Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2015
Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL.
While the classical indications and contraindications for unicondylar knee arthroplasty (UKA) are widely accepted there is not yet consensus if patients with partial thickness cartilage loss (PTCL) are equally suited for treatment with UKA. The aim of our study was to determine if patients with partial thickness cartilage loss do equally well after treatment with UKA. ⋯ Patients with PTCL are not equally suited for treatment with UKA like patients with bone on bone. Although PTCL has equal clinical results, it was associated with higher revision rates in our series.
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Arch Orthop Trauma Surg · Aug 2015
Is there a rationale to use a dual mobility poly insert for failed Birmingham metal-on-metal hip replacements? A retrieval analysis.
Previous studies showed poor outcomes for patients undergoing revision of failed metal-on-metal total hip arthroplasty (MoM-THA) and resurfacing (RS) with an increased risk of dislocation. Dual mobility inserts are an option to retain the acetabular component and change the metal-on-metal bearing to plastic-on-metal. The current study analyzes the rationale for the off-label use of a dual mobility poly insert (MDM X3, Stryker, Mahwah, NJ) in a Birmingham metal shell (Smith & Nephew, Memphis, TN). ⋯ Clearances of the MDM poly insert in a BHR shell are reduced, and although the majority of combinations appear safe, the indication needs to be made on an individual base carefully considering alternative treatment options.
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Arch Orthop Trauma Surg · Aug 2015
The effect of tibial slope in acute ACL-insufficient patients on concurrent meniscal tears.
The aim of this study is to evaluate the effect of the medial and lateral posterior tibial slope (MPTS, LPTS) in patients with acutely ruptured ACL on the menisci. It was hypothesized that medial and lateral meniscus lesions are seen more often with high PTS (posterior tibial slope). We hypothesized that in case of a high tibial slope a possible meniscus lesion is more often located in the posterior horn of the meniscus than in knees with a low tibial slope. ⋯ IV.
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Dwarfism is a challenge in arthroplasty. The anatomical features provide a lot of pitfalls. The aim of this study was to follow-up growth-restricted patients after endoprosthetic treatment. ⋯ Knee arthroplasty can be performed in patients suffering from dwarfism with good clinical benefits. However, survival rates are worse compared to the general population.
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Arch Orthop Trauma Surg · Aug 2015
The effect of postoperative wound infections on functional outcome following intra-articular calcaneal fractures.
High rates of postoperative wound infections (POWI) are reported following the operative treatment of calcaneal fractures. This leads to additional therapy, prolonged hospital stay, burden for patients and increased costs. The primary aim of this study is to evaluate the effect of POWI following the extended lateral approach of displaced intra-articular calcaneal fractures on functional outcome. Secondary aims are assessment of health-related quality of life and patient satisfaction. ⋯ Our results implicate that postoperative wound infection leads lower functional outcome scores following calcaneal fracture surgery, but no statistical significance was reached. In addition, patients do not report significant worse QOL or physical impairment. Overall patient satisfaction measured by a VAS was significantly lower in case of a POWI, reflecting the burden caused by a wound complication.