Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2015
Double mobility cup total hip arthroplasty in patients at high risk for dislocation: a single-center analysis.
Double mobility cup systems (DMCS) have gained increasing acceptance, especially in patients at high risk for dislocation. The aim of this investigation was to analyze the frequency and indications of the DMCS use in our praxis and to evaluate dislocation and cup revision rates after a minimum follow-up of 2 years. ⋯ This study supports the use of DMCS constructs in primary and revision hip arthroplasty for specific high-risk patients. We continue to indicate DMCS in this patient group. We do caution against extending indications for DMCS to lower risk patient groups due to unknown issues surrounding wear and component longevity.
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Arch Orthop Trauma Surg · Dec 2015
Meniscal tears associated with anterior cruciate ligament injury.
To investigate the frequency of meniscal tear and the location of tear associated with anterior cruciate ligament (ACL) injury. ⋯ The incidence of meniscal tear associated with ACL injury is higher in chronic cases; the number of medial meniscal tears is particularly high, many of which require meniscectomy. Early ACL reconstruction is recommended also for the prevention of secondary meniscal tear.
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Arch Orthop Trauma Surg · Dec 2015
The required minimum length of video sequences for obtaining a reliable interobserver diagnosis in wrist arthroscopies.
To examine the relationship between video length for wrist arthroscopy and interobserver reliability. ⋯ Diagnostic II.
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Arch Orthop Trauma Surg · Dec 2015
Interpretation of hip fracture patterns using areal bone mineral density in the proximal femur.
Bone mineral density scans are currently interpreted based on an average score of the entire proximal femur. Improvements in technology now allow us to measure bone density in specific regions of the proximal femur. The study attempts to explain the pathophysiology of neck of femur (NOF) and intertrochanteric/basi-cervical (IT) fractures by correlating areal BMD (aBMD) scores with fracture patterns, and explore possible predictors for these fracture patterns. ⋯ Hip fracture patterns following low energy trauma may be influenced by the pattern of reduced bone density in different areas of the hip. Intertrochanteric/basi-cervical fractures were associated with significantly lower T-Troc and T-Inter scores compared to neck of femur fractures, suggesting that the fracture traversed through the areas with the lowest bone density in the proximal femur. In the absence of reduced T.Troc and T.Inter, neck of femur fractures occurred more commonly. T-Total scores may underestimate the severity of osteoporosis/osteopenia and measuring T-score at the neck of femur may better reflect the severity of osteoporosis and likelihood of a fragility fracture.
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Arch Orthop Trauma Surg · Dec 2015
Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures.
Postoperative complications after hip fractures in osteoporotic bone such as implant cutout can be reduced by the use of specially designed implants or additional cement augmentation. It is not yet clear at which degree of osteoporosis, patients will profit from implant augmentation or specially designed implants for geriatric patients. As the surgeon ideally should obtain information on local bone quality at the site of implant anchorage already preoperatively, the aim of the study was to develop an easily applicable radiographic method to estimate bone quality in those patients. ⋯ The proposed method is an easily applicable, reliable and useful tool to estimate bone quality preoperatively using the contralateral hip as a reference. Obtained data may facilitate the decision-making towards the use of further therapeutic measures to improve implant anchorage in osteoporotic bone such as bone cement augmentation. Thus, our method allows for a more individualized surgical treatment of hip fracture patients adapted to the estimated cancellous bone quality of the patient.