Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2018
The epicondylar ratio can be reliably used on X-ray of the knee to determine the joint line.
The epicondylar ratio (ER) is used to restore the individual joint line (JL), especially in revision total knee arthroplasty. It was first described in magnetic resonance imaging (MRI) but is usually applied to a.p. radiographs of the knee for preoperative planning. The objective of the current study was to define reliable landmarks in MRI and X-ray images of the knee, which allow comparison of the image modalities. Furthermore, the correlation of the measured ER in MRI and X-rays of the knee was calculated. ⋯ The ER can be determined reliably on MRI and X-ray images of the knee. The correlation of the ER in MRI and X-ray is fair.
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Arch Orthop Trauma Surg · Sep 2018
An often-unrecognized entity as cause of recurrent infection after successfully treated two-stage exchange arthroplasty: hematogenous infection.
Reinfection after two-stage exchange arthroplasty is a difficult clinical scenario with limited data on adequate treatment algorithms. Beside the possibility of treatment failure and a new intraoperative infection at the time of reimplantation, hematogenous seeding could play an up to date underestimated crucial role as another cause of an infection after two-stage exchange. The aim of this study was to evaluate its incidence and treatment possibilities in a prospectively followed case series. ⋯ Hematogenous infection after a successful two-stage exchange arthroplasty is a rare but very important cause of a reinfection. With our work, we aim at raising the awareness for this entity and recommend consideration of irrigation and debridement with implant retention in these cases, as well as possibly the identification of a primary infection source.
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Arch Orthop Trauma Surg · Sep 2018
Arthroscopic debridement for septic arthritis of the shoulder joint: post-infectious arthritis is an inevitable consequence?
The purpose of this study was to compare clinical outcomes and development of post-infectious arthritis of the shoulder joint after single (Group S) or repeated (Group R) arthroscopic debridement surgeries. We hypothesized that (1) repeated surgeries might be attributable to initial subchondral involvement resulting from septic arthritis and (2) the repeated surgery group would exhibit a higher incidence of post-infectious arthritic changes and inferior clinical outcomes due to prolonged resolution of the infection. ⋯ Retrospective comparative study, III.
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Arch Orthop Trauma Surg · Sep 2018
Differences between traumatic and non-traumatic causes of ACL revision surgery.
The purpose of this study was to evaluate and classify causes for anterior cruciate ligament (ACL) reconstruction failure. It was hypothesized that specific technical and biological reconstruction aspects would differ when comparing traumatic and non-traumatic ACL reconstruction failures. ⋯ Technical causes, particularly tunnel malpositioning, were significantly correlated with increased incidence of non-traumatic ACL reconstruction failure. Transtibial femoral tunnel positioning techniques and femoral transfixation techniques, showed an increased incidence of non-traumatic, earlier graft failure.
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Arch Orthop Trauma Surg · Sep 2018
Treatment of infra-isthmal femoral fracture with an intramedullary nail: Is retrograde nailing a better option than antegrade nailing?
Antegrade intramedullary (IM) nailing is ideal for femoral shaft fractures, but fixing the fracture distal to the isthmal level may be difficult because of medullary canal widening and the proximity of fracture location from the distal femoral joint line. This study aimed to compare treatment results between antegrade and retrograde nailing for infra-isthmal femoral shaft fracture, and to identify influencing factors of nonunion and malalignment. ⋯ Although no significant difference was found in IM nail type, the IM nail with a shorter working length distal to the fracture showed a strong relationship with nonunion.