Custom-made triflanged acetabular components in the treatment of major acetabular defects. Short-term results and clinical experience.
We report on the Belgian experience with the aMace® custom-made triflange acetabular component in revision total hip arthroplasty between September 2009 and November 2014. We focused on (1) the complexity of the preoperative planning and reimbursement procedure; (2) the surgical problems and operative experience; and (3) the early outcome. We collected 20 patients' reviews and 22 surgeons' reviews, with a mean follow-up of 25 months. The preoperative planning and reimbursement procedures were rated as time-consuming and cumbersome. In 6/22 cases, the operation was difficult or very difficult. Technical problems occurre...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

External Fixation Versus Hemiartroplasty In Unstable Intertrochanteric Hip Fractures Of The Elderly.
Authors: Polat M, Arslan A, Utkan A Abstract To compare two alternative methods : external fixation (EF) and hemiarthroplasty (HA) in elderly patients with unstable intertrochanteric hip fractures. Forty-two patients with Orthopaedic Trauma Association type 31A2-2 or 31A2-3 fractures treated between January 2007 and December 2010 were included. Twenty-two patients underwent hemiarthroplasty and twenty patients underwent external fixation. The mean length of stay in the operation room was 45 minutes and 108 minutes in the EF and HA groups, respectively (p
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Changes In Pelvic Orientation After Total Hip Arthroplasty : A Prospective Study With EOS ™.
In conclusion, pelvic parameters could be modified after THA. PMID: 30423637 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Patellar Instability - An Update.
Authors: Blønd L Abstract This review is a current concept on the topic of patellofemoral instability purposing to highlight, reflect and in cooperate both recent important findings regarding the patellofemoral joint. In the past decade numerous studies have significantly contributed to our understanding of both the epidemiology, symptomatology and underlying pathomorphology of patella instability. The topic of patella instability is very complex and several biomechanical important factor have been elucidated and consequently treatment strategies are changing. Both non-surgical as well as surgical algorithms...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Minimally Invasive Versus Open Surgery For Acute Achilles Tendon Ruptures A Systematic Review And Meta-Analysis.
Authors: Alcelik I, Diana G, Craig A, Loster N, Budgen A Abstract The minimally invasive surgery (MIS) approach has been popularised as an alternative to the standard open approach in acute Achilles tendon repair. Advocates of MIS suggest earlier functional recovery, due to reduced trauma to adjacent soft tissues. Critics, however, argue that due to inadequate surgical exposure, complications of such surgery are higher compared to an open technique. A systematic review and meta-analysis of randomised, prospective studies weas conducted to compare MIS and open surgery in acute Achilles tendon ruptures. Thirteen stud...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Open Reduction And Internal Fixation Versus Primary Partial Arthrodesis For Lisfranc Injuries Accompanied By Comminution Of The Second Metatarsal Base.
The objective of this retrospective study was to compare open reduction and internal fixation (ORIF) with primary partial arthrodesis for the treatment of Lisfranc injuries accompanied by comminution of the second metatarsal base. Thirty-four patients were treated with ORIF or primary partial arthrodesis from 2007 to 2013. The patients were followed for an average of 28.5 months. Evaluation was performed with clinical examination, radiography, Visual Analogue Scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS) Midfoot Score, and the Short Form 36 (SF-36). Fifteen patients were treated with ORIF, and ninetee...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Efficacy of the Wallis interspinous implant for primary lumbar disc herniation : a prospective randomised controlled trial.
Authors: Gu H, Chang Y, Zeng S, Gao Y, Zhan S, Zheng Q Abstract PURPOSE: To investigate the efficacy of the Wallis implant after lumbar discectomy compared with discectomy alone for primary lumbar disc herniation. Seventy-seven patients with primary lumbar disc herniation were randomly assigned to undergo either posterior lumbar discectomy with (n=40, Wallis group) or without (n=37, control group) Wallis implantation. The primary outcomes were visual analogue scale score, Japanese Orthopedics Association score, and Oswestry Disability Index. The secondary outcomes were intervertebral disc height, range of motion of...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Greater Tuberosity Sclerosis: A Radiographic Sign Of Rotator Cuff Tear?
Authors: Ghandour TM, Elghazaly SA, Ghandour AM Abstract The study had been carried out to investigate the relation of sclerosis of the greater tuberosity to cuff tear, or whether this may signify partial or complete tear.This retrospective study conducted on 425 patients, 250 Females (58.8%) and 175 males (41.2%). Dominant side was affected in 342 Patients (80%). The average age in males was 46 years (24-68 years) and 54.5 years in Females (44-65 years). Greater tuberosity sclerosis had 93.5% sensitivity for rotator cuff tear, 67.5% specificity, 90.4% positive predictive value (PPV), 51.9% negative Predictive valu...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Latarjet reconstruction in patients with anterior shoulder instability and significant Hill-Sachs lesion.
This study was done to investigate if open Latarjet is sufficient to prevent recurrent instability in patients with significant Hill-Sachs defects without addressing these lesions. In the period between October 2009 and November 2014 twenty three patients with shoulder instability and significant bone loss were treated by open Latarjet. All patients were followed up for a period ranged from 17 to 58 months (median ± SD : 30 ± 13.9).The mean preoperative Rowe score was significantly increased from 45.4 to 91.5 (p value
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Operative Techniques For Treatment Of Chronic Massive Rotator Cuff Lesions : Deltoid Flap Transfer Versus Arthroscopic Debridement.
Authors: Blanke F, Sachser J, Majewski M Abstract The treatment of chronic massive rotator cuff lesions remains challenging. Extensive reconstruction techniques as deltoid flap transfer as well as low invasive arthroscopic debridement techniques were established and showed good results. In present study 106 patients with massive rotator cuff lesions were treated by deltoid muscle flap transfer (n = 47 group I) and by arthroscopic debridement (n = 59 group II). Postoperative outcome was determined by amount of pain, range of motion, shoulder functionality according to Constant-Murley Shoulder Score and radiological ...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Outcome Of Surgical Management Of Chronic Pectoralis Major Ruptures In Weightlifters.
We report our outcome of chronic pectoralis major ruptures following surgical repair. Retrospective analysis of 8 patients who were weightlifters, treated for primary pectoralis major repair by one surgeon. Surgical repair was direct via suture anchors and one additionally required fascia lata graft due to tendon retraction. Outcome was assessed by comparing strength to the contralateral pectoralis muscle and the Oxford Shoulder Score. All patients were male with mean age of 36 years. Mean delay to surgery was 25.6 months. Mean followup was 19.6 months and mean Oxford Shoulder Score was 43.7. Six out of eight patients had ...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Long-Term Efficiency Of Extracorporeal Shockwave Therapy On Lateral Epicondylitis.
Authors: Aydin CG, Aykut S, Öztürk K, Arslanoglu F, Kilinç CY, Kocaer N Abstract Lateral epicondilytis is a frequent cause of elbow pain in the adult age population. The purpose of this study was to determine the effects of extracorporeal shock wave therapy (ESWT) effective on long term clinical and functional results in the treatment on patients with lateral epicondylitis. Forty-six patients suffering from lateral epicondylitis for at least 3 months were treated in this study. Clinical evaluation scoring system tests were used before an done year after the treatment for each patients. The VAS impr...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Extension Casting For Both-Bone Forearm Fractures In Children.
Authors: Babazadeh S, Mason TG, Petterwood J, Taylor SW, Chapman N, Fettke GR Abstract Paediatric forearm fractures are commonly treated with closed reduction and cast immobilization. Determining the best way to cast these fractures during the initial presentation may prevent the need for re-manipulation . An analysis of casting technique for all patients under eighteen years of age treated with closed reduction and cast immobilization for both-bone fractures of the forearm at a regional tertiary referral hospital over 7 years was undertaken. One-hundred and eighty-nine consecutive patients with 207 fractures were ...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Role Of The Carpometacarpal Ligaments Of The Thumb In Stability And The Development Of Osteoarthritis Lesions : An Anatomical Study.
This study aims to assess ligament lesions and subluxations of the carpometacarpal (CMC) joint of the thumbs and the role that these ligament ruptures play in the pathophysiology of osteoarthritis (OA). Twenty-five fresh-frozen cadaver hands were dissected. There were 14 female and 11 male with mean age 65 years (51-92 years old). The origin, insertion, and fibre orientation of the ligaments were identified based on Berger´s anatomical descriptions. Length, thickness and width of the main ligaments were measured. The ligament ruptures and the metacarpal translation associated with these ruptures were measured (mm). C...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Limits Of Indications Of The Morrison Wrap-Around Procedure In Thumb Reconstruction.
In this study, we retrospectively report on 10 thumb reconstructions using the wraparound flap from the great toe. Functional results according to the level of amputation are compared. We found in our limited series, that although better results are achieved when the amputation was distal to the MCPJ, the 'wraparound' reconstruction technique still yielded acceptable functional results and outcome in amputation levels through or proximal to the MCPJ. PMID: 30423649 [PubMed] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Flexor Pollicis Longus Tendon Rupture After Volar Wrist Plating : Reconstruction With Palmaris Longus Interposition Graft.
Authors: Berger P, Duerinckx J Abstract Rupture of the flexor pollicis longus tendon is a rare complication after volar plating of distal radius fractures. Several surgical treatment options have been proposed but postoperative results are not well documented. The authors retrospectively studied the clinical outcome of 4 patients after flexor pollicis longus tendon reconstruction with a palmaris longus interposition graft. Minimal follow-up was 12 months. Mean active interphalangeal joint flexion (44°) and thumb opposition (Kapandji 8/10) were significantly reduced compared to the opposite side. Mean power grip...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Trapeziumectomy And Mini Tightrope Stabilization Of The First Metacarpal For Thumb Carpometacarpal Osteoarthritis : A Prospective Case Series.
Authors: Assiotis A, Giannakakis N, Hacker A Abstract Our purpose was to investigate the short-term results of trapeziumectomy and stabilization of the first metacarpal by using the TightRope© device, at a maximum follow-up of 1 year post-op. This is a novel method in treating first carpometacarpal joint osteoarthritis and an alternative to the variety of other methods that have been previously reported. We recruited 21 patients and assessed them at regular intervals, comparing pre-operative and postoperative variables. We recorded all complications during the study period. There was a statistically significan...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Percutaneous Cementoplasty For Acetabulum In Patients With Bone Metastasis.
Authors: Choi ES, Kim YI, Kang HG, Kim JH, Kim HS, Lin PP Abstract The purpose of this study is to demonstrate the surgical technique and to show the results of percutaneous cementoplasty (PC) for acetabular metastases using lateral approach under regional anesthesia. Forty-two cases underwent PC for acetabular metastases. The PC was performed using spinal anesthesia, lateral approach and fluoroscopic guidance. We assessed visual analogue scale (VAS) and revised musculoskeletal tumor society (MSTS) rating system and maximum standardized uptake value (SUVmax) of the acetabular lesion using F-18-FDG PET/CT before and...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Fracture Management In Osteopetrosis : An Intriguing Enigma A Guide For Surgeons.
We present a series of 4 Subtrochanteric fractures treated surgically in 3 patients of Osteopetrosis in a tertiary level Orthopaedic centre over the last 3 years with an aim to highlight our preparation and technique, especially as a guide to other surgeons, to minimize the complication rates and optimise the results. The patients had a mean Harris Hip Score of 85, at a mean follow up of 21.5 months ; the fractures united and all patients successfully returned to their normal activities of daily living. PMID: 30423653 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Inter- And Intraobserver Reliability In The Assessment Of Glenoid Fracture Classifications.
This study aimed to evaluate the intra- and interobserver agreement for fracture classifications of the glenoid, using either plain radiographs, computed tomography (CT) scans. The study was retrospective, using images with a variety of fracture types. Six observers classified the fracture patterns. Classifications of Ideberg, OTAAO, Mayo and Euler/Ruedi were used. Agreement was determined using kappa coefficients. Currently used glenoid fracture classification systems have a fair to moderate intraobserver reliability. Combining plain radiographs and CT scans led to a better observer agreement. For interoberserver reliabil...
Source: Acta Orthopaedica Belgica - November 17, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

A New 3D Reconstruction Method To Assess Anatomical Restoration In Vertebral Compression Fractures.
Authors: Noriega Gonzalez DC, Maestrett G, Mittlmeier T, Dufort P, Meeder PJ, Krüger A Abstract Deformation of the spine following vertebral compression fracture (VCF) can be associated with severe spinal dysfunction. Anatomical restoration is described as the complete reduction and stable fixation of the fracture with the goal to restore the pre-fracture local and global spine properties. The essential need to obtain endplate reduction, and consider the whole vertebral body in the management of vertebral fractures is pointed out. A new 3D imaging technique is described. A new assessment method based on CT sca...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Appropriate Management Of Osteoporotic Vertebral Compression Fractures : A Single Institute Evaluation Using The VCF Monitor.
This study aimed to evaluate the appropriateness of treatment choice in patients with OVCF in a German hospital. The prospective observational study in 190 patients with OCVF (2013-2015). Using the VCF Monitor, treatment choices were compared with the recommendations of the European expert panel. Treatment choices included balloon kyphoplasty (61%), non-surgical management (36%) and other surgical procedures (3%). Compared to the panel recommendations, 70% of treatment choices were appropriate, 24% uncertain, and 3% inappropriate. Less appropriate choices were partly due to patient preferences. The VCF Monitor proved to be...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Acute Injuries Sustained By Racing Drivers: A Cross-Sectional Study.
Authors: Koutras C, Antoniou SA, Jäger M, Heep H Abstract Aim of the present study was to investigate the prevalence and type of acute injuries sustained by 137 racing drivers. An ad hoc questionnaire was developed and was completed by 137 drivers with a mean age (SD) of 42 (15) years. Approximately half of the drivers had
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Antibiotic Impregnated Cement Coated Ilizarov Rod For The Management Of Infected Non Union Of Long Bone.
Authors: Dar TA, Dhar SA, Mir NA, Maajid S, Dar RA, Hussain A Abstract The infected non union of the long bones in the presence of the intramedullary nail is a dreaded complication of fracture management. Around 7% patients may develop an infected non union of the long bones in intramedullary nailing. Amongst the various grades of infection, grade three infection is the most difficult to cure and manage as it involves an osteomyelitic bone. Amongst an array of therapeutic modalities, the two stage methods are commonly used with the first stage aimed at controlling the infection and the second stage at inducing unio...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Is Parathyroid Hormone A Viable Solution For Nonunion? A Systematic Review And Pooled Analysis.
Authors: Kim SJ, Park HS, Lee DW, Lee JW Abstract We conducted a systematic review and pooled analysis of published studies to evaluate the clinical results of parathyroid hormone (PTH) in the treatment of nonunion and delayed union and assess whether there are any adverse effects of PTH. Four electronic databases (PubMed, Web of Science, EMBASE, and Cochrane library) were searched from 1950 to 2016. A total of 24 patients from 13 published studies were identified. The mean age of the patients was 57 years (range, 19-91 years). Mean duration of nonunion after initial treatment (surgical or conservative) was 8.4 mon...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Results Of The Treatement Of Intracapsular Femoral Neck Fractures With A New Dynamic Locking Plate.
Authors: Gruszka D, Dietz SO, Brodt R, Wagner D, Rommens PM, Kuechle R Abstract The purpose of this study was to evaluate the outcomes in patients with intracapsular femoral neck fractures treated with the novel Targon FN implant. Sixty two patients (mean age: 57 years) were included. The clinical and radiological results were investigated. Radiological and clinical followup (mean time: 21,2 months) was available for 51 patients; in 36 patients, Harris Hip Score (HHS) outcome data were additionally assessed. The overall complication rate was 8%. The median Harris Hip Score was 92 (range 30-100). The results of the ...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Comparison Of Acetabulum Posterior Wall Fractures And Fracture Dislocations: Dislocation Does Not Affect Clinical And Radiological Outcomes.
Authors: Kizkapan TB, Misir A, Uzun E, Ozcamdalli M, Yurdakul E, Argun M Abstract The aim of this study was to compare radiological and clinical outcomes of posterior wall acetabulum fractures and posterior wall fracture dislocations. Data were including 52 acetabulum fractures and fracture dislocations. Twenty-six patients (%50) had posterior acetabulum fractures and fracture dislocations who were operatively treated. Radiographic evaluations were performed before and after the operation and at the last follow up. Clinical outcome evaluation was performed at the last follow up. Clinical and radiological outcomes w...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Is There Any Difference Between The Biomechanical Strengths Of The Current Fixation Techniques For Comminuted Distal Patellar Fractures? (Comparison Of Distal Patella Fracture Fixation Techniques).
Authors: Kocadal O, Pepe M, Gunes Z, Aksahin E, Duran S, Aktekin CN Abstract In this biomechanical study, the strength of five different fixation techniques -anterior tension band wiring with K-wires, separate vertical wiring, headless compression screws with anterior tension band wiring, cannulated screws with tension band wiring and memory shape patellar fixator- for distal patellar fractures were compared. Forty calf knees were used for the biomechanical testing. Each specimen was pre-loaded with 10 N at 1 N/s. The distraction forces were applied consistently with the velocity of 5 mm/s. The ultimate load (N) an...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

In recent years, bisphosphonates and RANK-ligand inhibitors have become the mainstay of treatment for multiple types of osteoporosis, as well as several other metabolic bone diseases. Although rare, atypical femoral fracture is a recent but clearly defined complication of antiresorptive therapy with bisphosphonates, and likely also with denosumab. In this article, we present 3 different cases of atypical femoral fracture: an incomplete fracture linked to a bisphosphonate, an incomplete fracture linked to denosumab, and a complete atypical femoral fracture. Specific diagnostic steps and therapy are described. We also offer a complete overview of available literature concerning diagnosis, epidemiology, pathogenesis, treatment and future outlooks concerning this entity. Although antiresorptive therapy offers a very significant benefit in the prevention of osteoporotic fractures, clinicians should be aware of the possible complications, especially with long-term therapy.
Authors: Van Lieshout M, Putzeys G, Goemaere S, Van Der Straeten C, Audenaert E Abstract In recent years, bisphosphonates and RANK-ligand inhibitors have become the mainstay of treatment for multiple types of osteoporosis, as well as several other metabolic bone diseases. Although rare, atypical femoral fracture is a recent but clearly defined complication of antiresorptive therapy with bisphosphonates, and likely also with denosumab. In this article, we present 3 different cases of atypical femoral fracture: an incomplete fracture linked to a bisphosphonate, an incomplete fracture linked to denosumab, and a comple...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Fixation Of Tibial Pilon Fractures Based On Column Concept :A Prospective Study.
We report the functional and radiological outcome in 12 patients of complex tibial pilon fractures, who were treated on the basis of the novel column concept. PMID: 30423663 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Do Patients With Acute Isolated Pubic Ramus Fractures Have To Be Hospitalized?
Authors: Turgut A, Kalenderer Ö, Akan I, Ilyas G, Kumbaraci M, Karapinar L Abstract A total of 129 patients were included in the study. Haemoglobin levels on admission and at 24 hours were evaluated. Radiographs and computed tomography of the pelvis were also evaluated. The patients were divided into subgroups, according to the accompanying occult posterior pelvic injuries, whether they received anticoagulant-antiaggregant treatment, the number of pubic ramus fractures (single or multiple), the level of energy (low or high) and the zone(s) of the fracture(s). The mean haemoglobin decrease was 1.21 g/dL. Forty-...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Radiation Exposure From Computed Tomography Of The Upper Limbs.
Authors: Iordache SD, Goldberg N, Paz L, Peylan J, Hur RB, Steinmetz A Abstract To investigate exposure to radiation we identified a cohort of 312 patients who underwent standardized CT of an upper limb within a three years period. The effective dose per dose length product coefficient was used to calculate the effective doses of radiation. Mean effective doses were as follows: shoulder CT, 10.83 (SD 6.36) mSv; wrist CT, 0.15 (SD 0.07) mSv; elbow CT performed with the arm above the head, 0.21 (SD 0.11) mSv and with the arm adjacent to the torso, 13.1 (SD 10.8) mSv. The corresponding lifetime attributable risk of ca...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Efficacy Of 1,2- Intercompartmental Supraretinacular Artery Pedicled Vascularised Bone Graft For Scaphoid Proximal End Non-Union And Avascular Necrosis.
Authors: Özkan Y, Akalin Y, Çevik N, Cansabuncu G, Öztürk A Abstract The aim is to show the efficacy of 1,2-intercompartmental supraretinacular artery pedicled vascularised bone graft in treatment of scaphoid non-union with concomitant proximal end avascular necrosis retrospectively. Twentytwo cases of scaphoid nonunion with concomitant proximal end avascular necrosis were evaluated. Radiographic evaluation was made with radiographs, computed tomography, and magnetic resonance imaging. Clinical evaluation was made according to the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Ma...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Latarjet Procedure For Anterior Shoulder Instability : A Consecutive Prospective Series Of 50 Cases.
Authors: Gough A, Guyver P, Franklin M, Murphy A Abstract The Latarjet is a successful primary and revision option for anterior shoulder instability. However, recent reports have highlighted varying complication rates. Our study prospectively collected clinical, functional and radiological outcomes of patients undergoing the procedure. Forty-eight consecutive patients (fifty shoulders) underwent the Latarjet procedure in a single UK centre. Clinical, radiological and functional follow-up was performed. Mean clinical follow-up was 32 months and radiological follow-up 20 months. 95% shoulders were subjectively graded...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The Use Of Suture Anchors In Akin Osteotomy : A New Surgical Technique.
Authors: Kilinc CY, Kilinc B, Acar E, Kilinc RM, Aykut S, Oznur A Abstract To perform an Akin osteotomy using suture anchors to achieve stability of the osteotomy line and avoid the need for a further operation to remove an implant. Akin osteotomy using suture anchors was performed on 35 feet of 30 patients (21 female, 9 male ; mean age 45 years, range 18-60 yrs) diagnosed with hallux valgus. In bilateral cases, surgery was firstly carried out on the foot in the more serious condition, followed by the second foot 2 months later. Preoperative and postoperative clinical evaluation of the patients was made using Ameri...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Achievement Of Primary Stability Using 3D-CT Guided Custom Design Femoral Stems In Patients With Proximal Femoral Deformity : EBRA-FCA Analysis.
Authors: Hosny HA, Srinivasan SC, Hall MJ, Keenan J, Fekry H Abstract Hip replacement in patients with proximal femoral deformity and end stage arthrosis is technically challenging. The purpose of this study was to measure the subsidence rate of custom femoral stems using EBRA-Femoral Component Analysis (FCA) software, as an indicator of achievement of primary stability. We retrospectively reviewed 14 hips in 12 consecutive patients who underwent this procedure between June 2008 and Feb. 2011. There were 7 males and 5 females with a mean age 41 years (22-60). The primary diagnosis in the majority of the cases was P...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Neopterin, Interleukin-6, Procalcitonin, C-Reactive Protein And PET-CT Staining As Markers In Infected Total Knee Prosthesis, A Retrospective Analysis.
Authors: Yildirim K, Misir A, Kizkapan TB, Ozcamdalli M, Duygulu F Abstract Diagnosis in prosthetic joint infections is challenging as symptoms are variable, and currently most of the diagnostic tests are non-specific. Normal inflammatory reactions after orthopedic prosthetic surgery may generate false positives, as these tests have high sensitivity but low specificity. Thus, specific tests, as alpha defensin, are needed to distinguish bacterial infections from reactions to surgical trauma. The aim of this study was to determine the sensitivity and specificity of several diagnostic tools for detecting bacterial inf...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Cement Anchors With Screw Holes For Liner Cementation Into Cementless Acetabular Metal Shells.
Authors: Kaku N, Hirakawa M, Hara K, Tabata T, Tsumura H Abstract This mechanical study was conducted with the shellcement interface in order to construct an acetabular metal shell, and to fix a polyethylene liner with bone cement. Six types of models were tested, with all cementations performed under similar conditions. The "lever out" test was conducted 3 times for each group in order to measure the dissociation strength. The average dissociation strength values were 11.5 N• m for those without screw holes; 33.6, 34.7, and 78.7 N• m for those with single holes at 1, 3, and 6 mm depth, respecti...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Bilateral Early Knee Osteoarthritis Treated With Unilateral Proximal Tibial Osteotomy And Contralateral Non-Surgical Technique.
Authors: Wu CC Abstract Some non-surgical techniques that decrease the mechanical load of the knee may be effective in treating early primary knee osteoarthritis. Thirtysix consecutive patients with bilateral early primary knee osteoarthritis and genu varum were treated with unilateral proximal tibial osteotomy in the more degenerated knee. After the osteotomized bone healed, ambulation with protected weight bearing using a cane in the contralateral hand was advised continuously for at least three months or until knee pain subsided bilaterally. Thirty-one patients were followed for an average of 4.6 years (range, 2...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Is There Any Correlation Between Short-Term MRI And Mid-Term Clinical Resultsin Patients Undergoing An Osteochondral Autograft In The Knee?
Authors: Figueroa D, Figueroa F, Calvo R, Zilleruelo N, Serrano G, Arellano S Abstract Thirthy three patients (mean age 32 years) undergoing OA were retrospectively evaluated. All patients had MRI at mean 6.6 months. Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores. The aim is to evaluate Magnetic Resonance Imaging (MRI) in patients who underwent an Osteochondal Autograft (OA) and correlate them with their clinical results-evaluated at mean followup of 28 months (12-88). Tegner Pre-operatively: 6.6, Post-operative: 7.4 (p
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Tibial Component In Total Knee Replacement :The Effect Of Overhang And Sizing On Outcome.
This study confirms that neither medial or lateral overhang of the tibial component influences functional outcome, independent of the severity of overhang. Oversizing the tibial component however, does show worse functional outcome scores at a 5 year review. PMID: 30423675 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Vitamin D Deficiency Is Associated With Longer Hospital Stay And Lower Functionaloutcome After Total Knee Arthroplasty.
Authors: Joris JR, Jansen A, Tahmassebi J, Haddad FS Abstract High vitamin D deficiency prevalence has been found in hip and knee osteoarthritis, and a correlation between low vitamin D levels and worse functional outcome after hip arthroplasty was published before. Our goal was to examine the relation between vitamin D levels and outcome after knee arthroplasty on short and long term. In 138 patients with knee replacements preoperative vitamin D levels were recorded. 33 patients were vitamin D deficient (median 32 nmol/l, range 6-40 nmol/l) and 105 patients were vitamin D sufficient (median 65 nmol/l, range 41-177...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Comparison Of Isokinetic Muscle Strength And Clinical Outcomebetween Isolated And Combined PCL Reconstruction.
Authors: Kim JG, Lee YS, Yang SJ, Lim HW, Cho KJ Abstract The purposes of this study was to 1) compare the functional result and muscle strength between patients who underwent reconstruction by isolated posterior cruciate ligament (PCL) and combined PCLposeterolateral corner sling (PLCS) reconstruction. Nineteen (Group I: isolated PCL reconstruction) and 30 (Group II: combined PCL-PLCS reconstruction) were compared. The clinical results and isokinetic muscle strength were compared between groups. The clinical results were comparable between groups and posterior stability was not different between the two groups, ei...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Which Unicondylar Prosthesis Is Better In The Mid-Term In Obese Patients : Fixed Or Mobile?
Authors: Kuyucu E, Kara A, Say F, Erdil M, Bülbül AM Abstract As it is mentioned in the literature, rates of complications and revision are higher in the obese compared to non-obese patients, although obesity does not a contraindication for unicompartmental knee arthroplasty and successful outcomes are achieved. However, there is not any study in the literature comparing the outcomes of fixed and mobile unicompartmental prostheses which are applied in the obese patients. Objective of this study was to compare outcomes of our obese patients who we applied fixed or mobile unicompartmental arthroplasty and f...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Open Meniscus Repair In Full And Partial Horizontal Meniscal Lesions : A Biomechanical Cadaver Study.
Authors: Waibel FW, Bachmann E, Viehöfer AF, Schürholz K, Snedeker JG, Fucentese SF Abstract Horizontal meniscal tears are often treated by partial meniscectomy. Some clinical studies have shown successful repair. The purpose of this study was to show that axial loading causes less horizontal displacement in partial than in total horizontal lesions and that suture of those lesions prevents horizontal displacement. Forty menisci were tested : sutured partial horizontal lesions (ten), sutured total horizontal lesions (ten) and matched unsutured control groups (ten each). Samples were put in a custom made fi...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Is There A Difference In Outcome Between Two Types Of Valgus Unloading Braces? A Randomized Controlled Trial.
Authors: van Egmond N, van Grinsven S, van Loon CJ Abstract The short-term clinical and radiographic outcomes of two different valgus unloading braces were compared in patients with medial knee osteoarthritis (OA) and a varus leg alignment. A RCT was performed in 100 patients (50 Bledsoe Thruster brace, 50 SofTec OA brace) with symptomatic medial knee OA and a varus leg alignment. Outcomes were the visual analogue scale pain and satisfaction, Dutch Western Ontario and McMaster Universities Osteoarthritis Index, SF-12, 6-Minutes Walking Test, hip-knee-ankle alignment, analgesic use, complications and compliance afte...
Source: Acta Orthopaedica Belgica - November 16, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Small interprosthetic gaps do not increase femoral peri-prosthetic fracture risk. An in vitro biomechanical analysis.
Authors: Quirynen T, Corten K, Segal O, Simon JP, Vander Sloten J, van Lenthe HG Abstract It has been hypothesized that the interprosthetic gap between ipsilateral hip and knee replacements acts as a stress riser affecting bone fracture behaviour. The aim of this study was to quantify femoral strength and fracture morphology for a wide range of interprosthetic gaps. Seven interprosthetic gaps (0-20cm) were created in artificial femora (N = 6-9/group). All specimens were loaded to failure following a compressive loading protocol. Fracture load and fracture morphology were recorded. Outcomes were compared to femora w...
Source: Acta Orthopaedica Belgica - November 10, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Management of greater trochanteric pain syndrome : a systematic review.
Authors: Koulischer S, Callewier A, Zorman D Abstract Greater trochanteric pain syndrome is characterized by pain at or around the greater trochanter. Numerous management modalities have been proposed, with varying success. Cochrane and Pubmed database have been searched from 1990 for studies focusing on the management of this syndrome. We only selected studies with a validated outcome measure. 11 studies met our inclusion criteria. Evidence points towards a pain reduction in the first months after a corticosteroid injection, but this effect does not persist with time. Low energy shock wave therapy also has a posit...
Source: Acta Orthopaedica Belgica - November 10, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Functional outcome following internal fixation of intraarticular fractures of the distal femur.
Authors: Sahu RL Abstract Distal femur fracture with intra-articular extension is a major cause of severe morbidity in patients with lower extremity injuries. The purpose of this study was to evaluate functional outcome, fracture healing, and the complications of distal femoral intra-articular fractures using locking compression plates. A total of 170 patients with intraarticular fractures of the distal femur were recruited from Emergency and Outpatient department and treated with distal femoral locking compression plates. Clinical and functional outcomes were assessed using the Knee Society score. All patients wer...
Source: Acta Orthopaedica Belgica - November 10, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Femur can be lengthened over nail, along its mechanical axis : a modified lengthening over nail technique.
Authors: Açan AE, Demirhan N, Başçi O, Gürsan O, Karakaşli A, Havitçioglu H Abstract The theoretical risk of medialisation of the knee joint and the lateral shift of the lower extremity mechanical axis, due to achievement of lengthening along the anatomical axis is present in the process of lengthening with elongation nails and the "lengthening over nail" technique. With this new technique described in this study we aimed to prove that lengthening over nail can be performed along the mechanical axis of the femur. Six lower-limb models were used to perform three different length...
Source: Acta Orthopaedica Belgica - November 10, 2018 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research