Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2014
Comparative Study Clinical TrialThe effect of femoral component design on patellar tracking in total knee arthroplasty: Genesis II prosthesis versus Vanguard prosthesis.
The Genesis II knee system incorporates 3° of external rotation into the femoral component and the femoral component is implanted in neutral rotation to the femur. The purpose of this study was to compare patellar tracking of the Genesis II knee system with that of the Vanguard knee system, in which the femoral component is routinely implanted in a 3° externally rotated position to the posterior condylar axis (PCA) of the femur. ⋯ Prospective cohort study, Level II.
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Arch Orthop Trauma Surg · Apr 2014
Comparative StudyThe influence of joint line restoration on the results of revision total knee arthroplasty: comparison between distance and ratio-methods.
Restoring the joint line (JL) in primary as well as revision total knee arthroplasty (TKA) influences clinical results as well as long-term survival rates. Whereas studies agree about the negative effect of JL alteration, the reference system of choice is unclear. The purpose of the present study was to evaluate the effect of JL allocation comparing a ratio to a distance method on clinical outcome following revision TKA. ⋯ We recommend the epicondylar ratio to calculate the physiological JL rather than JL allocation by a distance.
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Arch Orthop Trauma Surg · Apr 2014
Intramedullary control of distal femoral resection results in precise coronal alignment in TKA.
There is still a relevant rate of outliers in coronal alignment >3° when the conventional technique is used, potentially accompanied by a poorer long-term clinical outcome and a reduced longevity of the implant. Intraoperative implementation of preoperative planning and above all checking of the bone resections carried out are decisive for reinstating a straight leg axis. Intramedullary control of femoral resection has not been described to date. The objective of this study was to present a new technique for the intramedullary control of femoral resection and the results obtained using this method. ⋯ The new technique of intramedullary control of distal femoral resection, together with preoperative planning, leads to a precise alignment of the femoral component in the coronal plane. Thus, for the first time, a simple and effective tool for checking distal femoral resection is available for standardized use.
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Arch Orthop Trauma Surg · Apr 2014
Poor outcome at 7.5 years after Stanisavljevic quadriceps transposition for patello-femoral instability.
Congenital dislocation of the patella and recurrent symptomatic dislocation in adolescents are difficult pathologies to treat. Stanisavljevic described an extensive release procedure essentially involving medializing the entire lateral quadriceps and medial soft tissue stabilization. There are no significant series reporting the success of this method. This procedure has been performed in our institution over several years and we report our results. ⋯ The Stanisavljevic procedure produces a mediocre success rate with our long-term follow-up series showing a failure rate up to 80 %. We therefore recommend more specific procedures dealing with the anatomical deformity such as trochleaplasty to produce superior success rates.
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Arch Orthop Trauma Surg · Apr 2014
Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach.
To evaluate cartilage healing using second-look arthroscopic examination in tibia plateau fracture patients who have undergone open reduction and internal fixation with a submeniscal approach technique. ⋯ Even in patients with normal joint range of motion and good clinical and radiological results, the actual condition of the articular cartilage varied significantly. Therefore, more long-term and regular follow-up is needed for proximal plateau fractures.