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Current status of anti-inflammatory therapy for posttraumatic osteoarthritis / Hagen Schmal in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 427-439 Titre : Current status of anti-inflammatory therapy for posttraumatic osteoarthritis Type de document : texte imprimé Auteurs : Hagen Schmal ; Ivan Marintschev ; Gian M. Salzmann Année de publication : 2016 Article en page(s) : p. 427-439 Langues : Anglais (eng) Mots-clés : revue systématique  anti inflammatoire  thérapeutique  arthrite  post traumatique Résumé : Although there is ample evidence that intra-articular injuries are associated with the up-regulation of proinflammatory cytokines, the success of anti-inflammatory, disease-modifying treatments to prevent posttraumatic osteoarthritis (PTOA) remain uncertain. To summarize the current status of anti-inflammatory therapy for PTOA, we conducted a systematic review. 9 clinical studies in humans were identified applying anti-inflammatory agents to prevent or treat PTOA. A total of 347 patients aged an average 41 ± 14 years were included in this review. 5 studies had comparable designs with randomized allocation. Those studies of course had a statistically significant higher Coleman Methodology Score (65 ± 6) than the case-control studies (39 ± 13, p = 0.013). The most frequently reported main outcome parameter was pain assessed by different scales (n = 7), the most examined joint the knee (n = 7). The majority of the analyses (n = 6) focused on the intra-articular (IA) application of hyaluronic acid (HA) reporting mainly positive effects. One study stated positive results following IA administration of Interleukin 1 receptor antagonist in patients presenting rupture of the anterior cruciate ligament. Platelet-rich plasma was also used to relieve symptoms following acute injury, but the study quality was too low to conclude any effects. Although the initial data, especially regarding IA HA injection, are encouraging, study designs differ substantially. Therefore, current data does not allow us to conclude that anti-inflammatory therapy following acute injuries has beneficial effects on short- or longterm outcomes. Permalink : ./index.php?lvl=notice_display&id=47169 [article] Current status of anti-inflammatory therapy for posttraumatic osteoarthritis [texte imprimé] / Hagen Schmal ; Ivan Marintschev ; Gian M. Salzmann . - 2016 . - p. 427-439. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 427-439 Mots-clés : revue systématique  anti inflammatoire  thérapeutique  arthrite  post traumatique Résumé : Although there is ample evidence that intra-articular injuries are associated with the up-regulation of proinflammatory cytokines, the success of anti-inflammatory, disease-modifying treatments to prevent posttraumatic osteoarthritis (PTOA) remain uncertain. To summarize the current status of anti-inflammatory therapy for PTOA, we conducted a systematic review. 9 clinical studies in humans were identified applying anti-inflammatory agents to prevent or treat PTOA. A total of 347 patients aged an average 41 ± 14 years were included in this review. 5 studies had comparable designs with randomized allocation. Those studies of course had a statistically significant higher Coleman Methodology Score (65 ± 6) than the case-control studies (39 ± 13, p = 0.013). The most frequently reported main outcome parameter was pain assessed by different scales (n = 7), the most examined joint the knee (n = 7). The majority of the analyses (n = 6) focused on the intra-articular (IA) application of hyaluronic acid (HA) reporting mainly positive effects. One study stated positive results following IA administration of Interleukin 1 receptor antagonist in patients presenting rupture of the anterior cruciate ligament. Platelet-rich plasma was also used to relieve symptoms following acute injury, but the study quality was too low to conclude any effects. Although the initial data, especially regarding IA HA injection, are encouraging, study designs differ substantially. Therefore, current data does not allow us to conclude that anti-inflammatory therapy following acute injuries has beneficial effects on short- or longterm outcomes. Permalink : ./index.php?lvl=notice_display&id=47169

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A retrospective review of 345 patients with lumbar TDR in two years follow-up over 10 years of practice in one Belgian clinical center : Results / Julie Bastien in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 440-455 Titre : A retrospective review of 345 patients with lumbar TDR in two years follow-up over 10 years of practice in one Belgian clinical center : Results Type de document : texte imprimé Auteurs : Julie Bastien ; Yves Lecomte ; Serge Willems Année de publication : 2016 Article en page(s) : p. 440-455 Langues : Anglais (eng) Mots-clés : lombalgie  remplacement total de disque vertébral  prothèse de disque Résumé : Low back pain is one of the most common symptom with high cost for the public health. When conservative treatment fails, patients are heading to surgical treatment. Instead of lumbar arthrodesis, we can offer an alternative that will keep the intervertebral mobility : Total disc replacement (TDR) by prosthesis. Many studies have published good results rate over 80%, since first implantation in 1984. Believing in keeping the mobility, we promote TDR since 2002. This retrospective study review 345 patients with two years follow-up. The outcomes show 81% of good and really good results, according to gain of improvement on VAS and ODI scores. We report 6.88% of complications for the abdominal approach and 4.57% for the device, without harmful complication. Same results are obtained in case of postdiscectomy syndrome. Permalink : ./index.php?lvl=notice_display&id=47170 [article] A retrospective review of 345 patients with lumbar TDR in two years follow-up over 10 years of practice in one Belgian clinical center : Results [texte imprimé] / Julie Bastien ; Yves Lecomte ; Serge Willems . - 2016 . - p. 440-455. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 440-455 Mots-clés : lombalgie  remplacement total de disque vertébral  prothèse de disque Résumé : Low back pain is one of the most common symptom with high cost for the public health. When conservative treatment fails, patients are heading to surgical treatment. Instead of lumbar arthrodesis, we can offer an alternative that will keep the intervertebral mobility : Total disc replacement (TDR) by prosthesis. Many studies have published good results rate over 80%, since first implantation in 1984. Believing in keeping the mobility, we promote TDR since 2002. This retrospective study review 345 patients with two years follow-up. The outcomes show 81% of good and really good results, according to gain of improvement on VAS and ODI scores. We report 6.88% of complications for the abdominal approach and 4.57% for the device, without harmful complication. Same results are obtained in case of postdiscectomy syndrome. Permalink : ./index.php?lvl=notice_display&id=47170

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Physicians versus surgeons. A pilot study on hand dexterity within a controlled population / Sergio Figueiredo in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 456-461 Titre : Physicians versus surgeons. A pilot study on hand dexterity within a controlled population Type de document : texte imprimé Auteurs : Sergio Figueiredo ; Luis Machado ; Ana Daniela Pereira Lousada ; [et al...] Année de publication : 2016 Article en page(s) : p. 456-461 Langues : Anglais (eng) Mots-clés : dextérité manuelle  chirurgien Résumé : Introduction : Hand dexterity is defined as the innate or acquired capacity of performing any given procedure with one’s hands. This study seeks the role of regular hand training on hand dexterity over time. Materials and Methods : Pilot study composed by two independent groups with 28 subjects each (surgeons and physicians), stratified according to gender and age. Measurement of hand dexterity using Lafayette’s Purdue Pegboard through the sum of the first three exercises as well as the assembly exercise. No difference was found between groups in regards of gender, age, time of practice and hand size (p = 0.415 ; p = 0.225 ; p = 0.267 ; p = 0.937). Statistical significance was assumed when p < 0.050. Results : Surgeons performed better but a statistically significant difference was not observed both on the assembly score (p = 0.560) and three tests sum score (p = 0.244). The decay of dexterity over time happened in a homogeneous fashion in the surgeons’ arm (p < 0.001 and p = 0.043) but not in the physicians’ arm (p = 0.157 and p = 0.098). Discussion : Surgeons seem to perform better than physicians in regards of hand dexterity, although no definitive conclusion was possible given our small sample. It is well known that aging worsens hand dexterity, but our study suggests it happens much more homogeneously within surgeons. Permalink : ./index.php?lvl=notice_display&id=47171 [article] Physicians versus surgeons. A pilot study on hand dexterity within a controlled population [texte imprimé] / Sergio Figueiredo ; Luis Machado ; Ana Daniela Pereira Lousada ; [et al...] . - 2016 . - p. 456-461. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 456-461 Mots-clés : dextérité manuelle  chirurgien Résumé : Introduction : Hand dexterity is defined as the innate or acquired capacity of performing any given procedure with one’s hands. This study seeks the role of regular hand training on hand dexterity over time. Materials and Methods : Pilot study composed by two independent groups with 28 subjects each (surgeons and physicians), stratified according to gender and age. Measurement of hand dexterity using Lafayette’s Purdue Pegboard through the sum of the first three exercises as well as the assembly exercise. No difference was found between groups in regards of gender, age, time of practice and hand size (p = 0.415 ; p = 0.225 ; p = 0.267 ; p = 0.937). Statistical significance was assumed when p < 0.050. Results : Surgeons performed better but a statistically significant difference was not observed both on the assembly score (p = 0.560) and three tests sum score (p = 0.244). The decay of dexterity over time happened in a homogeneous fashion in the surgeons’ arm (p < 0.001 and p = 0.043) but not in the physicians’ arm (p = 0.157 and p = 0.098). Discussion : Surgeons seem to perform better than physicians in regards of hand dexterity, although no definitive conclusion was possible given our small sample. It is well known that aging worsens hand dexterity, but our study suggests it happens much more homogeneously within surgeons. Permalink : ./index.php?lvl=notice_display&id=47171

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Management of osteoporotic compression vertebral fractures / Tameem Elkhateeb in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 462-466 Titre : Management of osteoporotic compression vertebral fractures Type de document : texte imprimé Auteurs : Tameem Elkhateeb ; Mohammed Zayan Année de publication : 2016 Article en page(s) : p. 462-466 Langues : Anglais (eng) Mots-clés : fracture  ostéoporose  vertèbre Résumé : Pathological vertebral fractures including osteoporotic compression fractures are common problems with an incidence which increases as the age of the population increases. The aim of this study is to evaluate the clinical outcome of percutaneous vertebroplasty in patients with refractory pathological fractures. It is a clinical prospective study conducted on 56 patients. The patients were assessed pre- and postoperatively with (VAS) with a 0 to 10 scaling. Local anesthesia was used in 51 patients and general anesthesia was used in 5 patients. Biplanar fluoroscopy was used. Unipedicular approach was used. 87.5% of patients experienced partial or complete pain relief within the first 24 hours after the procedure. The mean preoperative VAS was 8.4 ± 1.6, which improved to 2.5 ± 0.3 at four weeks after surgery. This mini-invasive procedure can immediately and significantly reduce pain and improve the quality of life of these patients. Permalink : ./index.php?lvl=notice_display&id=47172 [article] Management of osteoporotic compression vertebral fractures [texte imprimé] / Tameem Elkhateeb ; Mohammed Zayan . - 2016 . - p. 462-466. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 462-466 Mots-clés : fracture  ostéoporose  vertèbre Résumé : Pathological vertebral fractures including osteoporotic compression fractures are common problems with an incidence which increases as the age of the population increases. The aim of this study is to evaluate the clinical outcome of percutaneous vertebroplasty in patients with refractory pathological fractures. It is a clinical prospective study conducted on 56 patients. The patients were assessed pre- and postoperatively with (VAS) with a 0 to 10 scaling. Local anesthesia was used in 51 patients and general anesthesia was used in 5 patients. Biplanar fluoroscopy was used. Unipedicular approach was used. 87.5% of patients experienced partial or complete pain relief within the first 24 hours after the procedure. The mean preoperative VAS was 8.4 ± 1.6, which improved to 2.5 ± 0.3 at four weeks after surgery. This mini-invasive procedure can immediately and significantly reduce pain and improve the quality of life of these patients. Permalink : ./index.php?lvl=notice_display&id=47172

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Paraspinal muscle volume in patients with Scheuermann’s Kyphosis / Radek Kaiser in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 467-473 Titre : Paraspinal muscle volume in patients with Scheuermann’s Kyphosis Type de document : texte imprimé Auteurs : Radek Kaiser ; Eyal Behrbalk ; Petr Waldauf ; [et al...] Année de publication : 2016 Article en page(s) : p. 467-473 Langues : Anglais (eng) Mots-clés : maladie de Scheuermann  muscles paraspinaux  psoas Résumé : To measure the cross-sectional area (CSA) of paraspinal muscles in Scheuermann’s kyphosis patients. Preoperative MRI images of 16 Scheuermann’s kyphosis patients were analysed and compared to 16 patients with normal MRI images (control group). The CSAs were measured at L3-4 and L4-5. Both groups showed similar demographics and patient characteristics. The multifidus muscles CSA were found to be significantly smaller at L3/4 level in Scheuermann’s kyphosis patients (p = 0.022 on the left and p = 0.016 on the right side compared to control group). There was no significant change in multifidus CSA found at L4/5. The mean CSA of the extensor spinae muscles group were significantly smaller at all levels in Scheuermann’s kyphosis patients : p = 0.001 bilaterally at L3/4 and p = 0.015 right side and p = 0.009 left side at L4/5 level. This study shows that patients with Scheuermann’s kyphosis deformity have significantly smaller CSA of lumbar multifidus and extensor spinae muscles. Permalink : ./index.php?lvl=notice_display&id=47173 [article] Paraspinal muscle volume in patients with Scheuermann’s Kyphosis [texte imprimé] / Radek Kaiser ; Eyal Behrbalk ; Petr Waldauf ; [et al...] . - 2016 . - p. 467-473. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 467-473 Mots-clés : maladie de Scheuermann  muscles paraspinaux  psoas Résumé : To measure the cross-sectional area (CSA) of paraspinal muscles in Scheuermann’s kyphosis patients. Preoperative MRI images of 16 Scheuermann’s kyphosis patients were analysed and compared to 16 patients with normal MRI images (control group). The CSAs were measured at L3-4 and L4-5. Both groups showed similar demographics and patient characteristics. The multifidus muscles CSA were found to be significantly smaller at L3/4 level in Scheuermann’s kyphosis patients (p = 0.022 on the left and p = 0.016 on the right side compared to control group). There was no significant change in multifidus CSA found at L4/5. The mean CSA of the extensor spinae muscles group were significantly smaller at all levels in Scheuermann’s kyphosis patients : p = 0.001 bilaterally at L3/4 and p = 0.015 right side and p = 0.009 left side at L4/5 level. This study shows that patients with Scheuermann’s kyphosis deformity have significantly smaller CSA of lumbar multifidus and extensor spinae muscles. Permalink : ./index.php?lvl=notice_display&id=47173

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Aneurysmal bone cyst (ABC) : treatment options and proposal of a follow-up regime / Olivier Hauschild in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 474-483 Titre : Aneurysmal bone cyst (ABC) : treatment options and proposal of a follow-up regime Type de document : texte imprimé Auteurs : Olivier Hauschild ; Martin Lüdemann ; Monika Engelhardt ; [et al...] Année de publication : 2016 Article en page(s) : p. 474-483 Langues : Anglais (eng) Mots-clés : Kystes osseux anévrismaux Résumé : The aim of this study was to describe treatment options and develop a follow-up regime for the aneurysmal bone cyst, a neoplastic bone lesion with a noticeable recurrence rate. Reports of 28 patients and a mean follow-up of 42.2 months treated multidisciplinary were analysed. Data were complemented by a literature review including 790 patients. Patient age was from seven to 57 years, in line with the literature (1-69 years). Lesions most frequently affect long bones, spine and pelvis ; pain is the most common symptom. Treatment modalities vary, recurrences occurred in 26.1% in our series, rates ranged from 0-60% in the literature, with the vast majority within 2 years. With regard to the findings we propose, irrespective of treatment, a follow-up regime including clinical survey and imaging, best with MRI, at 3 months, 6 months and at half-yearly intervals within the first two and yearly within the third to fifth year. Permalink : ./index.php?lvl=notice_display&id=47174 [article] Aneurysmal bone cyst (ABC) : treatment options and proposal of a follow-up regime [texte imprimé] / Olivier Hauschild ; Martin Lüdemann ; Monika Engelhardt ; [et al...] . - 2016 . - p. 474-483. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 474-483 Mots-clés : Kystes osseux anévrismaux Résumé : The aim of this study was to describe treatment options and develop a follow-up regime for the aneurysmal bone cyst, a neoplastic bone lesion with a noticeable recurrence rate. Reports of 28 patients and a mean follow-up of 42.2 months treated multidisciplinary were analysed. Data were complemented by a literature review including 790 patients. Patient age was from seven to 57 years, in line with the literature (1-69 years). Lesions most frequently affect long bones, spine and pelvis ; pain is the most common symptom. Treatment modalities vary, recurrences occurred in 26.1% in our series, rates ranged from 0-60% in the literature, with the vast majority within 2 years. With regard to the findings we propose, irrespective of treatment, a follow-up regime including clinical survey and imaging, best with MRI, at 3 months, 6 months and at half-yearly intervals within the first two and yearly within the third to fifth year. Permalink : ./index.php?lvl=notice_display&id=47174

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Comparison between single stage and two stage bilateral total hip replacementour results and review of literature / Saurabh Agarwal in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 484-490 Titre : Comparison between single stage and two stage bilateral total hip replacementour results and review of literature Type de document : texte imprimé Auteurs : Saurabh Agarwal ; Gaurav Gupta ; Rajeev K. Sharma Année de publication : 2016 Article en page(s) : p. 484-490 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche  arthroplastie  complication Résumé : Bilateral total hip replacement (THR) is a common procedure nowdays. Staging of surgery is still a matter of debate. We performed a study to compare single stage and two stage bilateral THR and discuss the peri-operative and post-operative advantages and complications. This was a retrospective study. 48 patients underwent single stage and 56 patients underwent two stage bilateral THR. The average follow up period was 64 months and 70 months respectively. The hospital stay was 5.6 days in single stage and 9.0 days in two stage bilateral THR. The total blood loss was 280 ml and 440 ml ; average blood transfusion was 1.6 units and 2.2 units and walk without support was started at 42 days and 58 days respectively. No difference in complication rate was seen. Single staged bilateral THR is a safe procedure. The definite benefits are short hospital stay, lower cost and early rehabilitation. Permalink : ./index.php?lvl=notice_display&id=47175 [article] Comparison between single stage and two stage bilateral total hip replacementour results and review of literature [texte imprimé] / Saurabh Agarwal ; Gaurav Gupta ; Rajeev K. Sharma . - 2016 . - p. 484-490. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 484-490 Mots-clés : prothèse totale de hanche  arthroplastie  complication Résumé : Bilateral total hip replacement (THR) is a common procedure nowdays. Staging of surgery is still a matter of debate. We performed a study to compare single stage and two stage bilateral THR and discuss the peri-operative and post-operative advantages and complications. This was a retrospective study. 48 patients underwent single stage and 56 patients underwent two stage bilateral THR. The average follow up period was 64 months and 70 months respectively. The hospital stay was 5.6 days in single stage and 9.0 days in two stage bilateral THR. The total blood loss was 280 ml and 440 ml ; average blood transfusion was 1.6 units and 2.2 units and walk without support was started at 42 days and 58 days respectively. No difference in complication rate was seen. Single staged bilateral THR is a safe procedure. The definite benefits are short hospital stay, lower cost and early rehabilitation. Permalink : ./index.php?lvl=notice_display&id=47175

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Early clinical failure of the ACCIS metal on metal hip arthroplasty system – A metal on metal hip with a difference / Peter Jemmett in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 491-496 Titre : Early clinical failure of the ACCIS metal on metal hip arthroplasty system – A metal on metal hip with a difference Type de document : texte imprimé Auteurs : Peter Jemmett ; Dan Parfitt ; Robin Rice Année de publication : 2016 Article en page(s) : p. 491-496 Langues : Anglais (eng) Mots-clés : arthroplastie  hanche  défaillance Résumé : The ACCIS hip system has been marketed with a unique bearing surface which the manufacturers claim to reduce wear below the level of other MoM bearings and consequently less metal ion release. The cobalt-chrome-molybdenum alloy is heat treated to reduce the number and size of block carbides and the surface is modified with titanium-niobium-nitride to create a ceramic-like surface. We present our experience with ACCIS. 148 surgical procedures were carried out in 126 patients using the ACCIS hip resurfacing (77) or large head MOM total hip replacement(71). Patients were followed up with regular clinical and radiological assessment. In addition, metal ion levels were obtained. There have been 27 revision procedures carried out for a variety of indications with a current revision rate of 18%. Seven failures could not be attributed to the prosthesis itself, still leaving a failure rate of 13.5%. The mean survival time of these is 33 months, ranging from 1 to 72 months. 13 revisions were performed for pain and revision demonstrated poor cup integration. 7 were revised because of high ion levels but this was patient choice despite remaining asymptomatic. Whilst the testing phases indicated benefits in wear characteristics, this is not apparent in our group. We have demonstrated an unacceptably high revision rate due to unknown causes and have ceased implanting the ACCIS. Permalink : ./index.php?lvl=notice_display&id=47176 [article] Early clinical failure of the ACCIS metal on metal hip arthroplasty system – A metal on metal hip with a difference [texte imprimé] / Peter Jemmett ; Dan Parfitt ; Robin Rice . - 2016 . - p. 491-496. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 491-496 Mots-clés : arthroplastie  hanche  défaillance Résumé : The ACCIS hip system has been marketed with a unique bearing surface which the manufacturers claim to reduce wear below the level of other MoM bearings and consequently less metal ion release. The cobalt-chrome-molybdenum alloy is heat treated to reduce the number and size of block carbides and the surface is modified with titanium-niobium-nitride to create a ceramic-like surface. We present our experience with ACCIS. 148 surgical procedures were carried out in 126 patients using the ACCIS hip resurfacing (77) or large head MOM total hip replacement(71). Patients were followed up with regular clinical and radiological assessment. In addition, metal ion levels were obtained. There have been 27 revision procedures carried out for a variety of indications with a current revision rate of 18%. Seven failures could not be attributed to the prosthesis itself, still leaving a failure rate of 13.5%. The mean survival time of these is 33 months, ranging from 1 to 72 months. 13 revisions were performed for pain and revision demonstrated poor cup integration. 7 were revised because of high ion levels but this was patient choice despite remaining asymptomatic. Whilst the testing phases indicated benefits in wear characteristics, this is not apparent in our group. We have demonstrated an unacceptably high revision rate due to unknown causes and have ceased implanting the ACCIS. Permalink : ./index.php?lvl=notice_display&id=47176

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Simultaneous versus staged bilateral direct anterior Total Hip Arthroplasty: Are early patient-centered outcomes equivalent? / Atul F. Kamath in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 497-508 Titre : Simultaneous versus staged bilateral direct anterior Total Hip Arthroplasty: Are early patient-centered outcomes equivalent? Type de document : texte imprimé Auteurs : Atul F. Kamath ; Eurico L. Monteiro ; André Spranger ; [et al...] Année de publication : 2016 Article en page(s) : p. 497-508 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche Résumé : While accumulating data on the direct anterior approach to total hip arthroplasty (THA) have demonstrated clinical benefit and durable results, there is little data that exists on patient-centered outcomes and satisfaction when comparing simultaneous bilateral procedures with staged arthroplasty. The aim of this study was to determine whether simultaneous bilateral THA and staged arthroplasty result in equivalent early (1) patient-centered outcomes and patient satisfaction; while maintaining acceptable rates of (2) objective clinical outcome scores, (2) complication rates; and (3) radiographic results. In retrospective review, 41 patients who underwent bilateral one-stage THA were compared to 44 patients who underwent staged bilateral THA during the same time period. The minimum clinical follow up was two years. Generic (EQ-VAS and EuroQoL- 5D index) and condition-specific (Oxford Hip Score) instruments were used to assess patient-reported outcomes. Other variables included length of hospital stay (LOS), operative and anesthetic times, blood loss, intra- and post-operative (local and systemic) complications, and radiographic analysis. No significant differences between the two groups were found for patient-reported outcomes, complications, or radiographic assessment. The simultaneous THA group had shorter LOS and operative and anesthetic times, as well as less blood loss. Simultaneous and staged bilateral THA using the direct anterior approach offer equivalent short-term patient-reported outcomes, with acceptable safety and efficacy profiles. Simultaneous arthroplasty may offer superior benefit with respect to length of stay, operative time, and blood loss. These results may inform the patient-surgeon discussion regarding simultaneous versus staged THA. Permalink : ./index.php?lvl=notice_display&id=47177 [article] Simultaneous versus staged bilateral direct anterior Total Hip Arthroplasty: Are early patient-centered outcomes equivalent? [texte imprimé] / Atul F. Kamath ; Eurico L. Monteiro ; André Spranger ; [et al...] . - 2016 . - p. 497-508. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 497-508 Mots-clés : prothèse totale de hanche Résumé : While accumulating data on the direct anterior approach to total hip arthroplasty (THA) have demonstrated clinical benefit and durable results, there is little data that exists on patient-centered outcomes and satisfaction when comparing simultaneous bilateral procedures with staged arthroplasty. The aim of this study was to determine whether simultaneous bilateral THA and staged arthroplasty result in equivalent early (1) patient-centered outcomes and patient satisfaction; while maintaining acceptable rates of (2) objective clinical outcome scores, (2) complication rates; and (3) radiographic results. In retrospective review, 41 patients who underwent bilateral one-stage THA were compared to 44 patients who underwent staged bilateral THA during the same time period. The minimum clinical follow up was two years. Generic (EQ-VAS and EuroQoL- 5D index) and condition-specific (Oxford Hip Score) instruments were used to assess patient-reported outcomes. Other variables included length of hospital stay (LOS), operative and anesthetic times, blood loss, intra- and post-operative (local and systemic) complications, and radiographic analysis. No significant differences between the two groups were found for patient-reported outcomes, complications, or radiographic assessment. The simultaneous THA group had shorter LOS and operative and anesthetic times, as well as less blood loss. Simultaneous and staged bilateral THA using the direct anterior approach offer equivalent short-term patient-reported outcomes, with acceptable safety and efficacy profiles. Simultaneous arthroplasty may offer superior benefit with respect to length of stay, operative time, and blood loss. These results may inform the patient-surgeon discussion regarding simultaneous versus staged THA. Permalink : ./index.php?lvl=notice_display&id=47177

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The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study / Umut Hatay Gölge in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 508-515 Titre : The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study Type de document : texte imprimé Auteurs : Umut Hatay Gölge ; Özhan Pazarci ; Seyran Kilinç ; [et al...] Année de publication : 2016 Article en page(s) : p. 508-515 Langues : Anglais (eng) Mots-clés : Fractures de la hanche  mortalité  chirurgie Résumé : Intertrochanteric fractures in elderly patients can increase mortality due to complications and negative functional results. The aim of this study is to retrospectively compare the follow-up and mortality rates among patients given a proximal femoral nail (PFN), the current routine treatment for these types of fractures, with those given hemiarthroplasty.The study retrospectively investigated 202 patients over the age of 60 who completed at least 3 years of follow-up after hemiarthroplasty or PFN for intertrochanteric fractures between 2007 and 2012. While 132 patients underwent cemented hemiarthroplasty, 70 had PFN. The monitoring duration for those with PFN surgery was 31.25±1.3 months while the duration of follow-up for those with hemiarthroplasty surgery was 20.0±1.2 months. At the end of 3 years of monitoring of the 202 patients, 99 were deceased. There was a statistically significant difference found in terms of patient life expectancy between those with PFN and those with hemiarthroplasty; Cox regression analysis identified that the mortality rate of those with hemiarthroplasty was 5.1 times greater.As a result, patients undergoing hemiarthroplasty should be carefully chosen and if possible, PFN should be preferred. Permalink : ./index.php?lvl=notice_display&id=47178 [article] The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study [texte imprimé] / Umut Hatay Gölge ; Özhan Pazarci ; Seyran Kilinç ; [et al...] . - 2016 . - p. 508-515. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 508-515 Mots-clés : Fractures de la hanche  mortalité  chirurgie Résumé : Intertrochanteric fractures in elderly patients can increase mortality due to complications and negative functional results. The aim of this study is to retrospectively compare the follow-up and mortality rates among patients given a proximal femoral nail (PFN), the current routine treatment for these types of fractures, with those given hemiarthroplasty.The study retrospectively investigated 202 patients over the age of 60 who completed at least 3 years of follow-up after hemiarthroplasty or PFN for intertrochanteric fractures between 2007 and 2012. While 132 patients underwent cemented hemiarthroplasty, 70 had PFN. The monitoring duration for those with PFN surgery was 31.25±1.3 months while the duration of follow-up for those with hemiarthroplasty surgery was 20.0±1.2 months. At the end of 3 years of monitoring of the 202 patients, 99 were deceased. There was a statistically significant difference found in terms of patient life expectancy between those with PFN and those with hemiarthroplasty; Cox regression analysis identified that the mortality rate of those with hemiarthroplasty was 5.1 times greater.As a result, patients undergoing hemiarthroplasty should be carefully chosen and if possible, PFN should be preferred. Permalink : ./index.php?lvl=notice_display&id=47178

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Are there differences in Hip Biomechanics after hybrid and cementless resurfacing arthroplasty? / Michel J. Le Duff in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 516-521 Titre : Are there differences in Hip Biomechanics after hybrid and cementless resurfacing arthroplasty? Type de document : texte imprimé Auteurs : Michel J. Le Duff ; Sandeep K. Bhaurla ; Kohtaroh B. Takamura ; Harlan Amstutz (C.) Année de publication : 2016 Article en page(s) : p. 516-521 Langues : Anglais (eng) Mots-clés : arthroplastie  hanche Résumé : There is a paucity of information regarding the clinical performance of the fully cementless metalon-metal hip resurfacing designs. We compared the biomechanical reconstruction between the two hips of a group of patients treated with a hybrid resurfacing design on one side and a new, fully cementless version of the same resurfacing design on the other side. We retrospectively identified 20 patients with a hybrid hip resurfacing on one side and a fully cementless device on the contralateral side. The cemented femoral components were implanted with a target angle stem to shaft angle of 140° while the cementless femoral components were implanted with the aim to replicate the natural neck to shaft angle. No significant differences were observed postoperatively in femoral offset or leg length despite implantation with a larger metaphyseal stem to femoral shaft angle in the hybrid group. Both hybrid and cementless designs provide similar biomechanical reconstructions. Permalink : ./index.php?lvl=notice_display&id=47179 [article] Are there differences in Hip Biomechanics after hybrid and cementless resurfacing arthroplasty? [texte imprimé] / Michel J. Le Duff ; Sandeep K. Bhaurla ; Kohtaroh B. Takamura ; Harlan Amstutz (C.) . - 2016 . - p. 516-521. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 516-521 Mots-clés : arthroplastie  hanche Résumé : There is a paucity of information regarding the clinical performance of the fully cementless metalon-metal hip resurfacing designs. We compared the biomechanical reconstruction between the two hips of a group of patients treated with a hybrid resurfacing design on one side and a new, fully cementless version of the same resurfacing design on the other side. We retrospectively identified 20 patients with a hybrid hip resurfacing on one side and a fully cementless device on the contralateral side. The cemented femoral components were implanted with a target angle stem to shaft angle of 140° while the cementless femoral components were implanted with the aim to replicate the natural neck to shaft angle. No significant differences were observed postoperatively in femoral offset or leg length despite implantation with a larger metaphyseal stem to femoral shaft angle in the hybrid group. Both hybrid and cementless designs provide similar biomechanical reconstructions. Permalink : ./index.php?lvl=notice_display&id=47179

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Positive impacts of Patient Blood Management in total hip arthroplasty. Retrospective and prospective studies (N=700) / Vincent Druez in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 522-529 Titre : Positive impacts of Patient Blood Management in total hip arthroplasty. Retrospective and prospective studies (N=700) Type de document : texte imprimé Auteurs : Vincent Druez ; Claire Cammas ; Simon Van den Veyver ; [et al...] Année de publication : 2016 Article en page(s) : p. 522-529 Langues : Anglais (eng) Mots-clés : arthroplastie  hanche  transfusion sanguine Résumé : The study aimed to determine the impact of implementing a patient blood management (PBM) policy during total hip arthroplasty. Firstly, the authors collected retrospective data concerning blood consumption for all patients (N = 577) having undergone total hip arthroplasty between 2009 and 2011, other than for post-traumatic indications. During this period, no coherent blood management rules were in place. Based on the results obtained, a blood transfusion strategy called Patient Blood Management (PBM) was defined and implemented in our department for this type of surgical procedure beginning 2012. The impact of PBM was then analyzed after a 6-month prospective study during 2013/2014 on a cohort of 123 patients. These prospective data demonstrate that PBM significantly improved patient care and reduced the need for allogeneic labile blood transfusions. Permalink : ./index.php?lvl=notice_display&id=47180 [article] Positive impacts of Patient Blood Management in total hip arthroplasty. Retrospective and prospective studies (N=700) [texte imprimé] / Vincent Druez ; Claire Cammas ; Simon Van den Veyver ; [et al...] . - 2016 . - p. 522-529. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 522-529 Mots-clés : arthroplastie  hanche  transfusion sanguine Résumé : The study aimed to determine the impact of implementing a patient blood management (PBM) policy during total hip arthroplasty. Firstly, the authors collected retrospective data concerning blood consumption for all patients (N = 577) having undergone total hip arthroplasty between 2009 and 2011, other than for post-traumatic indications. During this period, no coherent blood management rules were in place. Based on the results obtained, a blood transfusion strategy called Patient Blood Management (PBM) was defined and implemented in our department for this type of surgical procedure beginning 2012. The impact of PBM was then analyzed after a 6-month prospective study during 2013/2014 on a cohort of 123 patients. These prospective data demonstrate that PBM significantly improved patient care and reduced the need for allogeneic labile blood transfusions. Permalink : ./index.php?lvl=notice_display&id=47180

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Debridement, antibiotics and implant retention in early periprosthetic joint infection after primary total hip arthroplasty : 88 percent survival after two years follow-up / S.G.M. Weenders in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 530-538 Titre : Debridement, antibiotics and implant retention in early periprosthetic joint infection after primary total hip arthroplasty : 88 percent survival after two years follow-up Type de document : texte imprimé Auteurs : S.G.M. Weenders ; M.W. Nijhof ; J.J.P. Schimmel ; J.H.M. Goosen Année de publication : 2016 Article en page(s) : p. 530-538 Langues : Anglais (eng) Mots-clés : hanche  arthroplastie Résumé : Treatment protocols and results of debridement, antibiotics, irrigation and retention of the prosthesis (DAIR) for early prosthetic joint infection (PJI) vary in literature. The purpose of this study was to analyze the results of DAIR with a multidisciplinary designed customized antibiotic protocol for early PJI after primary total hip replacement (THR). We retrospectively analyzed all patients with an early PJI between 2008 and 2012. When an infection was suspected, debridement of the prosthesis, and collection of intraoperative cultures, was performed. Patients were multidisciplinary discussed and treated with an appropriate antibiotic scheme for 12 weeks. Primary outcome was retention of the prosthesis after at least two years follow-up and without any signs of infection. We indentified 25 patients with early PJI. At a median follow-up time of 3.1 years (range 2.1-5.5 years), 88% had retention of the prosthesis and no signs of infection. This study suggests that DAIR with a multidisciplinary approach and an aimed antibiotic treatment for early PJI after THR is a reasonable treatment option with 88% implant retention after two years follow-up. Permalink : ./index.php?lvl=notice_display&id=47181 [article] Debridement, antibiotics and implant retention in early periprosthetic joint infection after primary total hip arthroplasty : 88 percent survival after two years follow-up [texte imprimé] / S.G.M. Weenders ; M.W. Nijhof ; J.J.P. Schimmel ; J.H.M. Goosen . - 2016 . - p. 530-538. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 530-538 Mots-clés : hanche  arthroplastie Résumé : Treatment protocols and results of debridement, antibiotics, irrigation and retention of the prosthesis (DAIR) for early prosthetic joint infection (PJI) vary in literature. The purpose of this study was to analyze the results of DAIR with a multidisciplinary designed customized antibiotic protocol for early PJI after primary total hip replacement (THR). We retrospectively analyzed all patients with an early PJI between 2008 and 2012. When an infection was suspected, debridement of the prosthesis, and collection of intraoperative cultures, was performed. Patients were multidisciplinary discussed and treated with an appropriate antibiotic scheme for 12 weeks. Primary outcome was retention of the prosthesis after at least two years follow-up and without any signs of infection. We indentified 25 patients with early PJI. At a median follow-up time of 3.1 years (range 2.1-5.5 years), 88% had retention of the prosthesis and no signs of infection. This study suggests that DAIR with a multidisciplinary approach and an aimed antibiotic treatment for early PJI after THR is a reasonable treatment option with 88% implant retention after two years follow-up. Permalink : ./index.php?lvl=notice_display&id=47181

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Total hip Replacement in Crowe type IV dysplastic hips – average 5 year follow-up and literature review / Jitesh Kumar Jain in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 539-548 Titre : Total hip Replacement in Crowe type IV dysplastic hips – average 5 year follow-up and literature review Type de document : texte imprimé Auteurs : Jitesh Kumar Jain ; Saurabh Agarwal ; Rajeev K. Sharma Année de publication : 2016 Article en page(s) : p. 539-548 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche Résumé : This is a retrospective study of 29 patients (34 hips) of Crowe grade IV dysplastic hips aged between 19 and 75 years who underwent THR for osteoarthritis secondary to DDH. The hips were evaluated radiologically for Sharp’s acetabular angle, cup inclination, loosening, and ectopic bone formation. Clinically the results were evaluated by pre and postoperative Harris hip scoring. The mean acetabular angle was 60.8° (range, 45°-68°) preoperatively. In 18 hips, subtrochanteric femoral osteotomy was performed. Pre-operatively, the mean leg length discrepancy was 5 cm (range, 2-8 cm). Correction within 1 cm was possible in all patients except in 4 patients. The mean Harris hip Score was 40.80 (32-45.90) preoperatively and 87.96 (74.78-94.72) at last follow-up. THR is successful in high dislocation dysplastic hips. Although there is no gold standard technique of THR in dysplastic hips and treatment of each patient should be individualized. Level of evidence : IV. Permalink : ./index.php?lvl=notice_display&id=47182 [article] Total hip Replacement in Crowe type IV dysplastic hips – average 5 year follow-up and literature review [texte imprimé] / Jitesh Kumar Jain ; Saurabh Agarwal ; Rajeev K. Sharma . - 2016 . - p. 539-548. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 539-548 Mots-clés : prothèse totale de hanche Résumé : This is a retrospective study of 29 patients (34 hips) of Crowe grade IV dysplastic hips aged between 19 and 75 years who underwent THR for osteoarthritis secondary to DDH. The hips were evaluated radiologically for Sharp’s acetabular angle, cup inclination, loosening, and ectopic bone formation. Clinically the results were evaluated by pre and postoperative Harris hip scoring. The mean acetabular angle was 60.8° (range, 45°-68°) preoperatively. In 18 hips, subtrochanteric femoral osteotomy was performed. Pre-operatively, the mean leg length discrepancy was 5 cm (range, 2-8 cm). Correction within 1 cm was possible in all patients except in 4 patients. The mean Harris hip Score was 40.80 (32-45.90) preoperatively and 87.96 (74.78-94.72) at last follow-up. THR is successful in high dislocation dysplastic hips. Although there is no gold standard technique of THR in dysplastic hips and treatment of each patient should be individualized. Level of evidence : IV. Permalink : ./index.php?lvl=notice_display&id=47182

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Influence of pelvic postural angle change on acetabulum implantation in total hip arthroplasty / Kegui Liu in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 549-556 Titre : Influence of pelvic postural angle change on acetabulum implantation in total hip arthroplasty Type de document : texte imprimé Auteurs : Kegui Liu ; Qunhui He ; Guangjun Liao ; [et al...] Année de publication : 2016 Article en page(s) : p. 549-556 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche  posture Résumé : The current study investigated the relationship between the implantation angle of the acetabular component and the change in the pelvic postural angle during hip arthroplasty surgery. One pelvis with a left lower limb prosthesis was used. Total hip arthroplasty on the left pelvis was simulated with the help of a computer-assisted navigation system. The pelvis revolved around the horizontal, longitudinal and sagittal axes at different angles, and the anteversion and abduction of the acetabular component were measured. The changing angle of the pelvis rotating around the horizontal and longitudinal axes greatly influenced acetabular component anteversion. The changing angle of the pelvis rotating around the sagittal axis had a relatively great influence on the acetabular component abduction angle. The change in the postural angle of the pelvis had a great influence on the installation angle of the acetabular component. It is important to standardize posture prior to the operation. Permalink : ./index.php?lvl=notice_display&id=47183 [article] Influence of pelvic postural angle change on acetabulum implantation in total hip arthroplasty [texte imprimé] / Kegui Liu ; Qunhui He ; Guangjun Liao ; [et al...] . - 2016 . - p. 549-556. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 549-556 Mots-clés : prothèse totale de hanche  posture Résumé : The current study investigated the relationship between the implantation angle of the acetabular component and the change in the pelvic postural angle during hip arthroplasty surgery. One pelvis with a left lower limb prosthesis was used. Total hip arthroplasty on the left pelvis was simulated with the help of a computer-assisted navigation system. The pelvis revolved around the horizontal, longitudinal and sagittal axes at different angles, and the anteversion and abduction of the acetabular component were measured. The changing angle of the pelvis rotating around the horizontal and longitudinal axes greatly influenced acetabular component anteversion. The changing angle of the pelvis rotating around the sagittal axis had a relatively great influence on the acetabular component abduction angle. The change in the postural angle of the pelvis had a great influence on the installation angle of the acetabular component. It is important to standardize posture prior to the operation. Permalink : ./index.php?lvl=notice_display&id=47183

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Geometrical restoration and component positioning after hip arthroplasty for femoral neck fracture / Sebastian Mukka in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 557-562 Titre : Geometrical restoration and component positioning after hip arthroplasty for femoral neck fracture Type de document : texte imprimé Auteurs : Sebastian Mukka ; Hamid H. Hassany ; Arkan S. Sayed-Noor Année de publication : 2016 Article en page(s) : p. 557-562 Langues : Anglais (eng) Mots-clés : fracture  col du fémur  hanche  longueur des membres inférieurs Résumé : In this study, the restoration of leg length and global femoral offset and positioning of the femoral stem and acetabular cup of hemiartroplasty (HA) and total hip arthroplasty (THA) after femoral neck fracture (FNF) were compared at the postoperative radiographs between 181 hips operated using the direct lateral (DL) approach and 127 hips operated using the posterolateral (PL) approach. Regarding HA, the DL approach was associated with lengthening of the operated leg (5.7 mm vs. 2.1 mm), p = 0.001. The PL approach had more varus stem position (23% vs. 12%, p = 0.03) and the DL approach had more stems with C-position (58% vs. 32%, p = 0.001). Regarding THA, the DL approach showed increased cup anteversion (28° vs. 21°), p = 0.016, and a decrease in FO (-5.9 mm vs. -2.0 mm, p = 0.04). Surgeons caring for FNF patients are to be aware of the differences in geometrical restroration and component positioning between the two approaches. Permalink : ./index.php?lvl=notice_display&id=47184 [article] Geometrical restoration and component positioning after hip arthroplasty for femoral neck fracture [texte imprimé] / Sebastian Mukka ; Hamid H. Hassany ; Arkan S. Sayed-Noor . - 2016 . - p. 557-562. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 557-562 Mots-clés : fracture  col du fémur  hanche  longueur des membres inférieurs Résumé : In this study, the restoration of leg length and global femoral offset and positioning of the femoral stem and acetabular cup of hemiartroplasty (HA) and total hip arthroplasty (THA) after femoral neck fracture (FNF) were compared at the postoperative radiographs between 181 hips operated using the direct lateral (DL) approach and 127 hips operated using the posterolateral (PL) approach. Regarding HA, the DL approach was associated with lengthening of the operated leg (5.7 mm vs. 2.1 mm), p = 0.001. The PL approach had more varus stem position (23% vs. 12%, p = 0.03) and the DL approach had more stems with C-position (58% vs. 32%, p = 0.001). Regarding THA, the DL approach showed increased cup anteversion (28° vs. 21°), p = 0.016, and a decrease in FO (-5.9 mm vs. -2.0 mm, p = 0.04). Surgeons caring for FNF patients are to be aware of the differences in geometrical restroration and component positioning between the two approaches. Permalink : ./index.php?lvl=notice_display&id=47184

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Constrained acetabular liners in hip revision surgery. A low-cost solution for senile patients / Daniel Hernandez-Vaquero in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 563-569 Titre : Constrained acetabular liners in hip revision surgery. A low-cost solution for senile patients Type de document : texte imprimé Auteurs : Daniel Hernandez-Vaquero ; Jimena Llorens De Los Rios ; Ivan Perez-Coto ; [et al...] Année de publication : 2016 Article en page(s) : p. 563-569 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche  arthroplastie  sénilité Résumé : The objective of this study was to analyze the results of a cemented polyethylene model that captures the hip prosthetic head. In a retrospective study we reviewed 36 cemented constrained acetabular liners implanted in patients older than 75 years (mean 83, SD : 4.4), of which 30 patients were aged 80-90 years and 26 were women. The average period of follow-up of our patients was 25.4 months (12-39 months, SD : 7.3). In 26 patients this model was implanted due to recurrent dislocation or instability, in 8 other cases this model was implanted during revision surgery for periprosthetic fractures, aseptic loosening of the acetabular component, wear of the polyethylene or replacement of the implant because of infection. There was a single case of recurrent dislocation (2.8%). Cemented acetabular constrained liners are a good option in revision surgery in senile patients in which the femoral stem is firmly fixed to the bone. Permalink : ./index.php?lvl=notice_display&id=47185 [article] Constrained acetabular liners in hip revision surgery. A low-cost solution for senile patients [texte imprimé] / Daniel Hernandez-Vaquero ; Jimena Llorens De Los Rios ; Ivan Perez-Coto ; [et al...] . - 2016 . - p. 563-569. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 563-569 Mots-clés : prothèse totale de hanche  arthroplastie  sénilité Résumé : The objective of this study was to analyze the results of a cemented polyethylene model that captures the hip prosthetic head. In a retrospective study we reviewed 36 cemented constrained acetabular liners implanted in patients older than 75 years (mean 83, SD : 4.4), of which 30 patients were aged 80-90 years and 26 were women. The average period of follow-up of our patients was 25.4 months (12-39 months, SD : 7.3). In 26 patients this model was implanted due to recurrent dislocation or instability, in 8 other cases this model was implanted during revision surgery for periprosthetic fractures, aseptic loosening of the acetabular component, wear of the polyethylene or replacement of the implant because of infection. There was a single case of recurrent dislocation (2.8%). Cemented acetabular constrained liners are a good option in revision surgery in senile patients in which the femoral stem is firmly fixed to the bone. Permalink : ./index.php?lvl=notice_display&id=47185

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Development of a lower limb arthroplasty service in a developing country : Lessons learned after the first 100 cases (joints) / L. Lisenda in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 570-578 Titre : Development of a lower limb arthroplasty service in a developing country : Lessons learned after the first 100 cases (joints) Type de document : texte imprimé Auteurs : L. Lisenda ; L. Mokete ; K. Nwokeyi ; [et al...] Année de publication : 2016 Article en page(s) : p. 570-578 Langues : Anglais (eng) Mots-clés : prothèse de hanche  prothèse de genou Résumé : There is emerging evidence that total hip arthroplasty (THR) can be safely practiced in developing countries but scant evidence of safety of total knee replacement (TKR). The purpose of this study is to evaluate the outcomes of these procedures focusing on procedure related complications. This is a retrospective study of the first 100 arthroplasties (92 patients) consisting of 58 TKR and 42 THR with a minimum follow-up of 26 months (range of 26 to 47 months). Major complications included deep infection in one TKR and dislocation of one THR and one TKR. Two patients died in the second post-operative week from cardiac events following TKR. Blood transfusion rate for hips and knees was 13.7% and 5.6% respectively. THR can be safely performed in less than ideal circumstances in developing countries in carefully selected patients. More importantly this study demonstrates that TKR can be safely practiced under the same circumstances. Permalink : ./index.php?lvl=notice_display&id=47186 [article] Development of a lower limb arthroplasty service in a developing country : Lessons learned after the first 100 cases (joints) [texte imprimé] / L. Lisenda ; L. Mokete ; K. Nwokeyi ; [et al...] . - 2016 . - p. 570-578. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 570-578 Mots-clés : prothèse de hanche  prothèse de genou Résumé : There is emerging evidence that total hip arthroplasty (THR) can be safely practiced in developing countries but scant evidence of safety of total knee replacement (TKR). The purpose of this study is to evaluate the outcomes of these procedures focusing on procedure related complications. This is a retrospective study of the first 100 arthroplasties (92 patients) consisting of 58 TKR and 42 THR with a minimum follow-up of 26 months (range of 26 to 47 months). Major complications included deep infection in one TKR and dislocation of one THR and one TKR. Two patients died in the second post-operative week from cardiac events following TKR. Blood transfusion rate for hips and knees was 13.7% and 5.6% respectively. THR can be safely performed in less than ideal circumstances in developing countries in carefully selected patients. More importantly this study demonstrates that TKR can be safely practiced under the same circumstances. Permalink : ./index.php?lvl=notice_display&id=47186

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Use of provisional K wires instead of Poller screws for treatment of diametaphyseal fractures of the distal femur and proximal and distal tibia / Oguz Poyanli in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 579-585 Titre : Use of provisional K wires instead of Poller screws for treatment of diametaphyseal fractures of the distal femur and proximal and distal tibia Type de document : texte imprimé Auteurs : Oguz Poyanli ; Mehmet S. Soylemez ; Afsar T. Ozkut ; [et al...] Année de publication : 2016 Article en page(s) : p. 579-585 Langues : Anglais (eng) Mots-clés : fracture  fémur  tibia  chirurgie Résumé : There are several important technical points that need to be observed when using an intramedullary nail to fix diametaphyseal fractures of femur and tibia. We aimed to describe a technique using 3.0-mm K wires, which act like Poller screws, in conjunction with intramedullary nails to obtain alignment of diametaphyseal fractures of the femur and tibia, and present our results. 7 distal femoral, 2 proximal tibial, and 4 distal tibial diametaphyseal fractures who were treated with this technique were identified. There was no case of nonunion at the last follow-up. In all, 12 of the 13 patients had postoperative fracture angulation that was less than 5Åã degrees in the coronal and sagittal planes. K wires function essentially as a Poller screw for centralization of the nail and help to ensure reduction. Locking the nail in different directions, appropriate reduction can be maintained until the bone heals and there is no need for additional fixation material. Permalink : ./index.php?lvl=notice_display&id=47187 [article] Use of provisional K wires instead of Poller screws for treatment of diametaphyseal fractures of the distal femur and proximal and distal tibia [texte imprimé] / Oguz Poyanli ; Mehmet S. Soylemez ; Afsar T. Ozkut ; [et al...] . - 2016 . - p. 579-585. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 579-585 Mots-clés : fracture  fémur  tibia  chirurgie Résumé : There are several important technical points that need to be observed when using an intramedullary nail to fix diametaphyseal fractures of femur and tibia. We aimed to describe a technique using 3.0-mm K wires, which act like Poller screws, in conjunction with intramedullary nails to obtain alignment of diametaphyseal fractures of the femur and tibia, and present our results. 7 distal femoral, 2 proximal tibial, and 4 distal tibial diametaphyseal fractures who were treated with this technique were identified. There was no case of nonunion at the last follow-up. In all, 12 of the 13 patients had postoperative fracture angulation that was less than 5Åã degrees in the coronal and sagittal planes. K wires function essentially as a Poller screw for centralization of the nail and help to ensure reduction. Locking the nail in different directions, appropriate reduction can be maintained until the bone heals and there is no need for additional fixation material. Permalink : ./index.php?lvl=notice_display&id=47187

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Comparison of interfragmentary compression in conventional and locked plating of proximal unicondylar tibia fractures : A biomechanical cadaver study / Stefan Rahm in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 586-592 Titre : Comparison of interfragmentary compression in conventional and locked plating of proximal unicondylar tibia fractures : A biomechanical cadaver study Type de document : texte imprimé Auteurs : Stefan Rahm ; Lukas Ebneter ; Birte Schultz ; [et al...] Année de publication : 2016 Article en page(s) : p. 586-592 Langues : Anglais (eng) Mots-clés : plateau tibial  fracture Résumé : The extent of interfragmentary compression in intraarticular fractures treated with various fixation methods have not yet been reported. Lateral split fractures were created in six pairs of cadaver tibiae treated using buttress plating with lag screws (group C) or locked buttress plating after clamp compression (group L). Interfragmentary compression and fracture displacement were continuously measured using pressure sensors and a stereoscopic 3-D image correlation system. Significantly larger interfragmentary compression was found initially after clamping the fragment (p < 0.05) in group C (median ± SD ; 45.1 ± 5.0 N/mm2) compared with group L (33.6 ± 3.4 N/mm2), and a statistical trend towards larger compression was also found after cyclic loading (p = 0.05) in group C (45.3 ± 8.6 N/mm2) compared with group L (28.7 ± 5.8 N/mm2). These data indicate that conventional plating with lag screws achieves higher interfragmentary compression in this model compared with external clamp compression and locked plating. Permalink : ./index.php?lvl=notice_display&id=47188 [article] Comparison of interfragmentary compression in conventional and locked plating of proximal unicondylar tibia fractures : A biomechanical cadaver study [texte imprimé] / Stefan Rahm ; Lukas Ebneter ; Birte Schultz ; [et al...] . - 2016 . - p. 586-592. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 586-592 Mots-clés : plateau tibial  fracture Résumé : The extent of interfragmentary compression in intraarticular fractures treated with various fixation methods have not yet been reported. Lateral split fractures were created in six pairs of cadaver tibiae treated using buttress plating with lag screws (group C) or locked buttress plating after clamp compression (group L). Interfragmentary compression and fracture displacement were continuously measured using pressure sensors and a stereoscopic 3-D image correlation system. Significantly larger interfragmentary compression was found initially after clamping the fragment (p < 0.05) in group C (median ± SD ; 45.1 ± 5.0 N/mm2) compared with group L (33.6 ± 3.4 N/mm2), and a statistical trend towards larger compression was also found after cyclic loading (p = 0.05) in group C (45.3 ± 8.6 N/mm2) compared with group L (28.7 ± 5.8 N/mm2). These data indicate that conventional plating with lag screws achieves higher interfragmentary compression in this model compared with external clamp compression and locked plating. Permalink : ./index.php?lvl=notice_display&id=47188

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Use of tantalum cones in primary arthroplasty of acute proximal tibial fractures / Harish Sivasbramanian in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 593-598 Titre : Use of tantalum cones in primary arthroplasty of acute proximal tibial fractures Type de document : texte imprimé Auteurs : Harish Sivasbramanian ; Sunil Gurpur Kini ; Kai Yun Ang ; S.S. Sathappan Année de publication : 2016 Article en page(s) : p. 593-598 Langues : Anglais (eng) Mots-clés : fracture  tibia  arthroplastie Résumé : Metaphyseal tantalum cones in primary total knee arthroplasty and their functional outcome is described using 3 case reports over 6 years. 3 knees in 3 elderly individuals (mean age of 70.4 years), with pre-existing osteoarthritis and complex proximal tibial fractures, were operated on. Ambulation with walking frame was achieved from post-operation day 1, with weightbearing as tolerated. Mean range of motion was 122° and Mean Knee Society Score was 88. All showed improvement in pre-operative limb alignment. Radiological fracture union was achieved on an average of 3 months. All were independent ambulators and painfree at the latest follow-up. Our case series shows that tantalum cones are associated with significant improvements in clinical scores, patient symptoms, range of movement, early weight-bearing and low rates of complications in complex proximal tibial fractures with poor bone stock. Permalink : ./index.php?lvl=notice_display&id=47189 [article] Use of tantalum cones in primary arthroplasty of acute proximal tibial fractures [texte imprimé] / Harish Sivasbramanian ; Sunil Gurpur Kini ; Kai Yun Ang ; S.S. Sathappan . - 2016 . - p. 593-598. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 593-598 Mots-clés : fracture  tibia  arthroplastie Résumé : Metaphyseal tantalum cones in primary total knee arthroplasty and their functional outcome is described using 3 case reports over 6 years. 3 knees in 3 elderly individuals (mean age of 70.4 years), with pre-existing osteoarthritis and complex proximal tibial fractures, were operated on. Ambulation with walking frame was achieved from post-operation day 1, with weightbearing as tolerated. Mean range of motion was 122° and Mean Knee Society Score was 88. All showed improvement in pre-operative limb alignment. Radiological fracture union was achieved on an average of 3 months. All were independent ambulators and painfree at the latest follow-up. Our case series shows that tantalum cones are associated with significant improvements in clinical scores, patient symptoms, range of movement, early weight-bearing and low rates of complications in complex proximal tibial fractures with poor bone stock. Permalink : ./index.php?lvl=notice_display&id=47189

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Is acute compression and distraction superior to segmental bone transport techniques in chronic tibial osteomyelitis ? Comparison of Distraction Osteogenesis Techniques / Levent Eralp in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 599-609 Titre : Is acute compression and distraction superior to segmental bone transport techniques in chronic tibial osteomyelitis ? Comparison of Distraction Osteogenesis Techniques Type de document : texte imprimé Auteurs : Levent Eralp ; Halil I. Balci ; Mehmet Kocaoglu ; [et al...] Année de publication : 2016 Article en page(s) : p. 599-609 Langues : Anglais (eng) Mots-clés : tibia  ostéomyélite  chirurgie Résumé : Treatment of tibial osteomyelitis with infected, necrotic, unstable bone segments (Cierny-Mader Type IV local osteomyelitis) includes débridement and segmental resection, which results in long bone defects. Reconstruction may be with distraction osteogenesis. Segmental bone transport and acute compression and distraction techniques are two main distraction osteogenesis techniques used in the treatment of Type IV local tibial osteomyelitis. In this retrospective, four-center study we compared these two techniques during a 15-year period. 29 patients treated using segmental bone transport technique and 45 patients were treated using acute compression and distraction technique. The mean age (p= 0,34) and the mean bone loss with preoperative shortening (P=0,08) and the mean number of previous operation (p=0,06) were not different in these two groups. . At latest followup, functional and radiographic results were evaluated There was no difference between two technique on the Paley’s scoring system ( p=0,33) and in the total number of complication(p=0,16). Mean external fixator index was lower in the second group ( p=0.02 ). Both techniques can be used safely; however, the acute compression distraction technique may provide greater patient satisfaction because of shorter external fixator index, although future studies will be needed to determine whether this is. Permalink : ./index.php?lvl=notice_display&id=47190 [article] Is acute compression and distraction superior to segmental bone transport techniques in chronic tibial osteomyelitis ? Comparison of Distraction Osteogenesis Techniques [texte imprimé] / Levent Eralp ; Halil I. Balci ; Mehmet Kocaoglu ; [et al...] . - 2016 . - p. 599-609. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 599-609 Mots-clés : tibia  ostéomyélite  chirurgie Résumé : Treatment of tibial osteomyelitis with infected, necrotic, unstable bone segments (Cierny-Mader Type IV local osteomyelitis) includes débridement and segmental resection, which results in long bone defects. Reconstruction may be with distraction osteogenesis. Segmental bone transport and acute compression and distraction techniques are two main distraction osteogenesis techniques used in the treatment of Type IV local tibial osteomyelitis. In this retrospective, four-center study we compared these two techniques during a 15-year period. 29 patients treated using segmental bone transport technique and 45 patients were treated using acute compression and distraction technique. The mean age (p= 0,34) and the mean bone loss with preoperative shortening (P=0,08) and the mean number of previous operation (p=0,06) were not different in these two groups. . At latest followup, functional and radiographic results were evaluated There was no difference between two technique on the Paley’s scoring system ( p=0,33) and in the total number of complication(p=0,16). Mean external fixator index was lower in the second group ( p=0.02 ). Both techniques can be used safely; however, the acute compression distraction technique may provide greater patient satisfaction because of shorter external fixator index, although future studies will be needed to determine whether this is. Permalink : ./index.php?lvl=notice_display&id=47190

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Outcome of surgery for chronic patellar tendinopathy: A systematic review / WS Khan in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 610-626 Titre : Outcome of surgery for chronic patellar tendinopathy: A systematic review Type de document : texte imprimé Auteurs : WS Khan ; A. Smart Année de publication : 2016 Article en page(s) : p. 610-626 Langues : Anglais (eng) Mots-clés : tendinopathie  tendon patellaire  chirurgie Résumé : There is no consensus on how to best surgically treat chronic patellar tendinopathy. This systematic review investigates the surgical treatment for chronic patellar tendinopathy, and the outcomes. A database search was performed to identify all relevant articles, to which exclusion criteria were then applied. Data was extracted from 24 studies, and the outcomes were then systematically reviewed. The results showed that the success rate of surgery for patellar tendinopathy is generally over 77%. Return to sports rates are better for proximal tendon patients who undergo bony procedures. Patients return to sports faster if they undergo arthroscopic procedures, and fewer complications are described. Studies that did not involve any procedure on the proximal tendon did not produce a different result to studies where the tendon was operated on. We found no effect of post-operative immobilisation on outcome. Based on the included studies, surgery gives satisfactory results in the treatment of patellar tendinopathy. There is a lack of high-quality evidence on the effects of surgery and post-operative rehabilitation regime on chronic patellar tendinopathy, as well as lack of objective outcome measures. Permalink : ./index.php?lvl=notice_display&id=47191 [article] Outcome of surgery for chronic patellar tendinopathy: A systematic review [texte imprimé] / WS Khan ; A. Smart . - 2016 . - p. 610-626. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 610-626 Mots-clés : tendinopathie  tendon patellaire  chirurgie Résumé : There is no consensus on how to best surgically treat chronic patellar tendinopathy. This systematic review investigates the surgical treatment for chronic patellar tendinopathy, and the outcomes. A database search was performed to identify all relevant articles, to which exclusion criteria were then applied. Data was extracted from 24 studies, and the outcomes were then systematically reviewed. The results showed that the success rate of surgery for patellar tendinopathy is generally over 77%. Return to sports rates are better for proximal tendon patients who undergo bony procedures. Patients return to sports faster if they undergo arthroscopic procedures, and fewer complications are described. Studies that did not involve any procedure on the proximal tendon did not produce a different result to studies where the tendon was operated on. We found no effect of post-operative immobilisation on outcome. Based on the included studies, surgery gives satisfactory results in the treatment of patellar tendinopathy. There is a lack of high-quality evidence on the effects of surgery and post-operative rehabilitation regime on chronic patellar tendinopathy, as well as lack of objective outcome measures. Permalink : ./index.php?lvl=notice_display&id=47191

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Tendon balancing in hallux valgus surgery / C. Van Elst in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 627-631 Titre : Tendon balancing in hallux valgus surgery Type de document : texte imprimé Auteurs : C. Van Elst ; A. Van Riet ; G. Vandeputte Année de publication : 2016 Article en page(s) : p. 627-631 Langues : Anglais (eng) Mots-clés : hallux valgus  chirurgie Résumé : Recurrent valgus of the hallux after hallux valgus surgery is an unpleasant complication. A possible cause is the imbalance and maltracking of particularly the extensor hallucis longus (EHL) and less frequently the flexor hallucis longus (FHL) or extensor hallucis brevis (EHB) tendon of the hallux. In patients with a tight achilles tendon, the EHL tendon can be recruited to aid dorsiflexion of the foot, creating imbalance. The literature on this subject is very scarce. In 10 patients with severe hallux valgus, a perioperative evaluation after performing the osteotomies and capsular closure showed tight extensor or flexor tendons of the hallux with residual valgus maltracking. A balancing of the tendons was performed with a realignment-lengthening procedure. A good clinical result was obtained in all patients. No adverse effects were seen after tendon balancing. Strength in all tendons was at least 3+, except in one patient with multiple sclerosis. No weaknesses or difficulties during walking were reported. Tendon balancing could play a role in prevention of hallux valgus recurrences and can be performed without loss of strength or compromising of walking ability. Permalink : ./index.php?lvl=notice_display&id=47192 [article] Tendon balancing in hallux valgus surgery [texte imprimé] / C. Van Elst ; A. Van Riet ; G. Vandeputte . - 2016 . - p. 627-631. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 627-631 Mots-clés : hallux valgus  chirurgie Résumé : Recurrent valgus of the hallux after hallux valgus surgery is an unpleasant complication. A possible cause is the imbalance and maltracking of particularly the extensor hallucis longus (EHL) and less frequently the flexor hallucis longus (FHL) or extensor hallucis brevis (EHB) tendon of the hallux. In patients with a tight achilles tendon, the EHL tendon can be recruited to aid dorsiflexion of the foot, creating imbalance. The literature on this subject is very scarce. In 10 patients with severe hallux valgus, a perioperative evaluation after performing the osteotomies and capsular closure showed tight extensor or flexor tendons of the hallux with residual valgus maltracking. A balancing of the tendons was performed with a realignment-lengthening procedure. A good clinical result was obtained in all patients. No adverse effects were seen after tendon balancing. Strength in all tendons was at least 3+, except in one patient with multiple sclerosis. No weaknesses or difficulties during walking were reported. Tendon balancing could play a role in prevention of hallux valgus recurrences and can be performed without loss of strength or compromising of walking ability. Permalink : ./index.php?lvl=notice_display&id=47192

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Reduced length of stay with minimally invasive repair of ruptured achilles tendon / Cezary Kocialkowski in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 632-636 Titre : Reduced length of stay with minimally invasive repair of ruptured achilles tendon Type de document : texte imprimé Auteurs : Cezary Kocialkowski ; Saqib Javed ; Rajesh Rachha ; Amer Shoaib Année de publication : 2016 Article en page(s) : p. 632-636 Langues : Anglais (eng) Mots-clés : tendon d'Achille  rupture  chirurgie Résumé : Minimally invasive techniques to repair ruptured achilles tendons have been developed to enhance recovery following tendon repair and decrease wound complications associated with open repair. We investigated outcomes of minimally invasive and open repair of acutely ruptured achilles tendons at our institution. We compared all cases of achilles tendon repair at our department, using open techniques and minimally invasive techniques with the Achillon device, over a two year period. Length of stay and operating time was recorded, as were any complication rates, including tendon re-rupture. Post-operatively functional outcome questionnaires were sent to all patients. In total 39 patients underwent open repair and 26 underwent minimally invasive repair. Length of stay was significantly shorter in the minimally invasive group, with 58% of minimally invasive cases performed as a day case, compared to 31.1% of open cases (p = 0.02). There was no difference in complication rates, including re-rupture, or functional outcome scores. Minimally invasive repair of ruptured achilles tendons results in reduced length of stay, compared to open repair. There is no evidence of weaker tendon repairs with minimally invasive techniques. Overall functional outcomes between both groups appear similar. Level of Evidence : III. Permalink : ./index.php?lvl=notice_display&id=47193 [article] Reduced length of stay with minimally invasive repair of ruptured achilles tendon [texte imprimé] / Cezary Kocialkowski ; Saqib Javed ; Rajesh Rachha ; Amer Shoaib . - 2016 . - p. 632-636. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 632-636 Mots-clés : tendon d'Achille  rupture  chirurgie Résumé : Minimally invasive techniques to repair ruptured achilles tendons have been developed to enhance recovery following tendon repair and decrease wound complications associated with open repair. We investigated outcomes of minimally invasive and open repair of acutely ruptured achilles tendons at our institution. We compared all cases of achilles tendon repair at our department, using open techniques and minimally invasive techniques with the Achillon device, over a two year period. Length of stay and operating time was recorded, as were any complication rates, including tendon re-rupture. Post-operatively functional outcome questionnaires were sent to all patients. In total 39 patients underwent open repair and 26 underwent minimally invasive repair. Length of stay was significantly shorter in the minimally invasive group, with 58% of minimally invasive cases performed as a day case, compared to 31.1% of open cases (p = 0.02). There was no difference in complication rates, including re-rupture, or functional outcome scores. Minimally invasive repair of ruptured achilles tendons results in reduced length of stay, compared to open repair. There is no evidence of weaker tendon repairs with minimally invasive techniques. Overall functional outcomes between both groups appear similar. Level of Evidence : III. Permalink : ./index.php?lvl=notice_display&id=47193

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Reversed shoulder arthroplasty as treatment for late or ancient chronic glenohumeral dislocation / Alexander Van Tongel in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 637-642 Titre : Reversed shoulder arthroplasty as treatment for late or ancient chronic glenohumeral dislocation Type de document : texte imprimé Auteurs : Alexander Van Tongel ; Thomas Claessens ; Bram Verhofste ; Lieven De Wilde Année de publication : 2016 Article en page(s) : p. 637-642 Langues : Anglais (eng) Mots-clés : luxation de l'épaule  chirurgie Résumé : Chronic glenohumeral dislocation is a rare entity and several treatment options have been proposed. The aim of this study is to report the long-term follow-up of the reversed shoulder arthroplasty in patients with chronic glenohumeral dislocation. A retrospective analysis of all patients between January 2002 and December 2012 that were treated with a reversed shoulder arthroplasty for chronic anterior glenohumeral dislocations was performed. Pre-operative CT evaluation of the bone loss and fatty degeneration of the rotator cuff muscles was performed. Pre- and postoperative Constant-Murley score was evaluated. 6 patients (4 males and 2 females) with anterior glenohumeral dislocations were evaluated. Average age was 73 years (between 65-86 years). The average time of dislocation was 18 weeks (between 4 and 52 weeks). Average time of follow-up was 39 months (between 12 and 90 months). The CM improved from 33 (between 17 and 45) preop to 76 postop (between 55 and 89). No postoperative complications were observed. Reversed shoulder arthroplasty gives good results in case of chronic glenohumeral dislocation. Permalink : ./index.php?lvl=notice_display&id=47194 [article] Reversed shoulder arthroplasty as treatment for late or ancient chronic glenohumeral dislocation [texte imprimé] / Alexander Van Tongel ; Thomas Claessens ; Bram Verhofste ; Lieven De Wilde . - 2016 . - p. 637-642. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 637-642 Mots-clés : luxation de l'épaule  chirurgie Résumé : Chronic glenohumeral dislocation is a rare entity and several treatment options have been proposed. The aim of this study is to report the long-term follow-up of the reversed shoulder arthroplasty in patients with chronic glenohumeral dislocation. A retrospective analysis of all patients between January 2002 and December 2012 that were treated with a reversed shoulder arthroplasty for chronic anterior glenohumeral dislocations was performed. Pre-operative CT evaluation of the bone loss and fatty degeneration of the rotator cuff muscles was performed. Pre- and postoperative Constant-Murley score was evaluated. 6 patients (4 males and 2 females) with anterior glenohumeral dislocations were evaluated. Average age was 73 years (between 65-86 years). The average time of dislocation was 18 weeks (between 4 and 52 weeks). Average time of follow-up was 39 months (between 12 and 90 months). The CM improved from 33 (between 17 and 45) preop to 76 postop (between 55 and 89). No postoperative complications were observed. Reversed shoulder arthroplasty gives good results in case of chronic glenohumeral dislocation. Permalink : ./index.php?lvl=notice_display&id=47194

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Comorbidity in Dupuytren disease / Verena Wijnen in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 643-648 Titre : Comorbidity in Dupuytren disease Type de document : texte imprimé Auteurs : Verena Wijnen ; Frank Buntinx ; Luc De Smet ; [et al...] Année de publication : 2016 Article en page(s) : p. 643-648 Langues : Anglais (eng) Mots-clés : maladie de Dupuytren  épidémiologie Résumé : In this report, a possible association between Dupuytren’s disease (DD) and other health problems was investigated. The health problems included in this study are : cardiac ischemia, hypertension, hyperlipidemia, diabetes mellitus, epilepsy, gout, rheumatoid arthritis, malignancy, asthma and COPD. The data of 725 patients with DD were collected from Intego, a database including all morbidity presented to the General Practitioners (GPs) in Flanders. The control group of 2900 age and sex matched non-DD patients was selected from the same database. A possible influence of severity of DD was evaluated by comparing the data of 333 patients operated for DD with the group of Integopatients with DD. This study showed a significant association of every single studied health condition with DD. Comparison of the operated group with the group from Intego with DD, demonstrated only some significant associations, a difference which may be explained by the difference in data collection. Permalink : ./index.php?lvl=notice_display&id=47195 [article] Comorbidity in Dupuytren disease [texte imprimé] / Verena Wijnen ; Frank Buntinx ; Luc De Smet ; [et al...] . - 2016 . - p. 643-648. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 643-648 Mots-clés : maladie de Dupuytren  épidémiologie Résumé : In this report, a possible association between Dupuytren’s disease (DD) and other health problems was investigated. The health problems included in this study are : cardiac ischemia, hypertension, hyperlipidemia, diabetes mellitus, epilepsy, gout, rheumatoid arthritis, malignancy, asthma and COPD. The data of 725 patients with DD were collected from Intego, a database including all morbidity presented to the General Practitioners (GPs) in Flanders. The control group of 2900 age and sex matched non-DD patients was selected from the same database. A possible influence of severity of DD was evaluated by comparing the data of 333 patients operated for DD with the group of Integopatients with DD. This study showed a significant association of every single studied health condition with DD. Comparison of the operated group with the group from Intego with DD, demonstrated only some significant associations, a difference which may be explained by the difference in data collection. Permalink : ./index.php?lvl=notice_display&id=47195

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Displaced distal end radius fractures un children treared with Kirschner wires - A systematic review / Sumukh Khandekar in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 649-655 Titre : Displaced distal end radius fractures un children treared with Kirschner wires - A systematic review Type de document : texte imprimé Auteurs : Sumukh Khandekar ; Emmanuel Tolessa ; Stanley Jones Année de publication : 2016 Article en page(s) : p. 649-655 Langues : Anglais (eng) Mots-clés : prothèse totale de hanche  chirurgie  obésité Permalink : ./index.php?lvl=notice_display&id=47196 [article] Displaced distal end radius fractures un children treared with Kirschner wires - A systematic review [texte imprimé] / Sumukh Khandekar ; Emmanuel Tolessa ; Stanley Jones . - 2016 . - p. 649-655. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 649-655 Mots-clés : prothèse totale de hanche  chirurgie  obésité Permalink : ./index.php?lvl=notice_display&id=47196

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The effect of femoral head size and body mass index on the outcome of Birmingham Hip Resurfacing. / Hui-Kuang Huang in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 656-662 Titre : The effect of femoral head size and body mass index on the outcome of Birmingham Hip Resurfacing. Type de document : texte imprimé Auteurs : Hui-Kuang Huang ; Jung-Pan Wang ; Shih-Tien Wang ; [et al...] Année de publication : 2016 Article en page(s) : p. 656-662 Langues : Anglais (eng) Mots-clés : compression du nerf ulnaire  poignet  chirurgie Résumé : The purpose was to analyse two reported risk factors on the outcome of Birmingham hip resurfacing (BHR). We reviewed consecutive BHR arthroplasties and found 1,476 cases eligible for analysis. The mean follow-up was 7.3 years. Patients were classified into groups according to their head size and body mass index (BMI). Statistical analysis examined the followup Oxford Hip Scores (OHS) and revision rates between groups. In the large head group (50mm and above) the OHS was 0.5 points higher (p=0.003) than the small head group. In the non-obese group (BMI <30) it was 0.3 points higher (p=0.007). No significant difference in the survival of the implants by either head size or by BMI was detected. BHR is a suitable option offering good survival and higher functional outcomes in non-obese patients (BMI<30) with larger femoral head diameters (50 and above). Although results are statistically significant such a small difference in OHS will rarely show significant clinical difference. Therefore, despite previous reports, BHR may be a reliable option offering predictable clinical results in these scenarios. Permalink : ./index.php?lvl=notice_display&id=47197 [article] The effect of femoral head size and body mass index on the outcome of Birmingham Hip Resurfacing. [texte imprimé] / Hui-Kuang Huang ; Jung-Pan Wang ; Shih-Tien Wang ; [et al...] . - 2016 . - p. 656-662. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 656-662 Mots-clés : compression du nerf ulnaire  poignet  chirurgie Résumé : The purpose was to analyse two reported risk factors on the outcome of Birmingham hip resurfacing (BHR). We reviewed consecutive BHR arthroplasties and found 1,476 cases eligible for analysis. The mean follow-up was 7.3 years. Patients were classified into groups according to their head size and body mass index (BMI). Statistical analysis examined the followup Oxford Hip Scores (OHS) and revision rates between groups. In the large head group (50mm and above) the OHS was 0.5 points higher (p=0.003) than the small head group. In the non-obese group (BMI <30) it was 0.3 points higher (p=0.007). No significant difference in the survival of the implants by either head size or by BMI was detected. BHR is a suitable option offering good survival and higher functional outcomes in non-obese patients (BMI<30) with larger femoral head diameters (50 and above). Although results are statistically significant such a small difference in OHS will rarely show significant clinical difference. Therefore, despite previous reports, BHR may be a reliable option offering predictable clinical results in these scenarios. Permalink : ./index.php?lvl=notice_display&id=47197

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Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis / Veroniek Saegeman in Acta Orthopaedica Belgica, Vol.82/3 (Septembre 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 663-667 Titre : Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis Type de document : texte imprimé Auteurs : Veroniek Saegeman ; Annette Schuermans Année de publication : 2016 Article en page(s) : p. 663-667 Langues : Anglais (eng) Mots-clés : MRSA  infection nosocomiale  chirurgie Résumé : In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. The study was based on observations of surgeries on MRSA positive patients. The average cost per surgery was calculated utilizing local information on unit costs. Robustness of the calculations was evaluated with a sensitivity analysis. The total extra costs of adherence to MRSA infection control guidelines averaged € 340.46 per surgical procedure (range € 207.76- € 473.15). A sensitivity analysis based on a standardized operating room hourly rate reached a cost of € 366.22. The extra costs of adherence to infection control guidelines are considerable. To reduce costs, the logistical planning of surgeries could be improved by for instance a dedicated room. Permalink : ./index.php?lvl=notice_display&id=47198 [article] Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis [texte imprimé] / Veroniek Saegeman ; Annette Schuermans . - 2016 . - p. 663-667. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/3 (Septembre 2016) . - p. 663-667 Mots-clés : MRSA  infection nosocomiale  chirurgie Résumé : In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. The study was based on observations of surgeries on MRSA positive patients. The average cost per surgery was calculated utilizing local information on unit costs. Robustness of the calculations was evaluated with a sensitivity analysis. The total extra costs of adherence to MRSA infection control guidelines averaged € 340.46 per surgical procedure (range € 207.76- € 473.15). A sensitivity analysis based on a standardized operating room hourly rate reached a cost of € 366.22. The extra costs of adherence to infection control guidelines are considerable. To reduce costs, the logistical planning of surgeries could be improved by for instance a dedicated room. Permalink : ./index.php?lvl=notice_display&id=47198

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