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1.
Hong Je Kang Churl Hong Chun Kwang Mee Kim Hang Hwan Cho Johnsel C. Espinosa 《Clinics in Orthopedic Surgery》2015,7(2):177-184
Background
Meniscus tears are commonly associated with anterior cruciate ligament (ACL) ruptures. It is essential to repair meniscal tears as much as possible to prevent early osteoarthritis and to gain additional stability in the knee joint. We evaluated the results of arthroscopic all-inside repair using the Meniscal Viper Repair System (Arthrex) on meniscus tears simultaneously with ACL reconstruction.Methods
Nineteen out of 22 patients who were treated with arthroscopic all-inside repair using the Meniscal Viper Repair System for meniscus tear associated with ACL rupture were evaluated. ACL reconstructions were performed at the same period. The mean follow-up period was 16.5 months (range, 12 to 24 months). The clinical results of the meniscus repair were evaluated by symptoms (such as catching or locking), tenderness, effusion, range of motion limitation, and the McMurray test. Clinical success was defined by negative results in all five categories. The Hospital for Special Surgery (HSS) score was evaluated. Objective results were evaluated with secondary look arthroscopy or magnetic resonance imaging (MRI). The MRI results were categorized as completely repaired, incompletely repaired, and failure by Henning''s classification. The results of second-look arthroscopy were evaluated with the criteria of meniscal healing.Results
The clinical success rate was 95.4% and the HSS scores were 93.9 ± 5.4 at the final follow-up. According to Henning''s classification, 15 out of 18 cases showed complete healing (83.3%) and two cases (11.1%) showed incomplete healing. Seventeen out of 18 cases that underwent second-look arthroscopy showed complete healing (94.4%) according to the criteria of meniscal healing. Only one case showed failure and the failure was due to a re-rupture at the sutured area. Complications of ACL reconstruction or meniscus repair were not present.Conclusions
The results demonstrate that arthroscopic all-inside repair using the Meniscal Viper Repair System is an effective treatment method when it is performed simultaneously with ACL reconstruction. 相似文献2.
Takayuki Furumatsu Shinichi Miyazawa Takaaki Tanaka Yukimasa Okada Masataka Fujii Toshifumi Ozaki 《International orthopaedics》2014,38(7):1393-1399
Purpose
Meniscus repair can restore meniscal function that transfers the axial compressive force to circumferential tensile strain. However, few reports have investigated the relationship between concurrent meniscus repair with acute anterior cruciate ligament (ACL) reconstruction and postoperative meniscal position. This study aimed to evaluate medial meniscal size and clinical results in patients who underwent ACL reconstruction and concomitant all-inside medial meniscus repair.Methods
Twenty patients underwent ACL reconstruction and concurrent medial meniscus repair of a peripheral longitudinal tear using the FasT-Fix meniscal repair device. Medial tibial plateau length (MTPL) and width (MTPW) were determined by radiographic images. We evaluated the Lysholm score, anteroposterior instability, meniscal healing and magnetic resonance imaging (MRI)-based medial meniscal length (MML) and width (MMW). Correlations between MRI-based meniscal size, radiographic measurement and height were investigated.Results
All patients showed complete healing of the repaired meniscus in arthroscopic evaluation. However, one patient needed a subsequent meniscus repair during the follow-up period. Lysholm score and anteroposterior instability improved significantly. A better correlation was observed between MMW and MTPW than between MML and MTPL. Concurrent all-inside medial meniscus repair with ACL reconstruction significantly increased MML percentage (%MML) (100 MML/MTPL) but did not affect MMW percentage (%MMW) (100 MMW/MTPW).Conclusions
Concurrent all-inside medial meniscus repair with ACL reconstruction had satisfactory clinical results. %MML was increased by concurrent medial meniscus repair without affecting %MMW. Our results suggest that medial meniscus repair associated with ACL reconstruction may restore meniscal function by adjusting the anteroposterior length of the torn medial meniscus. 相似文献3.
Patricio Melean Sven Lichtenberg Fredy Montoya Stephan Riedmann Petra Magosch Peter Habermeyer 《International orthopaedics》2013,37(11):2173-2179
Background
The main objective of this study was to evaluate the association between the acromial index (AI) and the incidence of recurrent tears of the rotator cuff (RC) in a cohort of patients with full thickness tears who underwent arthroscopic primary repair.Methods
A prognostic study of a prospective case series of 103 patients with full thickness RC tears was undertaken. The average age was 59.5 years (39–74) and follow-up was 30.81 months (12–72). True anterior–posterior X-rays were obtained during the pre-operative evaluation. Pre and post-operative magnetic resonance imaging (MRI) were recorded.Results
Eighteen cases with recurrent tears (17.4 %) were seen on post-operative MRI. The average AI for patients with recurrent tears was 0.711 ± 0.065 and for patients without recurrent tears 0.710 ± 0.064 (p < 0.05). A positive association between age and recurrent tears of the RC was noted (average ages: recurrent tears group 63 ± 5.9 years; group without recurrent tears 58.8 ± 7.5 years) (r = −0.216; p = 0.029). We did not find an association between size of the primary tear and recurrent tears (r = −0.075; p < 0.05) or between degrees of retraction of the primary and recurrent tears of the cuff (r = −0.073; p < 0.05). We observed that 38.9 % of the recurrent tears cases presented with more than one tendon affected before the arthroscopy. At follow-up, none of these recurrent tears showed more than one tendon affected on MRI evaluation.Conclusion
In this study, we found that the AI radiological measurement is not a predictor for recurrent tears of the RC after primary arthroscopic repair. 相似文献4.
Background:
Total meniscus resection after meniscus tear usually leads to faster degeneration and osteoarthritis of the knee joint. Preservation and repair of the injured menisci are therefore of great clinical importance. The aim of this study was to evaluate the clinical effects of arthroscopic repair of meniscal injuries using the Fast-Fix device.Materials and Methods:
96 patients (58 males, 38 females) with mean age of 24.3 years (range 12–46 years)) with a meniscus injury were treated with the Fast-Fix device under arthroscopy between July 2007 and June 2009. The right and left knees were involved in 46 and 50 patients respectively. In 12, 46 and 38 patients, the injury was located in the anterior horn, body and posterior horn respectively. In 38, 45 and 13 patients, it was in the red, red-white, and white regions, respectively. All-inside and outside-in techniques were used for these meniscal injuries. Criteria for successful surgery were no locking pain or swelling and a negative McMurray test.Results:
The mean followup period was 3.7 years (range 2–5 years). The surgical success rate was 91.7% (n = 88). The mean Lysholm score increased from 47.8 ± 10.4 preoperatively to 85.7 ± 12.8 postoperatively. The mean Tegner activity score was 7.4 ± 1.6 (range 5–9) preinjury, 2.1 ± 0.9 (range 0–4) preoperatively and 7.2 ± 2.2 (range 4–10) postoperatively (P < 0.001). A total of 92 patients (95.8%) returned to full-time work. The International Knee Documentation Committee score increased from 32.7 ± 10.7 (range 10.3–51.7) preoperatively to 82.5 ± 5.1 (range 65.1–91.2) postoperatively (P < 0.001).Conclusions:
The Fast-Fix system is an efficient, safe and effective suture technique for meniscal repair. 相似文献5.
Purpose
To compare and analyse the relationship between horizontal tear and root ligament tear of the posterior horn of the medial meniscus (PHMM) and the degree of varus in the axis of lower limb and body weight.Methods
One hundred and nineteen patients underwent surgical treatment as they were diagnosed with medial meniscus tear in our hospital from May 2006 to December 2009. Of these, 19 cases (group 1), underwent partial meniscectomy as they were confirmed to solely have horizontal tear of the PHMM on arthroscopic examination and 27 cases (group 2), underwent subtotal meniscectomy as they were confirmed to solely have root ligament tear of the PHMM on arthroscopic examination, were chosen for retrospective study. Standing radiographs were taken of every case prior to arthroscopic surgery to measure varus angle. Also, we checked body mass index (BMI) of two groups. The difference of varus angle and BMI between two groups were statistically verified using the Levene’s test, paired t-test.Results
Group 1 showed mean value of varus angle of 2.30 ± 0.54, and BMI of 25.32 ± 3.23. Group 2 showed mean value of varus angle of 5.64 ± 0.54, and BMI of 25.67 ± 3.12. The degree of varus of group 2 was statistically significantly higher than group 1 (p = 0.002). Comparison between the BMI of two groups showed no statistical significance (p = 0.053).Conclusion
Through a comparative study of sole horizontal tear and root ligament tear of the PHMM, the authors have found that sole root ligament tear of the PHMM is more relative to the genu varum than sole horizontal tear of the PHMM. However, body weight was statistically irrelevant to the incidence of the two lesions. 相似文献6.
The functional outcome of forty-nine single-incision suture anchor repairs for distal biceps tendon ruptures at the elbow 总被引:1,自引:0,他引:1
Sebastian Siebenlist Stephanie C. Fischer Gunther H. Sandmann Philipp Ahrens Petra Wolf Ulrich Stöckle Andreas B. Imhoff Peter U. Brucker 《International orthopaedics》2014,38(4):873-879
Purpose
The objective of this retrospective study was to evaluate the functional results of distal biceps tendon repair using suture anchors via a single-incision approach.Methods
Forty-nine patients were re-examined at a mean follow-up of 44.2 ± 32.1 months (range, 12–119 months). Subjective and objective criteria included patient’s satisfaction, active range of motion (ROM), maximum isometric strength in flexion (at 45° and 90°), and supination of both arms. Functional scoring included the Morrey elbow score (MES) and the QuickDASH. Furthermore, follow-up radiographs were performed.Results
Eighty-six percent of patients were highly satisfied or satisfied with their outcome. Compared to contralateral, the active ROM of elbow flexion, extension, and pronation was not affected; however, supination was decreased by 3° (P < 0.001). The isometric maximum strengths showed significant deficits in all tested scenarios (at 45°, P = 0.002; at 90°, P < 0.001; for supination, P < 0.001). The MES and the QuickDASH were 97.2 ± 4.9 and 7.9 ± 13.9, respectively. Heterotopic ossifications (HO) were found in 39 % of patients; however, with respect to scores and strength, no significant differences were seen compared to patients without HO. Moreover, four anchor failures were detected.Conclusions
Single-incision suture anchor repair provides high patient’s satisfaction and good results with respect to ROM and functional scoring. Nevertheless, based on presented data, the patient has to be informed of postoperative HO and especially for supination strength weakness after surgery. Distal biceps tendon repair should be reserved for experienced upper extremity surgeons to avoid procedure-related complications. 相似文献7.
Purpose
Septic arthritis is a life-threatening emergency with high mortality of up to 11 %. We investigated if delay of arthroscopic lavage of infected major joints would have a bearing on the mortality and morbidity such as admission to an intensive care unit (ICU).Methods
We retrospectively reviewed patients presenting with septic arthritis to two regional hospitals over a period of seven years from 1 January 2005 to 31 December 2011. We divided our sample of 82 patients into four groups based on the time delay between clinical diagnosis and arthroscopic lavage ranging from less than six hours to more than 24 hours.Results
We determined that 35.4 % of patients had prosthetic joints. Knee joints were predominantly involved (74.4 %). Staphylococcus aureus was the most commonly isolated pathogen (41.5 %). There were ten (12.2 %) deaths and the same number of admissions to an ICU. Our study revealed there was no statistical significance between the time delay and mortality (P = 0.25) or ICU admission (P = 0.74) or the number of washouts (P = 0.08) in all four groups.Conclusions
Up to 48 hours delayed arthroscopic lavage for septic arthritis does not increase the risk of mortality. Further prospective large sample studies are recommended to investigate this and the risk of long-term morbidity. 相似文献8.
Tsung-Yuan Tsai Dimitris Dimitriou Guoan Li Young-Min Kwon 《International orthopaedics》2014,38(8):1577-1583
Purpose
Component orientations and positions in total hip arthroplasty (THA) are important parameters in restoring hip function. However, measurements using plain radiographs and 2D computed tomography (CT) slices are affected by patient position during imaging. This study used 3D CT to determine whether contemporary THA restores native hip geometry.Methods
Fourteen patients with unilateral THA underwent CT scan for 3D hip reconstruction. Hip models of the nonoperated side were mirrored with the implanted side to quantify the differences in hip geometry between sides.Results
The study demonstrated that combined hip anteversion (sum of acetabular and femoral anteversion) and vertical hip offset significantly increased by 25.3° ± 29.3° (range, −25.7° to 55.9°, p = 0.003) and 4.1 ± 4.7 mm (range, −7.1 to 9.8 mm, p = 0.009) in THAs.Conclusions
These data suggest that hip anatomy is not fully restored following THA compared with the contralateral native hip. 相似文献9.
Conteduca F Iorio R Mazza D Caperna L Bolle G Argento G Ferretti A 《International orthopaedics》2012,36(8):1589-1593
Purpose
The aim of this study is to evaluate the accuracy of VISIONAIRE (Smith & Nephew Inc., Memphis, TN, USA) Patient Matched cutting tibial jigs in comparison with extramedullary (EM) tibial instrumentation by analysing data as detected by intra-operative use of VectorVision knee navigation software from BrainLAB (Redwood City, CA, USA).Methods
Twelve patients were selected for unilateral total knee replacement (TKR). They underwent a full-length weight-bearing anteroposterior (AP) radiograph and magnetic resonance imaging (MRI). During surgery, once the EM guides were placed and fixed on the tibia, the orientation in the coronal and sagittal planes was checked by the navigator and then compared with the data obtained by measuring the orientation of VISIONAIRE Patient Matched cutting tibial jigs. An unsatisfactory result was considered an error ≥2° in both coronal and sagittal planes for the tibial component as a possible error of 4° could result.Results
In the coronal plane the mean deviation of the EM tibial guides from the ideal alignment (0°) was 0.7 ± 0.39° and of the VISIONAIRE was 129 ± 1.55° (P = 0.22). In the sagittal plane the mean deviation of the EM tibial guides from 3° of posterior slope was −1.62 ± 1.78° and of the VISIONAIRE was +1.16 ± 4.29° (P < 0.05). Negative values indicate a more posterior slope from the ideal and positive values an anterior slope.Conclusions
This preliminary study documented only a fair accuracy of the method with a consistent risk of error of more of 3° especially in the sagittal plane. We could speculate that the problem in the sagittal plane was due to the fact that the pre-operative protocol does not include a lateral X-ray projection of the knee and only includes an AP standing X-ray of the straight leg and MRI. 相似文献10.
Purpose
In undetached osteochondral lesions (OCL) of the talus both revitalisation of the subchondral necrosis and cartilage preservation are essential. For these cases, we assess the results of minimally invasive retrograde core drilling and cancellous bone grafting.Methods
Forty-one osteochondral lesions of the talus (12x grade I, 22x grade II and 7x grade III according to the Pritsch classification, defect sizes 7–14 mm) in 38 patients (mean age 33.2 years) treated by fluoroscopy-guided retrograde core drilling and autologous cancellous bone grafting were evaluated by clinical scores and MRI. The mean follow-up was 29.0 (±13) months.Results
The AOFAS score increased significantly from 47.3 (±15.3) to 80.8 (±18.6) points. Lesions with intact cartilage (grades I and II) had a tendency to superior results than grade III lesions (83.1 ± 17.3 vs. 69.4 ± 22.2 points, p = 0.07). First-line treatments and open distal tibial growth plates led to significantly better outcomes (each p < 0.05). Age, gender, BMI, time to follow-up, defect localisation or a traumatic origin did not influence the score results. On a visual analogue scale pain intensity reduced from 7.5 (±1.5) to 3.7 (±2.6) while subjective function increased from 4.6 (±2.0) to 8.2 (±2.3) (each p < 0.001). In MRI follow-ups, five of the 41 patients showed a complete bone remodelling. In two cases demarcation was detectable.Conclusions
The technique reported is a highly effective therapeutic option in OCL of the talus with intact cartilage grades I and II. However, second-line treatments and grade III lesions with cracked cartilage surface can not be generally recommended for this procedure. 相似文献11.
Daniilidis K Vogt B Gosheger G Henrichs M Dieckmann R Schulz D Hoell S 《International orthopaedics》2012,36(6):1181-1183
Purpose
Knee pain after total knee arthroplasty may be caused by an unresurfaced patella. Secondary isolated resurfacing of the previously unresurfaced patella in total knee arthroplasty remains controversial. The aim of this retrospective study was to evaluate the outcome after patellar resurfacing as a second stage procedure.Methods
The study included 22 patients (13 female/nine male) who underwent resurfacing of the patella with a mean follow-up of 61.8 ± 39.2 months. The mean age of the patients was 60 ± 9.7 years at the time of operation. The average period between total knee arthroplasty and patellar resurfacing was 26.3 ± 15.2 months. The patient’s subjective satisfaction was assessed by a custom-made questionnaire.Results
The mean Knee Society Score improved significantly from 60.1 ± 8.3 to 77.0 ± 6.3 (p = 0.0063). The mean functional score also improved significantly from 42.7 ± 2.3 to 60.2 ± 3.9 (p = 0.001). Three patients (13.6%) needed further operative revision.Conclusions
Although clinical scores showed significant improvement some patients continued to have pain and remained dissatisfied without detecting a specific reason. Further studies are needed to better elucidate the benefit of patellar resurfacing as second stage procedure. 相似文献12.
Martin O. Brix David Stelzeneder Siegfried Trattnig Reinhard Windhager Stephan E. Domayer 《International orthopaedics》2013,37(1):39-43
Purpose
The aim of this study was to assess the stability of the glycosaminoglycan (GAG) content in the long term after matrix-associated autologous chondrocyte transplantation (MACT) with Hyalograft C in the knee over a follow-up period of one year.Methods
In this cross-sectional evaluation, 11 patients after MACT of the knee consented to delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) measurements. The mean post-operative interval before the first MR examination was 40.6 ± 22.0 months, and the second MR examination was carried out after another 12 months. The Lysholm score was assessed for clinical evaluation. Quantitative T1 measurements after intravenous negatively charged MR contrast agent administration were performed. Global post-contrast T1 of the reference cartilage and the repair tissue and a relative post-contrast T1 value were calculated.Results
The Lysholm score improved significantly from 59.8 ± 12.9 at baseline to 86.1 ± 15.7 at the second visit (p < 0.01). The mean global T1 of the repair tissue (1st visit 581.3 ± 126.4 ms; 2nd visit 684.1 ± 169.9 ms; p = 0.104) and the mean relative T1 value showed stable results over one year (1st visit 0.81 ± 0.28; 2nd visit 0.76 ± 0.32; p = 0.4).Conclusions
The study demonstrated stable glycosaminoglycan content of the repair tissue after MACT at midterm. 相似文献13.
Purpose
Magnetic resonance imaging (MRI) scans are a useful investigation for some shoulder pathology. They are costly however and a significant burden on radiology departments. In most cases clinical examination, plain radiography or ultrasound scan (USS) are sufficient for a diagnosis. There are no current UK guidelines regarding MRI shoulder scan requests.Methods
We reviewed 100 consecutive MRI shoulder scan requests and the associated formal reports; other investigations were also assessed.Results
Overall, 56 % of MRI scans were ordered inappropriately. Shoulder consultant''s requests were more appropriate than other groups (70 % vs. 38 %. p = 0.04). Excluding shoulder consultants 63 % of scans were inappropriately ordered. Shoulder consultants were more likely to order a preceding X-ray (80 % vs. 53 % respectively, p = 0.03). Of those with a clinical diagnosis of cuff pathology only 29 % had an USS.Conclusion
A high percentage of MRI shoulder scans are performed inappropriately. Shoulder consultants are more appropriate in their ordering than other groups. If all groups performed as well 50 % less MRI scans would need to be performed. 相似文献14.
Francesco Franceschi Rocco Papalia Angelo Del Buono Biagio Zampogna Lorenzo Diaz Balzani Nicola Maffulli Vincenzo Denaro 《International orthopaedics》2013,37(7):1369-1374
Purpose
The purpose of this study was to show that this two-stage procedure for ACL (anterior cruciate ligament) revision surgery could be straight-forward and provide satisfactory clinical and functional outcomes.Materials
This is a five-year prospective analysis of clinical and functional data on 30 patients (19 men and 11 women; average age 29.1 ± 5.4) who underwent a two-stage ACL revision procedure after traumatic re-rupture of the ACL. Diagnosis was on Lachman and pivot-shift tests, arthrometer 30-lb KT-1000 side-to-side findings, and on MRI and arthroscopic assessments.Results
Postoperative IKDC and Lysholm scores were significantly improved compared to baseline values (P < 0.001). At the last follow up, 20 of 30 patients (66.7 %) had returned to preoperative sport activity level (nine elite athletes, 11 county level), seven had changed to lower sport levels, and three had given up any sport activity. At the same appointment, 11 patients had degenerative changes. All these patients reported significantly lower Lysholm scores compared to patients without any degenerative change (p < 0.001).Conclusions
In ACL revision surgery, when the first femoral tunnel has been correctly placed, this procedure allows safe filling of large bony defects, with no donor site comorbidities. It provides comfortable clinical, functional and imaging outcomes. 相似文献15.
Purpose
The purpose of this study was to present a retrospective comparative overview of the Ilizarov non-free bone plasty techniques of one-stage multilevel fragment lengthening and gradual tibilisation of the fibula used for extensive tibial defect management.Methods
Extensive tibial defects in 83 patients were managed either by multilevel fragment lengthening (group I, n = 41, mean defect size 13.1 ± 0.9 cm) or gradual tibilisation of the fibula (group II, n = 42, mean defect size 12.5 ± 1.2 cm) using the Ilizarov apparatus. The initial findings, treatment protocols and outcomes of those patients treated within the period 1972–2011 were studied retrospectively by medical records and radiographs, and statistically assessed with Microsoft Excel and Attestat software.Results
Group I had multilevel fragment lengthening over one stage that averaged 288.0 ± 14.4 days. The mean total period of gradual tibilisation of the fibula in group II was 316.0 ± 29.7 days. The patient’s age in the latter group had an effect on the completeness of leg-length equalisation.Conclusions
The techniques can be used to manage extensive tibial defects as all the defects bridged, leg-length discrepancy and deformity were corrected and patients were able to load their limbs. 相似文献16.
Li Y Liu L Tang X Pei F Wang G Fang Y Zhang H Crook N 《International orthopaedics》2012,36(7):1457-1462
Purpose
The aim of this study was to compare the results of a new technique for low, multidirectional locked nailing with closed reduction and minimally invasive plating in the treatment of distal tibial metadiaphyseal fractures.Methods
Forty-six matched patients were divided according to age, gender, Injury Severity Score, and fracture pattern into group A (expert tibial nailing) and group B (minimally invasive plating). Then, the patients were followed up, and the clinical and radiographic results were retrospectively analysed.Results
The mean followed-up was 24.7 ± 2.7 months in group A and 25.8 ± 2.8 months in group B. No patient had nonunion, shortening, hardware breakdown, or deep-seated infection. Patients in group A had a significantly shorter mean operating time, hospital stay, full weight-bearing time and union time (76 ± 16.6 vs. 90 ± 20.3 minutes, p = 0.000; 5.8 ± 2.1 vs. 8.9 ± 3.1 days, p = 0.000; 9.0 ± 1.4 vs. 11.1 ± 1.7 weeks, p = 0.000; and 21.3 ± 3.5 vs. 23.1 ± 3.6 weeks, p = 0.047, respectively). Three patients in group A and one patient in group B presented with malalignment (p = 0.608). The mean Olerud-Molander Ankle score was 89.0 ± 7.1 in group A and 87.6 ± 8.4 in group B (p = 0.478).Conclusions
Distal tibia metadiaphyseal fractures may be treated successfully with low, multidirectional locked nails or plates. However, low, multidirectional locked nailing may represent a superior surgical option, since it offers advantages in terms of mean operating time, hospital stay, full weight-bearing time and union time. 相似文献17.
Kazuya Ikoma Masahiro Maki Masamitsu Kido Kan Imai Yuji Arai Hiroyoshi Fujiwara Yasuo Mikami Toshikazu Kubo 《International orthopaedics》2014,38(7):1401-1405
Purpose
The purpose of this study was to evaluate the clinical outcomes regarding the dorsal wedge osteotomy fixed using a polyblend suture and describe the usefulness of this fixation method for the treatment of Freiberg disease.Methods
The subjects consisted of 13 feet from 13 cases suffering from Freiberg disease that underwent extra-articular dorsal closing-wedge osteotomy using a polyblend suture. The average age was 31.7 (range 13–72) years. The average follow-up period was 17 (range 14–24) months. Regarding image findings, time to bone union and metatarsal shortening was reviewed. The investigation was carried out using the range of motion (ROM), visual analog scale (VAS), and Japanese Society of the Surgery of Foot lesser toe scale (JSSF score) in the MTP joint before surgery and at the latest follow-up.Results
Calluses under the metatarsal head were not observed in any cases. The mean metatarsal shortening was 2.33 ± 2.07 mm at follow-up. The bone union required an average of 8.4 ± 0.8 weeks. The average ROM of dorsal flexion improved from 37.2 ± 5.3° before surgery to 73.6 ± 9.9° at latest follow-up (p < 0.0001). The average ROM of plantar flexion improved from 16.0 ± 10.1° before surgery to 19.5 ± 8.6° at latest follow-up (p = 0.35). The average VAS significantly improved from 75.3 ± 8.5 before surgery to 4.9 ± 4.2 at latest follow-up (p < 0.0001). The average JSSF score significantly improved from 67.3 ± 9.4 points before surgery to 98.8 ± 3.0 points at the latest follow-up (p < 0.0001).Conclusion
Extra-articular dorsal closing-wedge osteotomy using a polyblend suture was carried out to treat Freiberg disease. The bone union was observed in all cases with improved clinical results. Fixation using a polyblend suture was considered to be useful. 相似文献18.
Alexandre Galland Stéphane Airaudi Renaud Gravier Sophie Le Cann Patrick Chabrand Jean-Noël Argenson 《International orthopaedics》2013,37(10):2017-2023
Purpose
We evaluated the biomechanical strength of two all suture anchors (ASA) of reduced diameter (1.4 mm) and compared them with the standard screw anchor (SA) with larger diameter (5.5 mm) used in rotator cuff tears.Methods
We conducted 30 uniaxial vertical pullout tests using Material Testing System Instron 5566A until failure of the anchorage defined as rupture of the threads or anchor or detachment of the anchor. Anchor fixation was on tuberosities of fresh bovine humerus bone. ASAs were spaced four millimetres apart and were compared with a control SA implanted on the same greater tubercle at two centimetres. The tests were all performed at room temperature in a dry environment. Tensile loads (10 mm/min) were applied parallel to the axis of insertion. A preloading of 10 N was used to overcome loading artifacts of the test sample at the beginning of the test.Results
Student’s t test showed no statistically significant difference between anchors in terms of load to failure (ASA: force 265.06 ± 87.25 N versus SA : 325.35 ± 113.46 N; p = 0.09) and mean elongation at rupture (ASA : 23 ± 7 mm versus SA : 21 ± 6 mm; p = 0.46).Conclusions
In vitro, this experimental study showed no statistically significant difference in pullout strength and displacement between ASA and SA at a chosen level of significance (p < 0.05). 相似文献19.
Thomas J. Heyse MD PhD Joseph D. Lipman MS Carl W. Imhauser PhD Scott M. Tucker MS Yogesh Rajak Geoffrey H. Westrich MD 《HSS journal》2014,10(3):260-265
Background
Component malposition is one of the major reasons for early failure of unicompartmental knee arthroplasty (UKA).Questions/Purposes
It was investigated how reproducibly patient-specific instrumentation (PSI) achieved preoperatively planned placement of the tibial component in UKA specifically assessing coronal alignment, slope and flexion of the components and axial rotation.Patients and Methods
Based on computer tomography models of ten cadaver legs, PSI jigs were generated to guide cuts perpendicular to the tibial axis in the coronal and sagittal planes and in neutral axial rotation. Deviation ≥3° from the designed orientation in a postoperative CT was defined as outside the range of acceptable alignment.Results
Mean coronal alignment was 0.4 ± 3.2° varus with two outliers. Mean slope was 2.8 ± 3.9° with six components in excessive flexion. It was noted that the implants were put in a mean of 1.7 ± 8.0° of external rotation with seven outliersConclusions
PSI helped achieve the planned coronal orientation of the component. The guides were less accurate in setting optimal tray rotation and slope.Electronic supplementary material
The online version of this article (doi:10.1007/s11420-014-9410-z) contains supplementary material, which is available to authorized users. 相似文献20.
Thomas Hoffelner Philipp Moroder Alexander Auffarth Mark Tauber Herbert Resch 《International orthopaedics》2014,38(4):775-782