Dépouillements

Tension Band Plating In Growth Modulation?: A Review Of Current Evidences / Sudhir MAHAPATRA in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.351-357 Titre : Tension Band Plating In Growth Modulation?: A Review Of Current Evidences Type de document : texte imprimé Auteurs : Sudhir MAHAPATRA, Auteur ; Aravind HAMPANNVAR, Auteur ; Madan SAHOO, Auteur Année de publication : 2015 Article en page(s) : p.351-357 Langues : Anglais (eng) Résumé : Tension band plating (TBF) has been pitted as the best method for correcting the angular deformities and limb length discrepancies (LLD) in growing children. In this review we examined the superiority of the tension band plating over other methods of growth modulation, in terms of safety and efficacy. As per the current literature, in angular deformities TBP has similar correction rates with lesser complications. However in LLD the results are less promising. Permalink : ./index.php?lvl=notice_display&id=40900 [article] Tension Band Plating In Growth Modulation?: A Review Of Current Evidences [texte imprimé] / Sudhir MAHAPATRA, Auteur ; Aravind HAMPANNVAR, Auteur ; Madan SAHOO, Auteur . - 2015 . - p.351-357. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.351-357 Résumé : Tension band plating (TBF) has been pitted as the best method for correcting the angular deformities and limb length discrepancies (LLD) in growing children. In this review we examined the superiority of the tension band plating over other methods of growth modulation, in terms of safety and efficacy. As per the current literature, in angular deformities TBP has similar correction rates with lesser complications. However in LLD the results are less promising. Permalink : ./index.php?lvl=notice_display&id=40900

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Internal fixation of femoral neck stress fractures in young female athletes with a dynamic locking plate / J. A. HUMPHREY in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.358-362 Titre : Internal fixation of femoral neck stress fractures in young female athletes with a dynamic locking plate Type de document : texte imprimé Auteurs : J. A. HUMPHREY, Auteur ; R. JANDOO, Auteur ; M. TOFIGHI, Auteur Année de publication : 2015 Article en page(s) : p.358-362 Langues : Anglais (eng) Mots-clés : stress fracture  young athletes  Targon FN  implant Résumé : Purpose : Displaced stress fractures of the femoral neck in young female athletes are a rare but a difficult injury to treat with a favourable outcome, as there is a reported high incidence of avascular necrosis. Traditionally they are internally fixed with either cannulated screws or a sliding hip screw. Our study aims to highlight the Targon Femoral Neck (FN, B-Braun, Aesculap Inc, Germany) implant as a safe alternative for fixation of these injuries. Methods : Three consecutive young female recreational athletes were reviewed from our institution with a displaced stress fracture of the femoral neck treated with the dynamic locking plate. Results : Two patients achieved good results with full union and no complications. One patient had a poor result as she developed avascular necrosis 5 months post-operatively requiring revision to a total hip arthroplasty. Conclusion : Our study highlights the Targon FN implant is a safe alternative for internal fixation of displaced stress fractures of the femoral neck in young female recreational athletes. Permalink : ./index.php?lvl=notice_display&id=40901 [article] Internal fixation of femoral neck stress fractures in young female athletes with a dynamic locking plate [texte imprimé] / J. A. HUMPHREY, Auteur ; R. JANDOO, Auteur ; M. TOFIGHI, Auteur . - 2015 . - p.358-362. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.358-362 Mots-clés : stress fracture  young athletes  Targon FN  implant Résumé : Purpose : Displaced stress fractures of the femoral neck in young female athletes are a rare but a difficult injury to treat with a favourable outcome, as there is a reported high incidence of avascular necrosis. Traditionally they are internally fixed with either cannulated screws or a sliding hip screw. Our study aims to highlight the Targon Femoral Neck (FN, B-Braun, Aesculap Inc, Germany) implant as a safe alternative for fixation of these injuries. Methods : Three consecutive young female recreational athletes were reviewed from our institution with a displaced stress fracture of the femoral neck treated with the dynamic locking plate. Results : Two patients achieved good results with full union and no complications. One patient had a poor result as she developed avascular necrosis 5 months post-operatively requiring revision to a total hip arthroplasty. Conclusion : Our study highlights the Targon FN implant is a safe alternative for internal fixation of displaced stress fractures of the femoral neck in young female recreational athletes. Permalink : ./index.php?lvl=notice_display&id=40901

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The role of external fixators in paediatric trauma / J. A. HUMPHREY in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.363-367 Titre : The role of external fixators in paediatric trauma Type de document : texte imprimé Auteurs : J. A. HUMPHREY, Auteur ; Syed GILLANI, Auteur ; Matthew J. BARRY, Auteur Année de publication : 2015 Article en page(s) : p.363-367 Langues : Anglais (eng) Mots-clés : paediatric trauma  external fixators Résumé : We report a retrospective review of all paediatric trauma patients managed with an external fixator admitted to our institution over a 7-year period. We identified 30 fractures in 28 children. The fractures included 20 tibiae, 5 femurs, 2 humerii, 2 radii and 1 phalanx. The indications were 23 open fractures, 4 comminuted fractures and 3 closed fractures in polytraumatised patients. It was the definitive treatment in 13 fractures. The mean length of total time with an external fixator was 9.6 weeks (range 1-38 weeks.) Difficulties encountered were eight problems, one obstacle and two true complications. There were no cases of re-fracture following removal of the external fixator. This review confirms that there is a role for the use of external fixation in selected paediatric fractures with a low complication rate. Permalink : ./index.php?lvl=notice_display&id=40902 [article] The role of external fixators in paediatric trauma [texte imprimé] / J. A. HUMPHREY, Auteur ; Syed GILLANI, Auteur ; Matthew J. BARRY, Auteur . - 2015 . - p.363-367. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.363-367 Mots-clés : paediatric trauma  external fixators Résumé : We report a retrospective review of all paediatric trauma patients managed with an external fixator admitted to our institution over a 7-year period. We identified 30 fractures in 28 children. The fractures included 20 tibiae, 5 femurs, 2 humerii, 2 radii and 1 phalanx. The indications were 23 open fractures, 4 comminuted fractures and 3 closed fractures in polytraumatised patients. It was the definitive treatment in 13 fractures. The mean length of total time with an external fixator was 9.6 weeks (range 1-38 weeks.) Difficulties encountered were eight problems, one obstacle and two true complications. There were no cases of re-fracture following removal of the external fixator. This review confirms that there is a role for the use of external fixation in selected paediatric fractures with a low complication rate. Permalink : ./index.php?lvl=notice_display&id=40902

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(Un)importance of physical therapy in treatment of displaced supracondylar humerus fractures in children / Sinisa DUCIC in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.368-374 Titre : (Un)importance of physical therapy in treatment of displaced supracondylar humerus fractures in children Type de document : texte imprimé Auteurs : Sinisa DUCIC, Auteur ; Marko BUMBASIREVIC, Auteur ; Vladimir RADLOVIC, Auteur Année de publication : 2015 Article en page(s) : p.368-374 Langues : Anglais (eng) Mots-clés : elbow fracture  children  joint stiffnes  flexion  extension  physical therapy. Résumé : Elbow joint stiffness is a common complication following supracondylar humerus fractures. In prospective study, dynamics of establishing a full range of motion in the elbow joint following the treatment of supracondylar humerus fractures were assessed, together with the effects of physical therapy on improvement in the range of motion. Two groups of patients were observed. Physical therapy was administered to the first group, comprised of 25 patients. The second group, comprised of 28 patients, underwent no physical therapy. In the first few months following treatment, the range of motion was significantly greater in the patients who had undergone physical therapy, but after 12 months, the range of motion was almost equal in the two groups. This study has shown that it takes about 12 months to establish a full range of motion after the injury, and that it is not necessary to apply physical therapy in patients with elbow fractures. Permalink : ./index.php?lvl=notice_display&id=40903 [article] (Un)importance of physical therapy in treatment of displaced supracondylar humerus fractures in children [texte imprimé] / Sinisa DUCIC, Auteur ; Marko BUMBASIREVIC, Auteur ; Vladimir RADLOVIC, Auteur . - 2015 . - p.368-374. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.368-374 Mots-clés : elbow fracture  children  joint stiffnes  flexion  extension  physical therapy. Résumé : Elbow joint stiffness is a common complication following supracondylar humerus fractures. In prospective study, dynamics of establishing a full range of motion in the elbow joint following the treatment of supracondylar humerus fractures were assessed, together with the effects of physical therapy on improvement in the range of motion. Two groups of patients were observed. Physical therapy was administered to the first group, comprised of 25 patients. The second group, comprised of 28 patients, underwent no physical therapy. In the first few months following treatment, the range of motion was significantly greater in the patients who had undergone physical therapy, but after 12 months, the range of motion was almost equal in the two groups. This study has shown that it takes about 12 months to establish a full range of motion after the injury, and that it is not necessary to apply physical therapy in patients with elbow fractures. Permalink : ./index.php?lvl=notice_display&id=40903

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Outcome of one-stage surgical treatment of developmental dysplasia of the hip in children from 1.5 to 6 years old. A retrospective study / Qiang CHEN in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.375-383 Titre : Outcome of one-stage surgical treatment of developmental dysplasia of the hip in children from 1.5 to 6 years old. A retrospective study Type de document : texte imprimé Auteurs : Qiang CHEN, Auteur ; Yu DENG, Auteur ; Bin FANG, Auteur Année de publication : 2015 Article en page(s) : p.375-383 Langues : Anglais (eng) Mots-clés : developmental dislocation of the hip  open reduction  pelvic osteotomy  older children. Résumé : This study aimed to evaluate the outcome of one-stage treatment for developmental dysplasia of the hip (DDH) in patients after walking age. A Total of 58 children (67 hips) were retrospectively investigated to assess the efficacy and safety of one-stage treatment of developmental dysplasia of the hip (DDH) in children from 1.5 to 6 years of age with a mean followup of 4.00 ± 0.43 (range 3-6.8) years. Eleven (19%) were male, forty-seven (81%) were female. Our method consisted of open reduction, Salter innominate osteotomy, femoral shortening and derotation. The patients were distributed into three groups according to the age at which they were operated: 12 (20.7%) patients with 12 hips (17.9%) were operated between 1.5 and 2 years of age (Group I), 35 (60.3%) patients with 44 hips (65.7%) were operated between 2 and 4 years (Group II), 11 (19%) patients with 11 hips (16.4%) were operated between 4 and 6 years (Group III). Clinical and radiological assessment at final follow-up showed that the outcome was not significantly different between group I and group II. But clinically, there was significant difference between group I and group III, and also between group II and group III. Although in the outcome of radiological assessment there was no significant difference between group I and group II compared with group III. The rate of avascular nerosis in group I was lower than in group II or in group III. Children with DDH between 1.5 and 6 years of age were treated successfully with one-stage treatment, but in our hands the best age at surgery is before 4 years of age. Permalink : ./index.php?lvl=notice_display&id=40904 [article] Outcome of one-stage surgical treatment of developmental dysplasia of the hip in children from 1.5 to 6 years old. A retrospective study [texte imprimé] / Qiang CHEN, Auteur ; Yu DENG, Auteur ; Bin FANG, Auteur . - 2015 . - p.375-383. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.375-383 Mots-clés : developmental dislocation of the hip  open reduction  pelvic osteotomy  older children. Résumé : This study aimed to evaluate the outcome of one-stage treatment for developmental dysplasia of the hip (DDH) in patients after walking age. A Total of 58 children (67 hips) were retrospectively investigated to assess the efficacy and safety of one-stage treatment of developmental dysplasia of the hip (DDH) in children from 1.5 to 6 years of age with a mean followup of 4.00 ± 0.43 (range 3-6.8) years. Eleven (19%) were male, forty-seven (81%) were female. Our method consisted of open reduction, Salter innominate osteotomy, femoral shortening and derotation. The patients were distributed into three groups according to the age at which they were operated: 12 (20.7%) patients with 12 hips (17.9%) were operated between 1.5 and 2 years of age (Group I), 35 (60.3%) patients with 44 hips (65.7%) were operated between 2 and 4 years (Group II), 11 (19%) patients with 11 hips (16.4%) were operated between 4 and 6 years (Group III). Clinical and radiological assessment at final follow-up showed that the outcome was not significantly different between group I and group II. But clinically, there was significant difference between group I and group III, and also between group II and group III. Although in the outcome of radiological assessment there was no significant difference between group I and group II compared with group III. The rate of avascular nerosis in group I was lower than in group II or in group III. Children with DDH between 1.5 and 6 years of age were treated successfully with one-stage treatment, but in our hands the best age at surgery is before 4 years of age. Permalink : ./index.php?lvl=notice_display&id=40904

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Shaft-Condylar Angle for surgical correction in neglected and displaced lateral humeral condyle fracture in children / Pornchai MULPRUEK in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.384-391 Titre : Shaft-Condylar Angle for surgical correction in neglected and displaced lateral humeral condyle fracture in children Type de document : texte imprimé Auteurs : Pornchai MULPRUEK, Auteur ; Chanika ANGSANUNTSUKH, Auteur ; Patarawan WORATANARAT, Auteur Année de publication : 2015 Article en page(s) : p.384-391 Langues : Anglais (eng) Mots-clés : lateral condylar fracture  fracture distal humerus in children  shaft-condylar angle  neglected fracture  displaced fracture. Résumé : Purpose: To assess the outcome after using the ShaftCondylar angle (SCA) as intraoperative reference for sagittal plane correction in displaced lateral humeral condyle fractures in children presented 3-weeks after injury. Methods: Ten children, with delayed presentation of a displaced lateral humeral condyle fracture and undergoing surgery during 1999-2011, were reviewed. The goal was to obtain a smooth articular surface with an intraoperative SCA of nearly 40° and nearestanatomical carrying angle. They were allocated into two groups according to the postoperative SCA [Good-reduction group (SCA = 30-50°), and Badreduction group (SCA < 30°, > 50°)] and the final outcomes were then compared. Results: All fractures united without avascular necrosis. The Good-reduction group (n = 7) showed a significant improvement in final range of motion and functional outcome compared to the Bad-reduction group (n = 3) (p = 0.02). However, there was no significant difference in pain, carrying angle and overall outcome between both groups. Conclusion: SCA is a possible intraoperative reference for sagittal alignment correction in late presented displaced lateral humeral condyle fractures. Permalink : ./index.php?lvl=notice_display&id=40905 [article] Shaft-Condylar Angle for surgical correction in neglected and displaced lateral humeral condyle fracture in children [texte imprimé] / Pornchai MULPRUEK, Auteur ; Chanika ANGSANUNTSUKH, Auteur ; Patarawan WORATANARAT, Auteur . - 2015 . - p.384-391. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.384-391 Mots-clés : lateral condylar fracture  fracture distal humerus in children  shaft-condylar angle  neglected fracture  displaced fracture. Résumé : Purpose: To assess the outcome after using the ShaftCondylar angle (SCA) as intraoperative reference for sagittal plane correction in displaced lateral humeral condyle fractures in children presented 3-weeks after injury. Methods: Ten children, with delayed presentation of a displaced lateral humeral condyle fracture and undergoing surgery during 1999-2011, were reviewed. The goal was to obtain a smooth articular surface with an intraoperative SCA of nearly 40° and nearestanatomical carrying angle. They were allocated into two groups according to the postoperative SCA [Good-reduction group (SCA = 30-50°), and Badreduction group (SCA < 30°, > 50°)] and the final outcomes were then compared. Results: All fractures united without avascular necrosis. The Good-reduction group (n = 7) showed a significant improvement in final range of motion and functional outcome compared to the Bad-reduction group (n = 3) (p = 0.02). However, there was no significant difference in pain, carrying angle and overall outcome between both groups. Conclusion: SCA is a possible intraoperative reference for sagittal alignment correction in late presented displaced lateral humeral condyle fractures. Permalink : ./index.php?lvl=notice_display&id=40905

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Distal Femoral Cortical Irregularity in children / Keiichi MURAMATSU in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.392-397 Titre : Distal Femoral Cortical Irregularity in children Type de document : texte imprimé Auteurs : Keiichi MURAMATSU, Auteur ; Yasuhiro TOMINAGA, Auteur ; Takahiro HASHIMOTO, Auteur Année de publication : 2015 Article en page(s) : p.392-397 Langues : Anglais (eng) Mots-clés : femur  cortical irregularity  adductor magnus  gastrocnemius  children  classification  diagnosis. Résumé : Cortical abnormalities at the distal postero-medial femoral metaphysis may be relatively common. We reviewed the plain radiographs of 197 knees in 130 children aged between 5 and 12 years to investigate the incidence of distal femoral cortical irregularities (DFCI) and their association with symptoms. An adductor magnus lesion was found in 15% of cases, with an even number of irregular and cystic lesions. A medial gastrocnemius lesion was found in 5% of cases, but no association was found between symptoms and the lesion. Overall, lesions were found in 25% of cases aged 5 to 9 years, but in only 13% of cases aged 12 and 13 years. Boys showed a higher incidence of both adductor magnus and medial gastrocnemius lesions. DFCI is a benign, self-limited entity and a relatively common radiologic finding. Regardless of whether or not symptoms are present, imaging findings should be carefully interpreted to avoid unnecessary diagnostic and invasive therapeutic procedures. Permalink : ./index.php?lvl=notice_display&id=40906 [article] Distal Femoral Cortical Irregularity in children [texte imprimé] / Keiichi MURAMATSU, Auteur ; Yasuhiro TOMINAGA, Auteur ; Takahiro HASHIMOTO, Auteur . - 2015 . - p.392-397. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.392-397 Mots-clés : femur  cortical irregularity  adductor magnus  gastrocnemius  children  classification  diagnosis. Résumé : Cortical abnormalities at the distal postero-medial femoral metaphysis may be relatively common. We reviewed the plain radiographs of 197 knees in 130 children aged between 5 and 12 years to investigate the incidence of distal femoral cortical irregularities (DFCI) and their association with symptoms. An adductor magnus lesion was found in 15% of cases, with an even number of irregular and cystic lesions. A medial gastrocnemius lesion was found in 5% of cases, but no association was found between symptoms and the lesion. Overall, lesions were found in 25% of cases aged 5 to 9 years, but in only 13% of cases aged 12 and 13 years. Boys showed a higher incidence of both adductor magnus and medial gastrocnemius lesions. DFCI is a benign, self-limited entity and a relatively common radiologic finding. Regardless of whether or not symptoms are present, imaging findings should be carefully interpreted to avoid unnecessary diagnostic and invasive therapeutic procedures. Permalink : ./index.php?lvl=notice_display&id=40906

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Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach / Deniz CANKAYA in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.398-405 Titre : Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach Type de document : texte imprimé Auteurs : Deniz CANKAYA, Auteur ; Cemal AYDIN, Auteur ; Dilek KARAKUS, Auteur Année de publication : 2015 Article en page(s) : p.398-405 Langues : Anglais (eng) Mots-clés : anterolateral approach  revision hip arthroplasty  isokinetic performance Résumé : We investigated the isokinetic performance of hip muscles and clinical outcomes after revision total hip arthroplasty (THA) via same anterolateral approach used in primary surgery. Thirty patients who had undergone previous THA via an anterolateral approach underwent both acetabular and femoral component revision after aseptic loosening. The Harris Hip Score (HHS) was evaluated during a minimum 2-year follow-up. The isokinetic muscle strength of the operated and nonoperated hips was assessed 1 year after surgery. The HHS improved from 49.0 to 77.4. Operated and nonoperated hips exhibited similar isokinetic performance during all measurements (flexion, extension, and abduction) (p > 0.05). This prospective study showed that the anterolateral approach preserves abductor strength after revision THA in aseptic cases with acceptable functional and clinical results. The main clinical relevance of this study is that the same anterolateral approach used in previous primary THA is also safe and viable for revision THA. Permalink : ./index.php?lvl=notice_display&id=40907 [article] Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach [texte imprimé] / Deniz CANKAYA, Auteur ; Cemal AYDIN, Auteur ; Dilek KARAKUS, Auteur . - 2015 . - p.398-405. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.398-405 Mots-clés : anterolateral approach  revision hip arthroplasty  isokinetic performance Résumé : We investigated the isokinetic performance of hip muscles and clinical outcomes after revision total hip arthroplasty (THA) via same anterolateral approach used in primary surgery. Thirty patients who had undergone previous THA via an anterolateral approach underwent both acetabular and femoral component revision after aseptic loosening. The Harris Hip Score (HHS) was evaluated during a minimum 2-year follow-up. The isokinetic muscle strength of the operated and nonoperated hips was assessed 1 year after surgery. The HHS improved from 49.0 to 77.4. Operated and nonoperated hips exhibited similar isokinetic performance during all measurements (flexion, extension, and abduction) (p > 0.05). This prospective study showed that the anterolateral approach preserves abductor strength after revision THA in aseptic cases with acceptable functional and clinical results. The main clinical relevance of this study is that the same anterolateral approach used in previous primary THA is also safe and viable for revision THA. Permalink : ./index.php?lvl=notice_display&id=40907

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Stage-related results in treatment of hip osteonecrosis with core-decompression and autologous mesenchymal stem cells / Pietro PERSIANI in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.406-412 Titre : Stage-related results in treatment of hip osteonecrosis with core-decompression and autologous mesenchymal stem cells Type de document : texte imprimé Auteurs : Pietro PERSIANI, Auteur ; Claudia DE CRISTO, Auteur ; Jole GRACI, Auteur Année de publication : 2015 Article en page(s) : p.406-412 Langues : Anglais (eng) Mots-clés : hip osteonecrosis  stromal cells  femoral head Résumé : Our aim is to analyse the clinical outcome of a series of patients affected by avascular necrosis of the femoral head and treated with core-decompression technique and autologous stromal cells of the bone marrow. We enrolled in our study 29 patients with 31 hips in total affected by avascular necrosis of the femoral head. The clinical and radiological outcome has been assessed through self-administered questionnaires (HHS, VAS and SF12) X-ray and Magnetic Resonance. Of all the examined hips, 25 showed a relief of the symptoms and a resolution of the osteonecrosis, 11 of these were at Stage I and 14 at Stage II. The progression of the disease occurred in 6 hips (2 Stage II, 2 Stage III and 2 Stage IV). Our results show a significant decrease in joint pain level and a success in avoiding or delaying the need of hip replacement in early stages of osteonecrosis. Permalink : ./index.php?lvl=notice_display&id=40908 [article] Stage-related results in treatment of hip osteonecrosis with core-decompression and autologous mesenchymal stem cells [texte imprimé] / Pietro PERSIANI, Auteur ; Claudia DE CRISTO, Auteur ; Jole GRACI, Auteur . - 2015 . - p.406-412. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.406-412 Mots-clés : hip osteonecrosis  stromal cells  femoral head Résumé : Our aim is to analyse the clinical outcome of a series of patients affected by avascular necrosis of the femoral head and treated with core-decompression technique and autologous stromal cells of the bone marrow. We enrolled in our study 29 patients with 31 hips in total affected by avascular necrosis of the femoral head. The clinical and radiological outcome has been assessed through self-administered questionnaires (HHS, VAS and SF12) X-ray and Magnetic Resonance. Of all the examined hips, 25 showed a relief of the symptoms and a resolution of the osteonecrosis, 11 of these were at Stage I and 14 at Stage II. The progression of the disease occurred in 6 hips (2 Stage II, 2 Stage III and 2 Stage IV). Our results show a significant decrease in joint pain level and a success in avoiding or delaying the need of hip replacement in early stages of osteonecrosis. Permalink : ./index.php?lvl=notice_display&id=40908

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Results of Conserve Plus Hip Resurfacing?: prospective clinical, radiographic and ion study / Jan F. A. SOMERS in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.413-419 Titre : Results of Conserve Plus Hip Resurfacing?: prospective clinical, radiographic and ion study Type de document : texte imprimé Auteurs : Jan F. A. SOMERS, Auteur ; Jens VANBIERVLIET, Auteur ; Filip LEFEVERE, Auteur Année de publication : 2015 Article en page(s) : p.413-419 Langues : Anglais (eng) Mots-clés : hip resurfacing  ion levels  clinical and radiographic results  conserve plus Résumé : We report the 3- to 5-year clinical, radiographic and serum ion level results of a prospective consecutive cohort of 42 hip resurfacing arthroplasties using the Conserve Plus implant in 39 male patients that were operated on by a single surgeon in a community hospital. Average age was 53 years (range 34-67) at surgery. There was one revision for a subcapital neck fracture. There were no surgery related complications. The survival of the implant was 95%. Clinical evaluation showed excellent results with a modified Charnley score of 17.6/18, Harris Hip Score of 96.2/100, WOMAC of 95.1/100, Oxford Score 15.3, and UCLA-Activity Score of 8/10. Radiographic analysis showed no implant at risk, no migration or signs of loosening, no neck narrowing and no osteolysis at final follow-up. Average cup inclination angle was 43.5° with 2 outliers (34° and 57°). Ion level study showed average cobalt in serum 1.04 µg/l (range 0-4) for the whole group, 0.7 µg/l (range 0-3) in patients with unilateral resurfacing and 2.0 µg/l (range 0-4) in patients with bilateral resurfacing. All patients had ion levels within the safe zone. This independent series of Conserve Plus HRA confirms good results at shortto mid-term with excellent wear characteristics. Results for avascular necrosis were equal to those for osteoarthritis. Permalink : ./index.php?lvl=notice_display&id=40910 [article] Results of Conserve Plus Hip Resurfacing?: prospective clinical, radiographic and ion study [texte imprimé] / Jan F. A. SOMERS, Auteur ; Jens VANBIERVLIET, Auteur ; Filip LEFEVERE, Auteur . - 2015 . - p.413-419. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.413-419 Mots-clés : hip resurfacing  ion levels  clinical and radiographic results  conserve plus Résumé : We report the 3- to 5-year clinical, radiographic and serum ion level results of a prospective consecutive cohort of 42 hip resurfacing arthroplasties using the Conserve Plus implant in 39 male patients that were operated on by a single surgeon in a community hospital. Average age was 53 years (range 34-67) at surgery. There was one revision for a subcapital neck fracture. There were no surgery related complications. The survival of the implant was 95%. Clinical evaluation showed excellent results with a modified Charnley score of 17.6/18, Harris Hip Score of 96.2/100, WOMAC of 95.1/100, Oxford Score 15.3, and UCLA-Activity Score of 8/10. Radiographic analysis showed no implant at risk, no migration or signs of loosening, no neck narrowing and no osteolysis at final follow-up. Average cup inclination angle was 43.5° with 2 outliers (34° and 57°). Ion level study showed average cobalt in serum 1.04 µg/l (range 0-4) for the whole group, 0.7 µg/l (range 0-3) in patients with unilateral resurfacing and 2.0 µg/l (range 0-4) in patients with bilateral resurfacing. All patients had ion levels within the safe zone. This independent series of Conserve Plus HRA confirms good results at shortto mid-term with excellent wear characteristics. Results for avascular necrosis were equal to those for osteoarthritis. Permalink : ./index.php?lvl=notice_display&id=40910

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Evaluation of results of conservative therapy in patients with transient osteoporosis of hip / Olcay GULER in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.420-426 Titre : Evaluation of results of conservative therapy in patients with transient osteoporosis of hip Type de document : texte imprimé Auteurs : Olcay GULER, Auteur ; Selahattin OZYUREK, Auteur ; Selami CAKMAK, Auteur Année de publication : 2015 Article en page(s) : p.420-426 Langues : Anglais (eng) Mots-clés : Transient osteoporosis  bisphosphonate  risedronate  hyperbaric oxygen Résumé : The present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of followup of TOH cases using physical examination and ­laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3 ± 4.3 years) and 12 males (mean age, 40.7 ± 10.5 years) was 6.1 ± 2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 ­sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intraarticular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6 ± 7.8 before the treatment, it increased to 88.8 ± 5.8 in the 3rd month and to 96.0 ± 1.8 in the 6th month after the treatment. This change in score over time was found to be significant. Permalink : ./index.php?lvl=notice_display&id=40911 [article] Evaluation of results of conservative therapy in patients with transient osteoporosis of hip [texte imprimé] / Olcay GULER, Auteur ; Selahattin OZYUREK, Auteur ; Selami CAKMAK, Auteur . - 2015 . - p.420-426. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.420-426 Mots-clés : Transient osteoporosis  bisphosphonate  risedronate  hyperbaric oxygen Résumé : The present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of followup of TOH cases using physical examination and ­laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3 ± 4.3 years) and 12 males (mean age, 40.7 ± 10.5 years) was 6.1 ± 2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 ­sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intraarticular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6 ± 7.8 before the treatment, it increased to 88.8 ± 5.8 in the 3rd month and to 96.0 ± 1.8 in the 6th month after the treatment. This change in score over time was found to be significant. Permalink : ./index.php?lvl=notice_display&id=40911

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Short-term results of surgical treatment with cephalomedullary nails for basicervical proximal femoral fractures / Levent TASYIKAN in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.427-434 Titre : Short-term results of surgical treatment with cephalomedullary nails for basicervical proximal femoral fractures Type de document : texte imprimé Auteurs : Levent TASYIKAN, Auteur ; Ender UGUTMEN, Auteur ; Selim SANEL, Auteur Année de publication : 2015 Article en page(s) : p.427-434 Langues : Anglais (eng) Mots-clés : Hip  survey  knee arthrrplasty  alignment Résumé : The treatment of basicervical femoral fractures remains controversial. The aim of this study was to examine the efficacy of intramedullary nail use in the surgical treatment of basicervical fractures. In total, 28 patients with basicervical fractures treated with proximal femoral nails were examined retrospectively. Fracture healing was in all patients, who were followed at least for 6 months. While the average radiological fracture healing timing was ~10.5 (8-14) weeks, clinical fracture healing occured in 6 (5-9) weeks on average. Screw cut-out, avascular necrosis, femur fracture, and surgical wound infections did not occur in any patient. Severe collapse (> 10%) was not noted in any patient. The postoperative mean Harris hip score was 81.2 ± 21.3. Osteosynthesis application with a proximal femoral nail in basicervical proximal femur fractures in a surgical treatment that can be performed with minimally invasive techniques with-out open surgery. This is a rapid, sound, and simple treatment method with low morbidity. Permalink : ./index.php?lvl=notice_display&id=40915 [article] Short-term results of surgical treatment with cephalomedullary nails for basicervical proximal femoral fractures [texte imprimé] / Levent TASYIKAN, Auteur ; Ender UGUTMEN, Auteur ; Selim SANEL, Auteur . - 2015 . - p.427-434. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.427-434 Mots-clés : Hip  survey  knee arthrrplasty  alignment Résumé : The treatment of basicervical femoral fractures remains controversial. The aim of this study was to examine the efficacy of intramedullary nail use in the surgical treatment of basicervical fractures. In total, 28 patients with basicervical fractures treated with proximal femoral nails were examined retrospectively. Fracture healing was in all patients, who were followed at least for 6 months. While the average radiological fracture healing timing was ~10.5 (8-14) weeks, clinical fracture healing occured in 6 (5-9) weeks on average. Screw cut-out, avascular necrosis, femur fracture, and surgical wound infections did not occur in any patient. Severe collapse (> 10%) was not noted in any patient. The postoperative mean Harris hip score was 81.2 ± 21.3. Osteosynthesis application with a proximal femoral nail in basicervical proximal femur fractures in a surgical treatment that can be performed with minimally invasive techniques with-out open surgery. This is a rapid, sound, and simple treatment method with low morbidity. Permalink : ./index.php?lvl=notice_display&id=40915

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Test-retest reliability of the 50-foot timed walk and 30-second chair stand test in patients with total hip arthroplasty / Bayram UNVER in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.435-441 Titre : Test-retest reliability of the 50-foot timed walk and 30-second chair stand test in patients with total hip arthroplasty Type de document : texte imprimé Auteurs : Bayram UNVER, Auteur ; Turhan KAHRAMAN, Auteur ; Serpil KALKAN, Auteur Année de publication : 2015 Article en page(s) : p.435-441 Langues : Anglais (eng) Mots-clés : hip  gait  outcome  arthroplasty Résumé : The purpose was to investigate the test-retest reliability of the 50-Foot Timed Walk (50FWT), and 30-Second Chair Stand Test (30CST) in the patients with total hip arthroplasty (THA). The study was a test-retest study. Thirty-seven patients with THA performed two trials for both the 30CTS and 50FWT on the same day with one hour interval. To assess reliability­, the intra-class correlation coefficient [ICC(2,1)], standard error of measurement (SEM), the smallest real difference at the 95% confidence level (SRD95) were calculated. The ICCs for the 50FWT and 30CTS were 0.98 and 0.94, respectively. The SEM and SRD95 for the 50FWT and 30CTS were 0.3 and 0.8 seconds and 0.4 and 1.2 repeats, respectively. The test-retest reliability of the tests was very high. The 50FWT and 30CST are very reliable to measure the functional performance in patients with THA in the clinical settings. Permalink : ./index.php?lvl=notice_display&id=40916 [article] Test-retest reliability of the 50-foot timed walk and 30-second chair stand test in patients with total hip arthroplasty [texte imprimé] / Bayram UNVER, Auteur ; Turhan KAHRAMAN, Auteur ; Serpil KALKAN, Auteur . - 2015 . - p.435-441. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.435-441 Mots-clés : hip  gait  outcome  arthroplasty Résumé : The purpose was to investigate the test-retest reliability of the 50-Foot Timed Walk (50FWT), and 30-Second Chair Stand Test (30CST) in the patients with total hip arthroplasty (THA). The study was a test-retest study. Thirty-seven patients with THA performed two trials for both the 30CTS and 50FWT on the same day with one hour interval. To assess reliability­, the intra-class correlation coefficient [ICC(2,1)], standard error of measurement (SEM), the smallest real difference at the 95% confidence level (SRD95) were calculated. The ICCs for the 50FWT and 30CTS were 0.98 and 0.94, respectively. The SEM and SRD95 for the 50FWT and 30CTS were 0.3 and 0.8 seconds and 0.4 and 1.2 repeats, respectively. The test-retest reliability of the tests was very high. The 50FWT and 30CST are very reliable to measure the functional performance in patients with THA in the clinical settings. Permalink : ./index.php?lvl=notice_display&id=40916

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Surgical technique for treatment of concomitant grade II MCL lesion in patients with ACL rupture / Fabian BLANKE in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.442-446 Titre : Surgical technique for treatment of concomitant grade II MCL lesion in patients with ACL rupture Type de document : texte imprimé Auteurs : Fabian BLANKE, Auteur ; Lutz VONWEHREN, Auteur ; Geert PAGENSTERT, Auteur Année de publication : 2015 Article en page(s) : p.442-446 Langues : Anglais (eng) Mots-clés : MCL  ACL  reconstruction  surgical technique  grade II. Résumé : Combined lesions of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are frequent in athletes. While surgical treatment of ACL injury is mandatory treatment regime of concomitant grade II MCL lesions remains unclear with tendency to surgical intervention. Standardized surgical technique is lacking. Present study wants to introduce surgical technique for treatment of concomitant grade II MCL lesion and report short term outcome results. 5 Patients with acute ACL rupture and grade II MCLlesion were included. All patients received surgical treatment of concomitant MCL lesion by distinct surgical technique and ACL reconstruction. We evaluated valgus instability, anterior instability and range of motion (ROM) according to international knee documentation commitee (IKDC) and Lysholm-Score both preoperative and after 6, 16 weeks and 9 months postoperative. All Patients showed excellent clinical results at final follow-up. Valgus and anterior stability could be restored in all patients. 1 patient (20%) lost 15° in flexion of ROM at final follow up. However in all 5 patients (100%) the findings were graded as normal or nearly nor-mal according to IKDC knee examination form. Lysholm-Score averaged 94,6. Therefore presented surgical technique improved both, valgus and anterior stability, and led to excellent short term results at final follow up. Permalink : ./index.php?lvl=notice_display&id=40919 [article] Surgical technique for treatment of concomitant grade II MCL lesion in patients with ACL rupture [texte imprimé] / Fabian BLANKE, Auteur ; Lutz VONWEHREN, Auteur ; Geert PAGENSTERT, Auteur . - 2015 . - p.442-446. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.442-446 Mots-clés : MCL  ACL  reconstruction  surgical technique  grade II. Résumé : Combined lesions of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are frequent in athletes. While surgical treatment of ACL injury is mandatory treatment regime of concomitant grade II MCL lesions remains unclear with tendency to surgical intervention. Standardized surgical technique is lacking. Present study wants to introduce surgical technique for treatment of concomitant grade II MCL lesion and report short term outcome results. 5 Patients with acute ACL rupture and grade II MCLlesion were included. All patients received surgical treatment of concomitant MCL lesion by distinct surgical technique and ACL reconstruction. We evaluated valgus instability, anterior instability and range of motion (ROM) according to international knee documentation commitee (IKDC) and Lysholm-Score both preoperative and after 6, 16 weeks and 9 months postoperative. All Patients showed excellent clinical results at final follow-up. Valgus and anterior stability could be restored in all patients. 1 patient (20%) lost 15° in flexion of ROM at final follow up. However in all 5 patients (100%) the findings were graded as normal or nearly nor-mal according to IKDC knee examination form. Lysholm-Score averaged 94,6. Therefore presented surgical technique improved both, valgus and anterior stability, and led to excellent short term results at final follow up. Permalink : ./index.php?lvl=notice_display&id=40919

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Early follow-up after primary total knee and total hip arthroplasty with rapid recovery?: Focus groups / Jeroen C. VAN EGMOND in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.447-453 Titre : Early follow-up after primary total knee and total hip arthroplasty with rapid recovery?: Focus groups Type de document : texte imprimé Auteurs : Jeroen C. VAN EGMOND, Auteur ; Hennie VERBURG, Auteur ; Stephan B.W. VEHMEIJER, Auteur Année de publication : 2015 Article en page(s) : p.447-453 Langues : Anglais (eng) Mots-clés : Total knee arthroplasty  total hip arthroplasty  rapid recovery  focus group  rehabilitation  qualitative study Résumé : Rapid recovery protocols reduce the length of hospital stay after Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA). However, little is known about the early postoperative phase. The purpose of this study was to examine which problems patients encountered during the first six weeks after primary TKA or THA surgery with rapid recovery. We invited twenty patients for a focus group meeting which discussed various subjects regarding the first six weeks after hospital discharge. The focus group meetings were analysed qualitatively. Patients were mostly satisfied by the short length of hospital stay. Patients who lived alone needs more care and would like to stay longer in the hospital. After THA surgery all patients complained of inability to sleep. More patients experienced pain after TKA surgery compared to THA surgery. All patients had various experiences regarding physical therapy therefore an evidence based rehabilitation protocol might be needed. Permalink : ./index.php?lvl=notice_display&id=40920 [article] Early follow-up after primary total knee and total hip arthroplasty with rapid recovery?: Focus groups [texte imprimé] / Jeroen C. VAN EGMOND, Auteur ; Hennie VERBURG, Auteur ; Stephan B.W. VEHMEIJER, Auteur . - 2015 . - p.447-453. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.447-453 Mots-clés : Total knee arthroplasty  total hip arthroplasty  rapid recovery  focus group  rehabilitation  qualitative study Résumé : Rapid recovery protocols reduce the length of hospital stay after Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA). However, little is known about the early postoperative phase. The purpose of this study was to examine which problems patients encountered during the first six weeks after primary TKA or THA surgery with rapid recovery. We invited twenty patients for a focus group meeting which discussed various subjects regarding the first six weeks after hospital discharge. The focus group meetings were analysed qualitatively. Patients were mostly satisfied by the short length of hospital stay. Patients who lived alone needs more care and would like to stay longer in the hospital. After THA surgery all patients complained of inability to sleep. More patients experienced pain after TKA surgery compared to THA surgery. All patients had various experiences regarding physical therapy therefore an evidence based rehabilitation protocol might be needed. Permalink : ./index.php?lvl=notice_display&id=40920

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Comparative study of innovative postoperative wound dressings after total knee arthroplasty / Andreas DOBBELAERE in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.454-461 Titre : Comparative study of innovative postoperative wound dressings after total knee arthroplasty Type de document : texte imprimé Auteurs : Andreas DOBBELAERE, Auteur ; Nika SCHUERMANS, Auteur ; Steven SMET, Auteur Année de publication : 2015 Article en page(s) : p.454-461 Langues : Anglais (eng) Mots-clés : knee arthroplasty Résumé : Purpose: Postoperative wound complications, especially surgical site infections, influence the outcome after total knee arthroplasty. The purpose of our study was to compare four different wound dressings. Following research questions were asked: (1) Which dressing is associated with least wound complications? (2) Which dressing application is the cheapest? (3) Which dressing is most comfortable for the patient? Methods: 111 patients undergoing a total knee arthroplasty were randomized in 4 groups. Each group received a different dressing with its specific wound management protocol: (1) Zetuvit® with Cosmopor E®, (2) Zetuvit® with Opsite Post-Op Visible®, (3) Aquacel Surgical® and (4) Mepilex Border®. Followup evaluations were performed on the fifth postoperative day and included assessment of the wound, status of the wound dressing and the patient’s own judgment. Cumulative costs were calculated. Results: Clinically Mepilex Border®, a silicone dressing, scored the best. No wound complications were seen in this group. The mean number of dressing renewals was 1.9 for the standard dressing which was significantly higher (p <.0001) compared to the other dressings. Opsite Post-op Visible® was the cheapest dressing. Mepilex Border® had the best scores for pain, freedom of movement and general comfort. Conclusions: Mepilex Border® is the most skinfriendly dressing. The number of dressing renewals is a defining factor to calculate the costs. Mepilex Border® appeared to be the best dressing to use after a total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=40921 [article] Comparative study of innovative postoperative wound dressings after total knee arthroplasty [texte imprimé] / Andreas DOBBELAERE, Auteur ; Nika SCHUERMANS, Auteur ; Steven SMET, Auteur . - 2015 . - p.454-461. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.454-461 Mots-clés : knee arthroplasty Résumé : Purpose: Postoperative wound complications, especially surgical site infections, influence the outcome after total knee arthroplasty. The purpose of our study was to compare four different wound dressings. Following research questions were asked: (1) Which dressing is associated with least wound complications? (2) Which dressing application is the cheapest? (3) Which dressing is most comfortable for the patient? Methods: 111 patients undergoing a total knee arthroplasty were randomized in 4 groups. Each group received a different dressing with its specific wound management protocol: (1) Zetuvit® with Cosmopor E®, (2) Zetuvit® with Opsite Post-Op Visible®, (3) Aquacel Surgical® and (4) Mepilex Border®. Followup evaluations were performed on the fifth postoperative day and included assessment of the wound, status of the wound dressing and the patient’s own judgment. Cumulative costs were calculated. Results: Clinically Mepilex Border®, a silicone dressing, scored the best. No wound complications were seen in this group. The mean number of dressing renewals was 1.9 for the standard dressing which was significantly higher (p <.0001) compared to the other dressings. Opsite Post-op Visible® was the cheapest dressing. Mepilex Border® had the best scores for pain, freedom of movement and general comfort. Conclusions: Mepilex Border® is the most skinfriendly dressing. The number of dressing renewals is a defining factor to calculate the costs. Mepilex Border® appeared to be the best dressing to use after a total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=40921

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The indirect cost of Patient-Specific Instruments / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.462-470 Titre : The indirect cost of Patient-Specific Instruments Type de document : texte imprimé Auteurs : Emmanuel Thienpont, Auteur ; Frederic PATERNOSTRE, Auteur ; Charles VAN WYMEERSCH, Auteur Année de publication : 2015 Article en page(s) : p.462-470 Langues : Anglais (eng) Mots-clés : Patient specific instruments  indirect costs  cost-effectiveness  total knee arthroplasty  economics. Résumé : Purpose: To calculate the indirect costs of Patient Specific Instruments (PSI) based on an opportunity cost, cost of efforts and a supply chain cost model to compare PSI for value with conventional total knee arthroplasty (TKA). Methods: In 81 patients the total (direct + indirect) cost of PSI-assisted TKA was compared with conventional TKA. Surgical times and coronal mechanical alignment were measured to evaluate the effectiveness of the PSI system. Results: Indirect costs (459 euro) make up 40% of the total cost that can run up to 1142 euro for a patient operated with PSI guides. No difference in surgical times or coronal alignment was observed in between both groups. Conclusion: Considering the total cost of PSI no value was found for the use of PSI in primary TKA as measured by surgical times or for obtaining a neutral mechanical axis in the coronal plane. Permalink : ./index.php?lvl=notice_display&id=40922 [article] The indirect cost of Patient-Specific Instruments [texte imprimé] / Emmanuel Thienpont, Auteur ; Frederic PATERNOSTRE, Auteur ; Charles VAN WYMEERSCH, Auteur . - 2015 . - p.462-470. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.462-470 Mots-clés : Patient specific instruments  indirect costs  cost-effectiveness  total knee arthroplasty  economics. Résumé : Purpose: To calculate the indirect costs of Patient Specific Instruments (PSI) based on an opportunity cost, cost of efforts and a supply chain cost model to compare PSI for value with conventional total knee arthroplasty (TKA). Methods: In 81 patients the total (direct + indirect) cost of PSI-assisted TKA was compared with conventional TKA. Surgical times and coronal mechanical alignment were measured to evaluate the effectiveness of the PSI system. Results: Indirect costs (459 euro) make up 40% of the total cost that can run up to 1142 euro for a patient operated with PSI guides. No difference in surgical times or coronal alignment was observed in between both groups. Conclusion: Considering the total cost of PSI no value was found for the use of PSI in primary TKA as measured by surgical times or for obtaining a neutral mechanical axis in the coronal plane. Permalink : ./index.php?lvl=notice_display&id=40922

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Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477 Titre : Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article Type de document : texte imprimé Auteurs : Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur Année de publication : 2015 Article en page(s) : p.471-477 Langues : Anglais (eng) Mots-clés : Knee arthroplasty  alignment  varus  survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty. Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention. Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty. Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis. Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction. Permalink : ./index.php?lvl=notice_display&id=40923 [article] Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article [texte imprimé] / Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur . - 2015 . - p.471-477. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477 Mots-clés : Knee arthroplasty  alignment  varus  survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty. Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention. Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty. Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis. Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction. Permalink : ./index.php?lvl=notice_display&id=40923

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Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? / Emilie DESPORTES in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.478-484 Titre : Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? Type de document : texte imprimé Auteurs : Emilie DESPORTES, Auteur ; Mathieu LEFERE, Auteur ; Pierre-Henri Flurin, Auteur Année de publication : 2015 Article en page(s) : p.478-484 Langues : Anglais (eng) Mots-clés : Ultrasound  shoulder  cuff  arthroscopic  postoperative  Constant’s Shoulder Score  repair  asymptomatic Résumé : Objective: To establish whether ultrasonographic (US) appearance is correlated to functional outcome in asymptomatic patients 12 months after rotator cuff repair. Materials and methods: 26 asymptomatic patients at twelve months after arthroscopic cuff repair and 26 controls were retrospectively included. A clinical score (Constant’s Shoulder Score, CSS) was compared with a US score (the modified Sugaya Score, mSS). The minimal thickness of the anterior and posterior parts of the cuff was also measured. Results: CSS improved significantly from preoperatively to postoperatively (mean increased from 41 to 82.6, p <.001). Correlation between the postoperative CSS and the minimal thickness of the cuff at its anterior and posterior part (p = 0.55 and p = 0.13) was not significant. There was also no significant correlation between the postoperative CSS and mSS (p = 0.34). Conclusion: The sonographic appearance of the cuff repair is not correlated to the functional outcome at 12 months after arthroscopic surgery in asymptomatic patients. Permalink : ./index.php?lvl=notice_display&id=40924 [article] Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? [texte imprimé] / Emilie DESPORTES, Auteur ; Mathieu LEFERE, Auteur ; Pierre-Henri Flurin, Auteur . - 2015 . - p.478-484. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.478-484 Mots-clés : Ultrasound  shoulder  cuff  arthroscopic  postoperative  Constant’s Shoulder Score  repair  asymptomatic Résumé : Objective: To establish whether ultrasonographic (US) appearance is correlated to functional outcome in asymptomatic patients 12 months after rotator cuff repair. Materials and methods: 26 asymptomatic patients at twelve months after arthroscopic cuff repair and 26 controls were retrospectively included. A clinical score (Constant’s Shoulder Score, CSS) was compared with a US score (the modified Sugaya Score, mSS). The minimal thickness of the anterior and posterior parts of the cuff was also measured. Results: CSS improved significantly from preoperatively to postoperatively (mean increased from 41 to 82.6, p <.001). Correlation between the postoperative CSS and the minimal thickness of the cuff at its anterior and posterior part (p = 0.55 and p = 0.13) was not significant. There was also no significant correlation between the postoperative CSS and mSS (p = 0.34). Conclusion: The sonographic appearance of the cuff repair is not correlated to the functional outcome at 12 months after arthroscopic surgery in asymptomatic patients. Permalink : ./index.php?lvl=notice_display&id=40924

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Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period / Pieter-Jan DE ROO in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.485-492 Titre : Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period Type de document : texte imprimé Auteurs : Pieter-Jan DE ROO, Auteur ; Stijn MUERMANS, Auteur ; Mathieu MAROY, Auteur Année de publication : 2015 Article en page(s) : p.485-492 Langues : Anglais (eng) Mots-clés : Arthroscopy  rehabilitation  shoulder  rotator cuff repair Résumé : This prospective randomized study compares the clinical results of immediate passive mobilization versus delayed mobilization in the rehabilitation of rotator cuff repair during the early postoperative period. The mobilization group (79 patients) received immediate daily passive mobilization. The immobilization group (51 patients) was immobilized for 4 weeks until physiotherapy was started. Passive range of motion was noted preoperatively, at 6 weeks and 4 months. Strength was measured preoperatively and at 4 months. Constant-Murley, Simple Shoulder Test, SPADI and UCLA scores were noted at baseline and at 4 months. Ultrasonography was performed at 6 weeks to exclude early failures of repair. We noted no significant difference between the two groups regarding range of motion at 6 weeks and range of motion, strength and functional outcome scores at 4 months. Ultrasound didn’t show a difference in healing at 6 w in either of both groups. Both rehabilitation protocols seem applicable as well as safe in the early post-operative phase. Level of evidence: Level 1, randomized prospective trial. Permalink : ./index.php?lvl=notice_display&id=40925 [article] Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period [texte imprimé] / Pieter-Jan DE ROO, Auteur ; Stijn MUERMANS, Auteur ; Mathieu MAROY, Auteur . - 2015 . - p.485-492. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.485-492 Mots-clés : Arthroscopy  rehabilitation  shoulder  rotator cuff repair Résumé : This prospective randomized study compares the clinical results of immediate passive mobilization versus delayed mobilization in the rehabilitation of rotator cuff repair during the early postoperative period. The mobilization group (79 patients) received immediate daily passive mobilization. The immobilization group (51 patients) was immobilized for 4 weeks until physiotherapy was started. Passive range of motion was noted preoperatively, at 6 weeks and 4 months. Strength was measured preoperatively and at 4 months. Constant-Murley, Simple Shoulder Test, SPADI and UCLA scores were noted at baseline and at 4 months. Ultrasonography was performed at 6 weeks to exclude early failures of repair. We noted no significant difference between the two groups regarding range of motion at 6 weeks and range of motion, strength and functional outcome scores at 4 months. Ultrasound didn’t show a difference in healing at 6 w in either of both groups. Both rehabilitation protocols seem applicable as well as safe in the early post-operative phase. Level of evidence: Level 1, randomized prospective trial. Permalink : ./index.php?lvl=notice_display&id=40925

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Fracture-dislocation of the humeral condyles in adults?: results of surgical treatment / Abdelhakim BENTOUNSI in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.493-500 Titre : Fracture-dislocation of the humeral condyles in adults?: results of surgical treatment Type de document : texte imprimé Auteurs : Abdelhakim BENTOUNSI, Auteur Année de publication : 2015 Article en page(s) : p.493-500 Langues : Anglais (eng) Mots-clés : Unicondylar fractures  elbow  dislocation  distal humerus  adults Résumé : Fracture-dislocation of the humeral condyle is exceptional in adults. The purpose was to analyze the results of surgical treatment by open reduction and internal fixation without ligamentous repair. There were six men with an average age of 31 years. According to the AO classification, five fractures were classified as AO type B1 and one as B2. Dislocation was reduced in emergency before osteosynthesis. Postoperatively, the joint was held immobile with a brace for 25.40 days. Five patients were reviewed after a mean follow-up of 52.96 months. The median arc of flexion/extension was 104.80° and 157.8° for pronation-supination. All elbows were stable and all fractures were consolidated. Two elbows were painful. The results were satisfactory in five patients. The elbow stability can be ensured only by the synthesis of bone structures. Surgical treatment should restore exact anatomy between the condyle and trochlea. This protocol may provide a joint stability and satisfactory results. Permalink : ./index.php?lvl=notice_display&id=40926 [article] Fracture-dislocation of the humeral condyles in adults?: results of surgical treatment [texte imprimé] / Abdelhakim BENTOUNSI, Auteur . - 2015 . - p.493-500. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.493-500 Mots-clés : Unicondylar fractures  elbow  dislocation  distal humerus  adults Résumé : Fracture-dislocation of the humeral condyle is exceptional in adults. The purpose was to analyze the results of surgical treatment by open reduction and internal fixation without ligamentous repair. There were six men with an average age of 31 years. According to the AO classification, five fractures were classified as AO type B1 and one as B2. Dislocation was reduced in emergency before osteosynthesis. Postoperatively, the joint was held immobile with a brace for 25.40 days. Five patients were reviewed after a mean follow-up of 52.96 months. The median arc of flexion/extension was 104.80° and 157.8° for pronation-supination. All elbows were stable and all fractures were consolidated. Two elbows were painful. The results were satisfactory in five patients. The elbow stability can be ensured only by the synthesis of bone structures. Surgical treatment should restore exact anatomy between the condyle and trochlea. This protocol may provide a joint stability and satisfactory results. Permalink : ./index.php?lvl=notice_display&id=40926

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Operative management of humeral nonunions. Factors that influence the outcome / Antonios KOUTALOS in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.501-510 Titre : Operative management of humeral nonunions. Factors that influence the outcome Type de document : texte imprimé Auteurs : Antonios KOUTALOS, Auteur ; Sokratis Varitimidis, Auteur ; Zoe Dailiana, Auteur Année de publication : 2015 Article en page(s) : p.501-510 Langues : Anglais (eng) Mots-clés : Humeral nonunion  plate fixation  bone graft  infection  atrophic nonunion Résumé : The purpose of this study is to present the outcome of surgically treated humeral nonunions and find factors that affect the outcome. Fortytwo patients with humeral nonunions (30 shaft, 7 proximal and 5 distal) were reviewed in a prospective manner. Treatment was based on a specific algorithm. Demographics, time to union, range of motion, functional outcome and complications were recorded and analysed. Results: Mean follow-up was 78 months and mean time to union was 4.3 months. Infection was associated with delayed union of the pseudarthrosis, while range of motion was negatively affected by the location (proximal) and the AO type of the initial fracture. Complication rate was 17%. Conclusion: The surgical management of humeral nonunions yields a favourable outcome with reduced rate of complications. Infection prolonged healing time, while proximal location of the nonunion and the type B or C fracture according to AO/OTA classification adversely affected range of motion. Permalink : ./index.php?lvl=notice_display&id=40927 [article] Operative management of humeral nonunions. Factors that influence the outcome [texte imprimé] / Antonios KOUTALOS, Auteur ; Sokratis Varitimidis, Auteur ; Zoe Dailiana, Auteur . - 2015 . - p.501-510. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.501-510 Mots-clés : Humeral nonunion  plate fixation  bone graft  infection  atrophic nonunion Résumé : The purpose of this study is to present the outcome of surgically treated humeral nonunions and find factors that affect the outcome. Fortytwo patients with humeral nonunions (30 shaft, 7 proximal and 5 distal) were reviewed in a prospective manner. Treatment was based on a specific algorithm. Demographics, time to union, range of motion, functional outcome and complications were recorded and analysed. Results: Mean follow-up was 78 months and mean time to union was 4.3 months. Infection was associated with delayed union of the pseudarthrosis, while range of motion was negatively affected by the location (proximal) and the AO type of the initial fracture. Complication rate was 17%. Conclusion: The surgical management of humeral nonunions yields a favourable outcome with reduced rate of complications. Infection prolonged healing time, while proximal location of the nonunion and the type B or C fracture according to AO/OTA classification adversely affected range of motion. Permalink : ./index.php?lvl=notice_display&id=40927

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Correlation between dorsovolar translation and rotation of the radius on the distal radioulnar joint during supination and pronation of forearm / Sang Ki Lee in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.511-522 Titre : Correlation between dorsovolar translation and rotation of the radius on the distal radioulnar joint during supination and pronation of forearm Type de document : texte imprimé Auteurs : Sang Ki Lee, Auteur ; Young Dong SONG, Auteur ; Won Sik CHOY, Auteur Année de publication : 2015 Article en page(s) : p.511-522 Langues : Anglais (eng) Mots-clés : Distal radioulnar joint  carpal joints  computed tomography Résumé : This study aimed to describe the patterns of movements about radius and ulna in individual degrees of forearm rotation. And, we also determined the effect of forearm rotation on translation and rotation of the radius with reference to the ulna, and to measure the relationship between forearm rotation, translation and rotation of the radius. Computed tomography of multiple, individual forearm positions, from 90° pronation to 90° supination, was conducted in 26 healthy volunteers (mean age, 43.9 years) to measure dorsovolar translation and rotation of the radius in the DRUJ in each forearm position. The mean dorsovolar translations were within 1.99 mm at 90° pronation to -2.03 mm at 90° supination. The rotations of the radius were 71.20° at 90° pronation and -46.63° at 90° supination. There were strong correlations between degrees of forearm rotation and dorsovolar translation (r = 0.861, p < 0.001) and rotation of the radius (r = 0.960, p < 0.001), suggesting that the DRUJ, carpal joints, and rotatory laxity of the carpal ligament, especially in supination, contribute to forearm supination and pronation. These findings provide an understanding of wrist kinematics, are may be useful in reconstructive wrist surgery to achieve normal range of motion, and are may be helpful for the design of DRUJ reconstruction using prostheses. Permalink : ./index.php?lvl=notice_display&id=40928 [article] Correlation between dorsovolar translation and rotation of the radius on the distal radioulnar joint during supination and pronation of forearm [texte imprimé] / Sang Ki Lee, Auteur ; Young Dong SONG, Auteur ; Won Sik CHOY, Auteur . - 2015 . - p.511-522. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.511-522 Mots-clés : Distal radioulnar joint  carpal joints  computed tomography Résumé : This study aimed to describe the patterns of movements about radius and ulna in individual degrees of forearm rotation. And, we also determined the effect of forearm rotation on translation and rotation of the radius with reference to the ulna, and to measure the relationship between forearm rotation, translation and rotation of the radius. Computed tomography of multiple, individual forearm positions, from 90° pronation to 90° supination, was conducted in 26 healthy volunteers (mean age, 43.9 years) to measure dorsovolar translation and rotation of the radius in the DRUJ in each forearm position. The mean dorsovolar translations were within 1.99 mm at 90° pronation to -2.03 mm at 90° supination. The rotations of the radius were 71.20° at 90° pronation and -46.63° at 90° supination. There were strong correlations between degrees of forearm rotation and dorsovolar translation (r = 0.861, p < 0.001) and rotation of the radius (r = 0.960, p < 0.001), suggesting that the DRUJ, carpal joints, and rotatory laxity of the carpal ligament, especially in supination, contribute to forearm supination and pronation. These findings provide an understanding of wrist kinematics, are may be useful in reconstructive wrist surgery to achieve normal range of motion, and are may be helpful for the design of DRUJ reconstruction using prostheses. Permalink : ./index.php?lvl=notice_display&id=40928

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Management of infectious fractures with “Non-Contact Plate” (NCP) method / Celil Alemdir in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.523-529 Titre : Management of infectious fractures with “Non-Contact Plate” (NCP) method Type de document : texte imprimé Auteurs : Celil Alemdir, Auteur ; Ibrahim AZBOY, Auteur ; Ramazan ATIÇ, Auteur Année de publication : 2015 Article en page(s) : p.523-529 Langues : Anglais (eng) Mots-clés : Infectious fracture  complication  internal fixation  locking plate  non-contact plate Résumé : The aim of this study was to evaluate the outcomes of internal fixation with Non-Contact Plating (NCP) after deep infection caused by previous surgeries of the tibia or femur fractures. The study included 15 patients (4 female and 11 male). The mean age patients was 36.6 years (range, 21-64 years). There were 6 femur and 9 tibia fractures. The mean followup period was 25.7 months (range, 15-45 months). The study comprised 11 open and 4 closed fractures. External fixator was used in 3, plate in 4, and intramedullary nail in 8 patients for index surgery. Deep infection was diagnosed via clinical findings, laboratory parameters, and microbiological evaulation. Deep infection was diagnosed within a mean period of 5.5 weeks (range, 2-10 weeks). The infecting organism was methicillin-resistant staphylococcus aureus (MRSA) in 5, methicillin-sensitive staphylococcus aureus (MSSA) in 6, pseudomonas auroginosa in 2, and enterobacteriacea in 2 patients. Union achieved in all patients. Mean time to union was 17 (range, 11-38) weeks. Delayed union was observed in 3 patients who required additional surgeries. Of these one patient developed osteomyelitis. The NCP is an effective alternative method in the treatment of deep infection encountered after internal or external fixation for the tibia, or femur fractures. Permalink : ./index.php?lvl=notice_display&id=40929 [article] Management of infectious fractures with “Non-Contact Plate” (NCP) method [texte imprimé] / Celil Alemdir, Auteur ; Ibrahim AZBOY, Auteur ; Ramazan ATIÇ, Auteur . - 2015 . - p.523-529. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.523-529 Mots-clés : Infectious fracture  complication  internal fixation  locking plate  non-contact plate Résumé : The aim of this study was to evaluate the outcomes of internal fixation with Non-Contact Plating (NCP) after deep infection caused by previous surgeries of the tibia or femur fractures. The study included 15 patients (4 female and 11 male). The mean age patients was 36.6 years (range, 21-64 years). There were 6 femur and 9 tibia fractures. The mean followup period was 25.7 months (range, 15-45 months). The study comprised 11 open and 4 closed fractures. External fixator was used in 3, plate in 4, and intramedullary nail in 8 patients for index surgery. Deep infection was diagnosed via clinical findings, laboratory parameters, and microbiological evaulation. Deep infection was diagnosed within a mean period of 5.5 weeks (range, 2-10 weeks). The infecting organism was methicillin-resistant staphylococcus aureus (MRSA) in 5, methicillin-sensitive staphylococcus aureus (MSSA) in 6, pseudomonas auroginosa in 2, and enterobacteriacea in 2 patients. Union achieved in all patients. Mean time to union was 17 (range, 11-38) weeks. Delayed union was observed in 3 patients who required additional surgeries. Of these one patient developed osteomyelitis. The NCP is an effective alternative method in the treatment of deep infection encountered after internal or external fixation for the tibia, or femur fractures. Permalink : ./index.php?lvl=notice_display&id=40929

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Oncological approach with antihelminthic chemotherapy and wide resection in the treatment of musculoskeletal hydatidosis. A review of 10 cases with mean follow-up of 64 months / Bülent EROL in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.530-537 Titre : Oncological approach with antihelminthic chemotherapy and wide resection in the treatment of musculoskeletal hydatidosis. A review of 10 cases with mean follow-up of 64 months Type de document : texte imprimé Auteurs : Bülent EROL, Auteur ; Tolga ONAY, Auteur ; Emrah ÇALISKAN, Auteur Année de publication : 2015 Article en page(s) : p.530-537 Langues : Anglais (eng) Mots-clés : Hydatidosis  muscle  bone  antihelminthic chemotherapy  wide resection Résumé : The objective of this retrospective study was to evaluate clinical outcomes, local recurrence and complication rates of antihelminthic chemotherapy and wide resection in patients with muscle or bone hydatidosis. The authors treated 10 patients (6 females, 4 males) between 2004 and 2012: 8 with muscle and 2 with bone hydatidosis. The mean age at surgery was 42.5 years (range, 11-66 years). All patients were treated with wide resection and pre- and postoperative chemotherapy with albendazole. The mean follow-up was 64 months (range, 28-120 months). All patients achieved satisfactory clinical outcomes. There were no local recurrences. Surgical complications were seen in 3 patients (30%) : one superficial infection, one deep infection, and one hematoma. Two (20%) required additional surgery. An aggressive oncological approach, consisting of antihelminthic chemotherapy and wide resection, can provide favorable clinical outcomes and prevent local recurrence in patients with musculoskeletal hydatidosis. Potential complications of aggressive surgery should be preferred to potential morbidity of local and systemic dissemination. Permalink : ./index.php?lvl=notice_display&id=40930 [article] Oncological approach with antihelminthic chemotherapy and wide resection in the treatment of musculoskeletal hydatidosis. A review of 10 cases with mean follow-up of 64 months [texte imprimé] / Bülent EROL, Auteur ; Tolga ONAY, Auteur ; Emrah ÇALISKAN, Auteur . - 2015 . - p.530-537. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.530-537 Mots-clés : Hydatidosis  muscle  bone  antihelminthic chemotherapy  wide resection Résumé : The objective of this retrospective study was to evaluate clinical outcomes, local recurrence and complication rates of antihelminthic chemotherapy and wide resection in patients with muscle or bone hydatidosis. The authors treated 10 patients (6 females, 4 males) between 2004 and 2012: 8 with muscle and 2 with bone hydatidosis. The mean age at surgery was 42.5 years (range, 11-66 years). All patients were treated with wide resection and pre- and postoperative chemotherapy with albendazole. The mean follow-up was 64 months (range, 28-120 months). All patients achieved satisfactory clinical outcomes. There were no local recurrences. Surgical complications were seen in 3 patients (30%) : one superficial infection, one deep infection, and one hematoma. Two (20%) required additional surgery. An aggressive oncological approach, consisting of antihelminthic chemotherapy and wide resection, can provide favorable clinical outcomes and prevent local recurrence in patients with musculoskeletal hydatidosis. Potential complications of aggressive surgery should be preferred to potential morbidity of local and systemic dissemination. Permalink : ./index.php?lvl=notice_display&id=40930

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Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery / Bin LIN in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.538-545 Titre : Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery Type de document : texte imprimé Auteurs : Bin LIN, Auteur ; Wen-Bin ZHANG, Auteur ; Tao-yi CAI, Auteur Année de publication : 2015 Article en page(s) : p.538-545 Langues : Anglais (eng) Mots-clés : Ankylosing spondylitis  sagittal balance  vertebral column decancellation  spinopelvic parameters Résumé : This study was designed to explore the change of spinopelvic parameters after vertebral column decancellation (VCD) for the management of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). Forty-two AS patients including thirty-six males and six females with thoracolumbar kyphosis, who underwent VCD from April 2005 to June 2012 in our hospital, were retrospectively reviewed. A series of spinopelvic parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA) measured on preoperative and postoperative free-standing radiographs were obtained and analyzed. Also clinical assessments were performed with the Oswestry disability index (ODI) and the Bath Ankylosing Spondylitis Activity and Function Index (BASDAI and BASFI) so as to seek correlations between radiological parameters and symptoms. Except for pelvic incidence (PI), significant difference was found in all radiological spinopelvic parameters between the preoperative and follow-up values. Furthermore, there was significant improvement in the clinical assessment parameters ODI, BASDAI and BASFI, which all correlated significantly with the postoperative pelvic tilt (PT). The results of this study show that posterior VCD is an effective option to manage sagittal imbalance in AS. In the current series, patients improving LL and PT were found to achieve good clinical outcomes. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance in the surgery for AS. Permalink : ./index.php?lvl=notice_display&id=40931 [article] Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery [texte imprimé] / Bin LIN, Auteur ; Wen-Bin ZHANG, Auteur ; Tao-yi CAI, Auteur . - 2015 . - p.538-545. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.538-545 Mots-clés : Ankylosing spondylitis  sagittal balance  vertebral column decancellation  spinopelvic parameters Résumé : This study was designed to explore the change of spinopelvic parameters after vertebral column decancellation (VCD) for the management of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). Forty-two AS patients including thirty-six males and six females with thoracolumbar kyphosis, who underwent VCD from April 2005 to June 2012 in our hospital, were retrospectively reviewed. A series of spinopelvic parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA) measured on preoperative and postoperative free-standing radiographs were obtained and analyzed. Also clinical assessments were performed with the Oswestry disability index (ODI) and the Bath Ankylosing Spondylitis Activity and Function Index (BASDAI and BASFI) so as to seek correlations between radiological parameters and symptoms. Except for pelvic incidence (PI), significant difference was found in all radiological spinopelvic parameters between the preoperative and follow-up values. Furthermore, there was significant improvement in the clinical assessment parameters ODI, BASDAI and BASFI, which all correlated significantly with the postoperative pelvic tilt (PT). The results of this study show that posterior VCD is an effective option to manage sagittal imbalance in AS. In the current series, patients improving LL and PT were found to achieve good clinical outcomes. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance in the surgery for AS. Permalink : ./index.php?lvl=notice_display&id=40931

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Long-term follow-up of the anterior lumbar interbody fusion procedure / Dimitri Verbruggen in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.546-552 Titre : Long-term follow-up of the anterior lumbar interbody fusion procedure Type de document : texte imprimé Auteurs : Dimitri Verbruggen, Auteur ; Thomas TAMPERE, Auteur ; Dirk UYTTENDAELE, Auteur Année de publication : 2015 Article en page(s) : p.546-552 Langues : Anglais (eng) Mots-clés : Spine  lumbar spine  interbody fusion  outcome  low back pain Résumé : Purpose: To evaluate the long-term clinical results and the effectiveness of the anterior lumbar interbody fusion procedure. Methods: Between 1999 and 2005, 60 ALIFs were performed in 59 patients. Mean age was 41.1 years. Clinically, patients were evaluated at a mean followup of 9.5 years using the Visual Analogue Scale grading scale, the Oswestry Disability score and the SF-36 questionnaire. Results: Preoperative and postoperative clinical evaluation scores of 38 patients were available. Nineteen patients were lost to follow-up, and 2 patients died during the follow-up. The fusion rate was 84%. Mean preoperative VAS-score for back pain was 6.69 (± 2.15); in the long term, the mean VAS-score was 4.95 (± 2.95), which was a significant improvement. (p < 0.01). The postoperative ODI-score was 36.11 (± 22.32), while the preoperative ODI-score was 59.31 (± 17.16), which demonstrates a significant improvement. According to the SF-36, mild to good results were observed. Conclusions: The ALIF procedure can offer significant pain relief and improved function if a strict indication policy is followed. Permalink : ./index.php?lvl=notice_display&id=40932 [article] Long-term follow-up of the anterior lumbar interbody fusion procedure [texte imprimé] / Dimitri Verbruggen, Auteur ; Thomas TAMPERE, Auteur ; Dirk UYTTENDAELE, Auteur . - 2015 . - p.546-552. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.546-552 Mots-clés : Spine  lumbar spine  interbody fusion  outcome  low back pain Résumé : Purpose: To evaluate the long-term clinical results and the effectiveness of the anterior lumbar interbody fusion procedure. Methods: Between 1999 and 2005, 60 ALIFs were performed in 59 patients. Mean age was 41.1 years. Clinically, patients were evaluated at a mean followup of 9.5 years using the Visual Analogue Scale grading scale, the Oswestry Disability score and the SF-36 questionnaire. Results: Preoperative and postoperative clinical evaluation scores of 38 patients were available. Nineteen patients were lost to follow-up, and 2 patients died during the follow-up. The fusion rate was 84%. Mean preoperative VAS-score for back pain was 6.69 (± 2.15); in the long term, the mean VAS-score was 4.95 (± 2.95), which was a significant improvement. (p < 0.01). The postoperative ODI-score was 36.11 (± 22.32), while the preoperative ODI-score was 59.31 (± 17.16), which demonstrates a significant improvement. According to the SF-36, mild to good results were observed. Conclusions: The ALIF procedure can offer significant pain relief and improved function if a strict indication policy is followed. Permalink : ./index.php?lvl=notice_display&id=40932

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Neglected Achilles Tendon Rupture Treated with Flexor Hallucis Longus transfer with two turndown gastrocnemius fascia flap and reinforced with plantaris tendon / Haijiao MAO in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.553-560 Titre : Neglected Achilles Tendon Rupture Treated with Flexor Hallucis Longus transfer with two turndown gastrocnemius fascia flap and reinforced with plantaris tendon Type de document : texte imprimé Auteurs : Haijiao MAO, Auteur ; Zengyuan SHI, Auteur ; Dachuan XU, Auteur Année de publication : 2015 Article en page(s) : p.553-560 Langues : Anglais (eng) Mots-clés : Foot  ankle  achilles tenson  surgery  tendon transfer Résumé : Neglected Achilles Tendon Ruptures are commonly seen by orthopaedic surgeons. In cases resistant to conservative treatment, a variety of surgical procedures have been utilized in the past. The senior surgeon at our institution has utilized a technique ­employing two turndown fascia flaps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus and plantaris tendon. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure. The medical records of 10 cases that underwent this procedure were retrospectively reviewed. We completed data collection sets using the American Orthopaedic Foot and Ankle Society ankle-hind foot scores, isokinetic evaluation, and postoperative magnetic resonance imaging (MRI) at 1 year of follow-up. The mean American Orthopaedic Foot and Ankle Society ankle-hind foot scores improved from 64.4 ± 3.54. Isokinetic testing at 30º/sec and 120º/sec revealed an mean deficits of 24.5%, respectively, in the plantar flexion peak torque of the involved ankle than noninvolved ankle. The flexor hallucis longus tendon, gastrocnemius fascia flap and plantaris were well integrated into the Achilles tendon forming a homogenous tendon, which was confirmed in MRI. Our subjective and objective data indicate that the reconstructive technique using flexor hallucis longus transfer with two turndown gastrocnemius fascia flaps and plantaris tendon is a good option for repairing large gap defect of Achilles tendon. Permalink : ./index.php?lvl=notice_display&id=40933 [article] Neglected Achilles Tendon Rupture Treated with Flexor Hallucis Longus transfer with two turndown gastrocnemius fascia flap and reinforced with plantaris tendon [texte imprimé] / Haijiao MAO, Auteur ; Zengyuan SHI, Auteur ; Dachuan XU, Auteur . - 2015 . - p.553-560. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.553-560 Mots-clés : Foot  ankle  achilles tenson  surgery  tendon transfer Résumé : Neglected Achilles Tendon Ruptures are commonly seen by orthopaedic surgeons. In cases resistant to conservative treatment, a variety of surgical procedures have been utilized in the past. The senior surgeon at our institution has utilized a technique ­employing two turndown fascia flaps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus and plantaris tendon. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure. The medical records of 10 cases that underwent this procedure were retrospectively reviewed. We completed data collection sets using the American Orthopaedic Foot and Ankle Society ankle-hind foot scores, isokinetic evaluation, and postoperative magnetic resonance imaging (MRI) at 1 year of follow-up. The mean American Orthopaedic Foot and Ankle Society ankle-hind foot scores improved from 64.4 ± 3.54. Isokinetic testing at 30º/sec and 120º/sec revealed an mean deficits of 24.5%, respectively, in the plantar flexion peak torque of the involved ankle than noninvolved ankle. The flexor hallucis longus tendon, gastrocnemius fascia flap and plantaris were well integrated into the Achilles tendon forming a homogenous tendon, which was confirmed in MRI. Our subjective and objective data indicate that the reconstructive technique using flexor hallucis longus transfer with two turndown gastrocnemius fascia flaps and plantaris tendon is a good option for repairing large gap defect of Achilles tendon. Permalink : ./index.php?lvl=notice_display&id=40933

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