Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2016
Systemic antibiotic therapy does not significantly improve outcome in a rat model of implant-associated osteomyelitis induced by Methicillin susceptible Staphylococcus aureus.
Treatment of implant-associated osteomyelitis regularly involves the use of systemic antibiotics in addition to surgical intervention. However, it remains unclear if perioperative systemic application of bactericide substances can improve overall outcome in models of severe intramedullary infection. The present study investigated the use of systemic gentamicin in addition to a controlled local release from a highly lipophilic gentamicinpalmitate compound while the previous study showed efficacy of sole antibiotic implant-coating. ⋯ Systemic perioperative and implant-associated application of antibiotics were both comparably effective to treat implant-associated infections whereas the combined antibiotic therapy further reduced systemic signs of infection time dependent.
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Arch Orthop Trauma Surg · Apr 2016
Clinical TrialStrength does not influence knee function in the ACL-deficient knee but is a correlate of knee function in the and ACL-reconstructed knee.
Knee function, whether anterior cruciate ligament (ACL)-deficient or ACL-reconstructed, is related to many conditions, and no single biomechanical variable can be used to definitively assess knee performance. The purpose of this study was to investigate the relationship between extension and flexion muscle strength and knee function in patients prior and following ACL reconstruction. ⋯ The findings of this study suggest that neither extension nor flexion peak torque were correlates of knee function in the ACL-deficient knee. However, leg symmetry indices were correlated to knee function. In the ACL-reconstructed knee, knee symmetry indices were not related to knee function but extension and flexion isokinetic concentric and isometric peak torque were.
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Arch Orthop Trauma Surg · Mar 2016
Observational StudyPerioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation.
Hypovitaminosis D is common in patients undergoing orthopaedic trauma surgery. While previous studies have shown that vitamin D levels correlate with functional outcome after hip fracture surgery, the significance of vitamin D levels on outcomes after surgery in other orthopaedic trauma patients is unknown. The purpose of this study was to determine if vitamin D levels correlated with outcomes in ankle fracture patients. ⋯ In our group of patients with operative treated ankle fractures, preoperative vitamin D deficiency correlated with inferior clinical outcomes at a minimum of 1 year follow-up. Our study suggests that deficient vitamin D levels may result in worse outcomes in orthopaedic trauma patients recovering from fracture fixation.
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Arch Orthop Trauma Surg · Mar 2016
Randomized Controlled Trial Comparative StudyContinuous adductor canal block versus continuous femoral nerve block after total knee arthroplasty for mobilisation capability and pain treatment: a randomised and blinded clinical trial.
Continuous femoral nerve blocks for total knee arthroplasty can cause motor weakness of the quadriceps muscle and thus prevent early mobilisation. Perioperative falls may result as an iatrogenic complication. In this randomised and blinded trial, we tested the hypothesis that a continuous adductor canal block is superior to continuous femoral nerve block regarding mobilisation ('timed up-and-go' test and other tests) after total knee arthroplasty under general anaesthesia. ⋯ Concerning the mobilisation capability, we did not actually observe a superior effect of CACB compared with CFNB technique in our patients following total knee arthroplasty. Moreover, no difference was observed concerning analgesia quality.
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Arch Orthop Trauma Surg · Mar 2016
Comparative StudyProphylactic augmentation of the proximal femur: an investigation of two techniques.
Osteoporotic hip fractures are an increasing problem in an ageing population. They result in high morbidity, mortality and high socioeconomic costs. For patients with poor bone quality, prophylactic augmentation of the proximal femur might be an option for fracture prevention. ⋯ Limited V-shaped PMMA augmentation and PFNA blade insertion did not show any improvement in failure load or energy to failure. Volumes of up to 15 ml PMMA did not cause a critical surface temperature increase.