Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled TrialWhich is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination?
Adolescent idiopathic scoliosis surgery is often associated with significant blood loss and blood transfusion. In this clinical trial, the authors investigated the efficacy of reducing blood loss and allogeneic blood transfusion by using batroxobin, tranexamic acid (TXA) and the combination of the two agents. ⋯ In our study, batroxobin and TXA can markedly reduce the blood loss and the transfusion requirements equivalently. However, TXA performs better in minimizing FFP and the overall drainage than batroxobin. The combination seems to achieve best results and was more effective than either of the two drugs alone. No apparent adverse events were detected in these groups.
-
Arch Orthop Trauma Surg · Jan 2012
Cup positioning in total hip arthoplasty: spatial alignment of the acetabular entry plane.
Correct cup positioning is one of the keys for successful total hip replacement. There are mechanical and computer assistant guides for correct cup positioning in the market. To optimize the cup positioning, the use of navigation systems is recommended. The aim of this study was to compare spatial orientation of the acetabulary entry plane in relation to tables plane which is used by mechanical guides as well as anterior pelvic plane used for cup orientation by navigation systems. ⋯ The use of mechanical alignment guides for cup orientation during total hip arthroplasty based on table's plane in patient's supine position is a successful method to achieve proper cup orientation.
-
Arch Orthop Trauma Surg · Jan 2012
Reduced length of stay following hip and knee arthroplasty in Denmark 2000-2009: from research to implementation.
Fast-track surgery is the combination of optimized clinical and organizational factors aiming at reducing convalescence and perioperative morbidity including the functional recovery resulting in reduced hospitalization. As the previous nationwide studies have demonstrated substantial variations in length of stay (LOS) following standardized operations such as total hip and knee arthroplasty (THA and TKA), this nationwide study was undertaken to evaluate the implementation process of fast-track THA and TKA in Denmark. ⋯ Fast-track surgery has been successfully implemented in the orthopedic departments in Denmark through a multi-disciplinary educational and multi-institutional effort. These implementation principles may be transferred to other countries and other specialties.
-
Arch Orthop Trauma Surg · Jan 2012
Comparative StudyAngle stable locking nails versus conventionally locked intramedullary nails in proximal tibial shaft fractures: a biomechanical study.
A tibial nail with fixed-angle locking screws intends to combine the advantages of angular stability and intramedullary stabilization in extraarticular proximal tibial fractures. The goal of this study is to analyze if the angle stable tibial nail (ASN) is biomechanically more stable than an established conventional standard nail (CN). ⋯ No significant difference in stability between the two compared implants could be demonstrated. A trend could be shown indicating that the rate of nail loosening in the proximal osteotomized part of the bone was lower for the angle stable nail. This trend, however, could not be substantiated statistically.
-
Arch Orthop Trauma Surg · Jan 2012
Octenidine in combination with polymethylmethacrylate: a new option for preventing infection?
Orthopedic implant infections represent a serious complication for both patient and surgeon. In order to minimize this risk, it has become standard practice in surgery and orthopedics to add antimicrobial substances to the polymethylmethacrylate (PMMA) bone cement. The aim of this study is to find new options for preventing infection by using alternative adjuvants in combination with PMMA. We hypothesized, that Octenidine, after being combined with PMMA, can be released in vitro and an antimicrobial efficacy of discharged Octenidine can be shown. ⋯ These results suggest that Octenidine is released after combining it with PMMA and reaches working concentrations in vitro. These findings suggest a new and effective alternative for prevention of infection in cemented implants. Further investigations on the biocompatibility of this combination is needed.