drawer test. ⋯ When investigating acute ACL ruptures (< 8 days) in the ED, the lever sign test offers a sensitivity of 92.5%, far superior to that of other well-known clinical tests. The lever sign test is relatively pain-free, easy to perform and its visual interpretation requires less experience. Positive lever sign test at the ED should lead to an MRI to combine high clinical sensitivity with high MRI specificity.
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Arch Orthop Trauma Surg · Aug 2022
Hip kinematics and kinetics in patients with femoroacetabular impingement syndrome before and 1 year after hip arthroscopic surgery. Results from the HAFAI cohort.
Patients with femoroacetabular impingement syndrome (FAIS) experience decreased function. Consequently, earlier studies have evaluated gait biomechanics in these patients, but a larger study evaluating gait biomechanics before and after an intervention standardising gait speed is lacking. We aimed at investigating gait kinematics and kinetics in patients with FAIS compared with pain-free controls before and 1 year after hip arthroscopic surgery. Secondary, we aimed at analysing gait pattern separately for the sexes and to investigate associations between peak kinematics and kinetics and the Copenhagen Hip and Groin Outcome Score (HAGOS). ⋯ Gait pattern was only vaguely altered in patients with FAIS compared with pain-free controls before and after surgery when using at standardised gait speed. Hence, analysing gait in patients with FAIS does not seem of major importance. Nevertheless, there was an association between HAGOS Sports function and peak kinematics and kinetics in male patients, implying that there could be a clinical importance.