Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2017
Intraoperative adjustment of alignment under valgus stress reduces outliers in patients undergoing medial opening-wedge high tibial osteotomy.
A considerable percentage of outliers with under- or over-correction continue to be reported despite precise preoperative planning and cautious intraoperative correction of lower limb alignment in medial opening-wedge high tibial osteotomy (MOWHTO). The purpose of this study was to determine whether our novel technique for the intraoperative adjustment of alignment under valgus stress reduces the number of outliers in patients undergoing MOWHTO compared to the conventional technique, which corrects alignment according to the cable method only. ⋯ Level III, retrospective comparative study.
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Arch Orthop Trauma Surg · Aug 2017
Robert Mathys Finger prosthesis of the proximal interphalangeal joint: a retrospective case series of 19 joints in 17 patients.
The Robert Mathys (RM) Finger is a hinged type of arthroplasty for the metacarpophalangeal and proximal interphalangeal (PIP) joint that compensates ligament instability. The aim of this study is to evaluate the outcomes and complications of RM Finger arthroplasty of the PIP joint. ⋯ IV.
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Arch Orthop Trauma Surg · Aug 2017
Correlation of serum metal ion levels with pathological changes of ARMD in failed metal-on-metal-hip-resurfacing arthroplasties.
Metal-on-metal-hip-resurfacing arthroplasties (MoMHRAs) have been associated with an increased failure rates due to an adverse-response-to-metal-debris (ARMD) associated with a spectrum of pathological features. Serum levels of cobalt (Co) and chromium (Cr) are used to assess MoMHRAs, with regard to ARMD, but it is not certain whether ion levels correlate with pathological changes in periprosthetic tissues. ⋯ Histological features of both innate and adaptive immune response to metal wear are seen in periprosthetic tissues in cases with both elevated and non-elevated metal ion levels. MoMHRA failures with acceptable ion levels exhibited a pronounced ALVAL response. Although metal ion levels are elevated in most cases of MoMHRA failure due to ARMD, the finding of a normal metal ion level does not exclude this diagnosis.
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Arch Orthop Trauma Surg · Aug 2017
The sinus tarsi approach in displaced intra-articular calcaneal fractures.
Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. ⋯ The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. Level of evidence IV.
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Medial knee instability is a key clinical parameter for assessing ligament injury and arthroplasty success, but current methods for measuring stability are typically either qualitative or involve ionizing radiation. The purpose of this study was to perform a preliminary analysis of whether ultrasound (US) could be used as an alternate approach for quantifying medial instability by comparing an US method with an approach mimicking the current gold standard fluoroscopy method. ⋯ Ultrasound shows promise as a suitable alternative for quantifying medial instability without radiation exposure. However, the outstanding limitations of existing approaches and lack of true ground-truth data require that further validation work is necessary to better understand the clinical viability of an US approach for measuring medial knee gap width.