Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2019
Case ReportsRetrograde fixation of the lesser trochanter in the adolescent: new surgical technique and clinical results of two cases.
Avulsions of the lesser femoral trochanter are rare injuries in the adolescent population. An acute avulsion causes severe functional impairment with compromised hip flexion. Recent literature reports the superiority of surgical treatment for apophyseal avulsion fractures of the pelvis in adolescents. Unfortunately, there are no guidelines for an evidence-based treatment of lesser trochanter avulsions established. We present the cases of two adolescent athletes treated operatively. ⋯ The retrograde fixation technique has led to an excellent outcome without complications in two adolescents with acute lesser trochanter apophyseal avulsions. Further clinical use may support the value of this new surgical technique.
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Arch Orthop Trauma Surg · Apr 2019
An accelerometer-based navigation did not improve the femoral component positioning compared to a modified conventional technique of pre-operatively planned placement of intramedullary rod in total knee arthroplasty.
Although the most commonly used method of femoral component alignment in total knee arthroplasty (TKA) is intramedullary (IM) guides, this method demonstrated a limited degree of accuracy. Because of the femoral anterior bowing, the tip of the guide rod will impinge on the anterior cortex if a long rod is inserted. We hypothesized that the pre-operative planned insertion depth of the rod could increase the accuracy of the femoral component positioning in conventional TKA (modified conventional technique). Accelerometer-based, portable navigation device has been postulated to have better accuracy than conventional TKA in component positioning. The purpose of this study was to compare the post-operative femoral component alignment of TKA using the modified conventional technique with the accelerometer-based navigation. ⋯ The modified conventional technique is a simple and equal to or more accurate method than the accelerometer-based navigation in positioning the femoral component in TKA at a mid-volume hospital.
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Arch Orthop Trauma Surg · Mar 2019
Meta AnalysisDoes unicompartmental knee arthroplasty have worse outcomes in spontaneous osteonecrosis of the knee than in medial compartment osteoarthritis? A systematic review and meta-analysis.
The role of unicompartmental knee arthroplasty (UKA) in spontaneous osteonecrosis of the knee (SONK) remains controversial, even though SONK involves only one compartment of the knee joint. We aimed to compare the survival rate and clinical outcomes of UKA in SONK and medial compartment osteoarthritis (MOA) via a meta-analysis of previous studies. ⋯ Cemented UKA has similar survival and clinical outcomes in SONK and MOA. Prospective studies designed specifically to compare the UKA outcomes in SONK and MOA are necessary.
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Arch Orthop Trauma Surg · Mar 2019
Arthroscopic excision of wrist ganglions: does trans-cystic or cystic-sparing portal technique affect clinical outcomes?
The preliminary results of arthroscopic wrist ganglionectomy were contradictory. The approach used for the arthroscopic excision of wrist ganglions may play an important role. We analyzed two surgical approaches for arthroscopic excision of wrist ganglions. ⋯ For performing arthroscopic resection of wrist ganglions, both techniques are safe regarding the complication rates. In recurrence rate, no significant difference was found between the two groups, but no recurrence was observed when the TCP technique was used.
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Arch Orthop Trauma Surg · Mar 2019
Outcome of short versus long interval in two-stage exchange for periprosthetic joint infection: a prospective cohort study.
A two-stage exchange is the standard treatment approach for chronic periprosthetic joint infection (PJI). While a 6-8 week interval is commonly used before reimplantation, the optimal length of the prosthesis-free interval has not yet been determined. We evaluated the influence of a short (< 4 weeks) and long (≥ 4 weeks) interval on reinfection rate and functional outcome of hip and knee PJI. ⋯ This study suggests that two-stage exchange with short interval has a similar outcome than with long interval, when highly active antibiotic therapy is used. Patient inconvenience and care costs due to immobilization were lower when strategies with a short interval were used.