Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2013
Femoral lateral bowing and varus condylar orientation are prevalent and affect axial alignment of TKA in Koreans.
Coronal alignment is considered key to the function and longevity of a TKA. However, most studies do not consider femoral and tibial anatomical features such as lateral femoral bowing and the effects of these features and subsequent alignment on function after TKA are unclear. ⋯ Lateral femoral bowing, varus condylar orientation, and severe varus inclination of the tibia plateau should be considered when performing TKA in Korean patients or patients with otherwise similar anatomical features.
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Clin. Orthop. Relat. Res. · May 2013
Comparative StudyCharlson comorbidity indices and in-hospital deaths in patients with hip fractures.
The Charlson Comorbidity Index (CCI) and its modifications are comorbidity-based measures that predict mortality. It was developed for patients without trauma and inconsistently predicted mortality and adverse events in several previous studies of patients with trauma. ⋯ While all three CCI variations predicted in-hospital mortality in patients with hip fractures, other factors may be of value in patients with trauma.
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Clin. Orthop. Relat. Res. · May 2013
Surgical technique: Computer-assisted sliding medial condylar osteotomy to achieve gap balance in varus knees during TKA.
Extensive posteromedial release to correct severe varus deformity during TKA may result in mediolateral or flexion instability and may require a constrained implant. We describe a technique combining computer navigation and medial condylar osteotomy in severe varus deformity to achieve a primary goal of ligament balance during TKA. ⋯ Computer-assisted SMCO in varus knees with recalcitrant medial contracture achieves improved mediolateral stability and knee function after TKA. Our technique uses navigation to accurately reposition the medial condylar block to equalize medial and lateral gaps, thereby ensuring a stable well-aligned knee without deploying constrained implants.
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Clin. Orthop. Relat. Res. · May 2013
Randomized Controlled TrialPatellar tracking and anterior knee pain are similar after medial parapatellar and midvastus approaches in minimally invasive TKA.
Since the medial parapatellar (MPP) approach in conventional TKA can cause patellar maltracking and anterior knee pain, some orthopaedic surgeons use the midvastus (MV) approach instead of the MPP approach to reduce patellar maltracking. Minimally invasive surgical (MIS) TKA has been developed to limit the damage to the surrounding muscle and reduce the necessity of patellar eversion during surgery. Thus, MIS TKA might be associated with proper patellar tracking and a low incidence of anterior knee pain. However, this presumption has not been confirmed. ⋯ MIS TKA using either the MPP or MV approach has a low incidence of patellar maltracking and anterior knee pain.
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Clin. Orthop. Relat. Res. · May 2013
Multicenter StudyDistal radius malunion increases risk of persistent disability 2 years after fracture: a prospective cohort study.
Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results. ⋯ After distal radius fracture, arm-related disabilities are more likely to persist at least 2 years in patients with fractures that healed with shortening and dorsal angulation than in patients with only shortening or dorsal angulation or without malunion.