Archives of orthopaedic and trauma surgery
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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.
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Arch Orthop Trauma Surg · Mar 2020
Review Meta AnalysisLaboratory-based versus qualitative assessment of α-defensin in periprosthetic hip and knee infections: a systematic review and meta-analysis.
Two methods are currently available for the assay of α-defensin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test. We aimed to assess the diagnostic accuracy of synovial fluid α-defensin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection. ⋯ Detection of α-defensin is an accurate test for diagnosis of hip and knee prosthetic infections. The diagnostic accuracy of the two alpha-defensin assessment methods is comparable. The lateral flow assay is a valid, rapid, and more available diagnostic tool, particularly to rule out PJI.
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Arch Orthop Trauma Surg · Mar 2020
ReviewAcetabular custom-made implants for severe acetabular bone defect in revision total hip arthroplasty: a systematic review of the literature.
The management of acetabular bone loss is a challenging problem in revision total hip arthroplasty (rTHA). The aim of this systematic review is to summarize and critically analyze indications, complications, clinical and radiological outcomes of custom-made acetabular components in rTHA. ⋯ The acetabular custom-made implants represent a reliable solution for pelvic discontinuity and particular cases of bone loss classified as Paprosky Type IIIA-B or type III-IV according to American Academy of Orthopaedic Surgeons system where the feature of the defect cannot be handled with standard implants. This strategy allows to fit the implant to the residual host bone, bypassing the bony deficiency and restoring hip biomechanics. Satisfactory clinical and radiological outcomes at mid-term follow-up are reported in literature.
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Arch Orthop Trauma Surg · Mar 2020
Comparative StudySecond-look arthroscopic findings and clinical outcomes of meniscal repair with concomitant anterior cruciate ligament reconstruction: comparison of suture and meniscus fixation device.
The purpose of this study was to evaluate the healing rate of repaired meniscus and functional outcomes of patients who received all-inside meniscal repair using sutures or devices with concomitant arthroscopic anterior cruciate ligament (ACL) reconstruction. ⋯ Among the patients who received meniscal repair with concomitant ACL reconstruction, suture group showed better healing status of repaired meniscus based on the second-look arthroscopy than device group. However, no significant between-group difference of clinical success rate and functional outcomes was observed.