Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2011
The Salto total ankle arthroplasty: survivorship and analysis of failures at 7 to 11 years.
Despite the appearance of new-generation, mobile-bearing, cementless prostheses, total ankle arthroplasty remains controversial. Among the criteria guiding the choice between arthrodesis and arthroplasty, the long-term survival and postoperative function are of critical importance. The mobile-bearing Salto prosthesis has been used in Europe since 1997, but only 2 to 5 years of followup data have been reported. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jan 2011
Management of intraoperative medial collateral ligament injury during TKA.
Intraoperative injuries to the medial collateral ligament are often unrecognized and failure to appropriately manage ligament loss may result in knee instability and loosening. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Dec 2010
Randomized Controlled Trial Comparative StudyA prospective randomized trial of mini-incision posterior and two-incision total hip arthroplasty.
The two-incision approach to THA has been controversial, with some authors reporting its use is associated with a rapid recovery whereas others report no differences in outcomes and a higher risk of perioperative complications secondary to increased surgical complexity. ⋯ We found no differences in perioperative outcomes between these two approaches for THA. Variables other than the surgical approach including perioperative protocols, patient expectations, and the patient's general health may have a greater effect on outcomes such as pain during the early postoperative period, functional recovery, and length of hospital stay. The use of small incisions for THA was safe as was a shortened hospital stay in selected patients.
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Clin. Orthop. Relat. Res. · Dec 2010
Review Case ReportsCase report: Spinal anesthesia by mini-laminotomy for a patient with ankylosing spondylitis who was difficult to anesthetize.
Orthopaedic surgeons frequently encounter patients with ankylosing spondylitis who would benefit from various types of lower limb operations; however, some of these patients present challenges for anesthesiologists. ⋯ We achieved successful anesthesia using spinal laminotomy with the patient under local anesthesia followed by insertion of a spinal catheter and injection of an anesthetic agent. The loosened component was revised to a cementless THA.
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Clin. Orthop. Relat. Res. · Dec 2010
Review Case ReportsCase reports: Painful limbs/moving extremities: report of two cases.
Painful limbs/moving extremities is a relatively rare condition characterized by aching pain in one limb and involuntary movement in the affected fingers or toes. Its pathomechanism is unknown. We report two patients with painful limbs/moving extremities. In one patient with a painful arm and moving fingers, the symptoms were resolved after surgery. ⋯ If imaging indicates compression of nerve tissue, we believe surgical decompression should be considered for patients with painful limbs/moving extremities who do not respond to nonoperative treatment.