Archives of orthopaedic and trauma surgery
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Osteolysis and aseptic loosening currently contribute 75 % of implant failures. Furthermore, with over four million joint replacements projected to be performed in the United States annually, osteolysis and aseptic loosening may continue to pose a significant morbidity. This paper reviews the osteolysis cascade leading to osteoclast activation and bone resorption at the biochemical level. ⋯ A non-surgical treatment of osteolysis has not been found in the literature and thus may become an area of future research. Even though this research is warranted, comprehensively understanding the immune response to orthopedic implants and their metallic ions, and thus, creating improved prostheses appears to be the most cost-effective approach to decrease the morbidity related to osteolysis and to design implants with greater longevity. The ionic forms, cytokines, toxicity, gene expression, biological effects, and hypersensitivity responses of metallic elements from metal implants are summarized as well.
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Arch Orthop Trauma Surg · May 2015
Lumbar lordosis and sacral slope in lumbar spinal stenosis: standard values and measurement accuracy.
Radiological study. ⋯ Manual measurement of LL and SS in patients with LSS on lateral radiographs is easily performed with excellent intra- and interobserver reliability. Correlation between LL and SS is very high. Differences between patients with and without previous decompression were not statistically significant.
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The feasibility of endoscopically assisted decompression of the superficial radial nerve at the midportion and distal forearm was assessed. ⋯ The endoscopically assisted release of the superficial radial nerve may be feasible in a safe and sufficient way.
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Arch Orthop Trauma Surg · May 2015
Surface or full cementation of the tibial component in total knee arthroplasty: a matched-pair analysis of mid- to long-term results.
Despite the clinical success of cemented TKA, aseptic loosening of the tibial component remains a potential long-term complication. Considering the constantly growing revision burden, there is a need for clarification regarding controversial views on primary fixation techniques. In this retrospective analysis, surface (SC) or full cementation (FC) of tibial components was compared in a matched-pair and long-term setting. ⋯ Results of this study showed no statistically significant difference regarding long-term survivorship for the two cementing techniques. This finding questions the claimed advantage of full cementation for tibial components. The presented data do not support the concern that surface cementation results in insufficient fixation in patients with rheumatoid arthritis.
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Arch Orthop Trauma Surg · May 2015
Three-dimensional virtual simulation and evaluation of the femoroacetabular impingement based on "black bone" MRA.
Femoroacetabular impingement (FAI) is a recognised cause of secondary osteoarthritis of the hip. Several imaging methods have been used to analyse the pathologic signs. Because of the lack of precise pre- and intraoperative overview and the difficulty locating osseous pathologies, arthroscopic and minimal invasive treatment is still challenging, even for trained surgeons. This paper describes a procedure that is based on magnetic resonance arthrography (MRA) and is used to virtually verify the range of motion (ROM) of the hip. It enables the evaluation of FAI and the preoperative simulation of adequate surgical manoeuvres. ⋯ The described procedure is a useful tool for the preoperative investigation of impinging hips. It enables appropriate planning of required surgical interventions.