Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2014
Comparative StudyDoes fracture affect the healing time or frequency of recurrence in a simple bone cyst of the proximal femur?
Studies have focused on intramedullary nailing of femoral simple bone cysts but have not clarified the recurrence frequency or management of recurrent cysts. In particular, the affect of pathologic fractures on cyst healing, recurrence, and complications of treatment have not been reported. ⋯ Whether a pathologic fracture had occurred before surgical treatment, intramedullary nailing of femoral simple bone cysts resulted in reliable healing, and the frequency of recurrence did not differ. Because this was a retrospective study, the optimal treatment for recurred cysts after intramedullary nailing should be further investigated through a comparative or prospective study.
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Clin. Orthop. Relat. Res. · Oct 2014
Benefit of cup medialization in total hip arthroplasty is associated with femoral anatomy.
Medialization of the cup with a respective increase in femoral offset has been proposed in THA to increase abductor moment arms. Insofar as there are potential disadvantages to cup medialization, it is important to ascertain whether the purported biomechanical benefits of cup medialization are large enough to warrant the downsides; to date, studies regarding this question have disagreed. ⋯ Cup medialization with compensatory increase of the femoral offset may be particularly effective in patients with less femoral antetorsion. However, cup medialization must be balanced against its tradeoffs, including the additional loss of medial acetabular bone stock, and eventual proprioceptive implications of the nonanatomic center of rotation and perhaps joint reaction forces. Clinical studies should better determine the relevance of small changes of moment arms on function and joint reaction forces.