Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2019
ReviewLaboratory-based versus qualitative assessment of α-defensin in periprosthetic hip and knee infections: a systematic review and meta-analysis.
Two methods are currently available for the assay of α-defensin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test. We aimed to assess the diagnostic accuracy of synovial fluid α-defensin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection. ⋯ Detection of α-defensin is an accurate test for diagnosis of hip and knee prosthetic infections. The diagnostic accuracy of the two alpha-defensin assessment methods is comparable. The lateral flow assay is a valid, rapid, and more available diagnostic tool, particularly to rule out PJI.
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Arch Orthop Trauma Surg · Jul 2019
Risk factors of hyperextension and its relationship with the clinical outcomes following mobile-bearing total knee arthroplasty.
To evaluate the incidence and risk factors of postoperative hyperextension after mobile-bearing total knee arthroplasty (TKA) and its clinical outcomes. ⋯ IV.
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Arch Orthop Trauma Surg · Jul 2019
Lateral extra-articular tenodesis with ACL reconstruction demonstrates better patient-reported outcomes compared to ACL reconstruction alone at 2 years minimum follow-up.
The role for extra-articular procedures in addition to ACL reconstruction to restore rotational stability is debated. We use lateral extra-articular tenodesis (LEAT) for patients that meet criteria. Our null hypothesis was that there would be no difference between two groups of patients that were treated with ACL reconstruction alone or ACL reconstruction with LEAT according to criteria. ⋯ Patient-reported outcomes and return to multi-directional sports after ACL reconstruction favour LEAT at the time of ACL reconstruction when narrow inclusion criteria are applied.
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Arch Orthop Trauma Surg · Jul 2019
Thermal damage of osteocytes during pig bone drilling: an in vivo comparative study of currently available and modified drills.
The Gekkou-drill® is an industrial drill that is highly efficient due to reduced cutting resistance resulting from its characteristic drill point shape. In this experiment, we compared the degree of thermal damage to bone tissue caused by conventional medical drills and these same drills with Gekkou modifications. ⋯ Gekkou-modified medical drills shortened drilling times despite low thrust force, and histopathological assessment demonstrated a significant reduction in osteocyte damage.
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Arch Orthop Trauma Surg · Jul 2019
Multi-segmental lumbar spinal stenosis treated with Dynesys stabilization versus lumbar fusion in elderly patients: a retrospective study with a minimum of 5 years' follow-up.
Middle- and long-term outcomes of multi-segmental lumbar spinal stenosis treated with Dynesys stabilization (DS) have rarely been reported. Older age and multi-segmental degeneration may be positive factors in achieving satisfactory outcomes following DS. The present study aimed to compare the middle- and long-term outcomes of DS with lumbar fusion for treatment of multi-segmental lumbar spinal stenosis (ms-LSS) in elderly patients. ⋯ DS is a safe and effective surgical treatment of multi-segmental lumbar spinal stenosis in the elderly population. DS preserves a certain degree of mobility of surgical segments.