Acta Orthop Belg
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Comparative Study
Early repetitive radiography is unnecessary after an uncomplicated cemented hip or knee arthroplasty for osteoarthritis.
Radiographs are necessary at some early point after a hip and knee arthroplasty. The aim of this study was to assess the value of routine repetitive radiographic examinations and the value of a reading of the images by a radiologist. ⋯ If post-operative radiographs are of good quality, there seems to be no need for early repetitive radiographs. Neither is a radiologist reading of the radiographs after joint arthroplasty of any benefit.
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Comparative Study
Sciatic nerve block causing heel ulcer after total knee replacement in 36 patients.
Femoral and sciatic nerve blocks are often used for postoperative analgesia following total knee replacement surgery. In this report, we focus on cases of heel ulcers which occurred following the implementation of peripheral nerve block in concert with knee replacement surgery. ⋯ Pressure points in the foot should be protected after the implementation of nerve blocks to prevent pressure sores. An awareness of this unusual complication related to knee replacement surgery is necessary to prevent its occurrence and avoid delays in patient rehabilitation and recovery.
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Case Reports
Occult ligamentous injury of the cervical spine associated with cervical spine fracture.
We report the case of a 20-year-old patient with a C5 cervical spine fracture and an undetected ligamentous lesion between C1 and C2. Cervical spine lesion protocols and the rates of lesions that are not diagnosed with standard evaluation protocols are reviewed, with particular emphasis on comatose patients. Dynamic studies during the surgical procedure for fixation of the fracture are recommended to increase the detection of ligamentous lesions.
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Isolated scapular spine fractures are rare and are usually associated with other injuries. We describe a patient with a Delta III shoulder replacement who sustained a displaced ipsilateral fracture of the scapular spine after a fall. Internal fixation of the fracture resulted in excellent pain relief and restoration of the pre-existing shoulder mobility.
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Patellar resurfacing in total knee arthroplasty (TKA) remains controversial. This study evaluates the results of resurfacing and non-resurfacing of the patella. Fifty-six patients with osteoarthritis (OA) of the knee were enrolled in a prospective randomised clinical trial using a posterior-stabilised TKA. ⋯ No significant differences were found between groups with regard to the clinical part of the Knee Society score (KSS) not even in obese patients, the ability of performing daily activities involving the patellofemoral joint, and patient satisfaction. Significant differences were found regarding the functional section of the KSS, passive flexion, anterior knee pain and patellar tilt and subluxation. In conclusion, the authors believe that, for the implant studied, patellar resurfacing can be indicated.