Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Discharging the medial knee compartment: comparison of pressure distribution and kinematic shifting after implantation of an extra-capsular absorber system (ATLAS) and open-wedge high tibial osteotomy-a biomechanical in vitro analysis.
Young and active patients suffering early degenerative changes of the medial compartment with an underlying straight-leg axis do face a therapeutical gap as unloading of the medial compartment cannot be achieved by high tibial osteotomy. Extracapsular absorbing implants were developed to close this existing therapeutical gap. Purpose of the present cadaveric biomechanical study was to compare the unloading effect of the knee joint after implantation of an extra-articular absorber system (ATLAS) in comparison to open-wedge high tibial osteotomy (OW-HTO) under physiological conditions. The hypothesis of the study was that implantation of an extra-capsular absorber results in an unloading effect comparable to the one achievable with OW-HTO. ⋯ OW-HTO results in a significant unloading of the medial compartment. Implantation of an extra-capsular absorbing device did not result in a significant unloading until the implantation technique was applied against the manufacturer's recommendation. While the clinical difficulty for young and active patients with straight-leg axis and early degenerative changes of the medial compartment persists further biomechanical research to develop sufficient unloading devices is required.
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Arch Orthop Trauma Surg · Jun 2023
Instrumented fusion versus instrumented non-fusion following expansive open-door laminoplasty for multilevel cervical ossification of the posterior longitudinal ligament.
To compare the outcomes of expansive open-door laminoplasty with instrumented fusion (ELIF) and expansive open-door laminoplasty with instrumented non-fusion (ELINF) for multilevel cervical ossification of the posterior longitudinal ligament (OPLL). ⋯ ELIF and ELINF were two effective surgical procedures for treating multilevel cervical OPLL. However, ELIF was superior to ELINF due to better postoperative JOA score and RR, significant improvement of C2-C7 Cobb angle and maintenance of SVA, and suppressant effect on OPLL progression, especially for patients with K-line ( - ) OPLL.
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Arch Orthop Trauma Surg · Jun 2023
Accuracy of pedicle screw placement using neuronavigation based on intraoperative 3D rotational fluoroscopy in the thoracic and lumbar spine.
In spinal surgery, precise instrumentation is essential. This study aims to evaluate the accuracy of navigated, O-arm-controlled screw positioning in thoracic and lumbar spine instabilities. ⋯ Combination of neuronavigation and 3D rotational fluoroscopy control ensures excellent accuracy in pedicle screw positioning. As misplaced screws can be detected reliably and revised intraoperatively, repeated surgery for screw malposition is rarely required.
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Arch Orthop Trauma Surg · Jun 2023
Mobile bearing versus fixed bearing medial unicompartmental knee replacement: an independent two center matched-pairs analysis.
The aim of the present study was to compare clinical outcome between patients following fixed-bearing (FB) or mobile-bearing (MB) unicompartmental knee replacement (UKR) for antero-medial knee osteoarthrosis (OA) at two independent orthopedic centers. ⋯ Retrospective cohort study, Level IV.
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Arch Orthop Trauma Surg · Jun 2023
Sexual activity after short-stem total hip arthroplasty. Does stem size matter?
Sexual activity is an important component of quality of life. To date, no studies have examined the impact of stem design on return to sexual activity (RTS) and quality of sex life after total hip arthroplasty (THA). ⋯ Level III, retrospective cohort study.