Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2015
Posteroinferior shoulder instability: clinical outcome of arthroscopic stabilization in 32 shoulders and categorization based on labral mapping.
Posterior shoulder instability is rare, appears in varying clinical patterns and can be the main symptom in patients with instability in more than one direction. The purpose was to analyze and categorize our patients and to report on the results of operative treatment by arthroscopy. ⋯ In patients with posteroinferior shoulder instability, good results can be obtained with the arthroscopic treatment of all identified pathologies. Categorization into one of four subgroups might be a valuable tool regarding the choice of the operative treatment options.
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Arch Orthop Trauma Surg · May 2015
Case ReportsRepair and augmentation of a spontaneous patellar tendon rupture in a patient with Ehlers-Danlos syndrome: a case report.
Disruption of the knee extensor mechanism is a serious disorder that requires prompt treatment. It often occurs in the form of a patellar tendon rupture. It may occur in association with systemic disease or after administration of corticosteroids or fluoroquinolones. These conditions can cause tendon weakness, and consequent ruptures usually require both repair and augmentation. This paper reports on repair and augmentation for treating patellar tendon rupture in patients with Ehlers-Danlos syndrome (EDS). ⋯ Repair and augmentation with hamstring tendon was an effective treatment option for patellar tendon rupture in a patient with EDS.
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Arch Orthop Trauma Surg · May 2015
No difference in clinical outcome, bone density and polyethylene wear 5-7 years after standard navigated vs. conventional cementfree total hip arthroplasty.
The purpose of this investigation was to compare clinical outcome, component loosening, polyethylene cup wear and periprosthetic bone mineral density between "cup first" navigated and conventional cementless total hip arthroplasty (THA) 5-7 years after surgery. ⋯ Standard "cup first" THA navigation does not improve mid-term functional outcome, bony ingrowth and/or polyethylene wear. New concepts in computer-assisted THA, considering cup and stem as coupled biomechanical partners are needed to justify the effort of navigation in routine operations.
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Arch Orthop Trauma Surg · May 2015
ReviewShort-stem hip arthroplasty in osteonecrosis of the femoral head.
Osteonecrosis of the femoral head (ONFH) is a locally destructive and complex disorder. Without treatment, infraction of the femoral head is likely. There is also a lack of consensus in the literature about the most appropriate arthroplasty method in patients with progressive ONFH. During the last decade, the number of short-stem prostheses has increased. Some short-stem designs have a metaphyseal anchorage. It is questionable whether ONFH represents a risk factor for failure after implantation of short stems. The aim of this study was to review existing literature regarding the outcome of short-stem arthroplasty in ONFH and to present the pros and cons of short-stem hip arthroplasty in osteonecrosis of the femoral head. ⋯ The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.