Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2019
Randomized Controlled Trial Comparative StudyComparison of intraoperative radiation exposure with and without use of distal targeting device: a randomized control study.
When locking intramedullary nails, inserting the distal interlocking screw accurately and quickly with less radiation exposure is very important. The purpose of this randomized control study was to compare radiation exposure and accuracy of distal locking screws between free-hand fluoroscopic guidance and the use of a distal targeting system (DTS). ⋯ The attempt number of image intensifier during the insertion of two distal locking screws was significantly reduced with DTS compared with that with free hand fluoroscopic guidance. Angle between distal locking screws and nail was also more accurate using DTS.
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Arch Orthop Trauma Surg · Nov 2019
Arthroscopic autologous chondrocyte implantation in the knee with an in situ crosslinking matrix: minimum 4-year clinical results of 15 cases and 1 histological evaluation.
To clinically evaluate an arthroscopic autologous chondrocyte implantation (ACI) technique with an in situ crosslinking matrix for the treatment of full thickness cartilage defects of the knee and to present histological results of a graft cartilage biopsy obtained after 1.5 years. ⋯ Arthroscopic ACI using an in situ crosslinking matrix is a safe and reliable treatment option for full-thickness cartilage defects of the knee.
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Arch Orthop Trauma Surg · Nov 2019
Reduced wound leakage in arthroplasty with modified wound closure: a retrospective cohort study.
Wound leakage has been shown to increase the risk of prosthetic joint infections (PJIs) in primary total hip (THA) and knee arthroplasty (unicondylar and total knee arthroplasty; KA). The aim of this study is to determine whether the addition of a continuous subcuticular bonding stitch to a conventional three-layer closure method reduces the incidence of prolonged wound leakage and PJIs after THA and KA. ⋯ The addition of a continuous subcuticular bonding stitch reduces the incidence of prolonged wound leakage and PJIs after THA and KA compared to a conventional three-layer wound closure method. The large reduction of incidence in wound leakage and PJIs in this study, combined with relatively negligible cost and effort of the modified wound closure method, would advocate for implementing this wound closure method in arthroplasty.
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Arch Orthop Trauma Surg · Nov 2019
Fragment specific fixation technique using 2.7 mm VA LCP for comminuted posterior wall acetabular fractures: a novel surgical technique.
The purposes of the study were to introduce surgical technique of fragment-specific fixation technique using multiple 2.7-mm variable-angle locking compression plates (VA LCPs) in comminuted posterior wall acetabular fractures and reported its clinical results. ⋯ Fragment-specific fixation technique using 2.7-mm VA LCPs for comminuted posterior wall acetabular fractures could be an acceptable alternative means of surgical fixation.
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Arch Orthop Trauma Surg · Nov 2019
Intraoperative measurement of cup inclination using fluoroscopy requires a correction factor.
Malpositioning of the cup in total hip arthroplasty (THA) is associated with dislocation, early polyethylene wear, and impingement. The direct anterior approach (DAA) THA allows for intraoperative fluoroscopy imaging (IF). The current study investigates the following research hypotheses: (1) intraoperative measurements of radiographic cup inclination (RI) are reliable and reproducible. (2) A correction factor can compensate for the complex parallax effects when using IF. ⋯ Intraoperative fluoroscopy is a reliable tool to measure RI during DAA THA. The surgeon needs to apply a 5°. correction factor to the intraoperative measurements to adjust for parallax.