Musculoskeletal injuries among elite artistic and rhythmic Greek gymnasts: A ten-year study of 156 elite athletes.
We report the injuries recorded over a period of 10 years in 156 Greek elite male and female gymnasts. A total of 2390 injuries were reported for a rate of 1,5 new injuries per year per athlete. Most commonly affected areas were the hip (18.5%), the ankle (16.5%), the lumbar spine (16%) and the foot (16%). The most frequent diagnosis was tendinitis (32%), followed by low back pain (20%), and sprains (12%). Fifteen athletes (9%) sustained serious injuries that required surgery. Rhythmic gymnasts had significantly more overuse type injuries compared to artistic gymnasts (p = 0.049). Gymnastics is a sport with a high incidenc...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Fractures and dislocations of the lisfranc tarso-metatarsal articulation: outcome related to timing and choice of treatment.
Authors: Persiani P, Dario Gurzi M, Formica A, Ruggeri A, Villani C Abstract A Lisfranc injury is when one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot, centred on the 2nd tarso-metatarsal joint. These fractures are sometimes easily overlooked, especially if they are part of a polytrauma. They are often difficult to diagnose and treat, but if they go undetected and are not properly treated, they can cause long-term or chronic disability. Our team reviewed a group of 71 patients with a Lisfranc fracture dislocation. The lesions were cla...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Protocol and descriptive epidemiology of the SIGASCOT Italian multicentric registry of revision ACL reconstruction: a 1-year pilot study.
Authors: Zaffagnini S, Grassi A, Adravanti P, Milano G, Schiavone Panni A, Berruto M, Giron F, Ronga M, Madonna V, Condello V, Rossi R, Canata GL, Benazzo F, Zanon G, Mazzola C, Pederzini L, Caraffa A, Tucciarone A, Stefani G, Randelli P Abstract The aim of the present study was to present the demographic and baseline results of the first year of course of the SIGASCOT Italian registry of Revision ACL reconstruction.The data of the patients undergoing revision ACL reconstruction, enrolled in by 20 SIGASCOT members from March 2015 to May 2016, were extracted from the Surgical Outcome System (SOS). Overall, 126 patie...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

10-year results of the Nesovic procedure combined with adductor release for groin pain in 33 competitive athletes.
We present the 10 years results of 33 patients operated on between April 2002 and May 2006 diagnosed with a "sports hernia". The injury was treated with a bilateral abdominal procedure according to Nesovic combined with a bilateral adductor release after unsuccessful conservative treatment of at least 2 months. There were 32 male patients between 18 and 43 years and one female patient aged 25 years with a mean age of 28.8 at time of surgery. All procedures were bilateral. Patients were seen in the postoperative clinic and a questionnaire was collected after 2 years and 10 years. Within 16 weeks, 30 patients (90,9...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

A combination of the modified Stoppa approach and the iliac fossa approach in treating compound acetabular fractures by using an anterior ilioischial plate.
This study aims to investigate the effectiveness of an ilioischial plate in treating compound acetabular fractures. A consecutive series of 40 patients with complex acetabular fractures were surgically treated and retrospectively reviewed. A modified Stoppa approach in combination with an iliac fossa approach was used. In all of the cases, the anterior column was stabilized with reconstruction plates for the iliac wing and along the iliopectineal line to the pubis. The posterior column was fixed either with the newly developed ilioischial plate running from the ilium to the ischial ramus or with standard fixation technique...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Comparative analysis of different total hip replacement implants used in a single health region of the United Kingdom - minimum 15 years follow-up.
We describe the functional and radiological results at minimum 15 years follow up of four groups of total hip replacement(THR) implants used in our health region. 876 THRs in 837 patients who were included in the study that used prospectively collected data in the Tayside Arthroplasty Audit Group(TAAG) database. There were 387 Charnley/Ogee cemented THRs, 188 hips in the cemented CPT/ZCA group, 106 hips in the uncemented Bicontact/Plasmacup group and 195 hips in the hybrid Exeter/Trident group. The most common complications were dislocation (3.88%) and superficial infection (3.76%). With revision surgery for any reason as ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Proximal femoral nail anti-rotation (PFNA) and hemi-arthroplasty in the treatment of elderly intertrochanteric fractures.
Authors: Xie Y, Dong Q, Xie Z Abstract To determine reasonable treatment of intertrochanteric fractures with proximal femoral nail anti-rotation (PFNA) or hemi-arthroplasty (HA) in elderly patients. Between January 2009 and June 2013, a total of 367 patients were admitted to the Orthopedics Department of The Second Affiliated Hospital of Soochow University. Patient data were retrospectively analyzed and included 160 males and 207 females. The ages of the patients were between 60 and 97 years and the average age was 72 +/- 3.9 years. According to the Evans-Jensen classification scheme, the fracture types were type I...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Plate augmentation combined with bone grafting for aseptic non-union of femoral shaft fractures following interlocking nails.
Authors: El Zahlawy H, Abdeldayem SM, Metwaly RG Abstract TThe aim of this study was to evaluate plate augmentation over previously inserted interlocking nails, combined with iliac bone grafting in treating aseptic femoral shaft non-unions. The research was conducted prospectively on 34 patients. A narrow dynamic compression plate was placed while the nail was retained. All the screws were directed posterior to the nail. There were 25 males and 9 females with mean age of 36.6 years old. The mean operative time was 95 minutes with 320ml blood loss. 28 patients showed solid healing by 6 months postoperatively (82%). ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

An evaluation of treating non-union of femoral neck fractures with valgus angulation osteotomy using sliding hip screws.
This study presents the outcomes of patients treated with non-union of femoral neck fractures healed with valgus osteotomy, fixed with a Dynamic Hip Screw (DHS). The study retrospectively evaluated 16 patients who, between 2007 and 2014, developed pseudarthrosis following treatment for a femoral neck fracture and who were treated with DHS-osteosynthesis, after a valgus subtrochanteric osteotomy. Postoperative clinical evaluation of the patients was done? using the Harris Hip Scoring (HHS) system. Union of both the fracture and the osteotomy site was achieved in 17.2 weeks (range: 14-24 weeks) in all patients. The average P...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Biomechanical comparison of fracture site stabilities of femur nails after fracture site resorption.
This study aimed to compare the fracture site stabilities of different femoral nails after fracture site resorption. Thirty composite femurs were divided into three groups of 10 interlocking nails. Using axial compression-distraction machines and a custom-made torsion device, the fracture site rotational and axial stabilities after 1 mm fracture site resorption were determined. Between 6 Nm external and 6 Nm internal rotation torques, the means of the maximum fracture site rotation arc of motion were 5.94 mm for compression nails, 5.9 mm for interlocking nails and 3.5 mm for CAROT nails. Between 2300 N compression and 150 ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Minimally Invasive Plate Osteosynthesis (MIPO) technique for complex tibial shaft fracture.
Authors: Choi S, Lee TJ, Kim S, Cho C, Shim S, Kang H Abstract TTo evaluate the clinical and radiological results of the treatment of complex tibial shaft fracture (AO/OTA type 42-C) with minimally invasive plate osteosynthesis(MIPO). Twenty patients diagnosed with complex tibial shaft fracture without extension to the articular surface and treated with MIPO, including 9 cases of AO/OTA type 42-C2 and 11 cases of AO/OTA type 42-C3, 6 of which were open fractures. External fixation was used for open fractures until the soft tissue damage had healed; then, 2nd stage operation with MIPO was performed to stabilize the ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Demographics, fracture patterns and treatment strategies following wrist trauma.
The objective of this study was to determine the percentage of radiographs which showed a fracture of the wrist. Secondary, the fracture characteristics and the received treatment were determined. Additionally, the percentage of operatively treated patients with a distal radius fracture was compared between the hospitals. A retrospective cohort study was performed in three Dutch hospitals in all consecutive adult patients with wrist trauma who presented at the ED. A fracture of the wrist was defined as a fracture of the distal one-third part of the radius, the distal one-third part of the ulna or any carpal bone. Fracture ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Excellent functional recovery after Kirschner-wire extension blocking technique for displaced closed bony mallet finger injuries; results of 36 cases.
In conclusion, the k-wire extension blocking technique is safe and results in excellent mid-term functional outcome. PMID: 31315016 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up.
Authors: Karaca S, Enercan M, Levent Ulusoy O, Hamaoglu A Abstract T55 patients with cement-augmented pedicle screw were retrospectively analyzed. All patients underwent computed tomography at a minimum of 2 years after index operation. Computed tomography scans were analyzed to determine pedicle screw loosening, cement leakage, and fusion rates at augmented levels. The purpose of this study was to analyze the efficacy and complications of cement augmentation in elderly patients. Screw loosening occurred at fused levels in all patients, except one patient with pseudoarthrosis. All cases of screw loosening occurred ...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Spinopelvic parameters in degenerative spondylolisthesis.
Authors: Ha JK, Hwang CJ, Lee DH, Lee MY, Yoon SJ, Lee CS Abstract The purpose of this study was to compare various sagittal spinopelvic parameters between patients with and without degenerative lumbar spondylolisthesis (DLS). A total of 165 patients who underwent surgery for low back and/or radicular pain were divided into two groups: those without DLS (non-DLS group; n = 85) and those with DLS (DLS group; n = 80). In all sagittal spinopelvic parameters, no significant difference was found between the non-DLS and DLS groups. The mean pelvic incidence (PI) value of the DLS group (56.4°) was almost similar to th...
Source: Acta Orthopaedica Belgica - July 19, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Use of sliding transphyseal flexible intramedullary nailing in pediatric osteogenesis imperfecta patients.
Authors: Popkov D, Popkov A, Mingazov E Abstract In our country, the sliding Flexible Intramedullary Nailing is used alone or in combination with Ilizarov frame in children with osteogenesis imperfecta. The study assesses the results of sliding intramedullary nailing in deformity correction in severe types of osteogenesis imperfecta. We retrospectively reviewed 17 consecutive cases (mean age 5.2 y.o.) of types III, IV and VII of osteogenesis imperfecta. In group I (9 patients) the transphyseal FIN was performed using titanium nails. Sliding flexible intramedullary nailing was associated with Ilizarov frame in group...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Rectus femoris transfer improves stiff knee gait in hemiplegic adults following stroke or traumatic brain injury.
Authors: Vermeiren A, Bar-On L, Van Campenhout A Abstract The aim of this study was to provide quantitative evidence of the effect of rectus femoris (RF) transfer surgery on improving gait in adults suffering from stiff knee gait (SKG) following stroke or traumatic brain injury (TBI). Retrospective cohort study University hospital, department of orthopaedic surgery Hemiplegic patients with decreased peak knee flexion in swing, reduced total knee range of motion and spasticity of the RF demonstrated by a positive Duncan Ely test and a pathologic dynamic electromyography of the RF. Ten right hemiplegic patients had a...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Surgical options in the management of landmine blast injuries of lower limb: a randomised prospective study.
Authors: Varma R, Arora NC, Rai S, Chaudhary A, Wani S Abstract Landmine blast injuries are high velocity shattering injuries that produce ghastly and gory wounds, presenting a dilemma to the treating surgeon, especially when the literature on this subject is limited. The aim of the present study is to enlist various surgical procedures that can be explored to treat such complex injuries. 60 cases having varied degrees of involvement of the lower limb from mine blasts were managed. Surgical treatment was tailored to the individual requirement depending on the extent and severity of injury. Serial surgical wound deb...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Anterior cervical discectomy and fusion with Scarlet AC-T cervical secured cage. Safety evaluation and 6 months radiological follow up.
Authors: Fransen P Abstract Fusion rates in ACDF procedures with classical cages are higher if supplemented with a plate. However, the use of plates has been associated with increased morbidity and dysphagia. As an alternative, we studied the ACDF approach using, a secured titanium cage with integrated fixation screws, which allows for "Zero Profile" segmental stabilization. We performed a retrospective analysis of prospectively collected data on a group of 32 patients which had been subjected to ACDF using the Scarlet AC-T (*) secured titanium cage. The studied population comprised 13 males (40.6%) and 1...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Management of spinal trauma patients: a national survey in The Netherlands.
Authors: Stadhouder A, Faraj S, Öner C Abstract Lack of consensus in spinal trauma management and differences in the practical organization between trauma regions can have significant consequences on the fate of patients with spine trauma. For this reason a national survey was conducted among the 11 trauma regions in the Netherlands. Representative surgeons were sent a survery on seven areas of spinal trauma management: treatment protocol, (2) referral, (3) advisory committee, (4) classification used, (5) responsible medical specialist, (6) timing of surgical intervention, and (7) the current view on spinal tr...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Prevalence of lumbar high-intensity zone: assessment using a screening tool independent of spinal symptoms.
Authors: Campos M, Vial R, Castro J, Urrutia J Abstract High-intensity zone is an area of high-intensity signal within the posterior annulus fibrosus observed in magnetic resonance imaging; initially described in painful discs, recent studies have described similar prevalence in symptomatic and asymptomatic subjects. Since its' prevalence in the general population has not been established, we used a screening tool independent of spinal symptoms to determine high-intensity zone prevalence. We studied 217 patients evaluated with abdominal-pelvic magnetic resonance imaging; we looked for high-intensity zone, disc dege...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Minimally invasive procedure of acute acromioclavicular joint dislocation: one suture-button device versus two suture-button devices.
Authors: Sun LJ, Lu D, Ma YF, Yu B Abstract The purpose of this study was to assess the clinical results of patients treated with either one suture-button device or two suture-button devices for acute acromioclavicular (AC) joint dislocations. Eighty patients were randomized to operative stabilization either by one suture-button device (OSB, 40) or by two suture-button devices (TSB, 40). Postoperative complications, the Constant, VAS and SST scores, patient subjective satisfaction result were reviewed. The total incidence of complications was similar in both groups (16/40 vs. 17/40, P =0 .820). There were no signif...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Central band reconstruction for the treatment of Essex-Lopresti injury : A novel technique using the brachioradialis tendon.
Authors: Apergis EP, Masouros PT, Nikolaou VS, Arealis G, Babis GC Abstract Longitudinal stability of the forearm is mainly provided by three structures: the radiocapitellar contact, which acts as the primary stabilizer, the central band of the interosseous ligamentous complex (IOLC) and the intact triangular fibrocartilage complex (TFCC). In an Essex-Lopresti lesion the forearm becomes fully destabilized, since all of these three components are injured. Fixation or replacement of the radial head with a metallic prosthesis along with repair of the TFCC and stabilization of the distal radioulnar joint (DRUJ) are wel...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The outcome comparison of headless screws and Mini-plate for treating type B3 distal humerus fractures.
Authors: Chen D, Huang X, Liu J, Li S Abstract The purpose of this retrospective study was to evaluate the outcome of headless screws and Mini-plate for treating Type B3 fractures of distal humerus. Seventeen patients with type B3 fracture were included and divided into headless screws group and Mini-plate group. Outcome was evaluated using Mayo Elbow Performance Score (MEPS), Short form 36 questionnaire (SF-36), visual analog score (VAS), and range of motion (ROM) at 12 months' follow-up. All patients received a minimum follow-up of 12 months. Postoperative complications mainly included elbow stiffness, heterotrop...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Does computerized tomography change the treatment decision in pediatric medial epicondyle fractures?
Authors: Onay T, Aydemir AN, Okay E, Topkar OM, Gulabi D, Erol B Abstract The amount of displacement in medial epicondylar fracture is one of the most important criteria for treatment decision. The displacement of medial epicondyle fractures of the humerus may be underestimated by standard AP and lateral views of elbow. The aim of the current study is to show the clinical relavance of computerized tomography (CT) for medial epicondyle fractures. A retrospective analysis on patients with medial epicondyle fracture was performed. Measurements were performed by 9 reviewer, there were 12 cases available for review with...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Metastasis from lung carcinoma to the finger: A case report.
We present a case of a skeletal metastasis from a lung carcinoma in the fourth digit of the hand and performed a curettage of the metastatic tumor, followed by a stabilization of the middle phalanx with a bone cement spacer and postoperative local radiation. The postoperative pain relief was acceptable and the functional outcome was relatively good, and therefore indicates that this treatment option could be considered in the palliative care setting of acrometastatis. PMID: 31023204 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Is high body mass index a potential risk factor for poor outcome after hip arthroplasty? A cohort study of 98 patients 1 year after surgery.
Authors: Liljensøe A, Laursen JO, Søballe K, Mechelenburg I Abstract The association between obesity and outcome after hip arthroplasty is controversial. We investigated whether there was an association between the preoperative body mass index in primary total hip arthroplasty patients and their quality of life and physical function 1 year after surgery. 98 patients were included in the study. The results were adjusted for age, sex, and comorbidities. The obese group had an increased risk of obtaining a worse physical score and a lower activity in daily living score at the 1-year follow-up than compar...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Conventional versus direct magnetic resonance imaging in detecting labral lesions in femoroacetabular impingment - a retrospective multicenter study.
Conclusions: In a clinically suspected labral tear MRA has higher sensitivity than MRI. Further studies on asymptomatic patients may be needed to determine the specificity of different MRI techniques. PMID: 31023206 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

The use of ultrasound in the diagnosis of adverse reaction to metallic debris following metal on metal hip replacement.
This study shows ultrasound as a reliable investigation in the diagnosis of ARMD following MoM hip replacements. PMID: 31023207 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Treatment of posterolateral tibial plateau fractures through fibular osteotomy approach.
Authors: Zhao G, He Q, Duan H, Ma J Abstract The best approach for treating posterolateral tibial plateau fractures remains controversial. The aim of the present study was to evaluate the outcomes of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with the fibular osteotomy approach. Between January 2009 and July 2012, twelve patients with posterolateral tibial plateau fracture were treated using the fibular osteotomy approach with a proximal tibia locking compression plate. The epidemiological data, operation details, and clinical outcomes over 25.6 ± 2.1 mon...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Comparison of local infiltration analgesia with single injection femoral nerve block in total knee arthroplasty.
Authors: Schwab PE, Yombi J, Lavand'homme P, Thienpont E Abstract The purpose of this study was to compare the analgesic and hemostatic effects of Local Infiltration Analgesia (LIA) with single injection femoral nerve block (SFNB). A database of patients undergoing knee arthroplasty between 2008 and 2013 was analyzed. A group of patients who underwent minimally invasive TKA either with SFNB (n = 112) or with LIA (n = 112) were matched. In the early postoperative period, the LIA group had a significantly lower VAS score, a lower drop in Hb and a lower length of hospital stay. Both the SFNB and LIA techniques provide...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Importance of assistant intra-operative medial distraction technique for intraarticular calcaneus fractures.
Authors: Yu T, Yang Y, Li B, Sah S, Chen K, Yu G Abstract To report the clinical efficacy of open reduction and internal fixation (ORIF) assisted by medial distraction for intra-articular calcaneus fractures. From September 2010 to November 2013, 151 patients with intra-articular calcaneus fractures were treated at our department by ORIF. They were 95 men and 56 women, 18 to 69 years of age. According to the Sanders classification, there were 24 cases of type II, 76 ones of type III and 51 ones of type IV. Medial distraction was used in 27 cases but not in 124 ones. The 2 groups were compatible, without significant...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Reconstruction of chronic achilles tendon ruptures in elderly patients, with vascularized flexor hallucis longus tendon transfer using single incision technique.
Authors: Pendse A, Kankate R Abstract The purpose is to report the outcome following reconstruction of neglected Achilles tendon ruptures in elderly patients with Flexor hallucis longus tendon (FHL) biotenodesis. Seventeen cases (mean age 65.7 years), of Achilles tendon reconstruction with FHL biotenodesis for chronic ruptures were reviewed. Outcomes evaluated with American orthopaedic foot and ankle score (AOFAS), calf girth atrophy, range of ankle movement, ability to perform single leg heel raise and patient satisfaction. The mean follow up was 27 months (range 17-52). The mean AOFAS score improved from 57.47 (+...
Source: Acta Orthopaedica Belgica - April 27, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

A growing stake in orthopaedic surgery and traumatology for the future management of obese patients.
Authors: Choufani C, Barbier O, Caubere A, Ollat D, Versier G Abstract The prevalence of obesity is increasing. In orthopaedic surgery, the impact of obesity is felt. The aim is to take stock of the consequences of obesity for patients at each stage of management. In this mini-review, we identify the main pathophysiological factors, specific orthopaedic complications and consequences to consider at each stage of management. Obese patients are subjected to a chronic inflammatory state and biomechanical stress. This augments the risk of sepsis and trauma, musculoskeletal damage, the frequency of organ failure and thu...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Staged bone grafting for the management of segmental long bone defects caused by trauma or infection using induced-membrane technique.
In conclusion, induced membrane (Masquelet) technique is a safe, simple and reliable method for treating segmental bone defect. The major complications of this technique include infection and graft resorption. PMID: 30879442 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

C-reactive protein kinetics and its predictive value in orthopedic (trauma) surgery: A systematic review.
Authors: Kruidenier J, Dingemans SA, Van Dieren S, De Jong VM, Goslings JC, Schepers T Abstract In Orthopedic Trauma Surgery (OTS), C-reactive- protein (CRP) is a widely used marker for the diagnosis of postoperative wound infections (POWI's) and other complications. The aim of this systematic review was to describe specific CRP kinetics and to evaluate the diagnostic value of CRP for te detection of post-operative complications in OTS. The same pattern is reported consistently, where the highest levels of CRP are found at post-operative-day two or three, returning to normal in three weeks. Amplitude varies per pro...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Pinnacle ® modular metal-on-metal articulation in primary total hip arthroplasty: mid-term results of 195 cases.
Pinnacle® modular metal-on-metal articulation in primary total hip arthroplasty: mid-term results of 195 cases. Acta Orthop Belg. 2018 Dec;84(4):407-414 Authors: Colen S, Kuiper JW, Thys P, De Schuyffeleer S, Mulier M Abstract Studies concerning Pinnacle® modular metal-on- metal (MoM) total hip arthroplasty (THA) show better results than for most other MoM THAs. The goal of this study was to report on the revision rate, clinical outcome and metal ion levels regarding this specific prosthesis. Retrospectively selected patients were evaluated clinically, and Visual Analogue Score for pain (VAS), ...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Current knowledge in orthopaedic surgery on recommending sport activities after total hip and knee replacement.
Authors: Oljaca A, Vidakovic I, Leithner A, Bergovec M Abstract The increasing number of younger patients with total hip arthroplasty and total knee arthroplasty sets higher demands on the postoperative quality of life. When it comes to athletic activity, recommendations and guidelines for sports remain unclear. We have reviewed published literature to determine the extent to which patients resume their athletic activities postoperatively, and what would be the best choice. Golf and double tennis remain the most recommended activities. No-impact, low power sports like swimming and bicycling are generally allowed. J...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Inclination but not anatomical reconstruction is related with higher cobalt levels in MoM hip arthroplasty.
In this study we investigate if there is a relation between the inclination and anteversion angle of the cup and the anatomical reconstruction of the hip on the serum cobalt level. Postoperative cobalt serum levels were measured in 250 patients with the M2a-38 cup and Taperloc stem combination. On standardized radiographs inclination and anteversion angle, lower limb length, lateral offset and center of rotation distance were evaluated. A difference of more than 5 millimeter compared to the preoperative situation was considered as a non-anatomical reconstruction. For every 10 degrees increase in inclination the cobalt leve...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Pelvic height planning versus conventional templating in preoperative planning of acetabulum cup size for THA.
This study aimed to compare the accuracy of pelvic height planning vs. the conventional templating method for acetabulum cup measurement. A total of 200 consecutive patients undergoing primary total hip arthroplasty (THA) were randomly grouped as follows: group A, accepting conventional templating; group B, accepting pelvic height planning. Preoperative measurement of the acetabular cup was performed with conventional templating and pelvic height planning, respectively. There were 57 cases with the same size or with one type size discrepancy, 49 with two type size discrepancies, and 14 with three type size discrepancies in...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Management of stress fractures of the proximal tibia in patients with advance knee osteoarthritis. A case series.
Authors: Rashid RH, Zubairi AJ, Umer M, Hashmi PM, Lakdawala RH Abstract To evaluate the outcome of one stage long stem total knee arthroplasty (TKA) of patients with stress fracture of the proximal tibia of the knee joint. Record of 15 patients, 14 females and one male who underwent one stage long stem TKAfrom the year January 2008 till December 2014 were reviewed retrospectively. Outcome variable was fracture healing which was seen clinically (pain free and postop ambulation) as well as radiologically (union of three out of four cortices). Mean age of the patients were 65 years and the mean BMI was 31. Of the 15 ...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Matrix-induced adipose-derived mesenchymal stem cells implantation for knee articular cartilage repair. Two years follow-up.
Authors: Kyriakidis T, Iosifidis M, Michalopoulos E, Melas I, Papadopoulos P, Stavropoulos-Giokas C Abstract The present study aims to evaluate the efficacy of matrix-induced adipose-derived mesenchymal stem cells (Ad-MSCs) for cartilage repair of focal chondral knee lesions. Twenty patients were initially treated for symptomatic full-thickness chondral defects and then prospectively followed for two years. All patients underwent a single- stage procedure consisting in filling each defect with autologous culture-expanded mesenchymal stem cells embedded in a trimmed-to-fit commercially available biodegradable matrix...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Principal component analysis as a tool for determining optimal tibial baseplate geometry in modern TKA design.
In this study "principal component analysis" was used as a statistical tool in order to determine the ideal tibia baseplate shape, based upon anthropometric CT- scan data defining an average proximal tibial shape and variations. Gender specificity was evaluated and differences in geometry depending on anatomic constitution (varus, neutral, valgus) were analyzed. The results from our study indicate that in the arthritic knee differences in proximal tibial morphology at the resection level were mainly attributed to size and not shape. This is true for both Caucasian men and women, and is independent from the anatom...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Intraoperative rotation control in closed intramedullary nailing in tibia diaphyseal fractures: a prospective, randomised study.
In this study, a more reliable method was used and it was a more practical means of checking rotation intra-operatively for tibia diaphysis fractures. 42 patients who presented with a unilateral tibia diaphyseal fracture. were randomly divided into two groups. In Group 1, the Intraoperative Rotation Control Method (IRCM) was used and compared with Group 2 as the control group. The Delta Rotation obtained from the MRI measurements were recorded and the Mean Delta Rotation (MDR) was obtained for each group separately. Malrotation was determined at a statistically significantly lower rate in Group 1. The MDR was statistically...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Operative treatment algorithm for intra-articular calcaneal fractures.
Authors: Popelka V, Zamborsky R Abstract Displaced calcaneus fracture often results in severe permanent sequelae and considerably limits the activities of daily living. In this prospective cohort study we present the outcomes of surgical treatment of 137 displaced intra-articular calcaneal fractures, over 8y period. Follow-up data were obtained up to 3 years post-operatively. Post-operative function was assessed by scoring systems - Creighton-Nebraska Health Foundation Assessment Scale (C-N score) and Ankle-Hindfoot Scale AOFAS (A-H score) and radiographic assessment revealed the accuracy of the position. According...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Intramedullary nailing of displaced midshaft clavicle fractures using a TEN with end cap: issues encountered.
In conclusion, because in 70% of the patients the implant-related irritation was directly caused by the end cap, we believe end caps should not be used after intramedullary nailing for displaced midshaft clavicle fractures. PMID: 30879453 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Late function and complications of hook plate implantation for distal-third clavicle fractures : a retrospective study.
In this study, the examined data was analysed from61 patients with Neer type II clavicle fractures treated with hook plate implantation between January 2008 and February 2011. The patients were divided into three groups depending on the removing time of plates after the fractures healing : early removal (6 months, n=6). All patients underwent clinical and radiographic follow-up in the outpatient department for a median of 18 months and every fracture healed eventually. Shoulder function was evaluated using the Constant shoulder score. The mean Constant shoulder score was greater, indicating better function, in the early re...
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Minimal Invasive Percutaneous Plate Osteosynthesis (MIPPO) vs. Open Plating in Superior Plating of Midshaft Clavicle Fractures.
Authors: Zehir S, Sahin E, Songür M, Altunkiliç T, ÖZdemir G PMID: 30879455 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

A systematic review of management of scapular fractures.
Authors: Kannan S, Singh HP, Pandey R Abstract There is no agreement within literature regarding management of scapula fractures. Our aim was to carry out a systematic review of literature on management of the scapular fractures. Our search across multiple medical databases for studies on the scapular fractures until February 2014 yielded 32 studies. We have excluded case series
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

Outcome at 3 to 5 years of a treatment algorithm for rotator cuff tears in an elderly population.
Authors: Mirzoyan H, Handelberg F, Pouliart N Abstract The purpose of this study is to evaluate the results of a conservative approach of rotator cuff tears in an elderly population at 3 to 5 years of follow-up. Prospective comparative study. All patients started with a program of exercises of at least 1 to 3 months. When no satisfying results for pain relief and ADL were achieved, surgery for cuff tear repair was offered. Patients were contacted after 3 to 5 years for evaluation by questionnaire, an ultrasound and a strength measurement exam. 97 patients (104 shoulders) with a mean age of 68,5 years were included....
Source: Acta Orthopaedica Belgica - March 20, 2019 Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research