Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2014
Randomized Controlled Trial Comparative StudyLaser method for intraoperative evaluation of lower extremity alignment: comparison of a novel technique to CT and a conventional method.
Accurate restoration of mechanical alignment is an important factor in reconstructive surgery of the lower extremity. Conventional intraoperative methods, such as using an electrocautery cable, provide only a momentary evaluation of alignment. In this study, we evaluated a novel technique using a laser emitter, which projected the mechanical axis of the lower extremity, providing continuous intraoperative information on alignment. ⋯ Determination of the mechanical axis during surgery remains a difficult clinical problem. Restoration of alignment is an important prognostic factor for surgical outcome. Based on these data, the laser method represents a simple, yet effective tool for continuous intraoperative evaluation of lower extremity alignment.
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Arch Orthop Trauma Surg · May 2014
Randomized Controlled TrialThe intraoperative use of ultrasound facilitates significantly the arthroscopic debridement of calcific rotator cuff tendinitis.
During arthroscopy, the localization of calcific deposit in patients suffering from calcifying tendinitis can be demanding and time consuming, frequently using ionizing radiation. Intraoperative ultrasound has been recently promoted, facilitating deposit localization and reducing radiation dose. ⋯ Intraoperative US significantly facilitates the detection of calcific deposits during arthroscopic debridement by speeding up surgery and reducing the number of needle punctures. Hence, we have changed our method of detecting calcific deposits intraoperatively from fluoroscopy to ultrasound.
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Arch Orthop Trauma Surg · May 2014
Comparative StudyEffect of intraoperative weight-bearing simulation on the mechanical axis in total knee arthroplasty.
Successful outcome after total knee arthroplasty (TKA) requires precise realignment of the mechanical axis. The intraoperative assessment of the mechanical axis is difficult. Intraoperatively, the effect of weight bearing on the lower limb mechanical axis is ignored. We developed a custom-made mechanical loading device to simulate weight-bearing conditions intraoperatively and analysed its effect on the mechanical axis during TKA. ⋯ Intraoperative quantification and analysis of the mechanical lower limb axis applying defined axial loading by our custom-made loading apparatus is reliable. Ligament stability was unbalanced before TKA and balanced after TKA. For TKA, intraoperative simulation of weight bearing may be helpful to quantify, control and correct knee stability and its influence of mechanical axis.
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Arch Orthop Trauma Surg · May 2014
Operative treatment of displaced Pipkin type I and II femoral head fractures.
The optimal surgical approach for the treatment of femoral head fracture remains controversial. We retrospectively reviewed patients with Pipkin type I and II femoral head fractures managed surgically through posterior Kocher-Langenbeck approach and Ganz trochanteric flip approach aiming to define the best approach with the least morbidity. ⋯ Despite the limited number of patients, we can conclude that good final outcome does not necessarily follow a specific approach.
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Arch Orthop Trauma Surg · May 2014
Comparative StudyFixation of the shorter cementless GTS™ stem: biomechanical comparison between a conventional and an innovative implant design.
Conventional cementless total hip arthroplasty already shows very good clinical results. Nevertheless, implant revision is often accompanied by massive bone loss. The new shorter GTS™ stem has been introduced to conserve femoral bone stock. However, no long-term clinical results were available for this implant. A biomechanical comparison of the GTS™ stem with the clinically well-established CLS(®) stem was therefore preformed to investigate the targeted stem philosophy. ⋯ Both stems seem to provide a comparable and adequate primary stability. The shortened GTS™ design has a comparable rotational stability and bone-implant flexibility compared to a conventional stem. This study demonstrates that the CLS(®) stem and the GTS™ stem exhibit similar biomechanical behavior. However, a clinical confirmation of these experimental results is still required.