Aims. Complex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in comparison with conventional
Aims. Both anatomical and reverse total shoulder arthroplasty (aTSA and rTSA) provide functional improvements. A reported benefit of aTSA is better range of motion (ROM). However, it is not clear which procedure provides better outcomes in patients with limited foward
We studied the position and rotational changes associated with
Aims. The aim of this study was to compare the pain caused by the application
of a tourniquet after exsanguination of the upper limb with that
occurring after simple
The
Introduction: Most hospitals that treat patients with Pectus Excavatum use the pectus bar designed by D. Nuss. In essence, chest
Introduction. Wear debris from polyethylene tibial inserts has been associated with limited longevity of total knee replacements (TKRs). While material factors were studied extensively and considerable progress has been made, there is little knowledge about surgical factors, particularly on how the wear rate is related to implant positioning. It was the purpose of this study to determine the combined effect of patient and implant positioning factors on the volumetric wear rate of TKRs. Our hypothesis was that implant alignment has a significant impact on the wear rate when controlled for other patient factors. Methods. This study included 59 tibial inserts of a cruciate retaining TKR design (Nexgen, Zimmer Inc.). The patients' age, sex, weight, height, and implant size were obtained. All implants were scanned with a coordinate measuring machine. Volumetric wear was determined using an autonomous mathematical reconstruction method (Figure 1). Radiographs were used to determine the anatomic lateral distal femoral angle (aLDFA), anatomic medial proximal tibial angle (aMPTA), femoral tilt angle (FTA) and posterior tibial slope (PTS). Also, the patella position was assessed using the Blackburne-Peel Index (BPI) and the Insall-Salvati Ratio (Figure 2). General linear modeling (SPSS) was conducted in order to determine the most significant patient and implant positioning factors on wear rate. Results. After adjustment for creep, the mean volumetric wear rate was 11.6 mm. 3. /yr (Figure 2). According to the linear regression model wear increased with younger age (p=0.0014) and male sex (p<0.001). The wear rate was independent of patient weight (p=0.17). From the multiple positioning factors only BPI and tibial slope were significant and inversely correlated with wear (p=0.009 and 0.026, respectively). The average ISR was normal before and after surgery, whereas the BPI was only in the normal range prior to surgery, and dropped postop into pseudo-baja (p<0.001, Figure 3). Discussion. The effect of male sex on wear volume can partially be explained by a larger average implant size; however, other unknown confounding factors may play a role too. The effect of younger age is likely related to higher patient activity. Based on previous gait analysis, we speculate that increasing tibial slope results in larger AP translations of the knee joint and thus more wear. Interestingly, BPI remained a highly significant factor when controlled for all other factors. The average BPI clearly dropped post-operatively, whereas the average ISR did not, indicating that not true patella baja, but a joint line
The aim of this study was to establish the ability of an invasive fibre-optic probe to measure intra-muscular pH, pCO. 2. , pO. 2. , HCO. 3. -. −. , ambient temperature, base excess and O. 2. saturation. The secondary aim was to determine the effect of
Introduction:. Acetabular revision Jumbo cups are used in revision hip surgeries to allow for large bone to implant contact and stability. However, jumbo cups may also result in hip center
Background. Severe infantile Blount's disease can result in a multiplanar deformity of the proximal tibia with both intra-articular and metaphyseal components. Correction can represent a significant surgical challenge. We describe our results using the Taylor spatial frame for acute tibial hemiplateau
Introduction. Optimal knee joint function obviously requires a delicate balance between the osseous anatomy and the surrounding soft tissues, which is distorted in the case of joint line
1. One hundred cases of congenital
Accurate and reproducible measurement of three-dimensional shoulder kinematics would contribute to better understanding shoulder mechanics, and therefore to better diagnosing and treating shoulder pathologies. Current techniques of 3D kinematics analysis use external markers (acromial cluster or scapula locator) or medical imaging (MRI or CT-Scan). However those methods present some drawbacks such as skin movements for external markers or cost and irradiation for imaging techniques. The EOS low dose biplanar X-Rays system can be used to track the scapula, humerus and thorax for different arm
We present the results of treatment for relapsed infantile Blounts disease using a technique of hemiplateau
Introduction. Higher concentrations of metal ion levels after Metal-on-metal (MoM) THA are a cause for concern. Elevated cobalt (Co) and chromium (Cr) ion levels in the blood indicate metal wear, and may predict secondary soft-tissue damage (adverse reaction to metal debris; ARMD). Although, it is well known that concentrations of metal ion levels are elevated in the short term after MoM, the long-term consequences in ion concentration and risk factors for increased ion levels are not clarified. We sequentially investigated the postoperative Co and Cr ion levels after MoM THA and the relationship between the metal ion levels and several risk factors. Materials and Methods. We reviewed the data on one hundred and eighty six patients of two hundred ninety one MoM THA cases. The one hundred eighty six patients were measured at least three times after a MoM THA surgery over a five year (2005–2010) period in our institution. Serum cobalt and chromium levels were measured by inductor coupled plasma – mass spectrometry at several times in follow-up period, (measured at the preoperative period, the third month, the sixth month, the first year, the second year, and the fourth year after MoM THA). Furthermore, we investigated the correlation between the metal ion levels and various factors which might influence the release of metal ions, such as Body mass index (BMI), renal function, femoral head size, unilateral or bilateral THA, the cup position, and postoperative activity. The renal function was evaluated by measuring estimated glomerular filtration ratio (GFR) at preoperative examination. A postoperative activity was assessed with a pedometer measurement counting number of steps a day. A cup position was evaluated by lateral inclination measured by X-ray or computed tomography. Results. Average serum Co and Cr concentrations in preoperative period were 0.69 and 0.05 mg/ ml, respectively. Postoperative serum Co and Cr ion levels were significantly increased compared with preoperative value throughout the postoperative period. There was no significant correlation with regards to BMI, renal function, femoral head size tothe metal ion level measurement. In bilateral THA cases, Co and Cr ion concentrations were significantly increased compared with unilateral THA cases. In addition, in cases that its cup inclination was more than 50 degrees, Co and Cr ion concentration were significantly increased compared with cases less than 50 degrees in the first year after surgery. There was a trend for higher metal ion levels in the group of patients who walked more than 7000 steps a day, but this did not reach statistical significance. Conclusion. Metal ion concentrations of almost patients were increased after MoM THA surgery. Side effects related to
We have treated seven children with relapsed infantile Blount’s disease by
Of forty-six patients with congenital
Ulnar nerve function, during and after open reduction and internal fixation of fractures of the distal humerus with subperiosteal
Purpose. While reverse shoulder arthroplasty (RSA) corrects vertical muscle imbalance, it cannot restore the horizontal imbalance seen in cuff-deficient shoulders with combined loss of active
An innovative Kirschner (K-) wire point was developed and compared in fresh pig femora in terms of drilling efficiency and temperature