Articles: tibia-surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cemented tibial component fixation performs better than cementless fixation: a randomized radiostereometric study comparing porous-coated, hydroxyapatite-coated and cemented tibial components over 5 years.
The question whether the tibial component of a total knee arthroplasty should be fixed to bone with or without bone cement has not yet been definitely answered. We studied movements between the tibial component and bone by radiostereometry (RSA) in total knee replacement (TKR) for 3 different types of fixation: cemented fixation (C-F), uncemented porous fixation (UC-F) and uncemented porous hydroxyapatite fixation (UCHA-F). ⋯ Cementing of the tibial component offers more stable bone-implant contact for 5 years compared to uncemented fixation. When using uncemented components, however, there is evidence that augmenting a porous surface with hydroxyapatite may mean less motion between implant and bone after the initial postoperative year.
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Randomized Controlled Trial Clinical Trial
High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study.
The clinical outcome of patients treated either by high tibial osteotomy or unicompartmental arthroplasty for medial unicompartmental osteoarthritis of the knee was compared in a prospective randomised study. In total, 32 patients received a high tibial osteotomy (HTO) and 28 patients a unicompartmental arthroplasty (UKA). More intra- and postoperative complications were observed after HTO. ⋯ Using the Knee Society Score, 71% (15) of patients after osteotomy and 65% (13) after replacement had a knee score of excellent or good 7-10 years postoperatively. The Kaplan-Meier survival analysis 7-10 years postoperatively showed a survivorship of 77% for UKA and 60% for HTO. Although the unicompartmental prosthesis used in this series has not shown promising results, we conclude that with the advanced design of unicompartmental prosthesis today, UKA offers better long-term success.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe incidence of thrombosis in high tibial osteotomies with and without the use of a tourniquet.
In a prospective randomised study, 65 high tibial osteotomies were performed in cases of varus osteoarthritis of the knee, and the incidence of thrombosis with and without the use of a tourniquet was studied. With an average incidence of thrombosis of 10.8%, no statistically significant differences between these two groups were seen.
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Randomized Controlled Trial Clinical Trial
The role of fibular osteotomy in rotational osteotomy of the distal tibia.
A randomized prospective study was undertaken to assess the role of fibular osteotomy in distal tibial derotational osteotomies. Thirty-five patients were randomized to "intact fibula" and "osteotomized fibula" groups. ⋯ In the osteotomized fibula group, there were two cases of loss of fixation, two pin-tract infections, one delayed union of tibia, one pressure sore in the cast, one distal tibial physeal arrest, and one recurrence. Although the difference in the complication rate between the two groups did not reach statistical significance, our results suggest that in distal tibial derotational osteotomies, fixed with cross pins, it might be advantageous to leave the fibula intact.