Hospital accreditation and patient care, a dilemma?
Acta Orthop Belg. 2021 Sep;87(3):385-391.ABSTRACTThere are concerns that increased BMI is associated with a greater length of stay (LOS) and perioperative complications following total knee (TKR) and total hip replacements (THR). We analysed data from a six-month period to see if there was a correlation between BMI and LOS. We performed a subgroup analysis for patients with morbid obesity (BMI>40) looking at perioperative complications. 285 TKRs and 195 THRs were analysed. For TKRs, the average length of stay was 2.7 days. The average BMI was 32.4. There was no significant correlation between BMI and LOS (r=-0.0447, p=0...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Martin Sharrock Ashwani Nugur Saqif Hossain Source Type: research

Long-term outcome of cementless total hip arthroplasty with threaded Tropic ® acetabular cup and Corail® femoral stem
This study investigates the clinical and radiological results of a tapered femoral stem (Corail®) and uncemented threaded acetabular cups (Tropic®) and in addition an analysis of the complications and retrieved implants was conducted. Between January 1990 and September 1998, 301 total hips arthroplasties in 268 patients were implanted. 78 patients (87 hips) had died and 9 patients (12 hips) had been lost to follow-up, leaving at the time of the latest follow-up 180 patients (202 hips). The mean age at surgery was 56,1 (27-75) years. Of the 154 unrevised hips, the median Harris and Merle d'Aubigne and Postel hip sco...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Fernando Almeida Silvia G állego Francisco Arg üelles Antonio Silvestre Source Type: research

Concomitant ipsilateral acetabular and femoral fractures - an appraisal of outcomes and complications in 34 patients
The objectives of this study were to evaluate the outcomes and study the complications in patients treated for concomitant ipsilateral acetabular and femoral fractures (type 'B' floating hip injuries). This retrospective study was conducted at a tertiary care teaching hospital on patients operated for type B floating hip injuries, who had completed a minimum of one-year follow-up after the surgery and whose complete records were available. Those with floating hip injuries with pelvic fractures were excluded. All patients were operated on the femoral side first, followed by the acetabular side. 34 patients were included ; m...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Umesh Kumar Meena Mahesh Chand Bansal Prateek Behera Divyanshu Goyal Rakesh Kumar Source Type: research

One sacroiliac screw for posterior ring fixation in unstable pelvic fractures
Acta Orthop Belg. 2021 Sep;87(3):411-418.ABSTRACTUnstable pelvic injuries are considered uncommon and they are usually associated with high rate of morbidity and mortality. High energy blunt trauma and falling from height are usually the main mechanism of injury. It is a retrospective study that was performed in academic level I trauma center. From September 2015 to December 2019, a consecutive series of 26 patients (7 females), with average age of 32 years with unstable pelvic fracture were included in this study. All patients underwent reduction and percutaneous fixation with one sacroiliac screw posteriorly for each sac...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Hossam Hosny Mohamed Ali Mohamed Moustafa Elsayed Ashraf Marzouk Wael Salama Source Type: research

Total hip replacements following acetabular fractures. 7 to 15 years clinical and radiological results
This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirt...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Mohamed S Kassem Mostafa A Elsayed Source Type: research

Digital templating in total hip arthroplasty using contralateral healthy hip results in decreased accuracy
Acta Orthop Belg. 2021 Sep;87(3):427-433.ABSTRACTThe accuracy of pre-operative digital templating for total hip arthroplasty (THA) using the diseased versus unaffected contralateral joint remains unclear. As such, we devised a study to compare templating precision between the operated hip joint versus the healthy side for patients with osteoarthritis (OA). The study hypothesis was that preoperative templating accuracy of THA on the ipsilateral diseased hip joint would be higher compared to the contralateral healthy hip in patients with OA. We retrospectively reviewed 100 patients who underwent THA for unilateral OA at our ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Ittai Shichman Or Shaked Samuel Morgan Simon Garceau Nimrod Snir Yaniv Warschawski Source Type: research

Evolution of head-shaft angle and neck-shaft angle in childhood
This study aims to characterize the evolution of HSA and compares it with the more commonly known NSA in healthy children. We measured radiographs of 84 different healthy hips of children between 3 and 14.5 years old who underwent at least 2 radiographs of the pelvis, corresponding to 286 measurements. We used a linear mixed model to determine the covariance between random intercept and slope while allowing each individual hip to change over time. The covariance for HSA between random intercept and random slope was -4.262 (p
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Pieter Van Geel Wilfried Cools Armand Laumen Source Type: research

Femoral bone growth after extendible endoprosthetic replacement of the proximal tibia in skeletally immature patients
This study was aimed at evaluating femoral growth following proximal tibia resection (PTR) and placement of an extendible endoprosthesis with sliding stem. This was a retrospective study. The demographic and clinical data were collected. All the patients with malignant tumors were fully staged and commenced on appropriate chemotherapy. An expected discrepancy of> 3cm was considered substantial enough to warrant extendible prosthesis. Twelve patients who had follow up full length scanogram of the lower limbs were included for the evaluation of femoral growth. The last available scanograms were used for growth comparison ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Oluwaseyi Kayode Idowu Oladimeji Ranti Babalola Adesegun Tibramiyu Abudu Source Type: research

A case of an atraumatic implant failure after primary rotating-hinge total knee arthroplasty
We present a rare case of 70-year-old Caucasian, male patient who suffered an atraumatic femoral stem breakage in a primary NexGen ® Rotating Hinge Knee (Zimmer-Biomet ® , Warsaw, IN, USA).PMID:34808718 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Lucas Petitqueux Karen Verhulst Jan Dauwe Dirk Dauwe Source Type: research

The role of joint line position and restoration of posterior condylar offset in revision total knee arthroplasty : a systematic review of 422 revision knees arthroplasty
Acta Orthop Belg. 2021 Sep;87(3):453-460.ABSTRACTThe aim of this systematic review was to evaluate the evidence on reservation of Posterior Femoral Condylar Offset (PFCO) and Joint Line (JL) after Revision Total Knee Arthroplasty (RTKA) for im- proved functional outcomes. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted, with papers published from the inception of the database to October 2020 included. All relevant articles were retrieved, and their bibliographies were hand searched for further references on Posterior condylar offset and revision total knee arthroplasty. The s...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Hany Elbardesy Andr é McLeod Rehan Gul James Harty Source Type: research

Lower total blood loss in total knee arthroplasty with a low-pressure tourniquet than without
This study showed that low- pressure tourniquet use reduces TBL without increasing HBL in TKA.PMID:34808720 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Simon Joufflineau Emmanuel Thienpont Source Type: research

Outcomes of total knee replacement with the use of a NexGen MIS Tibial Component (Mini-keel) : a systematic review
This study aimed to systematically review the literature describing the outcome following TKR with the use of a Mini-keel. Electronic searches of databases were undertaken in July 2019 by two experienced orthopaedic surgeons according to the PRISMA guidelines for literature describing the outcomes of TKR with the use of a Mini-keel. Quality of studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The initial search found a total of 623 studies from all the databases. Seven studies met all the inclusion criteria and were eligible for critical appraisal and quality assessment. In total, 2,198 c...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Naoki Nakano Kiyonori Mizuno Koji Takayama Shinya Hayashi Ryosuke Kuroda Tomoyuki Matsumoto Source Type: research

Tranexamic acid use in simultaneous bilateral total knee arthroplasty : a comparison of intravenous and intra-articular applications, which is more effective?
Acta Orthop Belg. 2021 Sep;87(3):479-486.ABSTRACTPatients applied with simultaneous bilateral total knee arthroplasty (SBTKA) with the administration of intravenous or intra-articular tranexamic acid (TXA) were compared in respect of blood loss and the need for allogenic blood transfusion. Of a total 53 patients applied with SBTKA, 32(60%) were administered intravenous TXA and 21(40%) intra-articular TXA. The patients were evaluated in respect of age, gender, height, weight, body mass index (BMI), body blood volume, preoperative and 1,2,3 and 4 days postoperative levels of hemoglobin (Hb) and hematocrit (Htc) and the chang...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Alpaslan Öztürk Yavuz Akalin Nazan Çevik Özgür Avcı O ğuz Çetin Harun Sa ğlicak Source Type: research

Comparison of functional outcome of simultaneous and staged bilateral total knee arthroplasty : systematic review of literature
Acta Orthop Belg. 2021 Sep;87(3):487-493.ABSTRACTSafety of simultaneous bilateral TKA (simBTKA) and staged BTKA (staBTKA) have been compared in previous systematic reviews but functional outcome remains neglected aspect of the debate. We performed a systematic review of contemporary literature to compare the functional outcome of simBTKA and staBTKA. We searched PubMed/MEDLINE, EMBASE and Cochrane Central Database to identify all articles published between 2000 and July 2020 that evaluated the outcome of patients undergoing BTKA either in simultaneous or staged manner. Ten articles were identified which met the inclusion c...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Irfan Qadir Latif Khan Jahanzeb Mazari Umair Ahmed Atiq Uz Zaman Amer Aziz Source Type: research

Secondary radial neuropathy after closed intramedullary nailing of humeral shaft fractures. Results over a 10-year period
CONCLUSIONS: In this study, the risk of a radial nerve palsy was 7.9 % with closed locked intramedullary nailing. This study suggests that exploration of the radial nerve is not necessary routinely in order to prevent radial nerve lesions when performing closed intramedullary nailing for humeral shaft fractures in adults with a preoperative normal radial nerve function.LEVEL OF EVIDENCE: Level IV.PMID:34808724 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Anton Ulstrup Source Type: research

Fracture patterns in midshaft clavicle fractures
Acta Orthop Belg. 2021 Sep;87(3):501-507.ABSTRACTCurrent classifications of midshaft clavicle fractures are based on radiography. The aim of the study was to evaluate the fracture pattern of clavicle fractures using 3-dimensional computed tomography (3D CT). A retrospective analysis was performed on CT scans of 65 acute clavicle fractures. Using quantitative 3D CT reconstruction techniques, the fracture of the clavicle was virtually reduced. Based on these reconstructions, a group-based fracture heat map and small fragment heat map, and the location of the most common fracture line were determined. Also, the direction and ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Alexander Van Tongel Lieven De Wilde Yasunori Shimamura Jan Sijbers Toon Huysmans Source Type: research

A novel treatment for prevention of post-traumatic elbow stiffness using onaBotulinum toxin type A: a prospective placebo controlled randomized trial
This study aimed to investigate the efficacy of onaBotulinum Toxin type A injection to prevent post-traumatic pain and elbow-stiffness. All patients were included who presented to a single surgeon with supracondylar/ intraarticular distal humerus fractures, proximal ulna and radius fractures. The study was developed in a randomized placebo controlled study between 2003-2007. The Disabilities of the Arm, Shoulder, and Hand (DASH) score as well as the arc-of-motion (AOM) were assessed after three, six, twelve-months and final follow up for evaluation. Of the 31-patients included, 15-patients (48.4%) received Botox injections...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Henrik C B äcker Christina E Freibott Eric Swart Carsten Perka Charles M Jobin Melvin P Rosenwasser Source Type: research

Palmar plating of distal radius fractures : 3-year follow-up with titanium and PEEK plates give similar outcomes
This study evaluates clinical results with a carbon fibre- reinforced (CFR)-polyether ether ketone (PEEK) plate in comparison to a standard titanium plate. Thirty-one distal radius fractures were included in this randomised controlled trial. Five fractures were classified as type A, 6 as type B and 20 as type C, in accordance with the AO classification. Patients were randomly allocated into two groups : 15 patients for titanium palmar plating (TPP) and 16 patients for PEEK palmar plating (PPP). Follow-up examinations were set at 2 weeks, 6 weeks, 3 months, 6 months and 3 years postop. In terms of wrist range of motion, rad...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Josephine Berger-Groch Ann-Christin Stodtmeister Jan P Petersen Michael Hoffmann Source Type: research

Thrombosis of persistent median artery as a cause of carpal tunnel syndrome : case report
Acta Orthop Belg. 2021 Sep;87(3):529-532.ABSTRACTCarpal tunnel syndrome (CTS) is a common peripheral neuropathy, caused by compression of the median nerve. Symptoms usually are present for months and aggravate over time. Acute onset of complaints and symptoms, like coldness of the hand, should raise awareness of a possible vascular cause of CTS.Persistent median artery (PMA) is a very rare anatomical variant of the blood supply of the upper limb. The presence of a thrombosed PMA is an extremely rare cause of CTS. In this article a case is presented in which the patient has carpal tunnel syndrome of his left hand, caused by...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: S Arnauw G De Wachter Source Type: research

Results of treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint with tendon allograft interposition
Acta Orthop Belg. 2021 Sep;87(3):533-539.ABSTRACTThe aim of the study was to determine if the use of tendon allografts in combination with distal scaphoid resection for the treatment of isolated STT arthrosis is a save procedure. We reviewed the postoperative complications, re-operations, clinical and radiological results of this treatment modality. A retrospective cohort study was conducted. Investigated parameters include wrist mobility (wrist extension and -flexion), strength (grip- and pinch strength), patient-reported outcome scores : Visual Analogue Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand score ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Annelies Eeckhoudt Nadine Hollevoet Source Type: research

Metacarpal chondrosarcoma, from negligence to rareness : a case report and review of the literature
We report an unusual case of a 46-year-old man with a huge chondrosarcoma on his left hand that has been evolving for more than 30 years. The mass has always been painless, the symptoms were only the deformation and a slight loss of motion. We did a subtotal resection since the patient refused the amputation. The investigation, which in- cluded thoracoabdominal tomography, scintigraphy and blood analysis, turned out to be negative. In the literature, CS are usually associated with a locally destructive growth but metastasis hasn't been often described. CS seems to be an aggressive tumor locally but, unlike in other sites, ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Pauline Ollero Sophie Vanden Dungen Katerina Cermak Louis Kinnen Source Type: research

Reduction of radiation exposure in scoliosis monitoring using flat detector and pulsed fluoroscopy technology
Acta Orthop Belg. 2021 Sep;87(3):545-552.ABSTRACTA new flat detector and pulsed fluoroscopy technology is available to further reduce radiation exposure in radiological monitoring during scoliosis treatment in children and adolescents. The aim of this study is to compare different settings of the system (opening area(OA) and image quality settings (IQS)) in order to find the optimal parameters with high image quality and the lowest possible radiation exposure. Therefore, we examined four cadaver spines (T1 to sacrum) with the flat detector technique using digital pulsed fluoroscopy and simulated the abdominal soft tissues....
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Christian Walter Juergen F Schaefer Ilias Tsiflikas Source Type: research

Gram stain microscopy in septic arthritis
Acta Orthop Belg. 2021 Sep;87(3):553-556.ABSTRACTSeptic arthritis is a serious condition that can lead to rapid destruction of joint if it is not rapidly diagnosed and treated appropriately. The reported annual incidence is 10 in 100 000 although this increases to 70 in 100 000 in those with risk factors for developing septic arthritis mainly rheumatoid arthritis and immune-compromised patients. The aim of this study is to examine the sensitivity and specificity, and thus the clinical usefulness, of gram stain results. This was a single centre, retrospective case series. All joint aspirates over a three year period from Ma...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Karam Al-Tawil Frederick Quiney Louis Pirkis Nicholas Birkett Aaron Rooney Source Type: research

Economic advantage of 'self-made' antibiotic-loaded spacer compared to prefabricated antibiotic-loaded spacer and spacer molds in two-staged revision arthroplasty
Acta Orthop Belg. 2021 Sep;87(3):557-562.ABSTRACTInfection after total hip or total knee arthroplasty is a serious complication implying great costs for the health care system. Amongst the different treatment options, the two-step exchange using a spacer in the interval is a valid option. We evaluate the economic impact of our self-made antibiotic-loaded hip and knee cement spacers compared with prefabricated spacers and spacer molds. Costs to prepare self-made cement spacers are detailed for each spacer type. We also assess the intraoperative time spent for fabricating our self-made hip and knee spacers. The price of thes...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: K Moerenhout S Steinmetz M Vautrin S Picarra G Udin O Borens Source Type: research

The alpha defensin lateral flow test is effective in predicting eradication of periprosthetic joint infection after surgical debridement
Acta Orthop Belg. 2021 Sep;87(3):563-569.ABSTRACTThe primary aim of this study was to assess the utility of the alpha defensin lateral flow (ADLF) test for predicting the eradication of PJI after surgical debridement. The secondary aim was to describe the reliability of ADLF test in diagnosis of PJI intra- operatively. A prospective observational study was conducted in three independent orthopaedic centres. Twenty-two patients undergoing revision surgery (debridement, antibiotics and implant retention (DAIR), single or two-stage revision) for PJI were recruited, 13 female and 9 male with an average age of 64 years. Samples...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Lucy C Walker Nick D Clement Munawar Hashmi Julie Samuel David J Deehan Source Type: research

Impact of the COVID-19 pandemic on the trauma and orthopaedic department at level one Major Trauma Centre in the republic of Ireland
Acta Orthop Belg. 2021 Sep;87(3):571-578.ABSTRACTThe Coronavirus Disease (COVID-19) has been identified as the cause of a rapidly spreading respiratory illness in Wuhan, Hubei Province, China in early December 2019. Since then, the free movement of people has decreased. The trauma-related injuries and the demand on the trauma and orthopaedic service would be expected to fall. The aim of this study to examine the impact of the COVID-19 pandemic on a level 1 Trauma Centre in the Republic of Ireland (ROI). Patients admitted to the Trauma & Orthopaedic (T&O) Department at Cork University Hospital (CUH) and the South In...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Hany Elbardesy Eoghan Meagher Shane Guerin Source Type: research

Hospital accreditation and patient care, a dilemma?
Acta Orthop Belg. 2021 Sep;87(3):385-391.ABSTRACTThere are concerns that increased BMI is associated with a greater length of stay (LOS) and perioperative complications following total knee (TKR) and total hip replacements (THR). We analysed data from a six-month period to see if there was a correlation between BMI and LOS. We performed a subgroup analysis for patients with morbid obesity (BMI>40) looking at perioperative complications. 285 TKRs and 195 THRs were analysed. For TKRs, the average length of stay was 2.7 days. The average BMI was 32.4. There was no significant correlation between BMI and LOS (r=-0.0447, p=0...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Martin Sharrock Ashwani Nugur Saqif Hossain Source Type: research

Long-term outcome of cementless total hip arthroplasty with threaded Tropic ® acetabular cup and Corail® femoral stem
This study investigates the clinical and radiological results of a tapered femoral stem (Corail®) and uncemented threaded acetabular cups (Tropic®) and in addition an analysis of the complications and retrieved implants was conducted. Between January 1990 and September 1998, 301 total hips arthroplasties in 268 patients were implanted. 78 patients (87 hips) had died and 9 patients (12 hips) had been lost to follow-up, leaving at the time of the latest follow-up 180 patients (202 hips). The mean age at surgery was 56,1 (27-75) years. Of the 154 unrevised hips, the median Harris and Merle d'Aubigne and Postel hip sco...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Fernando Almeida Silvia G állego Francisco Arg üelles Antonio Silvestre Source Type: research

Concomitant ipsilateral acetabular and femoral fractures - an appraisal of outcomes and complications in 34 patients
The objectives of this study were to evaluate the outcomes and study the complications in patients treated for concomitant ipsilateral acetabular and femoral fractures (type 'B' floating hip injuries). This retrospective study was conducted at a tertiary care teaching hospital on patients operated for type B floating hip injuries, who had completed a minimum of one-year follow-up after the surgery and whose complete records were available. Those with floating hip injuries with pelvic fractures were excluded. All patients were operated on the femoral side first, followed by the acetabular side. 34 patients were included ; m...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Umesh Kumar Meena Mahesh Chand Bansal Prateek Behera Divyanshu Goyal Rakesh Kumar Source Type: research

One sacroiliac screw for posterior ring fixation in unstable pelvic fractures
Acta Orthop Belg. 2021 Sep;87(3):411-418.ABSTRACTUnstable pelvic injuries are considered uncommon and they are usually associated with high rate of morbidity and mortality. High energy blunt trauma and falling from height are usually the main mechanism of injury. It is a retrospective study that was performed in academic level I trauma center. From September 2015 to December 2019, a consecutive series of 26 patients (7 females), with average age of 32 years with unstable pelvic fracture were included in this study. All patients underwent reduction and percutaneous fixation with one sacroiliac screw posteriorly for each sac...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Hossam Hosny Mohamed Ali Mohamed Moustafa Elsayed Ashraf Marzouk Wael Salama Source Type: research

Total hip replacements following acetabular fractures. 7 to 15 years clinical and radiological results
This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirt...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Mohamed S Kassem Mostafa A Elsayed Source Type: research

Digital templating in total hip arthroplasty using contralateral healthy hip results in decreased accuracy
Acta Orthop Belg. 2021 Sep;87(3):427-433.ABSTRACTThe accuracy of pre-operative digital templating for total hip arthroplasty (THA) using the diseased versus unaffected contralateral joint remains unclear. As such, we devised a study to compare templating precision between the operated hip joint versus the healthy side for patients with osteoarthritis (OA). The study hypothesis was that preoperative templating accuracy of THA on the ipsilateral diseased hip joint would be higher compared to the contralateral healthy hip in patients with OA. We retrospectively reviewed 100 patients who underwent THA for unilateral OA at our ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Ittai Shichman Or Shaked Samuel Morgan Simon Garceau Nimrod Snir Yaniv Warschawski Source Type: research

Evolution of head-shaft angle and neck-shaft angle in childhood
This study aims to characterize the evolution of HSA and compares it with the more commonly known NSA in healthy children. We measured radiographs of 84 different healthy hips of children between 3 and 14.5 years old who underwent at least 2 radiographs of the pelvis, corresponding to 286 measurements. We used a linear mixed model to determine the covariance between random intercept and slope while allowing each individual hip to change over time. The covariance for HSA between random intercept and random slope was -4.262 (p
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Pieter Van Geel Wilfried Cools Armand Laumen Source Type: research

Femoral bone growth after extendible endoprosthetic replacement of the proximal tibia in skeletally immature patients
This study was aimed at evaluating femoral growth following proximal tibia resection (PTR) and placement of an extendible endoprosthesis with sliding stem. This was a retrospective study. The demographic and clinical data were collected. All the patients with malignant tumors were fully staged and commenced on appropriate chemotherapy. An expected discrepancy of> 3cm was considered substantial enough to warrant extendible prosthesis. Twelve patients who had follow up full length scanogram of the lower limbs were included for the evaluation of femoral growth. The last available scanograms were used for growth comparison ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Oluwaseyi Kayode Idowu Oladimeji Ranti Babalola Adesegun Tibramiyu Abudu Source Type: research

A case of an atraumatic implant failure after primary rotating-hinge total knee arthroplasty
We present a rare case of 70-year-old Caucasian, male patient who suffered an atraumatic femoral stem breakage in a primary NexGen ® Rotating Hinge Knee (Zimmer-Biomet ® , Warsaw, IN, USA).PMID:34808718 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Lucas Petitqueux Karen Verhulst Jan Dauwe Dirk Dauwe Source Type: research

The role of joint line position and restoration of posterior condylar offset in revision total knee arthroplasty : a systematic review of 422 revision knees arthroplasty
Acta Orthop Belg. 2021 Sep;87(3):453-460.ABSTRACTThe aim of this systematic review was to evaluate the evidence on reservation of Posterior Femoral Condylar Offset (PFCO) and Joint Line (JL) after Revision Total Knee Arthroplasty (RTKA) for im- proved functional outcomes. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted, with papers published from the inception of the database to October 2020 included. All relevant articles were retrieved, and their bibliographies were hand searched for further references on Posterior condylar offset and revision total knee arthroplasty. The s...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Hany Elbardesy Andr é McLeod Rehan Gul James Harty Source Type: research

Lower total blood loss in total knee arthroplasty with a low-pressure tourniquet than without
This study showed that low- pressure tourniquet use reduces TBL without increasing HBL in TKA.PMID:34808720 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Simon Joufflineau Emmanuel Thienpont Source Type: research

Outcomes of total knee replacement with the use of a NexGen MIS Tibial Component (Mini-keel) : a systematic review
This study aimed to systematically review the literature describing the outcome following TKR with the use of a Mini-keel. Electronic searches of databases were undertaken in July 2019 by two experienced orthopaedic surgeons according to the PRISMA guidelines for literature describing the outcomes of TKR with the use of a Mini-keel. Quality of studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The initial search found a total of 623 studies from all the databases. Seven studies met all the inclusion criteria and were eligible for critical appraisal and quality assessment. In total, 2,198 c...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Naoki Nakano Kiyonori Mizuno Koji Takayama Shinya Hayashi Ryosuke Kuroda Tomoyuki Matsumoto Source Type: research

Tranexamic acid use in simultaneous bilateral total knee arthroplasty : a comparison of intravenous and intra-articular applications, which is more effective?
Acta Orthop Belg. 2021 Sep;87(3):479-486.ABSTRACTPatients applied with simultaneous bilateral total knee arthroplasty (SBTKA) with the administration of intravenous or intra-articular tranexamic acid (TXA) were compared in respect of blood loss and the need for allogenic blood transfusion. Of a total 53 patients applied with SBTKA, 32(60%) were administered intravenous TXA and 21(40%) intra-articular TXA. The patients were evaluated in respect of age, gender, height, weight, body mass index (BMI), body blood volume, preoperative and 1,2,3 and 4 days postoperative levels of hemoglobin (Hb) and hematocrit (Htc) and the chang...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Alpaslan Öztürk Yavuz Akalin Nazan Çevik Özgür Avcı O ğuz Çetin Harun Sa ğlicak Source Type: research

Comparison of functional outcome of simultaneous and staged bilateral total knee arthroplasty : systematic review of literature
Acta Orthop Belg. 2021 Sep;87(3):487-493.ABSTRACTSafety of simultaneous bilateral TKA (simBTKA) and staged BTKA (staBTKA) have been compared in previous systematic reviews but functional outcome remains neglected aspect of the debate. We performed a systematic review of contemporary literature to compare the functional outcome of simBTKA and staBTKA. We searched PubMed/MEDLINE, EMBASE and Cochrane Central Database to identify all articles published between 2000 and July 2020 that evaluated the outcome of patients undergoing BTKA either in simultaneous or staged manner. Ten articles were identified which met the inclusion c...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Irfan Qadir Latif Khan Jahanzeb Mazari Umair Ahmed Atiq Uz Zaman Amer Aziz Source Type: research

Secondary radial neuropathy after closed intramedullary nailing of humeral shaft fractures. Results over a 10-year period
CONCLUSIONS: In this study, the risk of a radial nerve palsy was 7.9 % with closed locked intramedullary nailing. This study suggests that exploration of the radial nerve is not necessary routinely in order to prevent radial nerve lesions when performing closed intramedullary nailing for humeral shaft fractures in adults with a preoperative normal radial nerve function.LEVEL OF EVIDENCE: Level IV.PMID:34808724 (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Anton Ulstrup Source Type: research

Fracture patterns in midshaft clavicle fractures
Acta Orthop Belg. 2021 Sep;87(3):501-507.ABSTRACTCurrent classifications of midshaft clavicle fractures are based on radiography. The aim of the study was to evaluate the fracture pattern of clavicle fractures using 3-dimensional computed tomography (3D CT). A retrospective analysis was performed on CT scans of 65 acute clavicle fractures. Using quantitative 3D CT reconstruction techniques, the fracture of the clavicle was virtually reduced. Based on these reconstructions, a group-based fracture heat map and small fragment heat map, and the location of the most common fracture line were determined. Also, the direction and ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Alexander Van Tongel Lieven De Wilde Yasunori Shimamura Jan Sijbers Toon Huysmans Source Type: research

A novel treatment for prevention of post-traumatic elbow stiffness using onaBotulinum toxin type A: a prospective placebo controlled randomized trial
This study aimed to investigate the efficacy of onaBotulinum Toxin type A injection to prevent post-traumatic pain and elbow-stiffness. All patients were included who presented to a single surgeon with supracondylar/ intraarticular distal humerus fractures, proximal ulna and radius fractures. The study was developed in a randomized placebo controlled study between 2003-2007. The Disabilities of the Arm, Shoulder, and Hand (DASH) score as well as the arc-of-motion (AOM) were assessed after three, six, twelve-months and final follow up for evaluation. Of the 31-patients included, 15-patients (48.4%) received Botox injections...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Henrik C B äcker Christina E Freibott Eric Swart Carsten Perka Charles M Jobin Melvin P Rosenwasser Source Type: research

Palmar plating of distal radius fractures : 3-year follow-up with titanium and PEEK plates give similar outcomes
This study evaluates clinical results with a carbon fibre- reinforced (CFR)-polyether ether ketone (PEEK) plate in comparison to a standard titanium plate. Thirty-one distal radius fractures were included in this randomised controlled trial. Five fractures were classified as type A, 6 as type B and 20 as type C, in accordance with the AO classification. Patients were randomly allocated into two groups : 15 patients for titanium palmar plating (TPP) and 16 patients for PEEK palmar plating (PPP). Follow-up examinations were set at 2 weeks, 6 weeks, 3 months, 6 months and 3 years postop. In terms of wrist range of motion, rad...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Josephine Berger-Groch Ann-Christin Stodtmeister Jan P Petersen Michael Hoffmann Source Type: research

Thrombosis of persistent median artery as a cause of carpal tunnel syndrome : case report
Acta Orthop Belg. 2021 Sep;87(3):529-532.ABSTRACTCarpal tunnel syndrome (CTS) is a common peripheral neuropathy, caused by compression of the median nerve. Symptoms usually are present for months and aggravate over time. Acute onset of complaints and symptoms, like coldness of the hand, should raise awareness of a possible vascular cause of CTS.Persistent median artery (PMA) is a very rare anatomical variant of the blood supply of the upper limb. The presence of a thrombosed PMA is an extremely rare cause of CTS. In this article a case is presented in which the patient has carpal tunnel syndrome of his left hand, caused by...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: S Arnauw G De Wachter Source Type: research

Results of treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint with tendon allograft interposition
Acta Orthop Belg. 2021 Sep;87(3):533-539.ABSTRACTThe aim of the study was to determine if the use of tendon allografts in combination with distal scaphoid resection for the treatment of isolated STT arthrosis is a save procedure. We reviewed the postoperative complications, re-operations, clinical and radiological results of this treatment modality. A retrospective cohort study was conducted. Investigated parameters include wrist mobility (wrist extension and -flexion), strength (grip- and pinch strength), patient-reported outcome scores : Visual Analogue Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand score ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Annelies Eeckhoudt Nadine Hollevoet Source Type: research

Metacarpal chondrosarcoma, from negligence to rareness : a case report and review of the literature
We report an unusual case of a 46-year-old man with a huge chondrosarcoma on his left hand that has been evolving for more than 30 years. The mass has always been painless, the symptoms were only the deformation and a slight loss of motion. We did a subtotal resection since the patient refused the amputation. The investigation, which in- cluded thoracoabdominal tomography, scintigraphy and blood analysis, turned out to be negative. In the literature, CS are usually associated with a locally destructive growth but metastasis hasn't been often described. CS seems to be an aggressive tumor locally but, unlike in other sites, ...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Pauline Ollero Sophie Vanden Dungen Katerina Cermak Louis Kinnen Source Type: research

Reduction of radiation exposure in scoliosis monitoring using flat detector and pulsed fluoroscopy technology
Acta Orthop Belg. 2021 Sep;87(3):545-552.ABSTRACTA new flat detector and pulsed fluoroscopy technology is available to further reduce radiation exposure in radiological monitoring during scoliosis treatment in children and adolescents. The aim of this study is to compare different settings of the system (opening area(OA) and image quality settings (IQS)) in order to find the optimal parameters with high image quality and the lowest possible radiation exposure. Therefore, we examined four cadaver spines (T1 to sacrum) with the flat detector technique using digital pulsed fluoroscopy and simulated the abdominal soft tissues....
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Christian Walter Juergen F Schaefer Ilias Tsiflikas Source Type: research

Gram stain microscopy in septic arthritis
Acta Orthop Belg. 2021 Sep;87(3):553-556.ABSTRACTSeptic arthritis is a serious condition that can lead to rapid destruction of joint if it is not rapidly diagnosed and treated appropriately. The reported annual incidence is 10 in 100 000 although this increases to 70 in 100 000 in those with risk factors for developing septic arthritis mainly rheumatoid arthritis and immune-compromised patients. The aim of this study is to examine the sensitivity and specificity, and thus the clinical usefulness, of gram stain results. This was a single centre, retrospective case series. All joint aspirates over a three year period from Ma...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: Karam Al-Tawil Frederick Quiney Louis Pirkis Nicholas Birkett Aaron Rooney Source Type: research

Economic advantage of 'self-made' antibiotic-loaded spacer compared to prefabricated antibiotic-loaded spacer and spacer molds in two-staged revision arthroplasty
Acta Orthop Belg. 2021 Sep;87(3):557-562.ABSTRACTInfection after total hip or total knee arthroplasty is a serious complication implying great costs for the health care system. Amongst the different treatment options, the two-step exchange using a spacer in the interval is a valid option. We evaluate the economic impact of our self-made antibiotic-loaded hip and knee cement spacers compared with prefabricated spacers and spacer molds. Costs to prepare self-made cement spacers are detailed for each spacer type. We also assess the intraoperative time spent for fabricating our self-made hip and knee spacers. The price of thes...
Source: Acta Orthopaedica Belgica - November 22, 2021 Category: Orthopaedics Authors: K Moerenhout S Steinmetz M Vautrin S Picarra G Udin O Borens Source Type: research