Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2015
Randomized Controlled TrialTemperature-controlled continuous cold flow device versus traditional icing regimen following anterior cruciate ligament reconstruction: a prospective randomized comparative trial.
Anterior cruciate ligament (ACL) reconstruction requires an intensive rehabilitation program to be completely successful. Cryotherapy has been described to be helpful in reducing post-operative pain and edema. Aim of this prospective randomized study is to compare two homogeneous groups of patients, one receiving traditional icing regimen and the other a temperature-controlled continuous cold flow device, in post-operative setting after ACL reconstruction. ⋯ II.
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Arch Orthop Trauma Surg · Oct 2015
Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.
In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. ⋯ Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.
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Arch Orthop Trauma Surg · Oct 2015
ReviewCurrent status of second-look arthroscopy after meniscal allograft transplantation: review of the literature.
Clinical assessments do not accurately reflect the status of meniscal transplants and cannot evaluate the graft condition itself and joint preservation effects of meniscal allograft transplantation correctly. The purpose of this review was to assess the need and to ascertain the indication and the role of second-look arthroscopy for objective evaluation after MAT. ⋯ Although second-look arthroscopy has inevitably ethical issues, especially for asymptomatic and well-functioning knees, in this review, it could be a more dependable method available to detect meniscal healing if performed for certain indications such as a symptomatic patient with a magnetic resonance image indicating abnormalities.
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Arch Orthop Trauma Surg · Oct 2015
The outcome of infected total knee arthroplasty: culture-positive versus culture-negative.
We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA). ⋯ The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.
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Arch Orthop Trauma Surg · Oct 2015
Improved identification of polymicrobial infection in total knee arthroplasty through sonicate fluid cultures.
Periprosthetic joint infection (PJI) is the leading cause for early failure of total knee arthroplasty (TKA). An insufficient diagnosis of the involved bacterial species can be a possible cause for this high failure rate. Sonicate fluid cultures (SFC) have been shown to increase the detection rate of PJI in comparison to the use of conventional microbiological methods. The hypothesis of this study is that sonication will improve not only the detection rate of PJI, but also the detection rate of polymicrobial infection in patients with TKA revision surgery. ⋯ In our study, SFC were the most sensitive microbiological method and were surpassed only by the histology. The use of SFC doubled the detection rate of polymicrobial isolations, which would be missed with conventional microbiological methods alone.