Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2014
Tibial component coverage based on bone mineral density of the cut tibial surface during unicompartmental knee arthroplasty: clinical relevance of the prevention of tibial component subsidence.
An optimally implanted tibial component during unicompartmental knee arthroplasty would be flush with all edges of the cut tibial surface. However, this is often not possible, partly because the tibial component may not be an ideal shape or because the ideal component size may not be available. In such situations, surgeons need to decide between component overhang and underhang and as to which sites must be covered and which sites could be undercovered. The objectives of this study were to evaluate the bone mineral density of the cut surface of the proximal tibia around the cortical rim and to compare the bone mineral density according to the inclusion of the cortex and the site-specific matched evaluation. ⋯ The mid-region of the medial side and the posterior region of the lateral side are relatively safe without cortical coverage when the component is not flush with all edges of the tibia. Cortical coverage is strongly recommended for the prevention of subsidence of the tibial component in the posterior region of the medial side, and in the anterior region of the lateral side.
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Arch Orthop Trauma Surg · Jan 2014
Comment LetterFracture of the patella in a young upcoming sportsman due to distraction injury, occurring after a healed distraction fracture or a traumatized bipartite patella : response to: a concern regarding the diagnosis of injury of a bipartite patella at the lower part of the patella (doi:10.1007/s00402-011-1295-4).
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Arch Orthop Trauma Surg · Dec 2013
Use of contact pressure-sensitive surfaces as an indicator of graft tension in medial patellofemoral ligament reconstruction.
No previous description has been made about an objective method to test the graft resistance in MPFL reconstruction intraoperatively. In our study, we aimed to obtain intraoperative objective data about the graft resistance using contact pressure-sensitive surfaces and measuring pressure formed under the graft. ⋯ Contact pressure-sensitive surfaces provided objective data when placed under the graft in natural MPFL and during surgery. Therefore, they may be used as an objective marker providing information about graft resistance.
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Arch Orthop Trauma Surg · Dec 2013
Subtrochanteric shortening osteotomy combined with cemented total hip arthroplasty for Crowe group IV hips.
Total hip arthroplasty (THA) is a challenging surgical procedure that can be used to treat severely dislocated hips. There are few reports regarding cemented THAs involving subtrochanteric shortening osteotomy (SSO), even though cemented THAs provide great advantages because the femur is generally hypoplastic with a narrow, deformed canal. ⋯ SSO combined with cemented THA is an effective treatment for severely dislocated hips. Leg lengthening is not necessarily associated with nerve injuries, and the likelihood of this surgical complication may be related to the presence of hip flexion contracture.
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Arch Orthop Trauma Surg · Dec 2013
Comparative StudyClinical comparison between double-row and transosseous-equivalent repairs for medium to large size rotator cuff tears.
The transosseous-equivalent (TOE) repair of the rotator cuff tears was invented to make up for several shortcomings of the double-row (DR) repair. However, no studies have compared the clinical aspects of the DR repair and the TOE technique, supporting the superior results of the TOE technique over the DR repair, including the benefit of minimizing surgical steps. We asked whether differences existed between the two repairs regarding clinical outcomes, time and costs. ⋯ This study failed to demonstrate clinical differences between the techniques. However, when stratifying rotator cuff tears according to the tear sizes, significant differences were found in operative time and cost: the DR repair had the advantage of cost effectiveness by saving anchors for the lateral row, while the TOE repair required less operative time with more anchors used for the lateral row in the large size tears. This finding provides evidence to support the use of the TOE repair to reduce surgical steps.