Comment on Medina et al.: orthopaedic surgery patients who use recreational marijuana have less pre-operative pain
(Source: International Orthopaedics)
Source: International Orthopaedics - March 5, 2019 Category: Orthopaedics Source Type: research

Strength of suture-button fixation versus ligament reconstruction in syndesmotic injury: a biomechanical study
ConclusionThe stability of the suture-button fixation was equivalent to ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury as determined with biomechanical testing. However, this study does not prove that one is advantageous over the other. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials
AbstractPurposeOsteoarthritis (OA) is one of the most common causes of disability and a prevalent chronic disease. The use of collagen is growing due to the satisfactory results in the treatment of OA. However, the possible beneficial effects of collagen for the treatment of OA are currently controversial. The aim of the present meta-analysis was to evaluate the effect of collagen-based supplements on OA symptoms.MethodsPubMed-Medline, Scopus, and Google Scholar databases were searched for randomized placebo-controlled trials evaluating the effect of orally administered collagen on OA symptoms using the Western Ontario and...
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Osteonecrosis of the femoral head: genetic basis
ConclusionTaken together, these associations may lead to new pathways of bone repair and remodeling while opening new avenues for therapeutic targets. Knowledge of genetic variations could help identify individuals considered to be at higher risk of developing ONFH and prevent the multiple hit effect. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Clinical application of a minimally invasive cement-augmentable Schanz screw rod system to treat pelvic ring fractures
ConclusionThe investigated Schanz screw rod system is a suitable implant to broaden the established procedures to stabilize dorsal pelvic ring fractures.Trial registrationThe study is registered at the Clinical Trial Registry University of Regensburg (Number Z-2017-0878-3). (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy —one of the causes affecting the patellofemoral joint?
ConclusionHigh rates of anterior-inclined osteotomy have been described previously as well as in this study. Anterior-inclined osteotomy tends to result in the anterior translation of the proximal fragment. This may result in increased vertical vector force onto the patellofemoral joint, which further accelerates patellofemoral joint degeneration. Therefore, surgeons should attempt to perform parallel osteotomy or avoid anterior displacement of the proximal fragment if there is concern of anterior-inclined osteotomy. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Socioeconomic factors and individual lifestyles influencing the incidence of patella fractures: a national population-based survey in China
ConclusionsSpecific public health policies focusing on decreasing alcohol consumption should be implemented. Individuals aged 45 –64 and 65–74 should pay more attention to bone mass density and prevention of falls, especially those with previous history of fracture. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Decision-making algorithm for sequential treatment of diaphyseal bone gaps in war-wounded patients in the Middle East
ConclusionsLess invasive procedures may lead to better patient outcomes, although unfortunately may not always be possible given the nature of the injury and/or injury site. (Source: International Orthopaedics)
Source: International Orthopaedics - February 23, 2019 Category: Orthopaedics Source Type: research

Reply to “Letter to the Editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
(Source: International Orthopaedics)
Source: International Orthopaedics - February 23, 2019 Category: Orthopaedics Source Type: research

Perceived skills for sports performance after primary hip arthroplasty: a cross-sectional study
ConclusionsA significant number of patients return to sports after hip arthroplasty and most of them perceive a good athletic performance after surgery. These findings should enrich the pre-operative assessment of patient ’s expectations, particularly for those who wish to resume physical activity. (Source: International Orthopaedics)
Source: International Orthopaedics - February 19, 2019 Category: Orthopaedics Source Type: research

Congenital orthopaedic limp deformities in Corpus Hippocraticum
AbstractDuring the fifth century BC in ancient Greece during the eve of orthopaedics, the Hippocratic School of Medicine diagnosed a series of congenital limb deformities. Congenital dislocation of the arm, elbow, wrist, hip, knee, tarsotibial joint, apex leg, as well as talipes valgus (clubfoot), congenital clavicle fractures, and thumb malfunction were all discussed by Hippocrates and his followers. Ancient Greek medico-philosophers, fond of a “perfect” human body, proposed an immediate non-interventional approach, while archaic orthotics and specialized footwear were suggested. The Hippocratic methodology wa...
Source: International Orthopaedics - February 15, 2019 Category: Orthopaedics Source Type: research

Lumbar disc herniation: what has the Spine Patient Outcomes Research Trial taught us?
ConclusionsThis report reviewed the current state of SPORT publications related to IDH to identify and summarize what we have learned about diagnosis, patient characteristics, treatments, outcomes, and cost-effectiveness in patients with lumbar disc herniations. Many important findings are now published from this robust trial ’s data. Clinicians should incorporate these results into their clinical decision-making and during counseling patients presenting with lumbar disc herniations. (Source: International Orthopaedics)
Source: International Orthopaedics - February 15, 2019 Category: Orthopaedics Source Type: research

Autologous mesenchymal stem cell implantation, hydroxyapatite, bone morphogenetic protein-2, and internal fixation for treating critical-sized defects: a translational study
ConclusionsThe combination of autologous BM-MSCs, HA granules, and BMP-2 is safe and remains to be a good option for the definitive treatment for CSD with previous failed surgical attempts. Further studies with a larger sample size are required to be done. (Source: International Orthopaedics)
Source: International Orthopaedics - February 12, 2019 Category: Orthopaedics Source Type: research

Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures
AbstractPurposeThe neutrophil to lymphocyte ratio (NLR) is a simple predictor used in oncology and cardiology. We aimed to analyze the NLR profile of patients with diaphyseal fractures of the humerus, femur, and tibia.MethodsWe performed a cross-sectional, consecutive-case population-based study including 148 patients (41.9% men respectively 58.1% women) with humeral (23.0%), femoral (30.4%), and tibial (46.6%) diaphyseal fractures, admitted for surgical treatment in our level 1 trauma centre over two  years.ResultsThe differences in NLR between the studied subgroups were not significant (p = 0.067), the h...
Source: International Orthopaedics - February 6, 2019 Category: Orthopaedics Source Type: research

Single-stage treatment of infected tibial non-unions and osteomyelitis with bone marrow granulocytes precursors protecting bone graft
(Source: International Orthopaedics)
Source: International Orthopaedics - February 2, 2019 Category: Orthopaedics Source Type: research

A “thank you” editorial concerning the evolution and growth of “International Orthopaedics”, the journal team, outstanding authors and acknowledged expert reviewers
(Source: International Orthopaedics)
Source: International Orthopaedics - February 2, 2019 Category: Orthopaedics Source Type: research

Correction to: A biomechanical comparison of different fixation techniques for fractures of the acetabular posterior wall
In the original publication, the following authors have been omitted due to a technical error in the original article: (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

The impact of obesity on resource utilization among patients undergoing total joint arthroplasty
AbstractPurposeThe presence of obesity poses a challenge for clinical and administrative staff in the peri-operative setting. Evidence indicates that obesity may increase peri-operative complications. However, data on resource utilization in patients undergoing total knee and hip arthroplasty remain rare. Using national data, we sought to determine whether increasing levels of patient obesity is associated with greater resource utilization. We hypothesized that patient care in individuals with a body mass index (BMI) greater than 40 is associated with longer operative and anaesthetic times, longer hospital stays, and great...
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures: a meta-analysis of biomechanical studies
ConclusionsThis meta-analysis shows that parallel constructs provide greater axial stiffness, axial strength, and torsional stiffness than orthogonal plate for DHF fixation. A subgroup analysis revealed that parallel constructs had better torsional stiffness in supracondylar fracture fixation.Level of evidenceIA (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Correction to: Denosumab does not decrease the risk of lung metastases from bone giant cell tumour
Last and second name of an author have been mixed up. It shows Piergiuseppe as the last name, but his second name is Tanzi and the first name is Piergiuseppe. (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Randomised clinical trial assessing migration of uncemented primary total hip replacement stems, with and without autologous impaction bone grafting
ConclusionsAutologous impaction bone grafting in uncemented primary THR has shown its short-term post-operative outcomes to be equivalent to standard uncemented technique, whilst offering a better fit in patients who are between femoral stem sizes.Australian clinical trial registration numberACTRN12618000652279. (Source: International Orthopaedics)
Source: International Orthopaedics - January 31, 2019 Category: Orthopaedics Source Type: research

Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review
ConclusionsThe LCL group has achieved more radiographic corrections and more improvements in the AOFAS score than the AR group. Complications were more common in the LCL group than in the AR group, and the re-operation rates were similar between the two groups. (Source: International Orthopaedics)
Source: International Orthopaedics - January 30, 2019 Category: Orthopaedics Source Type: research

Comparison of the modified Heuter approach and the Kocher-Langenbeck approach in the treatment of Pipkin type I and type II femoral head fractures
AbstractPurposeTo evaluate and compare the effectiveness of the modified Heuter approach and the Kocher-Langenbeck approach in the treatment of Pipkin type I and II femoral head fractures.MethodsThe study cohort consisted of 39 patients with Pipkin type I or type II femoral head fractures who were treated by open reduction and internal fixation through the modified Heuter approach (the Heuter group) or the Kocher-Langenbeck approach (the K-L group) between June 2013 and January 2016. Standard radiographs and computed tomography (CT) scans were obtained before surgery and during the follow-up. The two approaches were compar...
Source: International Orthopaedics - January 25, 2019 Category: Orthopaedics Source Type: research

Can surgical site infections be controlled through microbiological surveillance? A three-year laboratory-based surveillance at an orthopaedic unit, retrospective observatory study
ConclusionsThe infection control was a significant problem at the studied orthopaedic unit, as evidenced by the SSI incidence rate significantly higher than expected. We suggest implementing the infection control and prevention based on evidence-based medicine, and a unit-based surveillance. A cumulative unit-based antibiogram reflects the drug-susceptibility pattern for the strains from the infections acquired at the unit. (Source: International Orthopaedics)
Source: International Orthopaedics - January 24, 2019 Category: Orthopaedics Source Type: research

Joint replacement surgery in Ghana (West Africa) —an observational study
ConclusionThis observational study could serve as a springboard for establishment of arthroplasty registries for countries in the sub-region as a whole. (Source: International Orthopaedics)
Source: International Orthopaedics - January 24, 2019 Category: Orthopaedics Source Type: research

Tibiofemoral dislocation after primary total knee arthroplasty: a systematic review
ConclusionsImproved implant design has reduced the rate of tibiofemoral dislocation, although this complication remains serious in both the short and the long term. The present review identified patient- and surgeon-related risk factors. Awareness of the former, which are identifiable pre-operatively, and of the most frequent technical errors is critical. (Source: International Orthopaedics)
Source: International Orthopaedics - January 23, 2019 Category: Orthopaedics Source Type: research

Use of a fibrin sealant within a blood-saving protocol in patients undergoing revision hip arthroplasty: effects on post-operative blood transfusion and healthcare-related cost analysis
AbstractPurposeBlood transfusion and blood management are important aspects in orthopaedic surgery. Strategies include intra-operative and post-operative blood salvage and even the use of fibrin sealant in selected case. Objectives of the study were (1) to compare the total number of transfusions and the length of hospital stay in patients undergoing complete revision hip arthroplasty (RHA) with and without the use of a fibrin sealant (EVICEL ®) and (2) to evaluate the possible role in cost savings of EVICEL® in association with the blood-saving protocol.MethodsRetrospective observational study evaluating patients ...
Source: International Orthopaedics - January 23, 2019 Category: Orthopaedics Source Type: research

Inferior displacement of greater tuberosity fracture suggests  an occult humeral neck fracture: a retrospective single-centre study
AbstractPurposeTo radiographically characterize the relationship between inferior displacement of great tuberosity (GT) fracture and associated occult or minor displaced humeral neck fracture.MethodsThirty patients with inferior displacement of the GT on the initial anterior-posterior (AP) view X-ray were included in this study. Twenty-four patients received further computed tomography (CT) scans. One patient with negative CT scans underwent MRI. Radiographic indexes included the cervico-diaphyseal angle, the distance of the inferior displacement of the GT fracture, the apex-tuberosity distance, and the direction of the GT...
Source: International Orthopaedics - January 21, 2019 Category: Orthopaedics Source Type: research

Thoracic disc herniation, avoidance, and management of the surgical complications
In this study, we aim to describe the most common complications that can occur during or after surgical management of thoracic disc herniations. Furthermore, we describe tips and tricks for avoidance and, if necessary, management of surgical complications. Common complications addressed in this review include vertebral column instability, neurologic injury, cerebrospinal fluid leak/pleural fistula, thoracic viscera injury, wrong level surgery, incomplete disk resection, and intercostal neuralgia. (Source: International Orthopaedics)
Source: International Orthopaedics - January 21, 2019 Category: Orthopaedics Source Type: research

The Ganz acetabular reinforcement ring shows excellent long-term results when used as a primary implant: a retrospective analysis of two hundred and forty primary total hip arthroplasties with a minimum follow-up of twenty  years
AbstractPurposeThe acetabular reinforcement ring with a hook (ARRH) has been designed for acetabular total hip arthroplasty (THA) revision. Additionally, the ARRH offers several advantages when used as a primary implant especially in cases with altered acetabular morphology. The implant facilitates anatomic positioning by placing the hook around the teardrop and provides a homogenous base for cementing the polyethylene cup. Therefore, the implant has been widely used in primary total hip arthroplasty at our institution. The present study reports the long-term outcome of the ARRH after a minimum follow-up of 20  years....
Source: International Orthopaedics - January 20, 2019 Category: Orthopaedics Source Type: research

Two-stage hip revision arthroplasty for periprosthetic joint infection without the use of spacer or cemented implants
ConclusionWe demonstrated a high success rate for two-stage exchange of infected total hip arthroplasty. Spacer-free treatment does not negatively affect success rate or function. Implantation of an uncemented pressfit prosthesis was possible in all patients. (Source: International Orthopaedics)
Source: International Orthopaedics - January 18, 2019 Category: Orthopaedics Source Type: research

Lateral femoral sliding osteotomy in total knee arthroplasty with valgus deformity greater than twenty degrees
This study aims to investigate its utility in TKA with valgus deformity greater than 20 °, for which few studies have examined.MethodsConsecutive TKA patients with valgus deformity treated with the sliding osteotomy at our institution were retrospectively studied. Constraint implants were not used. Radiological and clinical parameters at follow-ups were compared with those pre-operatively. Radiological parameters included the hip-knee-ankle angle (HKA), the anatomical lateral distal femoral angle (aLDFA), the anatomical lateral plateau ankle angle (aLPTA), and the angle between the femoral mechanical axis and transepic...
Source: International Orthopaedics - January 18, 2019 Category: Orthopaedics Source Type: research

Functional outcome of two-stage reimplantation in patients with periprosthetic joint infection after primary total knee arthroplasty
AbstractIntroductionTwo-stage reimplantation in patients with chronic periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) with the use of either articulating or static antibiotic-loaded spacers during the first step is considered to be the golden standard in orthopaedics.The aim of the studyThe aim of the study was to evaluate the correlation of spacer type with the infection elimination rate as well as functional outcomes after two-staged revision TKA in patients with PJI.Materials and methodsThe cohort comprised 161 patients who were treated for PJI after TKA during a period from January 2007 to Dece...
Source: International Orthopaedics - January 16, 2019 Category: Orthopaedics Source Type: research

Iliac crest apophysis transfer to treat stump overgrowth after limb amputation in children: case series and literature review
ConclusionAlthough many studies showed capping of the stump with cartilaginous cap to be successful in preventing stump overgrowth, iliac crest apophysis transfer was only successful in one of four cases available to follow-up (25%). This is not a reliable enough method to be used routinely. (Source: International Orthopaedics)
Source: International Orthopaedics - January 15, 2019 Category: Orthopaedics Source Type: research

Letter to the Editor on “The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
(Source: International Orthopaedics)
Source: International Orthopaedics - January 15, 2019 Category: Orthopaedics Source Type: research

Biophysical stimulation of bone and cartilage: state of the art and future perspectives
ConclusionThe orthopaedic community has played a central role in the development and understanding of the importance of the physical stimuli. Biophysical stimulation requires care and precision in use if it is to ensure the success expected of it by physicians and patients. (Source: International Orthopaedics)
Source: International Orthopaedics - January 15, 2019 Category: Orthopaedics Source Type: research

Authors ’ reply to Comment on: Patient-related outcomes after proximal tibial fractures
(Source: International Orthopaedics)
Source: International Orthopaedics - January 15, 2019 Category: Orthopaedics Source Type: research

Outcome of femoral fractures in poliomyelitis patients
ConclusionsPolio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected. (Source: International Orthopaedics)
Source: International Orthopaedics - January 15, 2019 Category: Orthopaedics Source Type: research

The summary of experience of abdominal vascular injury related to posterior lumbar surgery
ConclusionsDifferent treatment choices should be conducted depending on different injury characteristics and patients ’ condition. Moreover, early recognition and prompt treatment are critical components to successful rescue. When a vascular injury is suspected, ultrasonography and positive abdominal exploration are recommended together with unified leadership in the rescue team. (Source: International Orthopaedics)
Source: International Orthopaedics - January 14, 2019 Category: Orthopaedics Source Type: research

Comment on: Patient-related outcomes after proximal tibial fractures
(Source: International Orthopaedics)
Source: International Orthopaedics - January 13, 2019 Category: Orthopaedics Source Type: research

Suspension arthroplasty versus interposition arthroplasty in the treatment of trapeziometacarpal osteoarthritis: a clinical and magnetic resonance imaging study
AbstractIntroductionBiological arthroplasties are the most used surgical techniques, for the treatment of trapeziometacarpal osteoarthritis; all of them provide the reconstruction of trapeziometacarpal joint by a tendon graft. The aim of the study is to compare two surgical techniques: interposition arthroplasty and suspension arthroplasty at 12-month follow-up in order to evaluate the clinical and radiographic results.MethodsSixty-seven patients surgically treated for basal thumb osteoarthritis were divided into two groups: 36 patients, (8 M; 27 F) (39 hands), treated with interposition arthroplasty are included in group ...
Source: International Orthopaedics - January 10, 2019 Category: Orthopaedics Source Type: research

Vitamin D: part II; cod liver oil, ultraviolet radiation, and eradication of rickets
ConclusionRickets therefore provides an excellent window into the early politics of preventive health and the promotion of targeted interventions in the world. It is also a relevant historical counterpoint for current debates over the role of risk factors (absence of light or sun) for disease (today ’s so-called “lifestyle” diseases). (Source: International Orthopaedics)
Source: International Orthopaedics - January 9, 2019 Category: Orthopaedics Source Type: research

Evidence-based use of arthroplasty in cervical degenerative disc disease
ConclusionsBased on this evidence we conclude that CDA is a safe and effective alternative to ACDF in properly selected patients for one- or two-level diseases. Defining superiority of specific implants and detailing optimal surgical indications will require further well-designed long-term studies. (Source: International Orthopaedics)
Source: International Orthopaedics - January 8, 2019 Category: Orthopaedics Source Type: research

Clinical results of revision total elbow arthroplasty: comparison of infected and non-infected total elbow arthroplasty
ConclusionRevision TEA provided clinical improvement in elbow function and resulted in satisfactory outcomes. Outcomes were worse in the infected than in the non-infected groups. Comorbidities and older age were apparent risk factors for infected TEA. (Source: International Orthopaedics)
Source: International Orthopaedics - January 7, 2019 Category: Orthopaedics Source Type: research

Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis —a systematic review
ConclusionPatients who undergo PFA may be more likely to return to the operating room for conversion to TKA and/or revision surgery than those who undergo TKA. (Source: International Orthopaedics)
Source: International Orthopaedics - January 7, 2019 Category: Orthopaedics Source Type: research

Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty
ConclusionsAll patients, including obese patients, have significant functional improvement after THA, objectively assessed by gait speed. Even if patients did not fully recover to the level of a healthy control person after THA, functional gain is comparable irrespective of BMI. (Source: International Orthopaedics)
Source: International Orthopaedics - January 5, 2019 Category: Orthopaedics Source Type: research

The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair
ConclusionsAs predicted, significant clinical improvements were observed in both groups with some differences.These clinical results showed that the use of rTSA with lateralized humerus and bony increase offset leads to realistic clinical improvements with a low risk of instability without the need for compression and stabilization of the tendon. (Source: International Orthopaedics)
Source: International Orthopaedics - January 5, 2019 Category: Orthopaedics Source Type: research

A comparative study about the incidence of dislocation and peri-prosthetic fracture between dual mobility versus standard cups after primary total hip arthroplasty
AbstractPurposeDislocation and peri-prosthetic fracture (PPF) are major reasons for revision THA (total hip arthroplasty). The main advantage of dual mobility (DM) cups is to minimize the incidence of dislocation compared to single mobility (SM) cups. We hypothesized that the use of DM would lead to an increased risk of PPF because of its greater stability. In  contrast, standard cups would be at higher risk of dislocation.MethodsA retrospective comparative study was performed in our institution including 126 revision THAs between January 2013 and December 2017. Collected data included gender, age, BMI, Parker score, ...
Source: International Orthopaedics - January 5, 2019 Category: Orthopaedics Source Type: research

Endoscopic spine discectomy: indications and outcomes
ConclusionsEndoscopic spine surgery for soft disc herniation can be effective with benefits of minimal tissue trauma in properly selected cases. Given the recent technical advancements, the surgical indications for endoscopic spine surgery are still expanding and the clinical results have become more practical and reliable. (Source: International Orthopaedics)
Source: International Orthopaedics - January 5, 2019 Category: Orthopaedics Source Type: research

Minimally invasive discectomy for lumbar disc herniation: current concepts, surgical techniques, and outcomes
ConclusionsClinical evidence supporting the superiority of MED and PED is still limited. Well-designed prospective multicentered randomized controlled trials with large samples are therefore needed in order to draw a convincing conclusion. (Source: International Orthopaedics)
Source: International Orthopaedics - January 3, 2019 Category: Orthopaedics Source Type: research