Articles: tibia-surgery.
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Since tunnel positioning is one of the key factors in anterior cruciate ligament (ACL) reconstruction and the variability of tunnel positioning in ACL reconstruction has so far never been analyzed, the objective of this study was to determine the inter- and intra-observer variability of tibial and femoral tunnel positioning in ACL reconstruction. ⋯ This study demonstrates that a reasonable inter- and intra-observer variability in ACL tunnel positioning exists even among experienced surgeons. Although deviations of 2-3 mm may seem to be acceptable at first sight, a range of up to 18.3 mm indicates that outliers exist, which can cause graft failure. More reliable reconstruction techniques should be developed to reduce the variability in tunnel positioning.
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J Bone Joint Surg Am · Sep 2014
Randomized Controlled Trial Comparative StudyComparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up.
Varus deformity increases the risk of progression of medial compartment knee osteoarthritis. The aim of this study was to investigate the clinical and radiographic mid-term results of closing-wedge and opening-wedge high tibial osteotomy when used to treat this condition. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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To investigate the efficacy of the Ilizarov technique with bone segment extension in tibial infected nonunion. ⋯ The Ilizarov technique with bone segment extension is effective in treating tibial infected nonunion with large bone defects.
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Orthop Traumatol Sur · Sep 2014
Tibial tubercle osteotomy hinged on the tibialis anterior muscle and fixed by circumferential cable cerclage in revision total knee arthroplasty.
Difficulties in knee exposure during revision total knee arthroplasty (RTKA) may require tibial tubercle osteotomy (TTO). The main objective of this study was to assess union after TTO hinged on the lateral soft tissues and fixed using circumferential cable cerclage during RTKA. ⋯ IV, retrospective study.
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This study was designed to evaluate the effectiveness of the treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator. We retrospectively reviewed 66 patients with infected tibial nonunion treated by bone transport using the Ilizarov external fixator. Our study included 62 males and 4 females with a mean of age 37.06 years. The average length of the bone defects after radical debridement was 6.27 cm (range 3-13 cm). The mean follow-up after removal of the apparatus was 25.91 months (18-46 months). 6 patients were lost to follow-up. All the patients achieved bone union and no recurrence of infection was observed. The mean external fixation index was 1.38 months/cm (range 1.15-1.58 months/cm). According to Association for the Study and Application of the Method of Ilizarov (ASAMI) classification, bone results were excellent in 44, good in 15, fair in 5 and poor in 2; functional results were excellent in 24, good in 26, fair in 10 and no poor. ⋯ Our study and the current evidence suggested that Ilizarov methods in the treatment of infected tibial nonunion acquired satisfied effects in bone results and functional results. Radical debridement is the key step to control bone infection.