Articles: tibia-surgery.
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Knee Surg Sports Traumatol Arthrosc · Nov 2019
Femoral-tibial fixation affects risk of revision and reoperation after anterior cruciate ligament reconstruction using hamstring autograft.
Newer fixation devices for hamstring (HS) autograft have been introduced over the years, yet the impact of these devices on ACLR outcomes requiring surgical intervention remains unclear. We sought to evaluate the risk of aseptic revision and reoperation after HS autograft ACLR according to various femoral-tibial fixation methods. ⋯ III.
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Externally magnetic-controlled intramedullary telescopic nails for bone lengthening have recently gained popularity due to many advantages when compared to more traditional lengthening methods. Patients requiring lengthening often present with a clinical history of previous multiple surgeries increasing the risk for complications of further procedures. However, studies regarding the treatment of complications following implantation of these devices remain scarce in literature. ⋯ The median interval between index and revision surgery was 11.5 months (range 2-15 months). Satisfying clinical results, the intended extend of lengthening and bony consolidation was observed in all 6 patients. We conclude that revision surgery using an intramedullary locking nail with autologous bone grafting after failed telescopic nail-based lengthening represents an useful salvage procedure in these cases.
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Comparative Study
Comparison of Clinical and Radiologic Outcomes Between Normal and Overcorrected Medial Proximal Tibial Angle Groups After Open-Wedge High Tibial Osteotomy.
To evaluate whether the overcorrected medial proximal tibial angle (MPTA) affects the clinical outcomes after open-wedge high tibial osteotomy (OWHTO) and to assess the correlation between knee joint line obliquity (KJLO) changes and the compensatory changes in the hip and ankle joints. ⋯ Level Ⅲ, retrospective comparative study.
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Comparative Study
Onlay Reconstruction of the Posterior Cruciate Ligament: Biomechanical Comparison of Unicortical and Bicortical Tibial Fixation.
Posterior cruciate ligament (PCL) injuries are generally associated with high-energy trauma. There are many controversies regarding optimal surgical technique in regard to graft selection and fixation methods. The recently described onlay technique allows for direct fixation of a hamstring autograft to the posterior aspect of the tibia with cancellous screw and spiked washer, while protecting the neurovascular structures and avoiding the so-called "killer turn." The objective of this study was to compare immediate postimplantation biomechanics of unicortical versus bicortical tibial fixation of onlay PCL grafts. ⋯ Regarding stiffness, there were no significant differences between unicortical and bicortical, and both were superior to PCL-deficient and inferior to PCL-intact knees. Based on cadaveric biomechanical testing, none of the reconstructed PCL knees was able to replicate the intact native PCL, but both techniques were superior to PCL-deficient knees. The bicortical tibial fixation technique appears to have biomechanical advantages when opting for onlay PCL reconstruction.
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The Precice nail is used to treat limb length discrepancies and has a low complication rate and a high patient satisfaction rate. While the Precice nail can be used for lengthening, unlike other lengthening nails, it can also be used for shortening. ⋯ The distal interlocking screws were then reattached to continue lengthening. This surgical technique can be used safely and satisfactorily in cases with more shortness as we can correct the extremity length discrepancy using only one nail.