Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2013
Controlled Clinical Trial Observational StudyModified direct anterior approach in minimally invasive hip hemiarthroplasty in a geriatric population: a feasibility study and description of the technique.
The direct anterior approach (DAA) is generally accepted method for minimal invasive arthroplasty of the hip. As good results for total hip arthroplasty are already published, there is a lack of evidence for the implantation of bipolar hip hemiarthroplasty (BHH) in elderly patients with osteoporosis after femoral neck fracture. ⋯ The described modifications of the DAA help to implant a BHH gently in elderly patients with increasing risk of complications like iatrogenic fractures, wound or prosthesis infections and haematoma. This will hopefully lead to a faster rehabilitation and lower mortality rate for patients with femoral neck fractures in the future.
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Arch Orthop Trauma Surg · Nov 2013
Marker-based or model-based RSA for evaluation of hip resurfacing arthroplasty? A clinical validation and 5-year follow-up.
The stability of implants is vital to ensure a long-term survival. RSA determines micro-motions of implants as a predictor of early implant failure. RSA can be performed as a marker- or model-based analysis. So far, CAD and RE model-based RSA have not been validated for use in hip resurfacing arthroplasty (HRA). ⋯ The precision of marker-based RSA was significantly better than model-based RSA. However, problems with occluded markers lead to exclusion of many patients which was not a problem with model-based RSA. HRA were stable at the 5-year follow-up. The detection limit was 0.2 mm TT and 1° TR for marker-based and 0.5 mm TT and 1° TR for CAD model-based RSA for HRA.
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Arch Orthop Trauma Surg · Nov 2013
Simultaneous and staged bilateral total hip arthroplasty: a Danish nationwide study.
Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days readmissions and 90 days mortality after BSTHA and BTHA on a nationwide basis. ⋯ If patients are carefully selected for BSTHA, the procedure appears to be safe when combined with a fast-track protocol in Denmark. We found significantly lower readmission rates and shorter total LOS in the BSTHA group compared with the BTHA groups, potentially reflecting selection bias. The results should stimulate to evaluate BSTHA in a randomised controlled trial or a detailed prospective, large multicenter study with a fast-track protocol regarding morbidity, convalescence and mortality.
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Arch Orthop Trauma Surg · Nov 2013
MRI after unicondylar knee arthroplasty: rotational alignment of components.
This pilot study used magnet resonance imaging (MRI) to analyse the rotation of medial unicondylar knee arthroplasty (UKA) components and assessed how accurately the results could be reproduced. ⋯ MRI allows good reproducible rotation analysis via the femoral epicondyles for both femoral and tibial UKA implants. For the tibia, the tibial tuberosity, the eminentia and the tibial epicondyles in particular were shown to be less reliable. The dorsal epicondyles seem to be most suitable for the tibial component.
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Arch Orthop Trauma Surg · Nov 2013
CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure.
The success of shoulder stabilization with the Latarjet procedure might depend on the size of the bone graft and the positioning of the coracoid at the glenoid. The aim of this study was to quantitatively assess the surface of the coracoid bone graft and to assess its positioning in the en-face view. ⋯ Level IV, prospective case series, treatment study.