Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2009
Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft.
Local bone tumor excision followed by pasteurization and reimplantation is a unique technique of reconstruction for sarcoma patients. The long-term scintigraphic findings of pasteurized bone grafts in relation to clinical patients' data were reviewed retrospectively. ⋯ The method of pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.
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Arch Orthop Trauma Surg · Apr 2009
The use of structural periacetabular allografts in acetabular revision surgery: 2.5-5 years follow-up.
"Acetabular bone loss" presents a major reconstructive challenge in total hip arthroplasty. Loss of acetabular bone stock is a consequence of removal of bone during the original procedure, subsequent prosthetic failure and osteolysis resulting from wear particles of cement and polyethylene. In case of severe bone loss treatment options are rather limited, as fixation requires either biological (cancellous allograft with cage or structural allograft) or non-biological (trabecular metal, triflange implant, etc.) scaffolds. ⋯ The bicortical allograft without protective device seems to function as a passive biocompatible dead scaffold, which has a less intrinsic strength at intermediate term follow-up, compared to the by ring or cage protected structural allografts.
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Bone transport is based on the principle of distraction osteogenesis described by Ilizarov and is a consecrated method for the treatment of segmental bone defects. One of its most problematic and, paradoxically, least studied aspects is the consolidation of the docking site. We studied histologically the ossification of the docking site and regenerate to determine any difference between them. ⋯ The experimental bone transport model proposed in the present study permits us to conclude that there is a clear difference between the ossification of the docking site and of the regenerate.
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Arch Orthop Trauma Surg · Apr 2009
Single stage arteriovenous short saphenous loops in microsurgical reconstruction of the lower extremity.
The short saphenous vein can be used "in situ" to create a temporary arteriovenous shunt for lengthening the recipient vessels of the injured limb in microsurgical reconstructions of the lower extremity. We report our results using this single-anastomosis turnover technique in three high-energy trauma patients who presented open tibial fractures associated with vascular injuries. ⋯ The use of the ipsilateral small saphenous vein "in situ" for immediate arteriovenous loop formation may be of great value in complex lower leg reconstructions. It is a reliable adjunctive technique that provides healthy vessels to supply the free flap, permitting stable wound coverage and high rate of limb salvage.
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Arch Orthop Trauma Surg · Mar 2009
Randomized Controlled Trial Multicenter StudyProspective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study.
Viscosupplementation by repeated intra-articular injections of hyaluronic acid (HA) is used widely in the treatment of symptomatic knee osteoarthritis (OA). The number of injections required can limit the availability of treatment and affect patient compliance. The aim of this study was to assess different dosing regimens of hylan G-F 20, a high molecular-weight cross-linked derivative of HA, in the treatment of pain due to knee OA. ⋯ This study suggests that a single 6 mL injection of hylan G-F 20 may be as efficacious, and as well tolerated, as 3 x 2 mL one week apart. A double-blind, controlled trial is needed to confirm these data.