Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2017
ReviewLower limb reconstruction in tumor patients using modular silver-coated megaprostheses with regard to perimegaprosthetic joint infection: a case series, including 100 patients and review of the literature.
Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used. Patients undergoing tumor-related endoprosthetic orthopedic surgery are facing high risk for developing a periprosthetic joint infection (PJI). The immunocompromised condition due to anti-neoplastic treatment and long operation time with large exposure of tissue contributes to a high risk of infection. ⋯ In conclusion, our own results show that perimegaprosthetic joint infection among silver-coated implants, in patients undergoing tumor-related surgery of the lower limb, is lower compared to non-silver-coated implants. Due to heterogeneity of patients and potential treatment options, the treatment regime should be tailored for the patients' individual situation.
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Arch Orthop Trauma Surg · Feb 2017
Multicenter StudyThe burden of rotator cuff surgery in Italy: a nationwide registry study.
This study aimed to estimate the yearly number of RC surgeries in Italy, a country with universal access to healthcare for its population, from 2001 to 2014, based on official information source as hospitalization records. A secondary aim was to explore geographical variation in equity in access to RC surgery between three macroregions of Italy (North, Center and South). A tertiary aim was to perform statistical projections of the number of RC procedure volumes and rates on the basis of data from 2001 to 2014. Finally, we aimed to perform a prediction of charges by 2025 to examine the economic impact of RC surgery. ⋯ II.
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Arch Orthop Trauma Surg · Feb 2017
Randomized Controlled TrialModified step aerobics training and neuromuscular function in osteoporotic patients: a randomized controlled pilot study.
Training programs directed to improve neuromuscular and musculoskeletal function of the legs are scarce with respect to older osteoporotic patients. We hypothesized that a modified step aerobics training program might be suitable for this purpose and performed a randomized controlled pilot study to assess the feasibility of conducting a large study. Here we report on the training-related effects on neuromuscular function of the plantar flexors. ⋯ It is worthwhile to investigate efficacy of this training program in a large randomized trial. However, a detailed neuromuscular assessment appears feasible only in a subset of participants.
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Arch Orthop Trauma Surg · Feb 2017
Predictors of medium-term clinical outcomes after total shoulder arthroplasty.
The study aims to measure the relationship of potential clinical and radiographic predictors and medium-term clinical outcomes after total shoulder arthroplasty in primary osteoarthritis. ⋯ A higher Walch classification is a negative predictor for the postoperative clinical function. The proven significant negative effect on outcomes in total shoulder arthroplasty emphasizes the importance of the preoperative evaluation of humeral head subluxation and glenoid erosion, which are associated with less favorable postoperative results. The measured internal patient variables gave no negative predictions on the medium-term clinical outcomes in the study population.
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Arch Orthop Trauma Surg · Feb 2017
Case ReportsSurgical treatment of two adolescent athletes with dislocated avulsion fracture of the anterior superior iliac spine (ASIS).
Avulsion fractures of the anterior superior iliac spine are rare. Therefore, evidence-based treatment guidelines do not exist. The therapeutic options are either conservative treatment or surgical intervention. The decision depends on grade of dislocation, age of the patient, and his sportive demands and competitive requirements. ⋯ Operative treatment of avulsion fracture of the ASIS using suture anchors shows excellent clinical outcome and a short convalescence period. The patients achieve their preinjury sportive levels within 3 months.