Articles: tibia-surgery.
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The aim of this study was to examine histological changes in bone morphology after surgical treatment of tibial plateau fractures using calcium phosphate cement as a substitute for autologous bone grafting. A total of 42 patients with tibial plateau fractures were treated with open reduction, internal fixation, and calcium phosphate cement. A further 34 control patients underwent open reduction and internal fixation. ⋯ Mean Hospital for Special Surgery knee scores were rated "good" for both the calcium phosphate cement group (82.3) and control group (79.4) in 12 months, and were not significantly different between groups. Histological examination of samples obtained during the second surgery revealed well-arranged trabeculae, in addition to new bone and blood vessel formation. These histological, radiological, and functional findings suggest that calcium phosphate cement may be an effective substitute for autologous bone grafting to treat tibial plateau fractures.
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Bacterial infection is a serious postoperative complication of joint replacement. To prevent infections related to implantation, we have developed a novel antibacterial coating with Ag-containing hydroxyapatite (Ag-HA). In the present study, we examined the antibacterial activity of Ag-HA implant coatings in the medullary cavity of rat tibiae. ⋯ Mean radiographic scores for infection were significantly lower with Ag-HA implants than with HA implants. Histological examination showed better results for abscesses, bone resorption, and destruction of cortical bone around Ag-HA-coated implants. These results indicate that Ag-HA coatings may help prevent surgical-site infections associated with joint replacement.
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Clinical Trial
[Implant-free tibial fixations of the posterior cruciate ligament. Development and biomechanical testing].
A secure tibial press fit technique in posterior cruciate ligament reconstructions may be a relevant alternative to common techniques because no hardware is necessary. Up to the present point in time no biomechanical data exist for a tibial press fit posterior cruciate ligament (PCL) reconstruction. This study compares the biomechanical properties of hamstring and quadriceps tendon grafts using a press fit technique with those of an interference screw fixation. ⋯ All techniques exhibited larger elongation during initial loading. Load to failure and stiffness were significantly different between the fixations. The Q fixation showed equal biomechanical properties compared to a pure tendon fixation (I) with an interference screw. The results of group K were inferior. All three investigated fixation techniques exhibit comparable biomechanical properties. Preconditioning of the constructs is critical. Future randomized, clinical trials have to investigate the biological effectiveness of these fixation techniques.
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Arch Orthop Trauma Surg · Jun 2013
Double-bundle anterior cruciate ligament reconstruction with split Achilles allograft and single tibia tunnel for small ACL tibial footprint : technical note with clinical results.
We describe a surgical technique of double-bundle ACL reconstruction with a single tibia tunnel and report the clinical outcome. ⋯ Level IV, therapeutic study.
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Meta Analysis Comparative Study
Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis.
We conducted a systematic review of comparative clinical trials assessing the results of high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) in patients with strictly unilateral osteoarthritis of the knee. A literature search was conducted through Medline, Embase and Cochrane library. ⋯ Postoperative rate of revision and complications did not differ significantly between two groups. With the correct patient selection, both HTO and UKA show effective and reliable results.