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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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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Although it is widespread in orthopaedic surgery, tourniquet use is associated with appreciable morbidity and even mortality. We review the use of tourniquets, highlighting how an understanding of their design and application can reduce the complications and injuries associated with their use. We also review the attempts being made to modulate these injuries through physical and pharmacological advances, in particular looking at the phenomenon of preconditioning.
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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.