Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2017
Pre-operative predictors of post-operative falls in people undergoing total hip and knee replacement surgery: a prospective study.
Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THR patients, and the incidence and circumstances of falls in the 12 months post-surgery. ⋯ People awaiting hip or knee joint replacement surgery might present with complex conditions that predispose them to greater risk of falling post-operation. Review of general health and history of falling is recommended pre-operatively to identify patients at risk.
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Arch Orthop Trauma Surg · Aug 2017
C-reactive protein course during the first 5 days after total knee arthroplasty cannot predict early prosthetic joint infection.
Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection. ⋯ The most important finding of the present study is that neither the absolute p.o. CRP value nor its course in the first 5 days after TKA is suitable for detecting an early infection. In contrast, an increased preoperative CRP value proved to be a valid predictor for septic revision due to an SSI or a PJI after TKA.
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Arch Orthop Trauma Surg · Aug 2017
Case ReportsRecurrent atraumatic acute carpal tunnel syndrome due to hematoma caused by distal radioulnar joint arthritis during anticoagulant treatment with apixaban.
Atraumatic acute carpal tunnel syndrome is a rare type of median nerve neuropathy caused by etiologies that increase compartment pressure in the carpal tunnel. This report describes a patient with flexor tendon abrasion as an unusual complication of distal radioulnar joint arthritis. This abrasion caused a hematoma to form in the carpal tunnel during anticoagulant treatment with apixaban, resulting in recurrent acute carpal tunnel syndrome.
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Arch Orthop Trauma Surg · Aug 2017
Surgical treatment of patellar instability: clinical and radiological outcome after medial patellofemoral ligament reconstruction and tibial tuberosity medialisation.
The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability. ⋯ MPFLR and TTM leed to good clinical results despite its own indications. For this reason-in selected cases-TTM may still be a suitable procedure for surgical treatment of patellar instability. However, patients treated by TTM (group B) revealed an increased retropatellar cartilage damage as well as significantly more pain during activity.
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Arch Orthop Trauma Surg · Aug 2017
Is the AO guideline for postoperative treatment of tibial plateau fractures still decisive? A survey among orthopaedic surgeons and trauma surgeons in the Netherlands.
The standard aftercare treatment (according to the AO guideline) for surgically treated trauma patients with fractures of the tibial plateau is non-weight bearing or partial weight bearing for 10-12 weeks. The purpose of this study was to investigate the current state of practice among orthopaedic surgeons and trauma surgeons in choosing the criteria and the time period of restricted weight bearing after surgically treated tibial plateau fractures. ⋯ This study demonstrates that consensus about the weight bearing aftercare for tibial plateau fractures are limited. A large majority of surgeons do not follow the AO guideline or their own local protocol. More transparent criteria and predictors are needed to design optimal weight-bearing regimes for the aftercare of tibial plateau fractures.