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Differential diagnosis of acute traumatic hip pain in the elderly / Matthew Hampton in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 1-7 Titre : Differential diagnosis of acute traumatic hip pain in the elderly Type de document : texte imprimé Auteurs : Matthew Hampton ; Richard Stevens ; Adrian Highland ; Richard Gibson ; Mark B. Davies Année de publication : 2021 Article en page(s) : p. 1-7 Note générale : https://doi.org/10.52628/87.1.01 Langues : Anglais (eng) Mots-clés : Hip pain  hip fracture  pelvic trauma  MRI  occult hip fracture Résumé : Elderly patients who present with an inability to weight bear following a fall, with normal radiographs, should be appropriately investigated to rule out an occult hip fracture (OHF). We aim to identify both the range and incidence of the differential diagnosis of acute traumatic hip pain in a large series of patients investigated for OHF.A retrospective analysis of consecutive patients investigated for an OHF with magnetic resonance imaging (MRI) was performed. Dedicated musculo-skeletal radiologists reported the MRI scans. All diagnoses including hip fractures, other fractures and soft tissue injuries were recorded. Case notes were reviewed for all patients to identify subsequent complications, management and outcomes. A total of 157 patients fulfilled the inclusion criteria. 52 (33%) patients had a fracture of the proximal femur. The majority of patients with proximal femoral fractures required surgical intervention. 9 patients who had fractures of the greater trochanter of the femur without fracture extension across the femoral neck were managed non-operatively.40 (25%) patients had fractures of the pelvis, with a combined pubic rami and sacral fracture occurring frequently. The most common diagnosis was a soft tissue injury alone that was seen in 60 (38%) patients imaged. Injuries to the gluteal muscle group, iliopsaos complex and trochanteric bursa were most prevalent. All patients with soft tissue injuries or fractures of the pelvis were successfully managed non-operatively. This study highlights a wide range of differential diagnoses in elderly patients presenting with acute traumatic hip pain. The proximal femur was frac-tured in 33% of patients imaged for OHFs in our series. The most common diagnosis was a soft tissue injury around the hip and pelvis ; these injuries can be successfully managed without surgery. Permalink : ./index.php?lvl=notice_display&id=96570 [article] Differential diagnosis of acute traumatic hip pain in the elderly [texte imprimé] / Matthew Hampton ; Richard Stevens ; Adrian Highland ; Richard Gibson ; Mark B. Davies . - 2021 . - p. 1-7. https://doi.org/10.52628/87.1.01 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 1-7 Mots-clés : Hip pain  hip fracture  pelvic trauma  MRI  occult hip fracture Résumé : Elderly patients who present with an inability to weight bear following a fall, with normal radiographs, should be appropriately investigated to rule out an occult hip fracture (OHF). We aim to identify both the range and incidence of the differential diagnosis of acute traumatic hip pain in a large series of patients investigated for OHF.A retrospective analysis of consecutive patients investigated for an OHF with magnetic resonance imaging (MRI) was performed. Dedicated musculo-skeletal radiologists reported the MRI scans. All diagnoses including hip fractures, other fractures and soft tissue injuries were recorded. Case notes were reviewed for all patients to identify subsequent complications, management and outcomes. A total of 157 patients fulfilled the inclusion criteria. 52 (33%) patients had a fracture of the proximal femur. The majority of patients with proximal femoral fractures required surgical intervention. 9 patients who had fractures of the greater trochanter of the femur without fracture extension across the femoral neck were managed non-operatively.40 (25%) patients had fractures of the pelvis, with a combined pubic rami and sacral fracture occurring frequently. The most common diagnosis was a soft tissue injury alone that was seen in 60 (38%) patients imaged. Injuries to the gluteal muscle group, iliopsaos complex and trochanteric bursa were most prevalent. All patients with soft tissue injuries or fractures of the pelvis were successfully managed non-operatively. This study highlights a wide range of differential diagnoses in elderly patients presenting with acute traumatic hip pain. The proximal femur was frac-tured in 33% of patients imaged for OHFs in our series. The most common diagnosis was a soft tissue injury around the hip and pelvis ; these injuries can be successfully managed without surgery. Permalink : ./index.php?lvl=notice_display&id=96570

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Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients / Yoeri Bemelmans in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16 Titre : Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients Type de document : texte imprimé Auteurs : Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus Année de publication : 2021 Article en page(s) : p. 9-16 Note générale : https://doi.org/10.52628/87.1.02 Langues : Anglais (eng) Mots-clés : Tranexamic acid  fast-track surgery  knee arthroplasty  hip arthroplasty  unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed. A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=96571 [article] Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients [texte imprimé] / Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus . - 2021 . - p. 9-16. https://doi.org/10.52628/87.1.02 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16 Mots-clés : Tranexamic acid  fast-track surgery  knee arthroplasty  hip arthroplasty  unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed. A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=96571

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The majority of conversion total hip arthroplasties can be considered primary replacements - a matched cohort study / Georges Vles in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 17-23 Titre : The majority of conversion total hip arthroplasties can be considered primary replacements - a matched cohort study Type de document : texte imprimé Auteurs : Georges Vles ; Luke Simmonds ; Mark Roussot ; Andrea Volpin ; Fares Haddad ; Sujith Konan Année de publication : 2021 Article en page(s) : p. 17-23 Note générale : https://doi.org/10.52628/87.1.03 Langues : Anglais (eng) Mots-clés : Proximal femur fracture  Total Hip Arthroplasty  Conversion  Primary  Revision  Matched cohort study Résumé : The success of conversion Total Hip Arthroplasty (THA) among primary THA and revision THA re- mains unclear. We hypothesized that most conversion THAss can be performed using primary implants and will have an uncomplicated post-operative course. Thirty-six patients (23 females, mean age 68,0y) who underwent conversion THA for failed interventions for proximal femur fractures in the period 2006-2018 were matched sequentially against patients of the same sex and age who underwent primary THA or revision THA. Data was collected on implants used, major complications, and mortality. PROMs used included the Western Ontario and McMaster Osteoarthritis Index, Harris Hip Score, Visual Analogue Scale and the EQ-5D Health Questionnaire. Seventy- two percent of patients who underwent conversion THA were treated with primary implants and never suffered from a major complication. PROMs were excellent for this group of patients. The distinction primary / conversion / revision THA could not explain differences in outcomes, however the necessity of using revision implants and the development of major complications could. The majority of conversion total hip arthroplasties can be considered a primary replacement. Predicting outcomes for THA should focus on patient frailty and technical difficulties dealing with infection, stability and loss of bone stock and should discard the conversion versus revision terminology. Permalink : ./index.php?lvl=notice_display&id=96572 [article] The majority of conversion total hip arthroplasties can be considered primary replacements - a matched cohort study [texte imprimé] / Georges Vles ; Luke Simmonds ; Mark Roussot ; Andrea Volpin ; Fares Haddad ; Sujith Konan . - 2021 . - p. 17-23. https://doi.org/10.52628/87.1.03 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 17-23 Mots-clés : Proximal femur fracture  Total Hip Arthroplasty  Conversion  Primary  Revision  Matched cohort study Résumé : The success of conversion Total Hip Arthroplasty (THA) among primary THA and revision THA re- mains unclear. We hypothesized that most conversion THAss can be performed using primary implants and will have an uncomplicated post-operative course. Thirty-six patients (23 females, mean age 68,0y) who underwent conversion THA for failed interventions for proximal femur fractures in the period 2006-2018 were matched sequentially against patients of the same sex and age who underwent primary THA or revision THA. Data was collected on implants used, major complications, and mortality. PROMs used included the Western Ontario and McMaster Osteoarthritis Index, Harris Hip Score, Visual Analogue Scale and the EQ-5D Health Questionnaire. Seventy- two percent of patients who underwent conversion THA were treated with primary implants and never suffered from a major complication. PROMs were excellent for this group of patients. The distinction primary / conversion / revision THA could not explain differences in outcomes, however the necessity of using revision implants and the development of major complications could. The majority of conversion total hip arthroplasties can be considered a primary replacement. Predicting outcomes for THA should focus on patient frailty and technical difficulties dealing with infection, stability and loss of bone stock and should discard the conversion versus revision terminology. Permalink : ./index.php?lvl=notice_display&id=96572

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Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head / Sumit Arora in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 25-34 Titre : Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head Type de document : texte imprimé Auteurs : Sumit Arora ; Manoj Kumar ; Nitish Khan ; Swati Gupta ; Jatin Talwar ; Vinod Kumar ; Lalit Mani Année de publication : 2021 Article en page(s) : p. 25-34 Note générale : https://doi.org/10.52628/87.1.04 Langues : Anglais (eng) Mots-clés : Osteonecrosis of femoral head  subcapital femoral neck fracture  corticosteroid Résumé : Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p<0.05). Corticosteroids induced ONFH has a propensity to develop SSF. This entity should find a place in existing classification system. Permalink : ./index.php?lvl=notice_display&id=96573 [article] Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head [texte imprimé] / Sumit Arora ; Manoj Kumar ; Nitish Khan ; Swati Gupta ; Jatin Talwar ; Vinod Kumar ; Lalit Mani . - 2021 . - p. 25-34. https://doi.org/10.52628/87.1.04 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 25-34 Mots-clés : Osteonecrosis of femoral head  subcapital femoral neck fracture  corticosteroid Résumé : Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p<0.05). Corticosteroids induced ONFH has a propensity to develop SSF. This entity should find a place in existing classification system. Permalink : ./index.php?lvl=notice_display&id=96573

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Dual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study / Zain Sadozai in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 35-39 Titre : Dual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study Type de document : texte imprimé Auteurs : Zain Sadozai ; Richard Limb ; Syed Awais Bokhari ; Aaron Ng ; Manjit Bhamra Année de publication : 2021 Article en page(s) : p. 35-39 Note générale : https://doi.org/10.52628/87.1.05 Langues : Anglais (eng) Mots-clés : Dual mobility  fracture femur  dislocation  comparison  hip arthroplasty Résumé : Current national guidelines (NICE) recommends that all medically fit, independently-mobile patients without cognitive impairment receive a total hip arTHAoplasty(THA) for displaced intracapsular neck of femur (NOF) fractures. Dislocation is a concern(2-10%). Dual mobility cups have been suggested to address this complication. Our study sets out to compare dislocation rates between dual mobility cups versus unipolar cups. We performed a retrospective single centre multiple surgeon study of all THAs performed for NOFs between January 2012 and May 2018. A total of 322 total hip replacements (127 dual mobility and 195 unipolar ; Age range of patients, 29 to 91, mean 70 years) were identified for analysis using a database. Data was obtained from electronic patient records and radiographs. 12 patients sustained a dislocation of their THA out of our 322 patients. Of these, 10 dislocations occurred in the unipolar group (5.13%). From the dual mobility cups, 2 had dislocations(1.57%), both with a 28mm head. Both of these dislocations were in alcohol dependent patients with increased susceptibility to falls. Statistical analysis of our data was performed using chi-squared test (p value = 0.0723) In ‘Getting It Right First Time’ (GIRFT), the authors recommend that all patients that sustain a NOF fracture meeting the criteria of a THA to be offered a dual mobility acetabular cup to reduce the risk of dislocation. The cost of the dual mobility acetabular cup is offset from the cost of overall revision surgery. Limitations of our study are its retrospective nature and selection bias. Permalink : ./index.php?lvl=notice_display&id=96574 [article] Dual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study [texte imprimé] / Zain Sadozai ; Richard Limb ; Syed Awais Bokhari ; Aaron Ng ; Manjit Bhamra . - 2021 . - p. 35-39. https://doi.org/10.52628/87.1.05 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 35-39 Mots-clés : Dual mobility  fracture femur  dislocation  comparison  hip arthroplasty Résumé : Current national guidelines (NICE) recommends that all medically fit, independently-mobile patients without cognitive impairment receive a total hip arTHAoplasty(THA) for displaced intracapsular neck of femur (NOF) fractures. Dislocation is a concern(2-10%). Dual mobility cups have been suggested to address this complication. Our study sets out to compare dislocation rates between dual mobility cups versus unipolar cups. We performed a retrospective single centre multiple surgeon study of all THAs performed for NOFs between January 2012 and May 2018. A total of 322 total hip replacements (127 dual mobility and 195 unipolar ; Age range of patients, 29 to 91, mean 70 years) were identified for analysis using a database. Data was obtained from electronic patient records and radiographs. 12 patients sustained a dislocation of their THA out of our 322 patients. Of these, 10 dislocations occurred in the unipolar group (5.13%). From the dual mobility cups, 2 had dislocations(1.57%), both with a 28mm head. Both of these dislocations were in alcohol dependent patients with increased susceptibility to falls. Statistical analysis of our data was performed using chi-squared test (p value = 0.0723) In ‘Getting It Right First Time’ (GIRFT), the authors recommend that all patients that sustain a NOF fracture meeting the criteria of a THA to be offered a dual mobility acetabular cup to reduce the risk of dislocation. The cost of the dual mobility acetabular cup is offset from the cost of overall revision surgery. Limitations of our study are its retrospective nature and selection bias. Permalink : ./index.php?lvl=notice_display&id=96574

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Fracture risk during extraction of well-fixed extended cementless stems : porous versus hydroxyapatite coated / Frederik Matthys in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 41-45 Titre : Fracture risk during extraction of well-fixed extended cementless stems : porous versus hydroxyapatite coated Type de document : texte imprimé Auteurs : Frederik Matthys ; Jan Peter Van Meirhaeghe ; Christophe Pattyn Année de publication : 2021 Article en page(s) : p. 41-45 Note générale : https://doi.org/10.52628/87.1.06 Langues : Anglais (eng) Mots-clés : Hydroxyapatite coating  porous coated  fracture risk  revision surgery  hip replacement  Harris hip score Résumé : The concern of extensive fracturing and bone damage during implant removal has been reported for ingrowing stems, in particular in extended porous coated stems, potentially impeding successful re- implantation of a femoral revision implant and con- sequently debilitating patients for life. The aim of the present study is to describe this par- ticular complication and comparing the occurrence in porous coated and hydroxyapatite (HA) coated femoral implants. 62 consecutive revision hip replacements were per- formed between January 2010 and December 2016 at a single academic institution. Only revisions of a primary total hip replacement were included. All surgeries were performed by the same senior surgeon. Clinical follow-up involved examination with the Harris hip score (HHS) at 2 years post surgical intervention. Fracture occurrence and severity were compared between groups by means of the Vancouver classification for intraoperative fractures. Overall, significant higher rates of fracturing were observed in the porous coated group (81.8%, p<0.05) compared to the HA coated group (43.5%, p<0.05). Of these fractures, the majority (72,7%) were B3 fractures. There was a significant difference between the mean HHS in the porous-coated group versus the group with HA coating (mean Harris Hip Scores of 68,45 vs 86,17, p = .004). Surgeons have to be wary with implanting porous coated stems in primary hip arthroplasty, especially in younger patients who have a high likelihood of future revision surgery, due to the catastrophic peri- operative fractures associated with the removal of these stems. Permalink : ./index.php?lvl=notice_display&id=96575 [article] Fracture risk during extraction of well-fixed extended cementless stems : porous versus hydroxyapatite coated [texte imprimé] / Frederik Matthys ; Jan Peter Van Meirhaeghe ; Christophe Pattyn . - 2021 . - p. 41-45. https://doi.org/10.52628/87.1.06 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 41-45 Mots-clés : Hydroxyapatite coating  porous coated  fracture risk  revision surgery  hip replacement  Harris hip score Résumé : The concern of extensive fracturing and bone damage during implant removal has been reported for ingrowing stems, in particular in extended porous coated stems, potentially impeding successful re- implantation of a femoral revision implant and con- sequently debilitating patients for life. The aim of the present study is to describe this par- ticular complication and comparing the occurrence in porous coated and hydroxyapatite (HA) coated femoral implants. 62 consecutive revision hip replacements were per- formed between January 2010 and December 2016 at a single academic institution. Only revisions of a primary total hip replacement were included. All surgeries were performed by the same senior surgeon. Clinical follow-up involved examination with the Harris hip score (HHS) at 2 years post surgical intervention. Fracture occurrence and severity were compared between groups by means of the Vancouver classification for intraoperative fractures. Overall, significant higher rates of fracturing were observed in the porous coated group (81.8%, p<0.05) compared to the HA coated group (43.5%, p<0.05). Of these fractures, the majority (72,7%) were B3 fractures. There was a significant difference between the mean HHS in the porous-coated group versus the group with HA coating (mean Harris Hip Scores of 68,45 vs 86,17, p = .004). Surgeons have to be wary with implanting porous coated stems in primary hip arthroplasty, especially in younger patients who have a high likelihood of future revision surgery, due to the catastrophic peri- operative fractures associated with the removal of these stems. Permalink : ./index.php?lvl=notice_display&id=96575

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Characteristics of femoroacetabular impingement morphology and relation with skeletal maturity among asymptomatic adolescents / Mehmet Kaymagoglu in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 47-54 Titre : Characteristics of femoroacetabular impingement morphology and relation with skeletal maturity among asymptomatic adolescents Type de document : texte imprimé Auteurs : Mehmet Kaymagoglu ; Raziye Dut ; Duygu Imre ; Fatma Bilge Ergen ; Mehmet Ali Talmac ; Cemalettin Aksoy Année de publication : 2021 Article en page(s) : p. 47-54 Note générale : https://doi.org/10.52628/87.1.07 Langues : Anglais (eng) Mots-clés : femoroacetabular impingement  cam  pincer  physeal closure Résumé : The aim of this study was to analyze presence of the morphological characteristics and prevalence of FAI in asymptomatic adolescents and assess the relation of skeletal maturation with development of FAI morphology. Abdominopelvic computed tomography (CT) of 265 adolescents (9-19 years old) who were admitted to the emergency department between 2011 and 2016 were evaluated retrospectively. Radial reformatted CT images from the femoral neck were created using the multiplanar reconstruction (MPR) method. The femoral neck was divided into 12 segments and alpha angle (AA), femoral head-neck ratio (FHNR) and center-edge angle (CEA) were measured from each segment. Additionally, images were evaluated for the physiological status (open or closed) of the triradiate- cartilage and proximal femoral epiphyses. 204 hips from 102 patients (32 females, 70 males) were retrospectively reviewed. There were 27 (26.5%) patients with cam-type morphology and 18 (17.6%) patients with pincer-type morphologies. No statistically significant difference was detected between the prevalences of cam and pincer morphologies between the two genders. Cam deformity was most frequently seen in anterosuperior segment. All of the patients (100%) with pincer-type morphology and 88% of the patients with cam-type morphology had closed triradiate cartilage, 89% of the patients with cam morphology and 83% with pincer morphology had open proximal femoral physis. Our results showed that prevalence of cam and pincer-type morphology in asymptomatic adolescents is similar to asymptomatic adults. Our findings also indicate that cam- and pincer-type FAI morphologies likely develop during late adolescence after closure of triradiate cartilage and before closure of proximal femoral physis. Permalink : ./index.php?lvl=notice_display&id=96576 [article] Characteristics of femoroacetabular impingement morphology and relation with skeletal maturity among asymptomatic adolescents [texte imprimé] / Mehmet Kaymagoglu ; Raziye Dut ; Duygu Imre ; Fatma Bilge Ergen ; Mehmet Ali Talmac ; Cemalettin Aksoy . - 2021 . - p. 47-54. https://doi.org/10.52628/87.1.07 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 47-54 Mots-clés : femoroacetabular impingement  cam  pincer  physeal closure Résumé : The aim of this study was to analyze presence of the morphological characteristics and prevalence of FAI in asymptomatic adolescents and assess the relation of skeletal maturation with development of FAI morphology. Abdominopelvic computed tomography (CT) of 265 adolescents (9-19 years old) who were admitted to the emergency department between 2011 and 2016 were evaluated retrospectively. Radial reformatted CT images from the femoral neck were created using the multiplanar reconstruction (MPR) method. The femoral neck was divided into 12 segments and alpha angle (AA), femoral head-neck ratio (FHNR) and center-edge angle (CEA) were measured from each segment. Additionally, images were evaluated for the physiological status (open or closed) of the triradiate- cartilage and proximal femoral epiphyses. 204 hips from 102 patients (32 females, 70 males) were retrospectively reviewed. There were 27 (26.5%) patients with cam-type morphology and 18 (17.6%) patients with pincer-type morphologies. No statistically significant difference was detected between the prevalences of cam and pincer morphologies between the two genders. Cam deformity was most frequently seen in anterosuperior segment. All of the patients (100%) with pincer-type morphology and 88% of the patients with cam-type morphology had closed triradiate cartilage, 89% of the patients with cam morphology and 83% with pincer morphology had open proximal femoral physis. Our results showed that prevalence of cam and pincer-type morphology in asymptomatic adolescents is similar to asymptomatic adults. Our findings also indicate that cam- and pincer-type FAI morphologies likely develop during late adolescence after closure of triradiate cartilage and before closure of proximal femoral physis. Permalink : ./index.php?lvl=notice_display&id=96576

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Subcuticular sutures versus staples for skin closure after primary hip arthroplasty / Hany Elbardesy in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64 Titre : Subcuticular sutures versus staples for skin closure after primary hip arthroplasty Type de document : texte imprimé Auteurs : Hany Elbardesy ; Rehan Gul ; Shane Guerin Année de publication : 2021 Article en page(s) : p. 55-64 Note générale : https://doi.org/10.52628/87.1.08 Langues : Anglais (eng) Mots-clés : total hip arthroplasty  total joint arthroplasty  skin closure  meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined. Permalink : ./index.php?lvl=notice_display&id=96577 [article] Subcuticular sutures versus staples for skin closure after primary hip arthroplasty [texte imprimé] / Hany Elbardesy ; Rehan Gul ; Shane Guerin . - 2021 . - p. 55-64. https://doi.org/10.52628/87.1.08 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64 Mots-clés : total hip arthroplasty  total joint arthroplasty  skin closure  meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined. Permalink : ./index.php?lvl=notice_display&id=96577

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Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design / Adnan A. Faraj in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 65-71 Titre : Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design Type de document : texte imprimé Auteurs : Adnan A. Faraj ; Mark Andrews ; Weiguang Li Année de publication : 2021 Article en page(s) : p. 65-71 Note générale : https://doi.org/10.52628/87.1.09 Langues : Anglais (eng) Mots-clés : total hip  radiographs  observer  errors  CAD  analysis Résumé : Plain radiographic assessment of primary total hip arthroplasty following surgery remains to be the commonest radiological assessment. The current paper, studies the accuracy and concordance between observers reviewing these radiographs. A prospective radiographic and medical note review of ten patients who underwent total hip replacement for primary osteoarthritis, with a mean age of 69 years. Early and 6 weeks postoperative x-rays were assessed for hip profile and version profile using computer aided design (CAD) by two observers on two different occasions. The observers were Orthopaedic surgeons who perform arthroplasty of the hip. The results were analyzed statistically. Dimensions, including Femoral offset, medial offset and ilioischial offset showed a high degree of inter- film and intra-film correlation, with inter-class cor- relation (ICC) over 0.8. Except of the intra-film correlation of ilioischial offset measured on the post- operative films (p=0.067) by the first rater, all the intra and inter film correlation were significantly over the benchmark of 0.6. In terms of stem alignment, cup inclination and cup version, the intra-film correlation by rater n°2 ranges from 0.574 to 0.975 and were significantly over the benchmark of 0.6, except in the case of cup inclination measured on the 6 th? week follow-up ; meanwhile the intra-film correlation by rater n°1 ranges from 0.581 to 0.819 and none were significantly over the benchmark of 0.6. The inter-rater reliability and inter-film correlation showed a dichotomy of results among different di- mensions of the measurement. Dimensions of femo- ral offset, medial offset and ilioischial offset showed a substantial degree of reliability in terms of inter-rater reliability, inter-film correlation, and intra-rater/film reliability. Permalink : ./index.php?lvl=notice_display&id=96578 [article] Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design [texte imprimé] / Adnan A. Faraj ; Mark Andrews ; Weiguang Li . - 2021 . - p. 65-71. https://doi.org/10.52628/87.1.09 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 65-71 Mots-clés : total hip  radiographs  observer  errors  CAD  analysis Résumé : Plain radiographic assessment of primary total hip arthroplasty following surgery remains to be the commonest radiological assessment. The current paper, studies the accuracy and concordance between observers reviewing these radiographs. A prospective radiographic and medical note review of ten patients who underwent total hip replacement for primary osteoarthritis, with a mean age of 69 years. Early and 6 weeks postoperative x-rays were assessed for hip profile and version profile using computer aided design (CAD) by two observers on two different occasions. The observers were Orthopaedic surgeons who perform arthroplasty of the hip. The results were analyzed statistically. Dimensions, including Femoral offset, medial offset and ilioischial offset showed a high degree of inter- film and intra-film correlation, with inter-class cor- relation (ICC) over 0.8. Except of the intra-film correlation of ilioischial offset measured on the post- operative films (p=0.067) by the first rater, all the intra and inter film correlation were significantly over the benchmark of 0.6. In terms of stem alignment, cup inclination and cup version, the intra-film correlation by rater n°2 ranges from 0.574 to 0.975 and were significantly over the benchmark of 0.6, except in the case of cup inclination measured on the 6 th? week follow-up ; meanwhile the intra-film correlation by rater n°1 ranges from 0.581 to 0.819 and none were significantly over the benchmark of 0.6. The inter-rater reliability and inter-film correlation showed a dichotomy of results among different di- mensions of the measurement. Dimensions of femo- ral offset, medial offset and ilioischial offset showed a substantial degree of reliability in terms of inter-rater reliability, inter-film correlation, and intra-rater/film reliability. Permalink : ./index.php?lvl=notice_display&id=96578

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Bicruciate retaining total knee arthroplasty : results throughout history / Jef De Mulder in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 73-83 Titre : Bicruciate retaining total knee arthroplasty : results throughout history Type de document : texte imprimé Auteurs : Jef De Mulder ; Pieter Berger ; Hilde Vandenneucker Année de publication : 2021 Article en page(s) : p. 73-83 Note générale : https://doi.org/10.52628/87.1.10 Langues : Anglais (eng) Mots-clés : Bicruciate retaining  total knee arthroplasty  Vanguard XP Résumé : Approximately 20% amongst patients are dissatisfied after total knee arthroplasty (TKA). Bicruciate retaining (BCR) TKA offers superior knee kinematics and proprioception, but many surgeons abandoned its use because of complications and technical difficulties. Recently, two new BCR implant designs were introduced : Vanguard XP (Zimmer Biomet) and Journey XR (Smith&Nephew). We searched Pubmed, Limo, Embase and Cochrane, screened reference lists of eligible studies and included studies that met the inclusion criteria. We included 35 articles reporting on ten different BCR implants, including three articles presenting results of the Vanguard XP prosthesis. Unfortunately, no articles reporting on the results of the Journey XR prosthesis had been published. The BCR implants of the early 1970s showed good functional results, but a high rate of complications, mainly loosening and infections. The Townley Anatomic TKA was the first BCR implant with good clinical results, a low incidence of loosening and a high survivorship. One article of the three reporting on the Vanguard XP yielded high patient satisfaction (94%) with two revisions (1.4%). The two other articles reported three revisions (5%) after one year of follow-up and 19 revisions (13.4%) after three years of follow-up. Throughout history, the functional results of BCR TKA improved, with lessening of the complications. The short-term results of the Vanguard XP implant showed good functional results, but two out of three articles reported a high rate of loosening. Based on the results reported in this review, the use of BCR TKA is still debatable. Further high-level evidence research is necessary to assess the clinical benefit of BCR TKA. Permalink : ./index.php?lvl=notice_display&id=96589 [article] Bicruciate retaining total knee arthroplasty : results throughout history [texte imprimé] / Jef De Mulder ; Pieter Berger ; Hilde Vandenneucker . - 2021 . - p. 73-83. https://doi.org/10.52628/87.1.10 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 73-83 Mots-clés : Bicruciate retaining  total knee arthroplasty  Vanguard XP Résumé : Approximately 20% amongst patients are dissatisfied after total knee arthroplasty (TKA). Bicruciate retaining (BCR) TKA offers superior knee kinematics and proprioception, but many surgeons abandoned its use because of complications and technical difficulties. Recently, two new BCR implant designs were introduced : Vanguard XP (Zimmer Biomet) and Journey XR (Smith&Nephew). We searched Pubmed, Limo, Embase and Cochrane, screened reference lists of eligible studies and included studies that met the inclusion criteria. We included 35 articles reporting on ten different BCR implants, including three articles presenting results of the Vanguard XP prosthesis. Unfortunately, no articles reporting on the results of the Journey XR prosthesis had been published. The BCR implants of the early 1970s showed good functional results, but a high rate of complications, mainly loosening and infections. The Townley Anatomic TKA was the first BCR implant with good clinical results, a low incidence of loosening and a high survivorship. One article of the three reporting on the Vanguard XP yielded high patient satisfaction (94%) with two revisions (1.4%). The two other articles reported three revisions (5%) after one year of follow-up and 19 revisions (13.4%) after three years of follow-up. Throughout history, the functional results of BCR TKA improved, with lessening of the complications. The short-term results of the Vanguard XP implant showed good functional results, but two out of three articles reported a high rate of loosening. Based on the results reported in this review, the use of BCR TKA is still debatable. Further high-level evidence research is necessary to assess the clinical benefit of BCR TKA. Permalink : ./index.php?lvl=notice_display&id=96589

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Treatment of open tibia fractures in Sub-Saharan African countries : a systematic review / Kouamé Jean-Eric Kouassi in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 85-92 Titre : Treatment of open tibia fractures in Sub-Saharan African countries : a systematic review Type de document : texte imprimé Auteurs : Kouamé Jean-Eric Kouassi ; Julie Manon ; Loïc Fonkoue ; Christine Detrembler ; Olivier Cornu Année de publication : 2021 Article en page(s) : p. 85-92 Note générale : https://doi.org/10.52628/87.1.11 Langues : Anglais (eng) Mots-clés : Africa  cast immobilization  developing countries  open fracture  tibia Résumé : Open tibia fracture (OTF) treatment is well documented in developed countries. Yet, this fracture pattern remains challenging because it is associated with an increased risk of infection and delayed union, particularly in case of Gustilo III B and C open fractures. Since access to healthcare is limited in Sub- Saharan African countries, this paper explores the results of OTF management in this setting. A systematic review of the literature was conducted using current databases such as MEDLINE, Cochrane, EMBASE, PubMed, ScienceDirect, Scopus, and Google Scholar in order to identify prospective studies with cohorts of patients treated for OTF. Studies were included based on predefined inclusion and exclusion criteria. The quality of studies was analyzed by the Coleman Methodology Score (CMS). Eight papers met the inclusion criteria and had an average CMS of 70 (range 54-73). The most common treatment was non-operative management of the fracture with cast immobilization (67%). Gustilo Type II and III fractures were associated with a higher risk of complications. The infection rate was 30%. Malunion, chronic osteomyelitis and nonunion were observed in 14.5%, 12.3%, and 7% of the cases, respectively. More complications were observed with non-operative treatment (cast immobilization) than with surgical fixation. Although the surgical environment does not allow for internal fixation, poor results of non-operative management of open fractures should lead to the introduction of trainings on the proper use of external fixators. It is also advisable to support the development of locally produced external devices that utilize local source materials, which would make external fixation available at a reasonable cost. Permalink : ./index.php?lvl=notice_display&id=96590 [article] Treatment of open tibia fractures in Sub-Saharan African countries : a systematic review [texte imprimé] / Kouamé Jean-Eric Kouassi ; Julie Manon ; Loïc Fonkoue ; Christine Detrembler ; Olivier Cornu . - 2021 . - p. 85-92. https://doi.org/10.52628/87.1.11 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 85-92 Mots-clés : Africa  cast immobilization  developing countries  open fracture  tibia Résumé : Open tibia fracture (OTF) treatment is well documented in developed countries. Yet, this fracture pattern remains challenging because it is associated with an increased risk of infection and delayed union, particularly in case of Gustilo III B and C open fractures. Since access to healthcare is limited in Sub- Saharan African countries, this paper explores the results of OTF management in this setting. A systematic review of the literature was conducted using current databases such as MEDLINE, Cochrane, EMBASE, PubMed, ScienceDirect, Scopus, and Google Scholar in order to identify prospective studies with cohorts of patients treated for OTF. Studies were included based on predefined inclusion and exclusion criteria. The quality of studies was analyzed by the Coleman Methodology Score (CMS). Eight papers met the inclusion criteria and had an average CMS of 70 (range 54-73). The most common treatment was non-operative management of the fracture with cast immobilization (67%). Gustilo Type II and III fractures were associated with a higher risk of complications. The infection rate was 30%. Malunion, chronic osteomyelitis and nonunion were observed in 14.5%, 12.3%, and 7% of the cases, respectively. More complications were observed with non-operative treatment (cast immobilization) than with surgical fixation. Although the surgical environment does not allow for internal fixation, poor results of non-operative management of open fractures should lead to the introduction of trainings on the proper use of external fixators. It is also advisable to support the development of locally produced external devices that utilize local source materials, which would make external fixation available at a reasonable cost. Permalink : ./index.php?lvl=notice_display&id=96590

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The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis / Hany Elbardesy in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 93-102 Titre : The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis Type de document : texte imprimé Auteurs : Hany Elbardesy ; Matthew Nagle ; Lydia Simmons ; James Harty Année de publication : 2021 Article en page(s) : p. 93-102 Note générale : https://doi.org/10.52628/87.1.12 Langues : Anglais (eng) Mots-clés : knee focal metallic implant  HemiCAP  UniCAP  Wave prosthesis  inlay design Résumé : Knee osteochondral defects are a common problem among people, especially young and active patients. So effective joint preserving surgeries is essential to prevent or even delay the onset of osteoarthritis for these group of patients. This study aims to critically appraise and evaluate the evidence for the results and effectiveness of femoral condyle resurfacing (HemiCAP/ UniCAP) in treatment of patients with focal femoral condyle cartilage defect. Using the search terms : HemiCAP, UniCAP, Episurf, focal, femoral, condyle, inlay and resur-facing, we reviewed the PubMed and EMBASE and the Cochrane Database of Systematic Reviews (CDSR) to find any articles published up to March 2020. The short term follow-up of the HemiCAP shows (6.74 %) revision rate. However, 29.13 % loss of follow up let us consider these results with caution especially if the revision rate progressively increased with time to 19.3 % in 5-7 years with no enough evidence for the long term results except the data from the Australian Joint Registry 2018, where the cumulative revision rate was 40.6 % (33.5, 48.4) at ten years. The UniCAP that used for defect more than 4 cm 2 has a high revision rate (53.66 %) which is considered unacceptable revision rate in com-parison to another similar prosthesis such as Uni-Knee Arthroplasty (UKA). The evidence from published studies and our meta- analysis suggests that partial resurfacing of the femoral condyle (HemiCAP) doesn’t support its usage as a tool to treat the focal cartilage defect in middle- aged patients. The UniCAP as femoral condyle resurfacing has very high revision rate at 5-7 years (53.66 %) which make us recommend against its usage. Permalink : ./index.php?lvl=notice_display&id=96591 [article] The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis [texte imprimé] / Hany Elbardesy ; Matthew Nagle ; Lydia Simmons ; James Harty . - 2021 . - p. 93-102. https://doi.org/10.52628/87.1.12 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 93-102 Mots-clés : knee focal metallic implant  HemiCAP  UniCAP  Wave prosthesis  inlay design Résumé : Knee osteochondral defects are a common problem among people, especially young and active patients. So effective joint preserving surgeries is essential to prevent or even delay the onset of osteoarthritis for these group of patients. This study aims to critically appraise and evaluate the evidence for the results and effectiveness of femoral condyle resurfacing (HemiCAP/ UniCAP) in treatment of patients with focal femoral condyle cartilage defect. Using the search terms : HemiCAP, UniCAP, Episurf, focal, femoral, condyle, inlay and resur-facing, we reviewed the PubMed and EMBASE and the Cochrane Database of Systematic Reviews (CDSR) to find any articles published up to March 2020. The short term follow-up of the HemiCAP shows (6.74 %) revision rate. However, 29.13 % loss of follow up let us consider these results with caution especially if the revision rate progressively increased with time to 19.3 % in 5-7 years with no enough evidence for the long term results except the data from the Australian Joint Registry 2018, where the cumulative revision rate was 40.6 % (33.5, 48.4) at ten years. The UniCAP that used for defect more than 4 cm 2 has a high revision rate (53.66 %) which is considered unacceptable revision rate in com-parison to another similar prosthesis such as Uni-Knee Arthroplasty (UKA). The evidence from published studies and our meta- analysis suggests that partial resurfacing of the femoral condyle (HemiCAP) doesn’t support its usage as a tool to treat the focal cartilage defect in middle- aged patients. The UniCAP as femoral condyle resurfacing has very high revision rate at 5-7 years (53.66 %) which make us recommend against its usage. Permalink : ./index.php?lvl=notice_display&id=96591

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Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes / Vincent Tomasi in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 103-109 Titre : Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes Type de document : texte imprimé Auteurs : Vincent Tomasi ; Alex Demurie ; Ignace Ghijselings ; Olivier Cornu ; Hans Van Den Wyngaert Année de publication : 2021 Article en page(s) : p. 103-109 Note générale : https://doi.org/10.52628/87.1.13 Langues : Anglais (eng) Mots-clés : Total knee arthroplasty  outpatient  fast-track program  complications  discharge criteria Résumé : Firstly, this study compared the rate of readmission after a total knee arthroplasty between selected out- patients (no hospitalization, directly sent home after surgery) and inpatients (3 days hospitalization) at 6 weeks. Secondly, it examined the mobility and the complications in the two groups after the same period of time. The rate of readmission, complications and knee mobility of 32 outpatients (M-age : 61 years ± 10 ; 10 females), were compared against those of 32 birth- matched inpatients (M-age : 64 years ± 8.6 ; 10 females). No patient was re-admitted in either group. Post- surgical complications included one hematoma resorbed at 6 weeks in the outpatient group and three joint effusions in the inpatient group. There were no instances of deep venous thrombosis, failure of primary fixation, infection, or wound dehiscence. Knee mobility was identical between the two groups. This is the first study to compare inpatient and outpatient total knee arthroplasty in a Belgian setting. Our study suggests that day-care total knee arthroplasty in selected patients is possible without increasing the rate of re-admission and complications, and without affecting the mobility at 6 weeks. However, the Belgian financial incentives do not seem to currently promote this surgical approach. These results should be confirmed with a larger sample to define the adequate length of stay after a total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=96592 [article] Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes [texte imprimé] / Vincent Tomasi ; Alex Demurie ; Ignace Ghijselings ; Olivier Cornu ; Hans Van Den Wyngaert . - 2021 . - p. 103-109. https://doi.org/10.52628/87.1.13 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 103-109 Mots-clés : Total knee arthroplasty  outpatient  fast-track program  complications  discharge criteria Résumé : Firstly, this study compared the rate of readmission after a total knee arthroplasty between selected out- patients (no hospitalization, directly sent home after surgery) and inpatients (3 days hospitalization) at 6 weeks. Secondly, it examined the mobility and the complications in the two groups after the same period of time. The rate of readmission, complications and knee mobility of 32 outpatients (M-age : 61 years ± 10 ; 10 females), were compared against those of 32 birth- matched inpatients (M-age : 64 years ± 8.6 ; 10 females). No patient was re-admitted in either group. Post- surgical complications included one hematoma resorbed at 6 weeks in the outpatient group and three joint effusions in the inpatient group. There were no instances of deep venous thrombosis, failure of primary fixation, infection, or wound dehiscence. Knee mobility was identical between the two groups. This is the first study to compare inpatient and outpatient total knee arthroplasty in a Belgian setting. Our study suggests that day-care total knee arthroplasty in selected patients is possible without increasing the rate of re-admission and complications, and without affecting the mobility at 6 weeks. However, the Belgian financial incentives do not seem to currently promote this surgical approach. These results should be confirmed with a larger sample to define the adequate length of stay after a total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=96592

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Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up / Y. Warschawski in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 111-116 Titre : Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up Type de document : texte imprimé Auteurs : Y. Warschawski ; S. Garceau ; M. Bonyun ; O. Dahduli ; J. Wolfstadt ; D. Backstein Année de publication : 2021 Article en page(s) : p. 111-116 Note générale : https://doi.org/10.52628/87.1.14 Langues : Anglais (eng) Mots-clés : revision total knee arthroplasty  distal femoral arthroplasty  periprosthetic fracture Résumé : Purpose : distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients. The purpose of the current study was to evaluate a consecutive series of DFPPF treated with DFA, with a minimum 2- year follow-up. Methods : We performed a retrospective study asses- sing the outcomes of distal femoral arthroplasty (DFA) for patients diagnosed with DFPPF. Results : Twenty patients were identified. The mean age of patients was 76.3 (SD, 9.41), the average time from the fracture to revision surgery was 6.7 days (SD, 11.35), The average operative time was 93.5 minutes (SD,16.6). The average follow-up time was 50.15 months (SD, 20.87). During this time, two patients (10%) had complications. One patient experienced a knee dislocation and the second patient had recurrent periprosthetic infections. At final follow up, the mean knee society score was 86.25 (SD, 9.44), the mean Forgotten joint score was 62.16(SD, 23.45) and 93.7 percent of patients were ambulatory. Conclusion : DFA following DFPPF is associated with high success rates and provides patients with the opportunity for return of function in a safe and reliable manner. Permalink : ./index.php?lvl=notice_display&id=96593 [article] Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up [texte imprimé] / Y. Warschawski ; S. Garceau ; M. Bonyun ; O. Dahduli ; J. Wolfstadt ; D. Backstein . - 2021 . - p. 111-116. https://doi.org/10.52628/87.1.14 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 111-116 Mots-clés : revision total knee arthroplasty  distal femoral arthroplasty  periprosthetic fracture Résumé : Purpose : distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients. The purpose of the current study was to evaluate a consecutive series of DFPPF treated with DFA, with a minimum 2- year follow-up. Methods : We performed a retrospective study asses- sing the outcomes of distal femoral arthroplasty (DFA) for patients diagnosed with DFPPF. Results : Twenty patients were identified. The mean age of patients was 76.3 (SD, 9.41), the average time from the fracture to revision surgery was 6.7 days (SD, 11.35), The average operative time was 93.5 minutes (SD,16.6). The average follow-up time was 50.15 months (SD, 20.87). During this time, two patients (10%) had complications. One patient experienced a knee dislocation and the second patient had recurrent periprosthetic infections. At final follow up, the mean knee society score was 86.25 (SD, 9.44), the mean Forgotten joint score was 62.16(SD, 23.45) and 93.7 percent of patients were ambulatory. Conclusion : DFA following DFPPF is associated with high success rates and provides patients with the opportunity for return of function in a safe and reliable manner. Permalink : ./index.php?lvl=notice_display&id=96593

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Return to sport and work after medial open wedge high tibial osteotomy : a case series / Francis De Neve in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 117-124 Titre : Return to sport and work after medial open wedge high tibial osteotomy : a case series Type de document : texte imprimé Auteurs : Francis De Neve ; Brecht Braems ; Milan Holvoet ; Marie-Angélique De Scheerder ; Nele Arnout ; Jan Victor Année de publication : 2021 Article en page(s) : p. 117-124 Note générale : https://doi.org/10.52628/87.1.15 Langues : Anglais (eng) Mots-clés : knee surgery  high tibial osteotomy  return to sport  return to work  osteoarthritis Résumé : Data on return to work and sport following open wedge high tibial osteotomy (HTO) have been underreported. Furthermore, there is no clear consensus in literature about the postoperative alignment goals following HTO. A retrospective case series was performed to evaluate return to sport and work following open wedge HTO. The University of California, Los Angeles scale, the German classification system according to the Reichsausschuß für Arbeitszeitermittlung, the Tegner score and the Knee injury and Osteoarthritis Outcome Score were used to asses the employment status, sport status and clinical outcome at the time of surgery and at final follow-up, minimum 2 years after surgery. The pre- and postoperative hip knee ankle angle (HKA) were documented. The desired postoperative alignment target was 0°-2° valgus mechanical axis. 30 open wedge HTOs were performed of which 27 patients were retrospectively included in the study. 25 out of 26 patients returned to work and 15 out of 17 patients returned to sport following surgery. Outcome scores were significantly higher after surgery. The mean postoperative HKA was 0,9° of valgus mechanical axis. This study shows excellent outcome in sport and work activity and clinical outcome after open wedge HTO. We furthermore suggest that these outcomes can be obtained with a postoperative alignment of 0°-2° of valgus mechanical axis. Permalink : ./index.php?lvl=notice_display&id=96595 [article] Return to sport and work after medial open wedge high tibial osteotomy : a case series [texte imprimé] / Francis De Neve ; Brecht Braems ; Milan Holvoet ; Marie-Angélique De Scheerder ; Nele Arnout ; Jan Victor . - 2021 . - p. 117-124. https://doi.org/10.52628/87.1.15 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 117-124 Mots-clés : knee surgery  high tibial osteotomy  return to sport  return to work  osteoarthritis Résumé : Data on return to work and sport following open wedge high tibial osteotomy (HTO) have been underreported. Furthermore, there is no clear consensus in literature about the postoperative alignment goals following HTO. A retrospective case series was performed to evaluate return to sport and work following open wedge HTO. The University of California, Los Angeles scale, the German classification system according to the Reichsausschuß für Arbeitszeitermittlung, the Tegner score and the Knee injury and Osteoarthritis Outcome Score were used to asses the employment status, sport status and clinical outcome at the time of surgery and at final follow-up, minimum 2 years after surgery. The pre- and postoperative hip knee ankle angle (HKA) were documented. The desired postoperative alignment target was 0°-2° valgus mechanical axis. 30 open wedge HTOs were performed of which 27 patients were retrospectively included in the study. 25 out of 26 patients returned to work and 15 out of 17 patients returned to sport following surgery. Outcome scores were significantly higher after surgery. The mean postoperative HKA was 0,9° of valgus mechanical axis. This study shows excellent outcome in sport and work activity and clinical outcome after open wedge HTO. We furthermore suggest that these outcomes can be obtained with a postoperative alignment of 0°-2° of valgus mechanical axis. Permalink : ./index.php?lvl=notice_display&id=96595

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Solving the enigma of posterolateral tibial plateau fractures, the clue protocol / Radwan G. Metwaly in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 125-136 Titre : Solving the enigma of posterolateral tibial plateau fractures, the clue protocol Type de document : texte imprimé Auteurs : Radwan G. Metwaly ; Zeiad M. Zakaria ; Mohamed A. Elgebeily ; Hany El Zahlawy Année de publication : 2021 Article en page(s) : p. 125-136 Note générale : https://doi.org/10.52628/87.1.16 Langues : Anglais (eng) Mots-clés : Tibial plateau fractures  postero-lateral column  protocol Résumé : The study aim is to evaluate functional and radio- logical outcomes following a suggested protocol based on the four-column classification for management of posterolateral column tibial plateau fractures. A prospective cohort study was performed in level I academic center on 42 patients with mean age of 36 years (22-59). Eleven patients had isolated posterolateral column fractures whereas 31 patients had associated columns fractures. According to the suggested protocol, all cases of isolated posterolateral column fracture started treatment via arthroscopic evaluation of soft tissue injuries (menisci and liga- ments), arthroscopically assisted reduction and inter- nal fixation by rafting screws followed by ORIF if plating was needed. If associated with other columns fractures, columns were fixed sequentially in an anti-clockwise direction starting from anteromedial column. Average follow up was 26 months. Mean time to union was 16.3 (12-22) weeks. No radiological evidence of loss of coronal or sagittal alignment was detected at final follow up. Five patients had an average depression of 5 millimeters that did not need further intervention at this short-term follow up. Mean KOOS was 81 (72- 88). The average knee range of motion was (0° - 127°). One patient had temporary common peroneal nerve injury, one patient had deep infection and two had superficial wound infection. implementing the suggested protocol gives good to excellent radiological and functional results as regard posterolateral tibial plateau fracture. A larger study group with longer follow up is needed. Permalink : ./index.php?lvl=notice_display&id=96596 [article] Solving the enigma of posterolateral tibial plateau fractures, the clue protocol [texte imprimé] / Radwan G. Metwaly ; Zeiad M. Zakaria ; Mohamed A. Elgebeily ; Hany El Zahlawy . - 2021 . - p. 125-136. https://doi.org/10.52628/87.1.16 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 125-136 Mots-clés : Tibial plateau fractures  postero-lateral column  protocol Résumé : The study aim is to evaluate functional and radio- logical outcomes following a suggested protocol based on the four-column classification for management of posterolateral column tibial plateau fractures. A prospective cohort study was performed in level I academic center on 42 patients with mean age of 36 years (22-59). Eleven patients had isolated posterolateral column fractures whereas 31 patients had associated columns fractures. According to the suggested protocol, all cases of isolated posterolateral column fracture started treatment via arthroscopic evaluation of soft tissue injuries (menisci and liga- ments), arthroscopically assisted reduction and inter- nal fixation by rafting screws followed by ORIF if plating was needed. If associated with other columns fractures, columns were fixed sequentially in an anti-clockwise direction starting from anteromedial column. Average follow up was 26 months. Mean time to union was 16.3 (12-22) weeks. No radiological evidence of loss of coronal or sagittal alignment was detected at final follow up. Five patients had an average depression of 5 millimeters that did not need further intervention at this short-term follow up. Mean KOOS was 81 (72- 88). The average knee range of motion was (0° - 127°). One patient had temporary common peroneal nerve injury, one patient had deep infection and two had superficial wound infection. implementing the suggested protocol gives good to excellent radiological and functional results as regard posterolateral tibial plateau fracture. A larger study group with longer follow up is needed. Permalink : ./index.php?lvl=notice_display&id=96596

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Functional outcome of ligament reconstruction with tendon interposition after failed first carpometacarpal joint prosthesis / Lyne Anthonissen in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 137-142 Titre : Functional outcome of ligament reconstruction with tendon interposition after failed first carpometacarpal joint prosthesis Type de document : texte imprimé Auteurs : Lyne Anthonissen ; Elke Van Eynde ; Maarten Van Nuffel ; Luc De Smet Année de publication : 2021 Article en page(s) : p. 137-142 Note générale : https://doi.org/10.52628/87.1.17 Langues : Anglais (eng) Mots-clés : thumb  LRTI  first carpometacarpal joint prosthesis  revision  strength loss Résumé : The purpose is to determine if ligament reconstruction with tendon interposition (LRTI) is a recommendable salvage option for failed total joint prosthesis of the first carpometacarpal joint. Twenty-two patients in our database met the in- clusion criteria for this retrospective study, with at least 6 months follow-up. Fourteen participated and were invited for a clinical examination and asked to fill out two questionnaires. They were evaluated for pain (VAS), impairment (NHS), disability (Quick DASH), opposition (Kapandji test) and grip strength (hydraulic dynamometer). Results of the questionnaires were compared to a cohort study of primary LRTI’s. Kapandji test and grip strength were compared to the contralateral side. Compared to primary LRTI’s, revision surgery showed mild deterioration of impairment and disability. The average VAS score was 2.9 out of 10. Twelve patients mentioned a sense of strength loss, which could be quantified with the dynamometer : a mean of 15.1 kg (operated thumb) versus 20.5 kg (contralateral). There was a relatively small decline of opposition with Kapandji 8.6 versus 9.9. The overall satisfaction was good for 8 patients, fair for 3 and poor for the remaining 3 (mainly based on strength loss). One patient needed a second revision. Failed first carpometacarpal joint replacement can be salvaged by ligament reconstruction with tendon interposition, providing an acceptable functional outcome in 79% of cases studied. However, compared to the functional outcome of primary LRTI’s, mild aggravation of impairment and disability should be taken into account. Permalink : ./index.php?lvl=notice_display&id=96597 [article] Functional outcome of ligament reconstruction with tendon interposition after failed first carpometacarpal joint prosthesis [texte imprimé] / Lyne Anthonissen ; Elke Van Eynde ; Maarten Van Nuffel ; Luc De Smet . - 2021 . - p. 137-142. https://doi.org/10.52628/87.1.17 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 137-142 Mots-clés : thumb  LRTI  first carpometacarpal joint prosthesis  revision  strength loss Résumé : The purpose is to determine if ligament reconstruction with tendon interposition (LRTI) is a recommendable salvage option for failed total joint prosthesis of the first carpometacarpal joint. Twenty-two patients in our database met the in- clusion criteria for this retrospective study, with at least 6 months follow-up. Fourteen participated and were invited for a clinical examination and asked to fill out two questionnaires. They were evaluated for pain (VAS), impairment (NHS), disability (Quick DASH), opposition (Kapandji test) and grip strength (hydraulic dynamometer). Results of the questionnaires were compared to a cohort study of primary LRTI’s. Kapandji test and grip strength were compared to the contralateral side. Compared to primary LRTI’s, revision surgery showed mild deterioration of impairment and disability. The average VAS score was 2.9 out of 10. Twelve patients mentioned a sense of strength loss, which could be quantified with the dynamometer : a mean of 15.1 kg (operated thumb) versus 20.5 kg (contralateral). There was a relatively small decline of opposition with Kapandji 8.6 versus 9.9. The overall satisfaction was good for 8 patients, fair for 3 and poor for the remaining 3 (mainly based on strength loss). One patient needed a second revision. Failed first carpometacarpal joint replacement can be salvaged by ligament reconstruction with tendon interposition, providing an acceptable functional outcome in 79% of cases studied. However, compared to the functional outcome of primary LRTI’s, mild aggravation of impairment and disability should be taken into account. Permalink : ./index.php?lvl=notice_display&id=96597

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Functional and radiological outcome after forearm plating in children and adolescent fracture / Paul Cremer in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 143-149 Titre : Functional and radiological outcome after forearm plating in children and adolescent fracture Type de document : texte imprimé Auteurs : Paul Cremer ; Audrey Angelliaume ; Abdelfetah Lalioui ; Gabriel Cellarier ; Luke Harper ; Yan Lefevre Année de publication : 2021 Article en page(s) : p. 143-149 Note générale : https://doi.org/10.52628/87.1.18 Langues : Anglais (eng) Mots-clés : forearm  overgrowth  plate  children and adolescent Résumé : The literature on forearm overgrowth after plating in traumatic conditions is relatively poor though this technique can be useful when intra-medullary nailing is not sufficient in pediatric cases. The goal of this study was to assess a potential overgrowth after plating and identify impact on function. We conducted a retrospective study of all pediatric patients who underwent open surgery of the radius and/or ulna diaphysis with internal fixation by plating, in our institution, between October 2013 and July 2019. At last follow-up, functional and radiological outcomes were compared between the operated and uninjured forearm. Range of motion (ROM) of the wrist and elbow, clinical scores, radial and ulnar length were measured. A positive bone length discrepancy of more than 2mm was considered as an overgrowth. Were also studied the radio-ulnar index, radial inclination and radiocarpal angle. Thirteen patients were included. The mean age was 12.1 years old (±3.0 years), they were plated on the radius (10 cases) or on the ulna (3 cases). Mean follow- up was 4.4 years (± 1.8). In two cases, the plated bone (radius) was significantly longer than the uninjured one. There was no significant difference regarding radio-ulnar index, radial inclination and radiocarpal angle. The only statistically significant difference between the operated and uninjured forearm was the pronation/supination range, which was greater in the uninjured forearm (mean 160 ±48° versus 175 ±49°, p=0.01). This study confirms the good functional and radiological outcomes after plating even in a skeletally immature forearm. Permalink : ./index.php?lvl=notice_display&id=96598 [article] Functional and radiological outcome after forearm plating in children and adolescent fracture [texte imprimé] / Paul Cremer ; Audrey Angelliaume ; Abdelfetah Lalioui ; Gabriel Cellarier ; Luke Harper ; Yan Lefevre . - 2021 . - p. 143-149. https://doi.org/10.52628/87.1.18 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 143-149 Mots-clés : forearm  overgrowth  plate  children and adolescent Résumé : The literature on forearm overgrowth after plating in traumatic conditions is relatively poor though this technique can be useful when intra-medullary nailing is not sufficient in pediatric cases. The goal of this study was to assess a potential overgrowth after plating and identify impact on function. We conducted a retrospective study of all pediatric patients who underwent open surgery of the radius and/or ulna diaphysis with internal fixation by plating, in our institution, between October 2013 and July 2019. At last follow-up, functional and radiological outcomes were compared between the operated and uninjured forearm. Range of motion (ROM) of the wrist and elbow, clinical scores, radial and ulnar length were measured. A positive bone length discrepancy of more than 2mm was considered as an overgrowth. Were also studied the radio-ulnar index, radial inclination and radiocarpal angle. Thirteen patients were included. The mean age was 12.1 years old (±3.0 years), they were plated on the radius (10 cases) or on the ulna (3 cases). Mean follow- up was 4.4 years (± 1.8). In two cases, the plated bone (radius) was significantly longer than the uninjured one. There was no significant difference regarding radio-ulnar index, radial inclination and radiocarpal angle. The only statistically significant difference between the operated and uninjured forearm was the pronation/supination range, which was greater in the uninjured forearm (mean 160 ±48° versus 175 ±49°, p=0.01). This study confirms the good functional and radiological outcomes after plating even in a skeletally immature forearm. Permalink : ./index.php?lvl=notice_display&id=96598

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Improved long-term functional outcome after a latissimus dorsi transfer with or without subscapularis muscle lengthening or release / Stijn De Joode in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p.151-157 Titre : Improved long-term functional outcome after a latissimus dorsi transfer with or without subscapularis muscle lengthening or release Type de document : texte imprimé Auteurs : Stijn De Joode ; Lazin Germawi ; Martijn Schotanus ; Juul Van Der Lingen ; Tom Van Mulken ; Ferry Van Nie ; Steven Samijo Année de publication : 2021 Article en page(s) : p.151-157 Note générale : https://doi.org/10.52628/87.1.19 Langues : Anglais (eng) Mots-clés : brachial plexus birth injury  latissimus dorsi transfer  subscapularis lengthening  subscapularis release  long-term follow-up Résumé : A brachial plexus birth injury (BPBI) can lead to a limited shoulder function, especially abduction and external rotation. One of the treatment options to restore those shoulder functions is a latissimus dorsi transfer (LDT). The aim of this study is to analyze long-term functional outcome after a single LDT and compare these results with LDT combined with subscapularis muscle lengthening (SSL) or subscapularis muscle release (SSR). This cohort study included 39 patients (≤12 years old) with one-sided BPBI. All patients had an inter- nal rotation- and adduction contracture without glenohumeral joint deformity. A LDT was performed with or without SSL or SSR, resulting in 3 patient study groups. Demographic data and pre- and post- operative Mallet scores were collected and analysed for each group. The median age was 4.0 years (IQR 3.1) and there were no differences in patient demographics. In all patients surgery improved external rotation and overall shoulder function, at 9.8 years follow-up. Also, the total Mallet score increased significantly with 1.7 (p=0.001) in our (entire) study cohort. A LDT, with a SSL or SSR in case of an intra-operative internal contracture, improves shoulder function and preserves external rotation in patients (≤12 years old) with BPBI, at a follow up of 9.8 years. Permalink : ./index.php?lvl=notice_display&id=96599 [article] Improved long-term functional outcome after a latissimus dorsi transfer with or without subscapularis muscle lengthening or release [texte imprimé] / Stijn De Joode ; Lazin Germawi ; Martijn Schotanus ; Juul Van Der Lingen ; Tom Van Mulken ; Ferry Van Nie ; Steven Samijo . - 2021 . - p.151-157. https://doi.org/10.52628/87.1.19 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p.151-157 Mots-clés : brachial plexus birth injury  latissimus dorsi transfer  subscapularis lengthening  subscapularis release  long-term follow-up Résumé : A brachial plexus birth injury (BPBI) can lead to a limited shoulder function, especially abduction and external rotation. One of the treatment options to restore those shoulder functions is a latissimus dorsi transfer (LDT). The aim of this study is to analyze long-term functional outcome after a single LDT and compare these results with LDT combined with subscapularis muscle lengthening (SSL) or subscapularis muscle release (SSR). This cohort study included 39 patients (≤12 years old) with one-sided BPBI. All patients had an inter- nal rotation- and adduction contracture without glenohumeral joint deformity. A LDT was performed with or without SSL or SSR, resulting in 3 patient study groups. Demographic data and pre- and post- operative Mallet scores were collected and analysed for each group. The median age was 4.0 years (IQR 3.1) and there were no differences in patient demographics. In all patients surgery improved external rotation and overall shoulder function, at 9.8 years follow-up. Also, the total Mallet score increased significantly with 1.7 (p=0.001) in our (entire) study cohort. A LDT, with a SSL or SSR in case of an intra-operative internal contracture, improves shoulder function and preserves external rotation in patients (≤12 years old) with BPBI, at a follow up of 9.8 years. Permalink : ./index.php?lvl=notice_display&id=96599

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Children with supracondylar humerus fractures have an increased risk of attention deficit hyperactivity disorder / Erdinç Genç in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 159-166 Titre : Children with supracondylar humerus fractures have an increased risk of attention deficit hyperactivity disorder Type de document : texte imprimé Auteurs : Erdinç Genç ; Herdem Aslan Genç ; Gresa Carkaxhiu Bulut Année de publication : 2021 Article en page(s) : p. 159-166 Note générale : https://doi.org/10.52628/87.1.20 Langues : Anglais (eng) Mots-clés : Supracondylar humerus fractures  children  Attention Deficit Hyperactivity Disorder (ADHD)  injury  behavior Résumé : Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sustaining fractures during their preschool years. Supracondylar humerus fractures (SHFs) comprise the majority of fracture surgeries in the pediatric age range. We hypothesized that ADHD symptoms would be present in children with SHFs, and this characteristic trauma may be associated with an ADHD diagnosis. Thus, we compared the ADHD symptoms of children with and without SHFs. Further, we compared the trauma characteristics, gender, proneness to injury, and presence of prior trauma history of children diagnosed with and without ADHD. We recruited 41 children who were admitted to emergency service with an SHF and 41 age- and gender-matched children without a fracture history. A semi-structured diagnostic inter- view and a Swanson Nolan Pelham questionnaire were used to obtain data about ADHD symptoms. A clinical intake form was utilized for further clinical data. ADHD symptoms were significantly higher in the fracture group ; male gender, parent- reported proneness to injury, and prior history of trauma were significantly associated with ADHD. Orthopedic surgeons may provide early detection of ADHD by using screening tools or asking questions to caregivers and making referrals when needed. This may lead to prevention of further injuries. Permalink : ./index.php?lvl=notice_display&id=96600 [article] Children with supracondylar humerus fractures have an increased risk of attention deficit hyperactivity disorder [texte imprimé] / Erdinç Genç ; Herdem Aslan Genç ; Gresa Carkaxhiu Bulut . - 2021 . - p. 159-166. https://doi.org/10.52628/87.1.20 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 159-166 Mots-clés : Supracondylar humerus fractures  children  Attention Deficit Hyperactivity Disorder (ADHD)  injury  behavior Résumé : Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sustaining fractures during their preschool years. Supracondylar humerus fractures (SHFs) comprise the majority of fracture surgeries in the pediatric age range. We hypothesized that ADHD symptoms would be present in children with SHFs, and this characteristic trauma may be associated with an ADHD diagnosis. Thus, we compared the ADHD symptoms of children with and without SHFs. Further, we compared the trauma characteristics, gender, proneness to injury, and presence of prior trauma history of children diagnosed with and without ADHD. We recruited 41 children who were admitted to emergency service with an SHF and 41 age- and gender-matched children without a fracture history. A semi-structured diagnostic inter- view and a Swanson Nolan Pelham questionnaire were used to obtain data about ADHD symptoms. A clinical intake form was utilized for further clinical data. ADHD symptoms were significantly higher in the fracture group ; male gender, parent- reported proneness to injury, and prior history of trauma were significantly associated with ADHD. Orthopedic surgeons may provide early detection of ADHD by using screening tools or asking questions to caregivers and making referrals when needed. This may lead to prevention of further injuries. Permalink : ./index.php?lvl=notice_display&id=96600

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Proximal femoral derotation osteotomy in children with CP : long term outcome and the role of age at time of surgery / Lieven Vermuyten in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 167-173 Titre : Proximal femoral derotation osteotomy in children with CP : long term outcome and the role of age at time of surgery Type de document : texte imprimé Auteurs : Lieven Vermuyten ; Katleen Desloovere ; Guy Molenaers ; Anja Van Campenhout Année de publication : 2021 Article en page(s) : p. 167-173 Note générale : https://doi.org/10.52628/87.1.21 Langues : Anglais (eng) Mots-clés : cerebral palsy  femoral derotation osteotomy  gait analysis  age Résumé : The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotated gait. This study provides quantitative evidence in support of the beneficial effect of FDO after long term follow up. Retrospective clinical and kinematic evaluation of 31 CP patients (55 operated limbs) pre-, 1 and 3 years postoperatively after proximal FDO was conducted for a minimal follow-up of 3 years. This group con- sisted of 20 men and 11 women, aged 10.68±3.31 years at the time of surgery. Minimum follow up was 3 years (3.16±0.53 years), with 22 patients (38 operated limbs) having an additional follow up at 5 years (5.02±0.49 years). Age at FU3 and FU5 was 14.06±3.52 years and 15.39±3.08 years respectively. A set of clinical and kinematic parameters were ana- lyzed and showed a significant correction of mean hip rotation and femoral anteversion after FDO. Further plotting of individual data comparing 3 or 5 year postoperative values to 1 year postoperative values showed no further significant changes, indicating sustained correction of internally rotted gait until end of our follow up. Plotting mean hip rotation in stance as well as kinematic knee parameters according to age grouped cohorts could not show age at time of surgery to be a significant factor in recurrence of internally rotated gait or preoperative disturbances of knee motion in the sagittal plane. This study provides quantitative evidence on the beneficial effect of FDO, a surgical technique to improve internally rotated gait in cerebral palsy patients with spastic diplegia. Pre- and postoperative clinical and kinematic parameters are compared and results are discussed. Minimum follow up was 3 years with a mean follow up of 4.65±0.83 years. The effect of age at time of surgery on recurrence and kinematic parameters were studied. Permalink : ./index.php?lvl=notice_display&id=96601 [article] Proximal femoral derotation osteotomy in children with CP : long term outcome and the role of age at time of surgery [texte imprimé] / Lieven Vermuyten ; Katleen Desloovere ; Guy Molenaers ; Anja Van Campenhout . - 2021 . - p. 167-173. https://doi.org/10.52628/87.1.21 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 167-173 Mots-clés : cerebral palsy  femoral derotation osteotomy  gait analysis  age Résumé : The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotated gait. This study provides quantitative evidence in support of the beneficial effect of FDO after long term follow up. Retrospective clinical and kinematic evaluation of 31 CP patients (55 operated limbs) pre-, 1 and 3 years postoperatively after proximal FDO was conducted for a minimal follow-up of 3 years. This group con- sisted of 20 men and 11 women, aged 10.68±3.31 years at the time of surgery. Minimum follow up was 3 years (3.16±0.53 years), with 22 patients (38 operated limbs) having an additional follow up at 5 years (5.02±0.49 years). Age at FU3 and FU5 was 14.06±3.52 years and 15.39±3.08 years respectively. A set of clinical and kinematic parameters were ana- lyzed and showed a significant correction of mean hip rotation and femoral anteversion after FDO. Further plotting of individual data comparing 3 or 5 year postoperative values to 1 year postoperative values showed no further significant changes, indicating sustained correction of internally rotted gait until end of our follow up. Plotting mean hip rotation in stance as well as kinematic knee parameters according to age grouped cohorts could not show age at time of surgery to be a significant factor in recurrence of internally rotated gait or preoperative disturbances of knee motion in the sagittal plane. This study provides quantitative evidence on the beneficial effect of FDO, a surgical technique to improve internally rotated gait in cerebral palsy patients with spastic diplegia. Pre- and postoperative clinical and kinematic parameters are compared and results are discussed. Minimum follow up was 3 years with a mean follow up of 4.65±0.83 years. The effect of age at time of surgery on recurrence and kinematic parameters were studied. Permalink : ./index.php?lvl=notice_display&id=96601

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Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study / Thibault Dewilde in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 175-179 Titre : Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study Type de document : texte imprimé Auteurs : Thibault Dewilde ; Sebastiaan Schelfaut ; Sven Bamps ; Matthias Papen ; Pierre Moens Année de publication : 2021 Article en page(s) : p. 175-179 Note générale : https://doi.org/10.52628/87.1.22 Langues : Anglais (eng) Mots-clés : scoliosis  coronal balance  intraoperative assesment  coronal alignement  scoliosis surgery Résumé : Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Permalink : ./index.php?lvl=notice_display&id=96602 [article] Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study [texte imprimé] / Thibault Dewilde ; Sebastiaan Schelfaut ; Sven Bamps ; Matthias Papen ; Pierre Moens . - 2021 . - p. 175-179. https://doi.org/10.52628/87.1.22 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 175-179 Mots-clés : scoliosis  coronal balance  intraoperative assesment  coronal alignement  scoliosis surgery Résumé : Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Permalink : ./index.php?lvl=notice_display&id=96602

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Is the AO spine thoracolumbar injury classification system reliable and practical? a systematic review / Zion Hwang in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 181-190 Titre : Is the AO spine thoracolumbar injury classification system reliable and practical? a systematic review Type de document : texte imprimé Auteurs : Zion Hwang ; James Houston ; Evangelos M. Fragakis ; Christina Lupu ; Jason Bernard ; Tim Bishop ; Darren F. Lui Année de publication : 2021 Article en page(s) : p. 181-190 Note générale : https://doi.org/10.52628/87.1.23 Langues : Anglais (eng) Mots-clés : AOTLIC  ATLICS  AO  spine  thoraco-lumbar  injury classification  systematic review, reliability Résumé : Controversy surrounding the classification of thoracolumbar injuries has given rise to various classification systems over the years, including the most recent AOSpine Thoracolumbar Injury Classification System (ATLICS). This systematic review aims to provide an up-to-date evaluation of the literature, including assessment of a further three studies not analysed in previous reviews. In doing so, this is the first systematic review to include the reliability among non-spine subspecialty professionals and to document the wide variety between reliability across studies, particularly with regard to sub-type classification. Relevant studies were found via a systematic search of PubMed, EBESCO, Cochrane and Web of Science. Data extraction and quality assessment were conducted in line with Cochrane Collaboration guidelines. Twelve articles assessing the reliability of ATLICS were included in this review. The overall inter-observer reliability varied from fair to substantial, but the three additional studies in this review, compared to previous reviews, presented on average only fair reliability. The greatest variation of results was seen in A1 and B3 subtypes. Least reliably classified on average was A4 subtype. This systematic review concludes that ATLICS is reliable for the majority of injuries, but the variability within subtypes suggests the need for further research in assessing the needs of users in order to increase familiarity with ATLICS or perhaps the necessity to include more subtype-specific criteria into the system. Further research is also recommended on the reliability of modifiers, neurological classification and the application of ATLICS in a paediatric context. Permalink : ./index.php?lvl=notice_display&id=96603 [article] Is the AO spine thoracolumbar injury classification system reliable and practical? a systematic review [texte imprimé] / Zion Hwang ; James Houston ; Evangelos M. Fragakis ; Christina Lupu ; Jason Bernard ; Tim Bishop ; Darren F. Lui . - 2021 . - p. 181-190. https://doi.org/10.52628/87.1.23 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 181-190 Mots-clés : AOTLIC  ATLICS  AO  spine  thoraco-lumbar  injury classification  systematic review, reliability Résumé : Controversy surrounding the classification of thoracolumbar injuries has given rise to various classification systems over the years, including the most recent AOSpine Thoracolumbar Injury Classification System (ATLICS). This systematic review aims to provide an up-to-date evaluation of the literature, including assessment of a further three studies not analysed in previous reviews. In doing so, this is the first systematic review to include the reliability among non-spine subspecialty professionals and to document the wide variety between reliability across studies, particularly with regard to sub-type classification. Relevant studies were found via a systematic search of PubMed, EBESCO, Cochrane and Web of Science. Data extraction and quality assessment were conducted in line with Cochrane Collaboration guidelines. Twelve articles assessing the reliability of ATLICS were included in this review. The overall inter-observer reliability varied from fair to substantial, but the three additional studies in this review, compared to previous reviews, presented on average only fair reliability. The greatest variation of results was seen in A1 and B3 subtypes. Least reliably classified on average was A4 subtype. This systematic review concludes that ATLICS is reliable for the majority of injuries, but the variability within subtypes suggests the need for further research in assessing the needs of users in order to increase familiarity with ATLICS or perhaps the necessity to include more subtype-specific criteria into the system. Further research is also recommended on the reliability of modifiers, neurological classification and the application of ATLICS in a paediatric context. Permalink : ./index.php?lvl=notice_display&id=96603

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Implant failure following pedicle based dynamic stabilization of the lumbar spine / Hans Schauvliege in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 191-196 Titre : Implant failure following pedicle based dynamic stabilization of the lumbar spine Type de document : texte imprimé Auteurs : Hans Schauvliege ; Marc Du Bois ; Jan Verlooy Année de publication : 2021 Article en page(s) : p. 191-196 Note générale : https://doi.org/10.52628/87.1.24 Langues : Anglais (eng) Mots-clés : medical device  pedicle based dynamic stabilization  market authorization  failure  product liability Résumé : Pedicle-based dynamic stabilization (PBDS) devices such as Dynesys are promoted as an alternative and less invasive option for rigid stabilization of one and even more levels of the lumbar spine. Promising features of the Dynesys system, as well as shortcomings, became obvious in several clinical studies. Since 2012, we started using a new PBDS device as an alternative for the Dynesys, to avoid the screw loosening and the kyphosing effect. The objective is to compare failure rates between the Dynesys and Balan-C type PBDS implant and factors affecting outcome. In a retrospective study we investigated a total of 90 patients with lumbar pedicle screw dynamic stabilization (a group of 64 patiënts with Dynesys stabilization is compared to a group of 26 patients with Balan-C stabilization). Mean follow-up was 48 and 38 months, respectively. Using logistic regression analysis the impact of baseline characteristics such as gender, age, body mass index (BMI), indication for surgery, primary or revision surgery, single versus more level surgery, surgeon’s experience and type of the implant on implant failure was analyzed. We found a statistically significant difference in failure rates between the two systems (13% in the Dynesys group versus 62% in the Balan-C group). In multivariate analysis, type of implant was associated with implant failure (odds ratio : 13). Our current results call for an optimization of the pre-and post-marketing surveillance of pedicle-based dynamic stabilization. Permalink : ./index.php?lvl=notice_display&id=96607 [article] Implant failure following pedicle based dynamic stabilization of the lumbar spine [texte imprimé] / Hans Schauvliege ; Marc Du Bois ; Jan Verlooy . - 2021 . - p. 191-196. https://doi.org/10.52628/87.1.24 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 191-196 Mots-clés : medical device  pedicle based dynamic stabilization  market authorization  failure  product liability Résumé : Pedicle-based dynamic stabilization (PBDS) devices such as Dynesys are promoted as an alternative and less invasive option for rigid stabilization of one and even more levels of the lumbar spine. Promising features of the Dynesys system, as well as shortcomings, became obvious in several clinical studies. Since 2012, we started using a new PBDS device as an alternative for the Dynesys, to avoid the screw loosening and the kyphosing effect. The objective is to compare failure rates between the Dynesys and Balan-C type PBDS implant and factors affecting outcome. In a retrospective study we investigated a total of 90 patients with lumbar pedicle screw dynamic stabilization (a group of 64 patiënts with Dynesys stabilization is compared to a group of 26 patients with Balan-C stabilization). Mean follow-up was 48 and 38 months, respectively. Using logistic regression analysis the impact of baseline characteristics such as gender, age, body mass index (BMI), indication for surgery, primary or revision surgery, single versus more level surgery, surgeon’s experience and type of the implant on implant failure was analyzed. We found a statistically significant difference in failure rates between the two systems (13% in the Dynesys group versus 62% in the Balan-C group). In multivariate analysis, type of implant was associated with implant failure (odds ratio : 13). Our current results call for an optimization of the pre-and post-marketing surveillance of pedicle-based dynamic stabilization. Permalink : ./index.php?lvl=notice_display&id=96607

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Big and deep seated lipomatous tumours in children : results of surgical treatment / Emin Özkul in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 197-200 Titre : Big and deep seated lipomatous tumours in children : results of surgical treatment Type de document : texte imprimé Auteurs : Emin Özkul ; Serhat Elçi ; Muhsin Elçi ; Celil Alemdir Année de publication : 2021 Article en page(s) : p. 197-200 Note générale : https://doi.org/10.52628/87.1.25 Langues : Anglais (eng) Mots-clés : lipoma  child  surgery Résumé : The objective of the study is aimed to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location. Permalink : ./index.php?lvl=notice_display&id=96608 [article] Big and deep seated lipomatous tumours in children : results of surgical treatment [texte imprimé] / Emin Özkul ; Serhat Elçi ; Muhsin Elçi ; Celil Alemdir . - 2021 . - p. 197-200. https://doi.org/10.52628/87.1.25 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 197-200 Mots-clés : lipoma  child  surgery Résumé : The objective of the study is aimed to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location. Permalink : ./index.php?lvl=notice_display&id=96608

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