Archives of orthopaedic and trauma surgery
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Some of the most important causes of shoulder pain are inflammation and degenerative changes in the rotator cuff (RC). Magnetic resonance imaging (MRI) is a noninvasive and safe imaging modality. MRI can be used for the evaluation of cuff tendinopathy. In this study, we evaluated the relationship between glenoid cavity depth and cuff tendinopathy and we investigated glenoid cavity depth on the pathogenesis of cuff tendinopathy. ⋯ High coronal and low axial depth of the glenoid cavity can be used to diagnose RC tendinitis.
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The treatment of adult non-traumatic avascular necrosis of the femoral head (AVN; N-ANFH) within an estimated incidence of 5000-7000 cases per annum in Germany remains a challenge. Risk factors include steroids, alcohol abuse, chemotherapy and immunosuppressive medication, but a genetic predisposition has been suggested. Early diagnosis of this often bilateral disease process is essential for successful conservative or joint preserving surgical management. In this review, we present the update German consensus S3 guideline "diagnosis and management for N-ANFH" as a concise summary. ⋯ Clinical suspicion of N-ANFH mandates radiographic evaluation. If radiographs are normal MRI scans are recommended, which should be evaluated according to the ARCO-classification. Differential diagnoses include transient osteoporosis, bone bruise, insufficiency fracture and destructive arthropathy. Untreated, subchondral fractures commonly occur within 2 years, during which the risk for contralateral involvement is high-thereafter unlikely. Conservative management with Ilomedin and Alendronat can be tried, but other pharmacological or physical treatments are inappropriate. No specific joint preserving procedure can be recommended, but core decompression should be considered in early stages if necrosis is <30 %. In ARCO stages IIIc or IV total hip arthroplasty (THA) should be contemplated, which offers similar outcome compared to osteoarthritis. Young age is the main risk factor for higher revision rates after THA for N-ANFH.
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Arch Orthop Trauma Surg · Feb 2016
Comparative StudyComparison of different femoral fixation implants and fit techniques for tunnel widening and clinical outcome in ACL reconstruction using hamstring autograft.
The purpose of the current study is to investigate in different femoral fixation devices whether tight (undersize drilled) fit technique decreases the tunnel widening and improves the clinical outcome compared to conventional technique in ACL reconstruction using hamstring tendon autograft. ⋯ Therapeutic case series, Level IV.
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Arch Orthop Trauma Surg · Feb 2016
Measurement of rotational and coronal alignment in total knee arthroplasty using a navigation system is reproducible.
Intraoperative kinematic analysis using a navigation system in total knee arthroplasty (TKA) has been increasing. The purpose of the present study was to assess the reproducibility of the intraoperative kinematics analysis in TKA using the image-free knee navigation system. ⋯ Manual intraoperative kinematic analysis using a navigation system in TKA showed excellent reproducibility. This result may encourage further studies about intraoperative kinematic analysis using a navigation system in TKA.