Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2015
Randomized Controlled TrialNo need for use of drainage after minimally invasive unicompartmental knee arthroplasty: a prospective randomized, controlled trial.
Drainage is a common procedure in unicompartmental knee arthroplasty (UKA), but evidence regarding its effectiveness is lacking. The aim of this study was to investigate the benefits of drainage after minimally invasive UKA with effective blood loss management. ⋯ The use of drainage in unilateral UKA provides no apparent advantage. With effective blood loss management and a minimally invasive procedure, blood loss and drainage volume in UKA are very low. Drainage does not improve the results. Foregoing non-drainage after UKA reduces both hospital costs and visible blood loss. Therefore, drainage is unnecessary in routine UKA.
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Arch Orthop Trauma Surg · May 2015
Pelvic ring reconstruction with a double-barreled free vascularized fibula graft after resection of malignant pelvic bone tumor.
In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized fibula graft (VFG) after internal hemipelvectomy with special reference to long-term complications. ⋯ In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
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Osteolysis and aseptic loosening currently contribute 75 % of implant failures. Furthermore, with over four million joint replacements projected to be performed in the United States annually, osteolysis and aseptic loosening may continue to pose a significant morbidity. This paper reviews the osteolysis cascade leading to osteoclast activation and bone resorption at the biochemical level. ⋯ A non-surgical treatment of osteolysis has not been found in the literature and thus may become an area of future research. Even though this research is warranted, comprehensively understanding the immune response to orthopedic implants and their metallic ions, and thus, creating improved prostheses appears to be the most cost-effective approach to decrease the morbidity related to osteolysis and to design implants with greater longevity. The ionic forms, cytokines, toxicity, gene expression, biological effects, and hypersensitivity responses of metallic elements from metal implants are summarized as well.
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Arch Orthop Trauma Surg · May 2015
Semiconstrained total elbow arthroplasty for rheumatoid arthritis patients: clinical and radiological results of 1-8 years follow-up.
We investigated whether the Discovery total elbow arthroplasty (TEA) system had good results and survival in rheumatoid arthritis (RA) patients. ⋯ The Discovery system has shown satisfactory results in RA patients even if the rate of complication remained relatively high. Further follow-up is required to investigate the radiological changes observed in some of our patients.
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Arch Orthop Trauma Surg · May 2015
Lumbar lordosis and sacral slope in lumbar spinal stenosis: standard values and measurement accuracy.
Radiological study. ⋯ Manual measurement of LL and SS in patients with LSS on lateral radiographs is easily performed with excellent intra- and interobserver reliability. Correlation between LL and SS is very high. Differences between patients with and without previous decompression were not statistically significant.