Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2022
Age-adjusted Charlson comorbidity index as a novel guideline for patient selection between unilateral versus bilateral simultaneous total knee arthroplasty.
The aim of this study was to validate the age-adjusted Charlson comorbidity index as a clinical practice guideline for patient selection between unilateral total knee arthroplasty (UTKA) and bilateral simultaneous total knee arthroplasty (BSTKA). ⋯ The BSTKA procedure is associated with significantly higher risk of post-operative complications than UTKA procedure in patients with ≥ 5 ACCI scores.
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Arch Orthop Trauma Surg · Apr 2022
Risk factors and preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy.
To investigate risk factors and suggest preventive strategy for excessive coronal inclination of tibial plateau following medial opening-wedge high tibial osteotomy (MOWHTO). ⋯ Level III.
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Arch Orthop Trauma Surg · Apr 2022
Destructive per continuitatem spondylodiscitis after endovascular abdominal or thoracic aneurysm repair (EVAR/TEVAR): rare and untreatable?
Very few publications have previously described spondylodiscitis as a potential complication of endovascular aortic procedures (EVAR/TEVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR/TEVAR based on our data base. Particular focus was laid on the complexity of disease treatment and grave outcome perspectives from a spine surgeon's point of view in this seriously affected patient group. ⋯ Destructive per continuitatem spondylodiscitis is a rare and severe complication post-EVAR/TEVAR. Clinical and imaging features of anterior paravertebral disease and anterior vertebral body involvement suggest direct continuous spread of the graft infection to the adjacent vertebral column. The mortality rate of these severe infections is extremely high and treatment with a permanent fistula may be one salvage procedure.
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Arch Orthop Trauma Surg · Apr 2022
Halo-pelvic traction for thoracic spine dislocation in neurofibromatosis type 1: a case series.
To present a case series of 6 patients with Neurofibromatosis type 1 (NF-1) who had severe kyphoscoliosis with vertebral dislocation, and were treated with halo-pelvic traction (HPT) and posterior fusion. To discuss the pathological characteristics of this rare entity, and report our experience using HPT to manage the condition. ⋯ HPT is a viable treatment option for vertebral dislocation in NF-1. After 6 weeks of traction, the vertebral dislocation, scoliosis, and kyphosis can be dramatically reduced, and thus the conditions for corrective surgery can be improved.
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Arch Orthop Trauma Surg · Apr 2022
Development and characterization of a predictive microCT-based non-union model in Fischer F344 rats.
Non-unions remain a clinical problem and are characterised by the failure to heal after a defined period of time. Current preclinical non-union models apply a wide variety of techniques to diminish intrinsic healing potential deviating from the clinical situation. The aim of this study was to develop and characterise a non-union model in rats using internal plate fixation without the need for additional healing insults, whereby bone healing can be longitudinally assessed using microCT. It was hypothesized that healing/non-unions can be accurately predicted at early time points by microCT. ⋯ The 2 mm thick plating system confers poor healing responses in female Fischer F344 rats, comparable to atrophic non-unions. By reducing plate thickness to increase interfragmentary strain within the defect site healing is improved, leading to borderline healing situations or increased abundance of cartilage tissue present in the defect site with ultimate failure to bridge the defect (hypertrophic non-union). Furthermore, microCT can reliably identify delayed/non-healing animals within 4 weeks, thereby allowing their selective targeting for the testing of novel, clinically relevant treatment strategies in different clinical situations aimed at restoring impaired bone healing.