Zeitschrift für Orthopädie und Unfallchirurgie
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Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. ⋯ Even in such a standardised collective as primary arthroplasty, this scattering of deviation was observed. Since professional experience did not lead to improved results, it can be speculated that, beside the technical dimension of surgery, other factors such as patient expectation are of crucial relevance for postoperative outcome. To further improve outcome and patient satisfaction with surgery we therefore recommend developing an individualised and realistic prognosis together with each patient, but bearing in mind own limits of outcome prediction.
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The purpose of this study was to determine the functional outcomes and radiographic results of the talus-stop screw method as minimally invasive subtalar arthroereisis in pediatric and juvenile flexible flatfoot. ⋯ The talus-stop screw method as a minimally invasive subtalar arthroereisis is a safe and effective treatment for the flexible pes planovalgus deformity in children and adolescents. It preserves canalis tarsi and its proprioceptive structures. The major complication rate is low and, with a vertically inserted cancellous screw, this is an economic procedure. The TMT-index incorporating both planes in pes planovalgus feet appears to be a more precise method to determine this multiplanar deformity and to evaluate treatment options and results.
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Review Meta Analysis
[Effect of continuous passive motion for cartilage regenerative surgery - a systematic literature review].
The aim of this systematic review was to evaluate treatment effects of continuous passive motion (CPM) after surgical cartilage repair. ⋯ Three studies described significant improvements with regard to subjective outcome such as pain, swelling, Quality Life Survey, Knee Society score, WOMAC score or rating Cincinnati due to the surgical treatment and the CPM intervention of cartilage defects in the knee. Six (case) studies suggested an enhanced cartilage quality of the patients after CPM. More high-quality randomised controlled trials are needed to provide high level evidence.
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Musculoskeletal conditions are the most frequent cause of long-term pain and disability. Scientifically funded, structured training would be highly desirable for all medical students and of great economic relevance for the health care system. The present article portrays the status quo of undergraduate training in orthopaedics and trauma surgery, with a comparison to the status quo of 2008. ⋯ Even closer collaboration between lecturers in orthopaedics and trauma surgery would be desirable. This would reflect the importance of the disciplines, as well as politico-economic relevance of musculoskeletal injuries and diseases, and would encourage the sharing of resources.
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Introduction Patellar dislocation is one of the commonest knee injuries in adolescents. Although treatment usually leads to good results, the influence of anatomical and functional factors on therapeutic strategy has been underestimated, especially in cases of recurrence. Patients and Methods The course of treatment has been analysed in 88 patients with 136 patellar dislocations. ⋯ Primary patellar dislocations without serious concomitant injuries may be treated conservatively. In the event of recurrence, the indication for surgery is given, even in young patients and in any patient with an osteochondral flake fracture. Tightening reconstruction of the MPFL used to be frequently performed, but is associated with a high rate of recurrence.