Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2009
Single stage arteriovenous short saphenous loops in microsurgical reconstruction of the lower extremity.
The short saphenous vein can be used "in situ" to create a temporary arteriovenous shunt for lengthening the recipient vessels of the injured limb in microsurgical reconstructions of the lower extremity. We report our results using this single-anastomosis turnover technique in three high-energy trauma patients who presented open tibial fractures associated with vascular injuries. ⋯ The use of the ipsilateral small saphenous vein "in situ" for immediate arteriovenous loop formation may be of great value in complex lower leg reconstructions. It is a reliable adjunctive technique that provides healthy vessels to supply the free flap, permitting stable wound coverage and high rate of limb salvage.
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Arch Orthop Trauma Surg · Mar 2009
Effects of articular cartilage and meniscus injuries at the time of surgery on osteoarthritic changes after anterior cruciate ligament reconstruction in patients under 40 years old.
The development of osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction is an unsolved problem. Articular cartilage and meniscus injuries are particularly important factors that contribute to OA progression. ⋯ Level 4, case series, therapeutic studies, investigating the results of treatment.
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Arch Orthop Trauma Surg · Mar 2009
A modified arthroscopic anterior cruciate ligament double-bundle reconstruction technique with autogenous quadriceps tendon graft: remnant-preserving technique.
Several techniques of anterior cruciate ligament (ACL) double-bundle reconstruction have been introduced to improve the functional outcome and restore normal kinematics of the knee. Meanwhile, a remnant-preserving technique was developed to preserve the proprioception and to enhance the revascularization of the reconstructed ACL. We developed double-bundle ACL reconstruction technique using autogenous quadriceps tendon graft while preserving the remnant. ⋯ To preserve the remnant of the ACL, the rotational direction of the reamer was set to counterclockwise just before perforation of the tibial tunnel. To pass the graft more easily without disturbance of the remnant, the graft passage was achieved through the tibial tunnel. We suggest that the remnant-preserving technique could be an effective alternative considering its mechanical stability as well as the proprioception and vascularization recovery in arthroscopic double-bundle ACL reconstruction.
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Arch Orthop Trauma Surg · Mar 2009
Randomized Controlled Trial Multicenter StudyProspective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study.
Viscosupplementation by repeated intra-articular injections of hyaluronic acid (HA) is used widely in the treatment of symptomatic knee osteoarthritis (OA). The number of injections required can limit the availability of treatment and affect patient compliance. The aim of this study was to assess different dosing regimens of hylan G-F 20, a high molecular-weight cross-linked derivative of HA, in the treatment of pain due to knee OA. ⋯ This study suggests that a single 6 mL injection of hylan G-F 20 may be as efficacious, and as well tolerated, as 3 x 2 mL one week apart. A double-blind, controlled trial is needed to confirm these data.