Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2018
Observational StudyFTFA change under valgus stress force radiography is useful for evaluating the correctability of intra-articular varus deformity in UKA.
The aim of this observational study was to investigate the postoperative alignment change with Oxford unicompartmental knee arthroplasties (UKA), and clarify whether femoro-tibial facet angle (FTFA) is useful for evaluating alignment correctability with UKA. ⋯ FTFA change under valgus stress force was useful for evaluating the correctability of UKA. It could reflect intra-articular varus deformity. Intra-articular varus deformity not corrected under valgus stress would result in varus after UKA. However, intra-articular deformity which could be overcorrected under valgus stress would have a tendency to valgus after Oxford UKA.
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Arch Orthop Trauma Surg · Jul 2018
Fragility fractures of the sacrum occur in elderly patients with severe loss of sacral bone mass.
Patients suffering from osteoporosis-associated fragility fractures of the sacrum (FFS; also termed sacral insufficiency fractures) are increasingly observed. They have typical fracture patterns with fracture lines located in the sacral ala. When treating these patients operatively, iliosacral screw loosening is not uncommon. We aimed to study the sacral bone mass in patients presenting with a FFS using 3D statistical models. ⋯ The extensive area of negative HU may explain the fracture location in the sacral ala. The low HU in the sacral bodies advocates the use of trans-sacral implants or augmented iliosacral screws to enhance the strength of fracture fixation. The increased HU in the fractured ala could be explained by fracture-asssociated hemorrhage and can be used as a diagnostic tool.
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Arch Orthop Trauma Surg · Jul 2018
ReviewIntralesional vs. extralesional procedures for low-grade central chondrosarcoma: a systematic review of the literature.
Chondroid lesions are very common bone tumors. In most cases, they are benign enchondromas (EC) and, in a minor percentage, chondrosarcomas (CSs), the malignant counterpart. In the latter cases, surgery is the mainstay treatment, because they are chemo- and radio-resistant unless dedifferentiation occurs. If resection is recognized as the gold standard for intermediate-, high-grade tumors, and for low-grade chondrosarcoma (LG-CS) located in the spine and pelvis to reduce the risk of local recurrence, there is still no consensus in literature on the treatment of central low-grade chondrosarcoma (cLG-CS) located in the limbs. Our aim is to perform a review of literature on evidence supporting this approach or not. ⋯ The absence of a preoperative histological diagnosis and the lack of a scientific method to conduct the studies do not sufficiently support curettage for low-grade chondrosarcomas. In the absence of this, resection must be considered a general rule for every malignancy. In our opinion, based on the low biological growth rate of low-grade chondrosarcoma, every chondromatous lesion can be followed-up. Biopsies must be performed based on clinical and radiological suspicions such as pain, scalloping or increase in size, rather than on performing a PET scan to evidence more informative high metabolic areas.
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Arch Orthop Trauma Surg · Jul 2018
Periprosthetic acetabular radiolucency progression in mid-term follow-up of the articular surface replacement hip system.
Recent registry studies show that aseptic loosening secondary to osteolysis is the second leading cause of hip implant failure in patients implanted with metal-on-metal (MoM) bearings. The primary aim of our study was to report on the progression of acetabular osteolysis during mid-term follow-up in patients treated with MoM hip resurfacing arthroplasty (HRA) and MoM total hip arthroplasty (THA). The secondary aim was to identify independent predictors of osteolytic lesion progression. ⋯ We suggest that physicians of patients implanted with ASR HRA implants closely monitor patients with higher chromium levels and lower version angles, as they are at increased risk for osteolytic lesion progression, and we recommend annual radiographic follow-up on all patients with ASR implants.
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Arch Orthop Trauma Surg · Jul 2018
Multicenter StudyEvaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis.
The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. ⋯ Descriptive Epidemiologic Study, Level II.