Zeitschrift für Orthopädie und ihre Grenzgebiete
-
Z Orthop Ihre Grenzgeb · Jan 2004
Randomized Controlled Trial Comparative Study Clinical Trial[First results of anterior versus posterior instrumentation-fusion in the treatment of spondylodiscitis].
The present study on spondylodiscitis patients was carried out to compare prospectively and randomized the results of clinical and radiological outcomes of anterior versus posterior instrumentation after debridement and grafting. We aimed to make a recommendation concerning the optimum treatment of spondylodiscitis. ⋯ We found advantages with anterior instrumentation in comparison to posterior stabilization in patients with spondylodiscitis. Advantages of ventral stabilization cause early mobilization postoperatively without any increase in complication rates. Except for operation time and intraoperative blood loss, no statistical difference were was seen. Important is the individual indication for each method depending on anatomical and clinical signs. Ventral instrumentation should be restricted to cases with sufficient bone stock.
-
Z Orthop Ihre Grenzgeb · Jan 2004
Case Reports[Resorbable pin refixation of an osteochondral fracture of the lateral femoral condyle due to traumatic patellar dislocation: case management, follow-up and strategy in adolescents].
Intraarticular osteochondral fractures resulting from traumatic patellar dislocation in children are reported most frequently between 13 and 15 years of age. Fracture localization concerns, apart from loose intraarticular bodies, the inferiomedial patellar facet and the lateral femoral condyle. Osteochondral fractures of the lateral femoral condyle with more than 50 % of its surface are extremely rare and reported infrequently. ⋯ Resorbable poly-p-dioxanon pins as a mean for refixation of an osteochondral, intraarticular fracture in an adolescent, with an arthroscopic confirmed acceptable result, seem to be a considerable therapy option.
-
The various radiological changes after implantation of the thrust plate prosthesis (TPP) are demonstrated and, with the help of a standardized radiological classification, divided in pathological and non-pathological findings. ⋯ The radiological changes of the bony stock of the TPP can be divided into physiological adaptation processes because of changed biomechanics and signs of loosening. As a stress-shielding phenomenon we see a progressive atrophy under the thrust plate and simultaneously a sclerosis of the spongious bone above the calcar femoris. An indication for a loosening of the prosthesis is a progressive radiolucency of sector B.
-
Z Orthop Ihre Grenzgeb · Jan 2004
Comparative Study[Midterm results and revisions of the thrust plate prosthesis (TPP)].
Although already in use for 20 years, the concept of the metaphyseal anchored thrust plate prosthesis has not yet gained general acceptance. Clinical and radiological follow-up examinations were carried out 5 to 8 years after implantation of a TPP. We tried to answer the question if the metaphyseal anchorage of the cement-less TPP is equal to a diaphyseal anchorage of a cement-less stem prosthesis and to define the advantages of the TPP. ⋯ Our study suggests that in spite of a slightly higher aseptic loosening rate in comparison to the cement-less stem prosthesis, the thrust plate prosthesis proved to be worthwhile. On the basis of previous experience we assume that the TPP is a good alternative implant especially for young patients.
-
Z Orthop Ihre Grenzgeb · Nov 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Cemented versus cementless revision femoral stems using morselized allograft--a prospective, randomized study with 5 years follow-up].
There are only few studies on hip revision using the impaction grafting technique. Furthermore, data on cementless femoral stems as compared to cemented and polished femoral stems are lacking. We wanted to determine whether cementless femoral stems were equally good in preserving bone mineral density around the femoral stem and in functional outcome. ⋯ Cemented technique in hip revisions using morselized bone allograft is as good as uncemented technique in preserving BMD measured by the DEXA method and restoring function in a 5 years follow-up.