Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2013
Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers.
The purpose of this article was to demonstrate an anterior cruciate ligament (ACL) reconstruction technique using oval tunnels. Aim of this single bundle technique is to fit the footprint anatomy of the ACL as closely as possible. TECHNIQUE AND PATIENTS: The presented technique is a single bundle technique using a semitendinosus graft. For femoral tunnel placement, a specific medial portal aimer (Karl Storz, Tuttlingen, Germany) is used. Aiming and drilling of the femoral tunnel are performed via the medial portal. Oval tunnels are created by stepwise dilatation with ovally shaped dilatators. The position of the femoral tunnel is visualized and controlled with the arthroscope via the medial portal. For the tibial tunnel placement, a specific aimer was used as well. With this technique, 24 patients were operated and all intra- and postoperative complications were analyzed prospectively. The tunnel position was documented postoperatively by CT scan. ⋯ Level IV, case series.
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Arch Orthop Trauma Surg · Jun 2013
Incongruity affecting osteochondral repair by mosaicplasty technique in an animal model.
To compare the influence of the different osteochondral incongruity grades on the osteochondral repair by the mosaicplasty technique in a goat model. ⋯ The incongruity could have an influence on the repair by the mosaicplasty technique in a goat model. The limited incongruity could be repaired by a vigorous remodeling process.
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Arch Orthop Trauma Surg · May 2013
Early migration characteristics of a 180° porous-coated cup with 1-mm press fit.
Evaluation of early cup movement is an important diagnostic tool to predict the likelihood of long-term implant loosening and clinical failure. The investigated cementless cup is clinically proven over 10 years, but there is a paucity of information that accurately describes the migration characteristics of this component. ⋯ Surgeons may expect to find a variable amount of early migration when using the Pinnacle cup. To our knowledge, these are the first results, which show an early "impaction" of a cementless cup, followed by subsequent osseointegration. We believe that an appropriate long-term outcome of the investigated cup is ensured. The data of the present investigation will provide clinicians with useful baseline information with which to compare new cup designs.
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Arch Orthop Trauma Surg · May 2013
Comparative StudyLocking versus standard screw fixation for acetabular cups: is there a difference?
Total hip replacement has been established as a valid treatment option for displaced subcapital fractures. However, insufficient primary fixation may be the reason for early loosening in these osteoporotic patients. Primary fixation of the cup is usually achieved by press-fit fixation that can be enhanced using screws. Locking the screws into their respective cups may seem to improve the primary fixation of the construct, as locked plates proved superior fixation for osteoporotic fractures. ⋯ These experimental results indicate that acetabular screws enhance primary cup fixation. This may become significant in conditions where the acetabular bone stock is suboptimal, such as when performing total hip arthroplasty after displaced subcapital fractures. However, there is no superiority for locked screws over standard screw fixation.
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Arch Orthop Trauma Surg · May 2013
Meta AnalysisRisk factors for deep infection after total knee arthroplasty: a meta-analysis.
Estimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence. ⋯ There were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.