Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2012
Comparative StudyAdjuncts in posterior lumbar spine fusion: comparison of complications and efficacy.
The purpose of this study was to define the efficacy of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) and Demineralized Bone Matrix (DBM) compared to autograft in posterior lumbar spine fusion by comparing complication rates. ⋯ ICBG is the gold standard. DBM leads to comparable fusion rates and does not increase infection or seroma formation. rhBMP-2 supplementation instead of ICBG or bone marrow aspirate results in higher fusion rates compared to autograft alone or autograft plus DBM.
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Arch Orthop Trauma Surg · Aug 2012
Bridging knee arthrodesis for limb salvage using an intramedullary cemented nail: a retrospective outcome analysis of a case series.
Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure. ⋯ Bridging knee arthrodesis with an intramedullary nail is a valuable salvage procedure with acceptable clinical results. As recurring infection remains the most challenging complication, regular clinical and radiological follow-up examinations are necessary following implant-related knee arthrodesis to allow timely intervention in case of loosening.
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Arch Orthop Trauma Surg · Aug 2012
Comparative StudyMarginal contribution of UKS- versus TKA in varus arthritis of the knee.
In recent years, decisions regarding the treatment of individual patients have increasingly been affected by economic considerations. The G-DRG system reimburses sledge endoprosthetic implantations at a much lower rate than surface replacements and at significantly different cost weights (CW). Therefore, when only G-DRG payments are considered, TKA produces higher gains. Taking only these revenues alone into consideration, however, does not provide the basis of an economically sound decision-making process. The target of this research was to present a comparison between variable costs of the two procedures. ⋯ Assuming the correct medical indication, the hospital seeking to maximize its marginal contribution would be wise to select sledge endoprosthesis implantation. Considering the economic perspective of gains and costs, the assumption that TKA is advantageous could not be confirmed in the present study.
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Arch Orthop Trauma Surg · Aug 2012
Cementless short stem hip arthroplasty METHA® as an encouraging option in adults with osteonecrosis of the femoral head.
The implantation of a total hip arthroplasty is the standard treatment for patients with progressive osteonecrosis. However, there is uncertainty about the type of arthroplasty that provides the best outcome and whether short stem arthroplasty represents a reasonable alternative for young patients in order to have more options in case of revision. This uncertainty exists due to the lack of studies analysing contemporary short stem arthroplasty in osteonecrosis. ⋯ The study confirms encouraging results as well as good bone ingrowth of the cementless short stem arthroplasty METHA(®) even in patients with osteonecrosis.
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Arch Orthop Trauma Surg · Aug 2012
Case ReportsRole of major revision spine surgery in recurrent adjacent segment osteoporotic vertebral body fracture: a case report.
Case report. ⋯ The current case demonstrates the need for posterior spinal reconstruction in osteoporotic vertebral collapse. Cement augmentation and extension of posterior instrumentation are both viable techniques that could be used to improve stabilization in the elderly spine.