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

Management of symptomatic os acromiale: a survey of the American shoulder and elbow surgeons
AbstractBackgroundThe purpose of this paper was to survey members of the American Shoulder and Elbow Surgeons (ASES) to assess their opinion on management options, help highlight important clinical factors, and elucidate surgical preferences for the treatment of a symptomatic meso-os.MethodsAn online questionnaire was distributed to the active members of the ASES. The survey queried surgeon demographics and perioperative management preferences, and presented multiple clinical case scenarios of patients with a presumed symptomatic, unstable os acromiale.ResultsThere were 116 ASES members who responded to the survey, and 26%...
Source: International Orthopaedics - January 3, 2019 Category: Orthopaedics Source Type: research

The unhappy triad of the knee re-revisited
ConclusionsThe unhappy triad of injuries to the knee is actually a tetrad involving not just the ACL, MCL, and medial/lateral meniscus but also involved the anterolateral complex. (Source: International Orthopaedics)
Source: International Orthopaedics - January 1, 2019 Category: Orthopaedics Source Type: research

Two-stage cementless hip revision for peri-prosthetic infection with an antibacterial hydrogel coating: results of a comparative series
ConclusionsAlthough in a relatively limited series of patients our data show that cementless two-stage hip revision, performed with an antibacterial hydrogel coating, may provide better infection control than two-stage without the coating, with reduced hospitalization time, these findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections. (Source: International Orthopaedics)
Source: International Orthopaedics - January 1, 2019 Category: Orthopaedics Source Type: research

The history of Italian Orthopaedics
(Source: International Orthopaedics)
Source: International Orthopaedics - December 21, 2018 Category: Orthopaedics Source Type: research

Functional impairment after successful surgical reconstruction for proximal hamstring avulsion
ConclusionThe presented study confirms good subjective functional outcomes after surgical intervention of hamstring avulsions in all scores. Nevertheless, using the PHAT, residual complaints are more common than often described in previous studies interpreting “conventional” scores. For future decision and patient guidance, more studies using injury-specific assessments such as the PHAT in combination with objective measurements are eligible. (Source: International Orthopaedics)
Source: International Orthopaedics - December 19, 2018 Category: Orthopaedics Source Type: research

Unicompartmental knee arthroplasty is superior to high tibial osteotomy in post-operative recovery and participation in recreational and sports activities
AbstractPurposeTo compare (1) the recovery pattern of post-operative physical activity and function in the early post-operative period and (2) the difference of participation in recreational and sports activities pre- and post-operatively following unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).MethodsIn this prospective comparative study, 49 HTOs (49 patients) and 42 UKAs (42 patients) performed to treat medial compartmental knee osteoarthritis (OA) were included. The pain visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), Tegner activity scor...
Source: International Orthopaedics - December 18, 2018 Category: Orthopaedics Source Type: research

What every spine surgeon should know about transforaminal lumbar interbody fusion surgery for herniated discs
AbstractPurposeThe aim of this study is to report our experiences on managing large lumbar disc herniations with several symptoms by surgery with transforaminal lumbar interbody fusion (TLIF) and to shed light for spine surgeons about TLIF surgery.MethodsWe retrospectively evaluated our database of patients with various lumbar spine pathologies who underwent TLIF surgery from 2014 to 2017. We separated 18 patients who had been operated on for extruded disc herniation, which causes severe pain and radicular symptoms. The pain was quantified by visual analog scores (VAS). The disability status were pre-operatively and post-o...
Source: International Orthopaedics - December 18, 2018 Category: Orthopaedics Source Type: research

Correction to: Demineralized bone matrix and hydroxyapatite/tri-calcium phosphate mixture for bone healing in rats
The first name of one author is missing in the published article. The correct abbreviation: H.C. Gemalmaz. (Source: International Orthopaedics)
Source: International Orthopaedics - December 17, 2018 Category: Orthopaedics Source Type: research

Spine deformities and trauma in Avicenna ’s Canon of Medicine
ConclusionAvicenna made an impact with his medical writings in which he summarized the works of ancient Greek and Roman physicians like Hippocrates and Galen with the influence of medieval authors and the knowledge of the Arabic medicine and pharmacology. His descriptions and comments in his workCanon of Medicine summarize and comment the work of his predecessors and it remained a work of reference until at least the sixteenth century. (Source: International Orthopaedics)
Source: International Orthopaedics - December 15, 2018 Category: Orthopaedics Source Type: research

Cementless revision femoral stems application of press-fit principles and clinical outcomes
ConclusionsWhile press-fit is an effective concept, it is a demanding one that requires the surgeon to choose the correct surgical strategy for the patient ’s anatomy. A meticulous surgical technique is required to achieve proximal press-fit or at a minimum, short diaphyseal press-fit. (Source: International Orthopaedics)
Source: International Orthopaedics - December 15, 2018 Category: Orthopaedics Source Type: research

Comparison of percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for the treatment of lumbar disc herniation: a meta-analysis
AbstractPurposeWe conducted a systematic review and meta-analysis to compare the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) for the treatment of lumbar disc herniation (LDH), and to clarify whether PELD is more superior to MED.MethodsWe performed a comprehensive search in the databases of MEDLINE, EMBASE, PubMed, Web of Science, Cochrane database, CNKI, and Wanfang Data to acquire all relevant studies up to July 2018. The searched literatures were then screened according to the strict inclusion and exclusion criteria. The critical data were extracted and analy...
Source: International Orthopaedics - December 13, 2018 Category: Orthopaedics Source Type: research

Size of ischial fibro-ostosis is associated with heterotopic ossification after total hip arthroplasty
ConclusionRadiographic evidence of asymptomatic FO is a potential risk factor for the development of HO following THA and may be used as a simple diagnostic tool to pre-operatively identify patients at risk for post-operative HO. This association has not been previously described and further research to confirm the present findings and to justify additional prophylactic treatment in these patients is warranted. (Source: International Orthopaedics)
Source: International Orthopaedics - December 13, 2018 Category: Orthopaedics Source Type: research

Letter to editor concerning the article “muscle pedicle bone grafting using the anterior one-third of the gluteus medius attached to the greater trochanter for treatment of Association Research Circulation Osseous stage II osteonecrosis of the femoral head” (Cho KJ et al. International Orthopaedics. doi: 10.1007/s00264-018-3839-5)
(Source: International Orthopaedics)
Source: International Orthopaedics - December 13, 2018 Category: Orthopaedics Source Type: research

The evidence-based approach for surgical complications in the treatment of lumbar disc herniation
ConclusionThis article provides the clinician and surgeon with a review of the evidence-based evaluation and management of surgical complications following disc herniation, offering best practice guidelines for informed discussions with patients in shared decision-making. (Source: International Orthopaedics)
Source: International Orthopaedics - December 12, 2018 Category: Orthopaedics Source Type: research

The augment-and-modular-cage revision system for reconstruction of severe acetabular defects —two-year clinical and radiographic results
AbstractPurposeAcetabular revision of failed total hip arthroplasty (THA) is often associated with severe bone loss. Therefore, a variety of revision implant systems has been developed during recent years, with the augment-and-modular-cage system being one of the newest additions to this portfolio. Together with biologic downsizing by means of impaction bone grafting, this uncemented system promises a high modularity and versatility to treat all acetabular defects up to Paprosky types IIIa and IIIb without pelvic discontinuity. The aim of the present study was to evaluate first short-term results of its clinical applicatio...
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

Clinical and radiologic outcomes of two patellar resection techniques during total knee arthroplasty: a prospective randomized controlled study
ConclusionsCutting guide technique group did not yield lower incidence of anterior knee pain. More outliers of lateral patellar tilt were observed in the freehand technique group. Overall, all patients in both groups had identical results in terms of patellofemoral functional capacity, clinical outcomes, and other radiographic results. (Source: International Orthopaedics)
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

Arthroscopic treatment of osteochondral knee defects with resorbable biphasic synthetic scaffold: clinical and radiological results and long-term survival analysis
AbstractPurposeThe aim of our study is to evaluate the long-term results in patients treated with a fully arthroscopic TruFit system for osteochondral lesions of the femoral condyle, analyzing the clinical and radiological outcomes, survival rate, complications, and correlations.MethodsThe study included all patients treated with the TruFit system with a full-thickness focal lesion of the knee cartilage (grade IV according to the ICRS classification), entirely arthroscopically with a minimum follow-up of five  years. All patients were evaluated clinically prior to surgery (T0) and at two consecutive follow-ups (T1 36....
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

Occult injuries of the contralateral sacroiliac joint in operatively treated pelvis fractures: incidence, root cause analysis, and proposal of treatment algorithm
ConclusionsThere is an 8.2% incidence of unrecognized contralateral SI joint instability in patients presenting with unstable pelvic ring injuries. Multiply traumatized patients with multiple orthopaedic injuries were an independent risk factor for this injury pattern. (Source: International Orthopaedics)
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

A case series of cementless revision total knee arthroplasty in patients with benzoyl peroxide allergy
ConclusionsThe regression of complaints after replacement with cementless and nickel-free revision implants suggests allergic implant intolerance. Implantation of a cementless, hypoallergenic endoprosthesis might, therefore, be a surgical treatment strategy in patients with evidence of allergies. (Source: International Orthopaedics)
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

Inversion of the acetabular labrum causes increased localized contact pressure on the femoral head: a biomechanical study
ConclusionsWhen silicone rubber representing an inverted acetabular labrum was placed between a hemispherical metallic platen and a composite bone model, the silicone rubber areas were subjected to extreme concentration of stress. The fractures that developed at the silicone rubber areas clearly represented subchondral fractures of the femoral head, rather than fractures of the femoral neck. (Source: International Orthopaedics)
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

A new classification for proximal femur bone defects in conservative hip arthroplasty revisions
ConclusionsIf literature offers well-established guidelines to femoral revision of conventional stems, there is, on the other hand, a lack of data about revision strategies in presence of failed conservative implants. Although the mean follow-up of our procedures is still too short (4.5  years) to give final conclusions, we would leave a message: a conservative hip arthroplasty is not a “one-time” opportunity for young and active people. A “conservative revision” is a valid option for at least a part of them, when an early failure of primary procedure occurred. (Source: International Orthopaedics)
Source: International Orthopaedics - December 11, 2018 Category: Orthopaedics Source Type: research

Cervical disc arthroplasty: tips and tricks
AbstractCervical disc arthroplasty (CDA) is a powerful, motion-sparing treatment option for managing cervical radiculopathy or myelopathy. While CDA can be an excellent surgery for properly indicated patients, it is also less forgiving than cervical fusion. Optimally resolving patient symptoms while maintaining range of motion relies on near perfection in the surgical technique. Different CDA options exist on the market, with some having long-term proven success and others in early stages of clinical trials. We discuss the different options available for use, as well as strategies of positioning, approach, disc space prepa...
Source: International Orthopaedics - December 5, 2018 Category: Orthopaedics Source Type: research

Predictors of mortality after pelvic fractures: a retrospective cohort study from a level one trauma centre in Upper Egypt
ConclusionsThe first 24  hours were confirmed to be critical for survival in pelvic fracture patients. Advancing age, associated soft tissue injury, associated head injury, admission to ICU, and positive FAST examination can serve as reliable predictors for an elevated mortality risk in such patients. (Source: International Orthopaedics)
Source: International Orthopaedics - December 4, 2018 Category: Orthopaedics Source Type: research

One and two-year clinical outcomes for a polyethylene glenoid with a fluted peg: one thousand two hundred seventy individual patients from eleven centers
AbstractPurposeClinical shoulder science lacks a benchmark against which the early clinical value of new glenoid components can be compared; such a benchmark may be derived from a multicenter study of patients receiving an established, internationally used design of glenoid component.MethodsWe obtained data from 11 centers on 1270 patients having total shoulder arthroplasty using an all-polyethylene component with a fluted central peg. We analyzedindividual patient outcomes at 1 and 2  years after surgery. We compared the improvement for each patient to the minimal clinically important difference (MCID) and calculated...
Source: International Orthopaedics - December 3, 2018 Category: Orthopaedics Source Type: research

Revision knee arthroplasty with rotating hinge systems in patients with gross ligament instability
ConclusionBoth prosthetic designs provide significant improvement in pain and function scores after TKA revision for gross instability. We found slight advantages in favor of the Endo-Model; however, no design yielded superior results throughout the study. (Source: International Orthopaedics)
Source: International Orthopaedics - December 1, 2018 Category: Orthopaedics Source Type: research

Ocular surface injury after shoulder surgery in the beach-chair position
ConclusionUnlike typical surgery, when shoulder surgery is performed in the beach-chair position, there is a risk of ocular surface injury due to improper head fixation; one manifestation of this problem is corneal injury. If a severe ophthalmodynia that cannot be controlled using analgesics occurs immediately after surgery in the beach-chair position, a corneal injury should be suspected, and the patient should wear a corneal protective lens.Level of evidenceLevel IV (Source: International Orthopaedics)
Source: International Orthopaedics - December 1, 2018 Category: Orthopaedics Source Type: research

Bernese-type triple pelvic osteotomy through a single incision in children over five years: a retrospective study of twenty eight cases
ConclusionsBTPO through a modified anterior Smith-Peterson approach is an alternative treatment for DDH and LCPD in older children who are skeletally immature. It not only provides for a large acetabular correction but also achieves good biomechanical stability. (Source: International Orthopaedics)
Source: International Orthopaedics - December 1, 2018 Category: Orthopaedics Source Type: research

Intervertebral disc herniation in elite athletes
AbstractIntervertebral disc herniations are a common cause of neck and back pain in athletes. It is thought to be more prevalent in athletes than in the general population due to the consistent pressure placed on the spine and concurrent microtraumas that are unable to heal. Prevention focuses on neck and trunk stability and flexibility, training on proper technique, and rule changes to minimize catastrophic injuries. The evaluation for athletes includes a full neurologic exam and imaging. The imaging modality of choice is MRI, but CT myelography can be a useful alternative. Standard management includes a six  week tr...
Source: International Orthopaedics - December 1, 2018 Category: Orthopaedics Source Type: research

Current concepts for lumbar disc herniation
ConclusionsThe exact event leading to disc herniation remains unclear. Non-operative treatments should be the first-line treatment for most patients with lumbar disc herniation. Operative treatment remains the current gold standard, with minimally invasive endoscopic microdiscectomy techniques showing best results with respect to postoperative pain and function. Regenerative medicine is promising. (Source: International Orthopaedics)
Source: International Orthopaedics - November 30, 2018 Category: Orthopaedics Source Type: research

The relevance of high-intensity zones in degenerative disc disease
ConclusionsHIZ are likely a risk factor for discogenic LBP. However, its etiology and pathophysiology are not well understood. Some clinical studies suggest a link between its occurrence and LBP. However, the results are not consistent as a result of studies which are underpowered and based on heterogeneous study populations, lacking control groups, and without standardized imaging phenotypes. HIZ may be an important pain biomarker that should be further studied. With more modern MRI technology and a detailed classification system, future large-scale population studies will improve our knowledge on its role in the disc deg...
Source: International Orthopaedics - November 30, 2018 Category: Orthopaedics Source Type: research

Benefits of a metallic lateralized baseplate prolonged by a long metallic post in reverse shoulder arthroplasty to address glenoid bone loss
ConclusionA lateralized metal-backed 15.2-mm keeled baseplate prolonged by a thin 24.8-mm metallic post fixed directly in the subscapularis fossa may provide satisfactory mid-term outcomes in patients with large glenoid bone defects where initial press-fit of a regular baseplate is impossible to obtain. (Source: International Orthopaedics)
Source: International Orthopaedics - November 30, 2018 Category: Orthopaedics Source Type: research

Aggressive granulomatosis of the hip: a forgotten mode of aseptic failure
ConclusionsWe found a prevalence of 1% of this aseptic mode of implant failure. Since most of the retrieved stems were not loose, we did not find any alarming clinical symptoms anticipating implant failure. In this scenario, surgeons should be aware of the rapidly progressive nature of this entity and propose a revision THA in a timely fashion. (Source: International Orthopaedics)
Source: International Orthopaedics - November 30, 2018 Category: Orthopaedics Source Type: research