Orthop Traumatol Sur
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Orthop Traumatol Sur · Feb 2015
Randomized Controlled TrialBleeding reduction after topical application of tranexamic acid together with Betadine solution in total knee arthroplasty. A randomised controlled study.
Topical application of tranexamic acid to the knee joint before closure in total knee arthroplasty reduces postoperative bleeding without increase in complication. However, it is unknown the effectiveness of topic TXA performed with other topical medications, like povidone-iodine solution. ⋯ I - I: high-powered prospective randomized trial.
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Orthop Traumatol Sur · Feb 2015
Two-level lumbar total disc replacement: functional outcomes and segmental motion after 4 years.
Lumbar total disc replacement is an effective treatment for single-level discogenic lower back pain. But the replacement of two disc levels is controversial. ⋯ Two-level lumbar disc replacement improves spinal function while preserving its mobility. But this procedure is fraught with risks and must be carried out by a highly-experienced team. A longer follow-up is needed to evaluate the sustainability of the results and to detect any adjacent segment disease. The French National Authority for Health (HAS) has recommended against two-level lumbar disc replacement, so it no longer can be performed in France.
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Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. ⋯ Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.
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Orthop Traumatol Sur · Feb 2015
Survey of French spine surgeons reveals significant variability in spine trauma practices in 2013.
In France, attempts to define common ground during spine surgery meetings have revealed significant variability in clinical practices across different schools of surgery and the two specialities involved in spine surgery, namely, neurosurgery and orthopaedic surgery. ⋯ Clinical practice regarding spine trauma varies widely in France. Little published evidence is available on which to base recommendations that would diminish this variability.
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Orthop Traumatol Sur · Feb 2015
The keyhole technique for arthroscopic tenodesis of the long head of the biceps tendon. In vivo prospective study with a radio-opaque marker.
In some clinical situations such as when the Long Head of the Biceps (LHB) is unstable or with an "hourglass biceps", treatment is required. Tenodesis is an alternative to tenotomy to prevent the Popeye sign. Although sutures, anchors or interference screws may be used, they all have complications and drawbacks. Moreover, the number of failures is underestimated because it only considers the visible deformities of the arm. MRI provides more accurate assessment, but is more expensive. We hypothesized that Froimson's "keyhole technique" which has been described in open surgery could be performed arthroscopically with similar clinical outcomes to conventional techniques and without the complications or drawbacks. We also propose an objective and less expensive assessment of treatment failure. ⋯ IV.