Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2015
Atypical fractures of the femur: effect of anterolateral bowing of the femur on fracture location.
Bisphosphonate therapy has been associated with the development of atypical femoral fractures. The most common sites of bisphosphonate-associated fractures are at the subtrochanteric region followed by the femoral shaft. This retrospective study hypothesizes that increasing anterolateral femoral bow is associated with more distal diaphyseal fractures. Awareness of this relationship is essential in the pre-operative planning and successful surgical management of these fractures. ⋯ In atypical femoral fractures associated with bisphosphonate use, more distal diaphyseal fractures occurred with a higher degree of anterior and lateral femoral bow.
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Arch Orthop Trauma Surg · Nov 2015
Biomechanical comparison of two surgical techniques for press-fit reconstruction of the posterolateral complex of the knee.
To date, various surgical techniques to treat posterolateral knee instability have been described. Recent studies recommended an anatomical and isometric reconstruction of the posterolateral corner addressing the key structures, such as lateral collateral ligament (LCL), popliteus tendon (POP) and popliteofibular ligament (PFL). Two clinical established autologous respective local reconstruction methods of the posterolateral complex were tested for knot-bone cylinder press-fit fixation to assess efficacy of each reconstruction technique in comparison to the intact knee. ⋯ Both PLC reconstructions showed equal biomechanical stability as the intact posterolateral knee structures when using knot-bone cylinder press-fit fixation. We registered restoration of the rotational and varus-valgus stability with both surgical techniques. The anterior-posterior translational stability was not influenced significantly. The Larson technique showed significant higher varus/valgus stability in 90° flexion. The latter is easier to perform and takes half the preparation time, but needs grafting of the semitendinosus tendon. The Kawano reconstruction technique is an interesting alternative in cases of missing autografts.
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Arch Orthop Trauma Surg · Nov 2015
A novel implant-free tibial pull-press-fixation for ACL reconstruction.
Extracortical fixation techniques in anterior cruciate ligament reconstruction bear the risk of tunnel enlargement, while close-to-aperture fixations often show lower failure loads. The purpose for this study was to investigate the biomechanical benefits of a novel implant-free combination of an extra-cortical and close-to-aperture fixation. ⋯ Not applicable, basic science study.
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Arch Orthop Trauma Surg · Nov 2015
Platelet-rich plasma did not improve early healing of medial collateral ligament in rats.
The medial collateral ligament (MCL) is the most frequently injured ligament of the knee. Platelet-rich plasma (PRP) is a relatively new treatment option developed to enhance the healing response after injury to different tissue types. This study aimed at investigating whether the addition of PRP to MCL tears in rats would alter healing both biomechanically and histologically. ⋯ The addition of PRP to a healing MCL did not improve any of the outcome measures in this model.
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Arch Orthop Trauma Surg · Nov 2015
Influences of fit and fill following hip arthroplasty using a cementless short-stem prosthesis.
The purpose of this study consisted in examining the effects of fit and fill ratio of the Metha prosthesis (BBraun, Aesculap, Tuttlingen, Germany) on radiological and clinical outcomes at a follow-up of 1 year. ⋯ Implanting the Metha prosthesis induces tight fit and fill ratio at the proximal and coated sections. Preoperative femur configuration should be considered to achieve best fit and fill situation and therefore excellent primary stability. In most cases "normal" and "stove-pipe" configurations provide good proximal fit and fill. Since "champagne-flute" configuration induces undesirable tight distal fit and fill ratio the size of the Metha (®) stem should be adequately increased to achieve a more proximal load transmission.