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Hoell S Dedy N Gosheger G Dieckmann R Daniilidis K Hardes J 《Archives of orthopaedic and trauma surgery》2012,132(3):405-410
Introduction
The Burch–Schneider cage is an established implant in revision surgery after hip arthroplasty that is used for reconstructing osseous defects in the acetabulum. However, there are only a few reports about the use of cages in patients with metastatic destruction of the acetabulum. The aim of this retrospective study was to assess the outcome and complications of this procedure. 相似文献22.
Maurice Balke Carolin Schmidt Nicolas Dedy Marc Banerjee Bertil Bouillon Dennis Liem 《Acta orthopaedica》2013,84(2):178-183
Background and purpose Whether or not uncemented total hip arthroplasty (THA) can achieve durable fixation of implants to bone in patients on chronic hemodialysis is unknown. We analyzed the 2–13-year clinical outcomes of cementless THA in patients with end-stage renal diseases who were maintained on long-term hemodialysis.Patients and methods We reviewed the outcome of 23 consecutive uncemented THAs undertaken between 1993 and 2004, in patients with chronic renal failure who had been on long-term hemodialysis (2–18 years). 1 patient died and 2 patients were lost to follow-up within 2 years, leaving 20 hips (20 patients, median age 66 (38–81) years at the time of THA, 11 females) that were reviewed at median 7 (2–13) years postoperatively.Results Radiographic bone-ingrowth fixation of the components was found in 19 patients. 1 patient had aseptic loosening requiring revision surgery. The median d'Aubigne and Postel score was 10 (8–14) preoperatively and 15 (12–18) at final review. No prosthetic infections were found in any of the patients.Interpretation Uncemented THA shows promising medium-term results in patients receiving long-term hemodialysis. 相似文献
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Esther M. Bonrath Nicolas J. Dedy Boris Zevin Teodor P. Grantcharov 《Surgical endoscopy》2014,28(5):1535-1544
Background
Definitions of errors and poor technique in laparoscopic surgery are lacking in modern clinical practice. As a result, educators often base their teaching on personal experience and individual preferences. The objective of this study was to achieve expert consensus regarding these definitions in order to provide a framework for a standardized approach to teaching safe technique and avoiding common errors in laparoscopic surgery.Methods
A Delphi survey was conducted with an international panel of experts in laparoscopic surgery. Survey items for definitions and examples of errors and resulting injuries (events) were derived from literature reviews and procedural observations. An online platform was used to administer the survey. Experts were requested to rate their level of agreement regarding survey items on a 5-point Likert-type scale; additional comments were facilitated through free-text entries. Consensus was defined as Cronbach’s α > 0.70. Items that were rated ≥3 (“somewhat agree”) by 75 % or more of the panel were included in the consensus list. The Delphi process was continued until all subsections of the survey met the defined consensus level.Results
Two survey rounds were completed with 33 experts from 12 countries (round 1) and 25 experts from nine countries (round 2). Overall consensus was high for both rounds (α = 0.9). Seventeen definitions and 39 examples of errors and events were included in the final consensus list.Conclusions
Standardized definitions and examples of technical errors in laparoscopic surgery were established using a consensus-based approach. These definitions can serve as uniform nomenclature and can be used by educators as a reference guide to ensure standardization in surgical training and performance assessment. 相似文献24.
Balke Maurice Dedy Nicolas Mueller-Huebenthal Jonas Liem Dennis Hardes Jendrik Hoeher Juergen 《Sports medicine, arthroscopy, rehabilitation, therapy & technology》2010,2(1):1-4
Traumatic injury and surgical meniscectomy of a medial meniscus are known to cause subsequent knee osteoarthritis. However, the difference in the prevalence of osteoarthritis caused by the individual type of the medial meniscal tear has not been elucidated. The aim of this study was to investigate what type of tear is predominantly responsible for the degradation of articular cartilage in the medial compartment of knee joints. Five hundred and forty eight cadaveric knees (290 male and 258 female) were registered in this study. The average age of cadavers at death was 78.8 years old (range: 52-103 years). The knees were macroscopically examined and their medial menisci were classified into four groups according to types of tears: "no tear", "radial tear of posterior horn", "other types of tear" and "worn-out meniscus" groups. The severity of cartilage degradation in their medial compartment of knee joints was evaluated using the international cartilage repair society (ICRS) grading system. We statistically compared the ICRS grades among the groups using Mann-Whitney U test. The knees were assigned into the four groups: 416 "no tear" knees, 51 "radial tear of posterior horn" knees, 71 "other types of tear" knees, and 10 "worn-out meniscus" knees. The knees with substantial meniscal tears showed the severer ICRS grades of cartilage degradation than those without meniscal tears. In addition, the ICRS grades were significantly severer in the "radial tear of posterior horn" group than in the "other types of tear" group, suggesting that the radial tear of posterior horn in the medial meniscus is one of the risk factors for cartilage degradation of joint surface. We have clarified the relationship between the radial tear of posterior horn in the medial meniscus and the severer grade of cartilage degradation. This study indicates that the efforts should be made to restore the anatomical role of the posterior horn in keeping the hoop strain, when patients' physical activity levels are high and the tear pattern is simple enough to be securely sutured. 相似文献
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Weidle PA Brankamp J Dedy N Haenisch C Windolf J Jonas M 《Archives of orthopaedic and trauma surgery》2009,129(1):75-78
We report a case of a 77-year-old female patient who died 4 days after a closed colles-fracture of the right wrist because
of secondary emerged necrotising fasciitis. At the time of visiting our emergency department, the patient reports about untypical
pain and progressive swelling of the entire right arm 3 days following a fall onto the outstretched hand where she sustained
a closed distal radius fracture. Within 6 h, the patient developed hypotension and fever leading to cardiac and respiratory
failure. The emergent-induced diagnostic presented a severe septic situation in the laboratory examination of the blood samples,
an apparent before unknown diabetes mellitus and an unknown bronchial carcinoma with part of post-stenosis pneumonia of the
right lung. After initial CPR and stabilisation, the patient underwent an urgent and aggressive surgical debridement with
fasciotomies of the muscle compartments of the entire right upper extremity. The microbiological investigation of the intraoperative
taken specimens presented plentiful group-A-β-haemolytic streptococcus. Despite a broad spectrum intravenous antibiotic therapy,
intensive care support and a second look operation 12 h later with exarticulation of the right arm in the shoulder joint,
the patient died of septic shock and multiorgan failure 34 h after admission.
The patient reported about in the following case report died and could not give attestation of informed consent. 相似文献
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