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The role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation / erden Sahim in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 587-592 Titre : The role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation Type de document : texte imprimé Auteurs : erden Sahim ; Bedri Karaismailoglu ; Mahmut Kursat Ozsahim Année de publication : 2021 Article en page(s) : p. 587-592 Note générale : https://doi.org/10.52628/87.4.02 Langues : Anglais (eng) Mots-clés : periprosthetic joint infection  diagnosis  arthroplasty  knee revision  hip revision  d-dimer Résumé : D-dimer is a fibrin degradation product formed by the destruction of the cross-linked fibrin clot by activation of the coagulation system. Many studies have shown that systemic and local infections cause fibrinolytic activities. The purpose of this study was to determine the role of serum D-dimer in the diagnosis of periprosthetic joint infection (PJI) and the timing of reimplantation. The patients who underwent primary and revision knee or hip arthroplasty between July 2018 and May 2019 were prospectively evaluated. All surgeries were performed by the same surgeon. 60 of 71 patients who met our criteria were included in the study, comprising of 27 primary arthroplasties (PA), 21 two-stage septic revision (SR) and 12 aseptic revision (AR). We analyzed D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. The values of the septic group were evaluated as two groups; Group 1 (before the first stage) and Group 2 (before the second stage) to investigate the role of D-dimer in determining the timing of reimplantation. D-dimer level was significantly higher in the SR group compared to PA and AR groups (p<0.001 and p=0.045). CRP and ESR levels were significantly higher in the SR group compared to PA and AR groups. There was no statistically significant difference between preoperative D-dimer levels of Group 1 and Group 2 (p=0.2). Serum D-dimer level can be used as an easy and inexpensive test to support the diagnosis of PJI. But the D-dimer level is not useful to determine the timing of reimplantation. Permalink : ./index.php?lvl=notice_display&id=102006 [article] The role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation [texte imprimé] / erden Sahim ; Bedri Karaismailoglu ; Mahmut Kursat Ozsahim . - 2021 . - p. 587-592. https://doi.org/10.52628/87.4.02 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 587-592 Mots-clés : periprosthetic joint infection  diagnosis  arthroplasty  knee revision  hip revision  d-dimer Résumé : D-dimer is a fibrin degradation product formed by the destruction of the cross-linked fibrin clot by activation of the coagulation system. Many studies have shown that systemic and local infections cause fibrinolytic activities. The purpose of this study was to determine the role of serum D-dimer in the diagnosis of periprosthetic joint infection (PJI) and the timing of reimplantation. The patients who underwent primary and revision knee or hip arthroplasty between July 2018 and May 2019 were prospectively evaluated. All surgeries were performed by the same surgeon. 60 of 71 patients who met our criteria were included in the study, comprising of 27 primary arthroplasties (PA), 21 two-stage septic revision (SR) and 12 aseptic revision (AR). We analyzed D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. The values of the septic group were evaluated as two groups; Group 1 (before the first stage) and Group 2 (before the second stage) to investigate the role of D-dimer in determining the timing of reimplantation. D-dimer level was significantly higher in the SR group compared to PA and AR groups (p<0.001 and p=0.045). CRP and ESR levels were significantly higher in the SR group compared to PA and AR groups. There was no statistically significant difference between preoperative D-dimer levels of Group 1 and Group 2 (p=0.2). Serum D-dimer level can be used as an easy and inexpensive test to support the diagnosis of PJI. But the D-dimer level is not useful to determine the timing of reimplantation. Permalink : ./index.php?lvl=notice_display&id=102006

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Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA / Jetse Jelsma in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 593-599 Titre : Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA Type de document : texte imprimé Auteurs : Jetse Jelsma, Auteur ; Sander Van Kuijk ; Ivo Buil Année de publication : 2021 Article en page(s) : p. 593-599 Note générale : https://doi.org/10.52628/87.4.03 Langues : Anglais (eng) Mots-clés : hip arthroplasty  patient reported outcomes (PROMs)  physical activity  physical activity monitoring  wearables Résumé : In orthopaedics, patient reported outcomes (PROMs) are designed to quantify changes in pain and to assess physical function, most often after joint arthroplasty. However, PROMs have some disadvantages, most important is their subjective nature. The aim was to investigate how patient-self-reported-outcomes of general health, disease-specific outcome and physical function, joint-awareness and self-perceived activity- levels are correlated with objectively-measured physical-activity (PA) parameters derived from wearable activity-monitors (AM) in subjects with a hip-arthroplasty. A prospective cohort study was conducted in a group of 32 patients, with a mean follow-up of 10 years after total hip arthroplasty. To assess different domains, the SF-36 (general health), HOOS-PS (pain/functional outcome), FJS-12 (joint awareness) and SQUASH (physical activity) were chosen. Activity-monitoring was performed using a 3-axis accelerometer, gyroscope and magnetometer. No significant correlations between PA-parameters and the FJS-12 and SQUASH were found. The HOOS- PS was significant correlated with BMI, the daily time walking and total-time active and the amount of daily steps. The physical functioning-subscale of the SF-36 was significant negative correlated with BMI and time sitting, but significant positive correlated with time walking, total-time active and the amount of daily steps. Considering the value of PA for maintaining general health, the value of using sensor-based AMs to assess efficacy of treatments in this health related dimension or use it as a tool for patient education, awareness and communication, seems very high. Permalink : ./index.php?lvl=notice_display&id=102008 [article] Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA [texte imprimé] / Jetse Jelsma, Auteur ; Sander Van Kuijk ; Ivo Buil . - 2021 . - p. 593-599. https://doi.org/10.52628/87.4.03 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 593-599 Mots-clés : hip arthroplasty  patient reported outcomes (PROMs)  physical activity  physical activity monitoring  wearables Résumé : In orthopaedics, patient reported outcomes (PROMs) are designed to quantify changes in pain and to assess physical function, most often after joint arthroplasty. However, PROMs have some disadvantages, most important is their subjective nature. The aim was to investigate how patient-self-reported-outcomes of general health, disease-specific outcome and physical function, joint-awareness and self-perceived activity- levels are correlated with objectively-measured physical-activity (PA) parameters derived from wearable activity-monitors (AM) in subjects with a hip-arthroplasty. A prospective cohort study was conducted in a group of 32 patients, with a mean follow-up of 10 years after total hip arthroplasty. To assess different domains, the SF-36 (general health), HOOS-PS (pain/functional outcome), FJS-12 (joint awareness) and SQUASH (physical activity) were chosen. Activity-monitoring was performed using a 3-axis accelerometer, gyroscope and magnetometer. No significant correlations between PA-parameters and the FJS-12 and SQUASH were found. The HOOS- PS was significant correlated with BMI, the daily time walking and total-time active and the amount of daily steps. The physical functioning-subscale of the SF-36 was significant negative correlated with BMI and time sitting, but significant positive correlated with time walking, total-time active and the amount of daily steps. Considering the value of PA for maintaining general health, the value of using sensor-based AMs to assess efficacy of treatments in this health related dimension or use it as a tool for patient education, awareness and communication, seems very high. Permalink : ./index.php?lvl=notice_display&id=102008

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Risk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients / Florian Radetzki in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 601-606 Titre : Risk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients Type de document : texte imprimé Auteurs : Florian Radetzki ; Tina Körber ; David Wohlrab Année de publication : 2021 Article en page(s) : p. 601-606 Note générale : https://doi.org/10.52628/87.4.04 Langues : Anglais (eng) Mots-clés : fast track program  hip arthroplasty  restrictive factors Résumé : Fast track programs have been introduced to reduce perioperative complication rates and to quickly reintegrate the patient into everyday life. The aim of this retrospective case-control study was to identify patient characteristics and patient-independent factors that influence fast track programs in hip arthroplasty. A total of 1138 patients were examined. A hospital stay of more than seven days was used to define the case group. In addition to the causes for the longer hospitalisation, age, sex, BMI, chronic nicotine and alcohol abuse, ASA score, surgical duration, anaemia and blood transfusion as well as concomitant diseases were assessed. The statistical analysis included two-sample t-test, chi-square test and logistic regression analyses. An 95% confidence interval was calculated (p<0.05). 16.9% of patients could not leave the hospital on the seventh day. The main causes were delayed wound healing (69.4%), increased CRP (43.0%>100 mg/l), and internal complications (19.7%). At a mean of 69.2 ± 10.7 years, the age of the case group was significantly higher than that of the control group, which had a mean of 63.3 ± 10.3 years (p<0.001). Cardiac comorbidities (p<0.001), BMI (p=0.023), and alcohol consumption (p<0.001) increased the risk for longer hospitalisation. Significant patient-independent factors were duration of the surgery (p<0.001) and transfusion (p<0.001). Successful application of fast-track hip arthroplasty is possible for every patient. However, longer hospi- talisation and delayed discharge must be taken into account for patients with advanced age, cardiac comorbidities, alcohol consumption, and high BMI. Permalink : ./index.php?lvl=notice_display&id=102009 [article] Risk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients [texte imprimé] / Florian Radetzki ; Tina Körber ; David Wohlrab . - 2021 . - p. 601-606. https://doi.org/10.52628/87.4.04 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 601-606 Mots-clés : fast track program  hip arthroplasty  restrictive factors Résumé : Fast track programs have been introduced to reduce perioperative complication rates and to quickly reintegrate the patient into everyday life. The aim of this retrospective case-control study was to identify patient characteristics and patient-independent factors that influence fast track programs in hip arthroplasty. A total of 1138 patients were examined. A hospital stay of more than seven days was used to define the case group. In addition to the causes for the longer hospitalisation, age, sex, BMI, chronic nicotine and alcohol abuse, ASA score, surgical duration, anaemia and blood transfusion as well as concomitant diseases were assessed. The statistical analysis included two-sample t-test, chi-square test and logistic regression analyses. An 95% confidence interval was calculated (p<0.05). 16.9% of patients could not leave the hospital on the seventh day. The main causes were delayed wound healing (69.4%), increased CRP (43.0%>100 mg/l), and internal complications (19.7%). At a mean of 69.2 ± 10.7 years, the age of the case group was significantly higher than that of the control group, which had a mean of 63.3 ± 10.3 years (p<0.001). Cardiac comorbidities (p<0.001), BMI (p=0.023), and alcohol consumption (p<0.001) increased the risk for longer hospitalisation. Significant patient-independent factors were duration of the surgery (p<0.001) and transfusion (p<0.001). Successful application of fast-track hip arthroplasty is possible for every patient. However, longer hospi- talisation and delayed discharge must be taken into account for patients with advanced age, cardiac comorbidities, alcohol consumption, and high BMI. Permalink : ./index.php?lvl=notice_display&id=102009

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Length of hospital stay following hip fracture and risk of 30 and 90 day mortality in a United Kingdom cohort / Hassaan Q. Sheikh in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 607-617 Titre : Length of hospital stay following hip fracture and risk of 30 and 90 day mortality in a United Kingdom cohort Type de document : texte imprimé Auteurs : Hassaan Q. Sheikh ; Amro Alnahhal ; Adeel Aquil Année de publication : 2021 Article en page(s) : p. 607-617 Note générale : https://doi.org/10.52628/87.4.05 Langues : Anglais (eng) Mots-clés : length of stay  hip fracture  proximal femur fracture  epidemiology  mortality Résumé : A recent study identified a length of stay (LOS) of 10 days or less following hip fracture is associated with increased risk of 30-day mortality. This effect has not been previously studied for 90-day mortality or in the United Kingdom (UK). Our aim was to investigate the effect of LOS on 30-day and 90-day mortality following hip fracture in a UK population. In this single-centre study, we retrospectively identified consecutive patients with a hip fracture from the National Hip Fracture Database over 3 years. We excluded patients who died as inpatient during their index admission. The main end-points were 30-day and 90-day mortalities and risk factors for these were examined using stepwise univariate and multivariate Cox regression analyses. Of 1228 patients, mortality at 30-days was 1.2% (15 patients) and 7.8% (96 patients) at 90-days. Mean LOS was 24 days and a total of 206 patients had a LOS of 10 days or less. Following cariate analysis, the highest risk factor for 30-day mortality was a LOS of 10 days or less with a hazard ratio of 7.26 (95% confidence interval 2.56-20.51). Other risk factors for 30-day mortality included increasing age, male gender and chest infection. A LOS of 10 days or less was not associated with increased mortality at 90-days. A short LOS was associated with higher risk of early mortality. We recommend that hip fracture patients be fully rehabilitated prior to discharge to reduce the risk of early mortality. Permalink : ./index.php?lvl=notice_display&id=102010 [article] Length of hospital stay following hip fracture and risk of 30 and 90 day mortality in a United Kingdom cohort [texte imprimé] / Hassaan Q. Sheikh ; Amro Alnahhal ; Adeel Aquil . - 2021 . - p. 607-617. https://doi.org/10.52628/87.4.05 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 607-617 Mots-clés : length of stay  hip fracture  proximal femur fracture  epidemiology  mortality Résumé : A recent study identified a length of stay (LOS) of 10 days or less following hip fracture is associated with increased risk of 30-day mortality. This effect has not been previously studied for 90-day mortality or in the United Kingdom (UK). Our aim was to investigate the effect of LOS on 30-day and 90-day mortality following hip fracture in a UK population. In this single-centre study, we retrospectively identified consecutive patients with a hip fracture from the National Hip Fracture Database over 3 years. We excluded patients who died as inpatient during their index admission. The main end-points were 30-day and 90-day mortalities and risk factors for these were examined using stepwise univariate and multivariate Cox regression analyses. Of 1228 patients, mortality at 30-days was 1.2% (15 patients) and 7.8% (96 patients) at 90-days. Mean LOS was 24 days and a total of 206 patients had a LOS of 10 days or less. Following cariate analysis, the highest risk factor for 30-day mortality was a LOS of 10 days or less with a hazard ratio of 7.26 (95% confidence interval 2.56-20.51). Other risk factors for 30-day mortality included increasing age, male gender and chest infection. A LOS of 10 days or less was not associated with increased mortality at 90-days. A short LOS was associated with higher risk of early mortality. We recommend that hip fracture patients be fully rehabilitated prior to discharge to reduce the risk of early mortality. Permalink : ./index.php?lvl=notice_display&id=102010

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Ultra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years / Marian Melisik in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 619-627 Titre : Ultra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years Type de document : texte imprimé Auteurs : Marian Melisik ; Maros Hrubina ; Matej Daniel Année de publication : 2021 Article en page(s) : p. 619-627 Note générale : https://doi.org/10.52628/87.4.06 Langues : Anglais (eng) Mots-clés : total hip arthroplasty  femoral neck fracture  ultra-short anatomical cementless stem Résumé : The aim of this study was to present the midterm results of total hip arthroplasty with ultra-short anatomical cementless stem in the primary treatment of displaced intracapsular femoral neck fractures in patients younger 60 years. From 2006 to 2015, 17 hip arthroplasties (with the Proxima stem) were performed in group of 17 patients for the treatment of acute femoral neck fractures Garden type III and IV. The mean follow-up period was 112.7 (range: 64-148) months. Patients were evaluated retrospectively - clinically and radiographically, using the Harris hip scoring system during the year 2020. Seven males and ten females (mean age: 45.0 years) were included in the study. Each of them had one or more risk factors (time delay, comminution of the femoral neck, corticosteroids usage, the presence of coxarthrosis, rheumatoid arthritis, alcohol abuse, etc…), because of which the osteosynthesis was not performed. Harris hip scores were 6.3 preoperatively and 82.9 at the final follow-up. Three patients (17.6%) had complications: luxation, aseptic stem loosening (migration with subsidence - “varisation” and thigh pain) and deep infection. One patient (5.9%) with infection was revised. In carefully selected younger patients with displaced intracapsular femoral neck fracture, where the osteosynthesis as first treatment option should be associated with high risk of complication (avascular femoral head necrosis, non-union) due to the presence of risk factors, the primary total hip arthroplasty could be performed. The ultra-short cementless stem offers promising results in these rare cases in the midterm. Permalink : ./index.php?lvl=notice_display&id=102011 [article] Ultra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years [texte imprimé] / Marian Melisik ; Maros Hrubina ; Matej Daniel . - 2021 . - p. 619-627. https://doi.org/10.52628/87.4.06 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 619-627 Mots-clés : total hip arthroplasty  femoral neck fracture  ultra-short anatomical cementless stem Résumé : The aim of this study was to present the midterm results of total hip arthroplasty with ultra-short anatomical cementless stem in the primary treatment of displaced intracapsular femoral neck fractures in patients younger 60 years. From 2006 to 2015, 17 hip arthroplasties (with the Proxima stem) were performed in group of 17 patients for the treatment of acute femoral neck fractures Garden type III and IV. The mean follow-up period was 112.7 (range: 64-148) months. Patients were evaluated retrospectively - clinically and radiographically, using the Harris hip scoring system during the year 2020. Seven males and ten females (mean age: 45.0 years) were included in the study. Each of them had one or more risk factors (time delay, comminution of the femoral neck, corticosteroids usage, the presence of coxarthrosis, rheumatoid arthritis, alcohol abuse, etc…), because of which the osteosynthesis was not performed. Harris hip scores were 6.3 preoperatively and 82.9 at the final follow-up. Three patients (17.6%) had complications: luxation, aseptic stem loosening (migration with subsidence - “varisation” and thigh pain) and deep infection. One patient (5.9%) with infection was revised. In carefully selected younger patients with displaced intracapsular femoral neck fracture, where the osteosynthesis as first treatment option should be associated with high risk of complication (avascular femoral head necrosis, non-union) due to the presence of risk factors, the primary total hip arthroplasty could be performed. The ultra-short cementless stem offers promising results in these rare cases in the midterm. Permalink : ./index.php?lvl=notice_display&id=102011

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Minimally invasive plate osteosynthesis without floating segment fixation for segmental fracture of femur / Surasak Jitprapaikulsarn in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 629-634 Titre : Minimally invasive plate osteosynthesis without floating segment fixation for segmental fracture of femur Type de document : texte imprimé Auteurs : Surasak Jitprapaikulsarn ; Arthit Grompasit ; Chawanan Patamamongkonchai Année de publication : 2021 Article en page(s) : p. 629-634 Note générale : https://doi.org/10.52628/87.4.07 Langues : Anglais (eng) Mots-clés : MIPO  segmental fractures of the femur  floating segment fixation Résumé : Segmental fractures of the femur are technically difficult to manage by intramedullary nailing, the gold standard treatment. We specifically describe minimally invasive plate osteosynthesis (MIPO) without floating segment fixation for this particular fracture pattern. Twenty patients with segmental fractures of the femur were operated on by the MIPO technique. Data were collected on operative time, postoperative complications, union times, and clinical outcomes. The mean operative time was 63.5 minutes (range 50-90). There were no peri-operative complications. All fractures were united with a mean union time of 16.1 weeks (range 12-20). Regarding postoperative malalignment, limb shortening was demonstrated in 4 patients, valgus angulation in 2 and varus angulation in 3. One patient had a bent plate with 7°varus angulation. According to the Thoresen score, 13 were determined to be excellent values, 6 to be good and 1 to be fair. MIPO without floating segment fixation is a safe and effective alternative for segmental fractures of the femur especially in circumstances that are unsuitable or unfeasible for intramedullary nailing. Permalink : ./index.php?lvl=notice_display&id=102012 [article] Minimally invasive plate osteosynthesis without floating segment fixation for segmental fracture of femur [texte imprimé] / Surasak Jitprapaikulsarn ; Arthit Grompasit ; Chawanan Patamamongkonchai . - 2021 . - p. 629-634. https://doi.org/10.52628/87.4.07 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 629-634 Mots-clés : MIPO  segmental fractures of the femur  floating segment fixation Résumé : Segmental fractures of the femur are technically difficult to manage by intramedullary nailing, the gold standard treatment. We specifically describe minimally invasive plate osteosynthesis (MIPO) without floating segment fixation for this particular fracture pattern. Twenty patients with segmental fractures of the femur were operated on by the MIPO technique. Data were collected on operative time, postoperative complications, union times, and clinical outcomes. The mean operative time was 63.5 minutes (range 50-90). There were no peri-operative complications. All fractures were united with a mean union time of 16.1 weeks (range 12-20). Regarding postoperative malalignment, limb shortening was demonstrated in 4 patients, valgus angulation in 2 and varus angulation in 3. One patient had a bent plate with 7°varus angulation. According to the Thoresen score, 13 were determined to be excellent values, 6 to be good and 1 to be fair. MIPO without floating segment fixation is a safe and effective alternative for segmental fractures of the femur especially in circumstances that are unsuitable or unfeasible for intramedullary nailing. Permalink : ./index.php?lvl=notice_display&id=102012

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Outcomes of acute fix and replace in complex hip posterior fracture dislocations with acetabular fractures / Veenesh Selvaratnam in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 635-642 Titre : Outcomes of acute fix and replace in complex hip posterior fracture dislocations with acetabular fractures : a minimum of 3 years follow-up Type de document : texte imprimé Auteurs : Veenesh Selvaratnam ; Sunil Panchani ; Henry Wynn Jones Année de publication : 2021 Article en page(s) : p. 635-642 Note générale : https://doi.org/10.52628/87.4.08 Langues : Anglais (eng) Mots-clés : Fix and replace  hip fracture dislocation  acetabular fracture  total hip replacement Résumé : Simultaneous open reduction and internal fixation of acetabular fractures combined with total hip replacement (THR) have some potential advantages over the more traditional approach in specific patient subgroups. The aim of this study was to evaluate the outcomes of patients who had the “fix and replace” construct for complex posterior hip fracture dislocation treated at our tertiary referral pelvic unit. This was a retrospective review of prospectively collected data for patients who underwent this procedure between 2011-2018 with a minimum of 3 year follow up. Data collected were: patient demographics, date of injury, injury pattern, fixation methods, type of implants used and post-operative complications. There were 14 patients with a mean age of 63.2 years (range 43-94 years) who underwent this procedure between 2011-2018. The mean follow up was 58 months. All cases involved a posterior wall fracture and six cases had an associated posterior column involvement. Femoral head autograft was used in 13 patients (93%). Six patients (43%) had their posterior acetabular wall reconstructed with a femoral head autograft. Seven patients had a fully cemented (THR) and the seven others had a hybrid implant. There were no surgical related complications. From our study we can conclude that the acute “fix and replace” construct for complex posterior hip fracture dislocation yields good clinical outcomes in the short and medium term with low complication rate. It is best performed by a surgeon who specialises in both acetabular and hip arthroplasty surgery. Permalink : ./index.php?lvl=notice_display&id=102013 [article] Outcomes of acute fix and replace in complex hip posterior fracture dislocations with acetabular fractures : a minimum of 3 years follow-up [texte imprimé] / Veenesh Selvaratnam ; Sunil Panchani ; Henry Wynn Jones . - 2021 . - p. 635-642. https://doi.org/10.52628/87.4.08 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 635-642 Mots-clés : Fix and replace  hip fracture dislocation  acetabular fracture  total hip replacement Résumé : Simultaneous open reduction and internal fixation of acetabular fractures combined with total hip replacement (THR) have some potential advantages over the more traditional approach in specific patient subgroups. The aim of this study was to evaluate the outcomes of patients who had the “fix and replace” construct for complex posterior hip fracture dislocation treated at our tertiary referral pelvic unit. This was a retrospective review of prospectively collected data for patients who underwent this procedure between 2011-2018 with a minimum of 3 year follow up. Data collected were: patient demographics, date of injury, injury pattern, fixation methods, type of implants used and post-operative complications. There were 14 patients with a mean age of 63.2 years (range 43-94 years) who underwent this procedure between 2011-2018. The mean follow up was 58 months. All cases involved a posterior wall fracture and six cases had an associated posterior column involvement. Femoral head autograft was used in 13 patients (93%). Six patients (43%) had their posterior acetabular wall reconstructed with a femoral head autograft. Seven patients had a fully cemented (THR) and the seven others had a hybrid implant. There were no surgical related complications. From our study we can conclude that the acute “fix and replace” construct for complex posterior hip fracture dislocation yields good clinical outcomes in the short and medium term with low complication rate. It is best performed by a surgeon who specialises in both acetabular and hip arthroplasty surgery. Permalink : ./index.php?lvl=notice_display&id=102013

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Ganz osteotomy for treatment of hip dysplasia through intra-pelvic approach / Ahmed M. Saied in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 643-647 Titre : Ganz osteotomy for treatment of hip dysplasia through intra-pelvic approach : early results Type de document : texte imprimé Auteurs : Ahmed M. Saied ; Bassam Abouelnas ; Wael El-Adl Année de publication : 2021 Article en page(s) : p. 643-647 Note générale : https://doi.org/10.52628/87.4.09 Langues : Anglais (eng) Mots-clés : dysplasia  hip  Ganz  Stoppa  osteotomy  periacetabular Résumé : Ganz periacetabular osteotomy (PAO) is a technically demanding surgical procedure. It requires cutting around the acetabulum to mobilize it under fluoro- scopic control. The radiolucent table and good quality imaging are mandatory to perform this osteotomy in a safe way. Modification of Ganz osteotomy was developed a with minimal soft tissue exposure using intra-pelvic approach which allows direct visualization of the quadrilateral plate. The purpose of the present study was to review the early results in the initial group of patients who had this procedure. The Ganz PAO was performed on 8 cases painful dysplastic hips, using the intra-pelvic approach through the Pfannenstiel incision. All of the osteotomies were performed under fluoroscopic control and direct visualizing the osteotomy site from the same incision. The acetabular fragment was medialized and redirected anterolaterally then fixed with 3 screws. The pre-operative Harris hip score mean was 66.8 and improved to be 92.7 (p value <0.0005) and this was statistically significant. Radiologically the CEA improved in the pre-operative X-ray from mean of 13.12 degree to 28.37 degrees (p value <0.0005) and this was statistically significant. Painful dysplastic hips should be treated before function becomes seriously impaired. The Ganz osteotomy through an intra-pelvic approach, can be done with minimal exposure to radiation in a relatively short time. Permalink : ./index.php?lvl=notice_display&id=102014 [article] Ganz osteotomy for treatment of hip dysplasia through intra-pelvic approach : early results [texte imprimé] / Ahmed M. Saied ; Bassam Abouelnas ; Wael El-Adl . - 2021 . - p. 643-647. https://doi.org/10.52628/87.4.09 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 643-647 Mots-clés : dysplasia  hip  Ganz  Stoppa  osteotomy  periacetabular Résumé : Ganz periacetabular osteotomy (PAO) is a technically demanding surgical procedure. It requires cutting around the acetabulum to mobilize it under fluoro- scopic control. The radiolucent table and good quality imaging are mandatory to perform this osteotomy in a safe way. Modification of Ganz osteotomy was developed a with minimal soft tissue exposure using intra-pelvic approach which allows direct visualization of the quadrilateral plate. The purpose of the present study was to review the early results in the initial group of patients who had this procedure. The Ganz PAO was performed on 8 cases painful dysplastic hips, using the intra-pelvic approach through the Pfannenstiel incision. All of the osteotomies were performed under fluoroscopic control and direct visualizing the osteotomy site from the same incision. The acetabular fragment was medialized and redirected anterolaterally then fixed with 3 screws. The pre-operative Harris hip score mean was 66.8 and improved to be 92.7 (p value <0.0005) and this was statistically significant. Radiologically the CEA improved in the pre-operative X-ray from mean of 13.12 degree to 28.37 degrees (p value <0.0005) and this was statistically significant. Painful dysplastic hips should be treated before function becomes seriously impaired. The Ganz osteotomy through an intra-pelvic approach, can be done with minimal exposure to radiation in a relatively short time. Permalink : ./index.php?lvl=notice_display&id=102014

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Superior clinical results and higher satisfaction after customized compared with conventional TKA / Alexander Zeh in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 649-658 Titre : Superior clinical results and higher satisfaction after customized compared with conventional TKA Type de document : texte imprimé Auteurs : Alexander Zeh ; Valentina Gehler ; Natalia Gutteck Année de publication : 2021 Article en page(s) : p. 649-658 Note générale : https://doi.org/10.52628/87.4.10 Langues : Anglais (eng) Mots-clés : customized implants  individual  total knee arthroplasty  outcome  off-the-shelf implants  patients expectations Résumé : Investigation of functional outcome and patient`s satisfaction after implantation of a customized versus conventional TKA. In 31 consecutively enrolled patients with primary gonarthrosis, 33 customized TKA (custTKA) and in 31 patients, a conventional TKA (convTKA) was implanted. Perioperative and postoperative management were identical. Radio- graphic evaluation, ROM, KSS (Knee society score) and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) were performed and patients satisfaction was evaluated after 3 and 12 months. Groups were comparable for age, sex, body mass index and extension/flexion. After 92 days average flexion in the convTKA group was significantly higher (119 vs. 113 degrees; unpaired t-test). At 375 days, mean flexion in both groups was 120 degrees. There was a significant higher number of outliers of neutral mechanical axis for convTKA patients (11 vs. 3; Chi-squared test). After 92 days there was no difference for KSS (convTKA: 160, custTKA: 167) but significant better results for WOMAC (19 vs. 40) in the custTKA group (unpaired t-test, p= 0.02). In addition, significantly better KSS (181 vs. 156) and WOMAC (99 vs. 42) were found for the custTKA group at 375 days (unpaired t-test, p= 0.002 and 0.001). Patients with the custTKA implant reported significant higher fulfillment of their ex- pectations regarding function and knee strength. In the present study, the patients with a custTKA implant showed significantly superior short-term clinical results and fulfillment of their expectations regarding knee function. Permalink : ./index.php?lvl=notice_display&id=102015 [article] Superior clinical results and higher satisfaction after customized compared with conventional TKA [texte imprimé] / Alexander Zeh ; Valentina Gehler ; Natalia Gutteck . - 2021 . - p. 649-658. https://doi.org/10.52628/87.4.10 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 649-658 Mots-clés : customized implants  individual  total knee arthroplasty  outcome  off-the-shelf implants  patients expectations Résumé : Investigation of functional outcome and patient`s satisfaction after implantation of a customized versus conventional TKA. In 31 consecutively enrolled patients with primary gonarthrosis, 33 customized TKA (custTKA) and in 31 patients, a conventional TKA (convTKA) was implanted. Perioperative and postoperative management were identical. Radio- graphic evaluation, ROM, KSS (Knee society score) and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) were performed and patients satisfaction was evaluated after 3 and 12 months. Groups were comparable for age, sex, body mass index and extension/flexion. After 92 days average flexion in the convTKA group was significantly higher (119 vs. 113 degrees; unpaired t-test). At 375 days, mean flexion in both groups was 120 degrees. There was a significant higher number of outliers of neutral mechanical axis for convTKA patients (11 vs. 3; Chi-squared test). After 92 days there was no difference for KSS (convTKA: 160, custTKA: 167) but significant better results for WOMAC (19 vs. 40) in the custTKA group (unpaired t-test, p= 0.02). In addition, significantly better KSS (181 vs. 156) and WOMAC (99 vs. 42) were found for the custTKA group at 375 days (unpaired t-test, p= 0.002 and 0.001). Patients with the custTKA implant reported significant higher fulfillment of their ex- pectations regarding function and knee strength. In the present study, the patients with a custTKA implant showed significantly superior short-term clinical results and fulfillment of their expectations regarding knee function. Permalink : ./index.php?lvl=notice_display&id=102015

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Extra-articular tibial deformity management in total knee replacement / Sanjeev Agarwal in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664 Titre : Extra-articular tibial deformity management in total knee replacement Type de document : texte imprimé Auteurs : Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar Année de publication : 2021 Article en page(s) : p. 659-664 Note générale : https://doi.org/10.52628/87.4.11 Langues : Anglais (eng) Mots-clés : Knee replacement  knee arthroplasty  tibia malunion  tibia  deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant. Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance. The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction. Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6. Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction. Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm. Permalink : ./index.php?lvl=notice_display&id=102016 [article] Extra-articular tibial deformity management in total knee replacement [texte imprimé] / Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar . - 2021 . - p. 659-664. https://doi.org/10.52628/87.4.11 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664 Mots-clés : Knee replacement  knee arthroplasty  tibia malunion  tibia  deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant. Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance. The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction. Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6. Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction. Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm. Permalink : ./index.php?lvl=notice_display&id=102016

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Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees / Hany Elbardesy in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680 Titre : Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees Type de document : texte imprimé Auteurs : Hany Elbardesy ; Hazem M. Salamah ; André McLeod Année de publication : 2021 Article en page(s) : p. 665-680 Note générale : https://doi.org/10.52628/87.7.12 Langues : Anglais (eng) Mots-clés : Medial pivot  posterior stabilised  total knee arthroplasty  meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted 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. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017 [article] Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees [texte imprimé] / Hany Elbardesy ; Hazem M. Salamah ; André McLeod . - 2021 . - p. 665-680. https://doi.org/10.52628/87.7.12 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680 Mots-clés : Medial pivot  posterior stabilised  total knee arthroplasty  meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted 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. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017

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Metal wear debris generation in primary total knee arthroplasty / Jonas Kellens in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 681-695 Titre : Metal wear debris generation in primary total knee arthroplasty : is it an issue? Type de document : texte imprimé Auteurs : Jonas Kellens ; Pieter Berger ; Hilde Vandenneucker Année de publication : 2021 Article en page(s) : p. 681-695 Note générale : https://doi.org/10.52628/87.4.13 Langues : Anglais (eng) Mots-clés : knee  prosthesis  arthroplasty  metal  adverseeffects Résumé : More durable total knee arthroplasties (TKAs) are needed, due to the rising life expectancy, the higher activity levels of patients and the growing concerns about aseptic loosening being caused by metal hypersensitivity. In response, different hypoallergenic metal coatings have been developed for TKAs. How- ever, possible adverse effects of these different metals (cobalt-chromium-molybdenum, zirconium, titanium and tantalum) have been neglected. The aim was to summarize the local and systemic adverse effects (including metal hypersensitivity), survival ratios, patient-reported outcome measures (PROMs) and the plasma metal ion concentrations of the different TKA coatings. A literature search on PubMed and EMBASE was performed. In total, 15 studies were found eligible. Common adverse effects of TKA were infection, loosening, pain, instability and hyper- coagulation disorders. Serious adverse effects related to TKA implants were not reported. The survival ratios and patient-reported outcome measures seem to confirm these good results. In contrast with chromium and cobalt, no significant differences were reported in the nickel, molybdenum and titanium concentrations. No significant differences between the hypoallergenic and standard TKA implants were found in terms of adverse effects, survival ratios and PROMs. A causal relationship between the common adverse effects and the different metals is unlikely. Due to the heterogeneity of the TKA implants used, no firm conclusions could be made. Further research with longer follow-up studies are needed to find possible adverse effects and differences. Thus far, the hypoallergenic implants seem to perform equal to the standard implants. Permalink : ./index.php?lvl=notice_display&id=102048 [article] Metal wear debris generation in primary total knee arthroplasty : is it an issue? [texte imprimé] / Jonas Kellens ; Pieter Berger ; Hilde Vandenneucker . - 2021 . - p. 681-695. https://doi.org/10.52628/87.4.13 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 681-695 Mots-clés : knee  prosthesis  arthroplasty  metal  adverseeffects Résumé : More durable total knee arthroplasties (TKAs) are needed, due to the rising life expectancy, the higher activity levels of patients and the growing concerns about aseptic loosening being caused by metal hypersensitivity. In response, different hypoallergenic metal coatings have been developed for TKAs. How- ever, possible adverse effects of these different metals (cobalt-chromium-molybdenum, zirconium, titanium and tantalum) have been neglected. The aim was to summarize the local and systemic adverse effects (including metal hypersensitivity), survival ratios, patient-reported outcome measures (PROMs) and the plasma metal ion concentrations of the different TKA coatings. A literature search on PubMed and EMBASE was performed. In total, 15 studies were found eligible. Common adverse effects of TKA were infection, loosening, pain, instability and hyper- coagulation disorders. Serious adverse effects related to TKA implants were not reported. The survival ratios and patient-reported outcome measures seem to confirm these good results. In contrast with chromium and cobalt, no significant differences were reported in the nickel, molybdenum and titanium concentrations. No significant differences between the hypoallergenic and standard TKA implants were found in terms of adverse effects, survival ratios and PROMs. A causal relationship between the common adverse effects and the different metals is unlikely. Due to the heterogeneity of the TKA implants used, no firm conclusions could be made. Further research with longer follow-up studies are needed to find possible adverse effects and differences. Thus far, the hypoallergenic implants seem to perform equal to the standard implants. Permalink : ./index.php?lvl=notice_display&id=102048

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Should tranexamic acid be used for 3 days after total knee replacement? / Nilen Shah in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 697-703 Titre : Should tranexamic acid be used for 3 days after total knee replacement? : a randomized study in 250 patients Type de document : texte imprimé Auteurs : Nilen Shah, Auteur ; Vatsal Khetan, Auteur ; Hari Sivanadan Année de publication : 2021 Article en page(s) : p. 697-703 Note générale : https://doi.org/10.52628/87.4.14 Langues : Anglais (eng) Mots-clés : Tranexamic acid  total knee replacement  routes  duration Résumé : The aim is to study whether a 3 day course of Tranexamic acid (TXA) is more effective in reducing blood loss following a TKR than a 1 day course. 250 patients were prospectively randomised into Group A (n=138; Perioperative and additional oral TXA for two days) and Group B (n=112; only perioperative TXA). Total Blood loss was calculated by the Haemoglobin (Hb) loss method at 4 days and compared in both groups using Mann Whitney test. The mean peri- operative blood loss in group A was 631.69 ± 264.99 ml as compared to 685.55 ± 239.033 ml in group B (p=0.0434). Use of TXA for 3 days following a TKR can be more effective in reducing blood loss. Permalink : ./index.php?lvl=notice_display&id=102049 [article] Should tranexamic acid be used for 3 days after total knee replacement? : a randomized study in 250 patients [texte imprimé] / Nilen Shah, Auteur ; Vatsal Khetan, Auteur ; Hari Sivanadan . - 2021 . - p. 697-703. https://doi.org/10.52628/87.4.14 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 697-703 Mots-clés : Tranexamic acid  total knee replacement  routes  duration Résumé : The aim is to study whether a 3 day course of Tranexamic acid (TXA) is more effective in reducing blood loss following a TKR than a 1 day course. 250 patients were prospectively randomised into Group A (n=138; Perioperative and additional oral TXA for two days) and Group B (n=112; only perioperative TXA). Total Blood loss was calculated by the Haemoglobin (Hb) loss method at 4 days and compared in both groups using Mann Whitney test. The mean peri- operative blood loss in group A was 631.69 ± 264.99 ml as compared to 685.55 ± 239.033 ml in group B (p=0.0434). Use of TXA for 3 days following a TKR can be more effective in reducing blood loss. Permalink : ./index.php?lvl=notice_display&id=102049

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Platelet-rich plasma vs platelet-rich plasma plus hyaluronic acid for haemophilic knee arthropathy treatment / Maria Eulalia Landro in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 705-712 Titre : Platelet-rich plasma vs platelet-rich plasma plus hyaluronic acid for haemophilic knee arthropathy treatment Type de document : texte imprimé Auteurs : Maria Eulalia Landro ; Carla Daffunchio ; Guillermo Cambiaggi ; Gustavo Galatro Année de publication : 2021 Article en page(s) : p. 705-712 Note générale : https://doi.org/10.52628/87.4.15 Langues : Anglais (eng) Mots-clés : Knee arthropathy  haemophilia  platelet-rich plasma  hyaluronic acid Résumé : Repeated joint bleeding leads to chronic synovitis, cartilage damage and bone alterations which result in haemophilic arthropathy and are associated with pain, functional impairment and poor quality of life. There are evidence that Hyaluronic Acid (HA) and Platelet-rich Plasma (PRP) have different mechanisms of action in the treatment of arthropathy for this reason we decided to use both components. The aim of this study is to compare, the efficacy, safety and duration of a single intra-articular injection of PRP against PRP+HA for pain, bleeding episodes and joint health, in the same patient with bilateral hemophilic knee arthropathy. Twenty-one men patients (42 knee joints) were treated with intra- articular injections of PRP or PRP+HA. All of them were haemophilia type A severe. The mean age was 36.6 years (21-72). All patients were evaluated for: Haemophilia Joint Health Score (HJHS), pain (VAS), the number of bleeding episodes (BE) in the last 30 days, before treatment, at three and six months after treatment. Statistically significant improvement were shown for both knee joints at three and six months after treatment for VAS and BE (P < 0.00001). The HJHS score did not significantly improve for either knee in the 6-month period after injection. A single PRP or PRP+HA injection is safe and effective in treating haemophilic arthropathy of the knee for up to 6 months follow-up, reducing pain, bleeding episodes and delaying total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=102050 [article] Platelet-rich plasma vs platelet-rich plasma plus hyaluronic acid for haemophilic knee arthropathy treatment [texte imprimé] / Maria Eulalia Landro ; Carla Daffunchio ; Guillermo Cambiaggi ; Gustavo Galatro . - 2021 . - p. 705-712. https://doi.org/10.52628/87.4.15 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 705-712 Mots-clés : Knee arthropathy  haemophilia  platelet-rich plasma  hyaluronic acid Résumé : Repeated joint bleeding leads to chronic synovitis, cartilage damage and bone alterations which result in haemophilic arthropathy and are associated with pain, functional impairment and poor quality of life. There are evidence that Hyaluronic Acid (HA) and Platelet-rich Plasma (PRP) have different mechanisms of action in the treatment of arthropathy for this reason we decided to use both components. The aim of this study is to compare, the efficacy, safety and duration of a single intra-articular injection of PRP against PRP+HA for pain, bleeding episodes and joint health, in the same patient with bilateral hemophilic knee arthropathy. Twenty-one men patients (42 knee joints) were treated with intra- articular injections of PRP or PRP+HA. All of them were haemophilia type A severe. The mean age was 36.6 years (21-72). All patients were evaluated for: Haemophilia Joint Health Score (HJHS), pain (VAS), the number of bleeding episodes (BE) in the last 30 days, before treatment, at three and six months after treatment. Statistically significant improvement were shown for both knee joints at three and six months after treatment for VAS and BE (P < 0.00001). The HJHS score did not significantly improve for either knee in the 6-month period after injection. A single PRP or PRP+HA injection is safe and effective in treating haemophilic arthropathy of the knee for up to 6 months follow-up, reducing pain, bleeding episodes and delaying total knee arthroplasty. Permalink : ./index.php?lvl=notice_display&id=102050

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Associations between biomarkers and histological assessment in individual animals in a destabilization of the medial meniscus (DMM) model of osteoarthritis (OA) / Seon Young Choi in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 712-721 Titre : Associations between biomarkers and histological assessment in individual animals in a destabilization of the medial meniscus (DMM) model of osteoarthritis (OA) Type de document : texte imprimé Auteurs : Seon Young Choi ; Jiheon Rhim ; Woo-Jung Han Année de publication : 2021 Article en page(s) : p. 712-721 Note générale : https://doi.org/10.52628/87.4.16 Langues : Anglais (eng) Mots-clés : osteoarthritis  biomarker  destabilization of the medial meniscus Résumé : To date, the use of biomarkers for assessing individual severity of osteoarthritis (OA) is limited, and the correlation of histological scores with biomarkers for individual animals in the destabilization of the medial meniscus (DMM) model of OA has not been well investigated. Accordingly, this study investigated how well representative biomarkers in the DMM model reflected specific changes in individual animals. Rats were randomly divided into the OA group and the sham group. OA model was established by destabilization of the medial meniscus (DMM). After 2,4,6,8,10 and 12 weeks (n=14, each week), the concentrations of CTXII, COMP, C2C, and OC in serum were measured, and cartilage degeneration, osteophytes, and synovial membrane inflammation, typical of OA, were scored using Osteoarthritis Research Society International (OARSI) scoring system. Additionally, the correlation between each biomarker and the specific changes in osteoarthritis was analyzed for individual animals using the Generalized Estimating Equation (GEE). Statistical analysis showed a low correlation between CTXII and osteophyte score of the medial femur (coefficient = -0.0088, p= 0.0103), COMP and osteophyte score of the medial tibia (coefficient = -0.0911, p= 0.0003), and C2C and synovial membrane inflammation scores of the medial femoral (coefficient = 0.054, p= 0.0131). These results suggest that representative OA bio- markers in individual animals in the DMM model did not reflect histological scores well. Permalink : ./index.php?lvl=notice_display&id=102051 [article] Associations between biomarkers and histological assessment in individual animals in a destabilization of the medial meniscus (DMM) model of osteoarthritis (OA) [texte imprimé] / Seon Young Choi ; Jiheon Rhim ; Woo-Jung Han . - 2021 . - p. 712-721. https://doi.org/10.52628/87.4.16 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 712-721 Mots-clés : osteoarthritis  biomarker  destabilization of the medial meniscus Résumé : To date, the use of biomarkers for assessing individual severity of osteoarthritis (OA) is limited, and the correlation of histological scores with biomarkers for individual animals in the destabilization of the medial meniscus (DMM) model of OA has not been well investigated. Accordingly, this study investigated how well representative biomarkers in the DMM model reflected specific changes in individual animals. Rats were randomly divided into the OA group and the sham group. OA model was established by destabilization of the medial meniscus (DMM). After 2,4,6,8,10 and 12 weeks (n=14, each week), the concentrations of CTXII, COMP, C2C, and OC in serum were measured, and cartilage degeneration, osteophytes, and synovial membrane inflammation, typical of OA, were scored using Osteoarthritis Research Society International (OARSI) scoring system. Additionally, the correlation between each biomarker and the specific changes in osteoarthritis was analyzed for individual animals using the Generalized Estimating Equation (GEE). Statistical analysis showed a low correlation between CTXII and osteophyte score of the medial femur (coefficient = -0.0088, p= 0.0103), COMP and osteophyte score of the medial tibia (coefficient = -0.0911, p= 0.0003), and C2C and synovial membrane inflammation scores of the medial femoral (coefficient = 0.054, p= 0.0131). These results suggest that representative OA bio- markers in individual animals in the DMM model did not reflect histological scores well. Permalink : ./index.php?lvl=notice_display&id=102051

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Tenosynovial giant cell tumor of the pes anserinus bursa with secondary involvement of a reconstructed autologous anterior cruciate ligament / Loïc Van Oost in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 723-728 Titre : Tenosynovial giant cell tumor of the pes anserinus bursa with secondary involvement of a reconstructed autologous anterior cruciate ligament : a case report Type de document : texte imprimé Auteurs : Loïc Van Oost ; Friedl Sinnaeve Année de publication : 2021 Article en page(s) : p. 723-728 Note générale : https://doi.org/10.52628/87.4.17 Langues : Anglais (eng) Mots-clés : Tenosynovial giant cell tumor  anterior cruciate ligament  ACL reconstruction  pes anserinus  case study  and pigmented villonodular synovitis Résumé : Tenosynovial giant cell tumor (TGCT) is defined by the World Health Organization (WHO) as a family of lesions most often arising from the synovium of joints, bursae and tendon sheaths. It is composed of synovial- like mononuclear cells, admixed with multinucleate giant cells, foam cells, siderophages and inflammatory cells (1). It can have various clinical manifestations, and is therefore subdivided in a diffuse and a localized/ nodular subtype. Furthermore, the lesions can have an intra- or extra-articular location. The purpose of this paper is to present the case of a 41-year-old male suffering from multifocal extra- and intra-articular TGCT of the right knee, with involvement of the pes anserinus bursa and an anterior cruciate ligament (ACL) autograft respectively. The ACL reconstruction was performed 11 years prior to the diagnosis of the TGCT, using tendons harvested from the pes anserinus. Our case illustrates the risk of transferring TGCT from an extra- to intra-articular location during ACL reconstruction, when using tendons of a pes anserinus prone to develop this condition. To our knowledge, no similar case was published in the literature so far. Permalink : ./index.php?lvl=notice_display&id=102052 [article] Tenosynovial giant cell tumor of the pes anserinus bursa with secondary involvement of a reconstructed autologous anterior cruciate ligament : a case report [texte imprimé] / Loïc Van Oost ; Friedl Sinnaeve . - 2021 . - p. 723-728. https://doi.org/10.52628/87.4.17 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 723-728 Mots-clés : Tenosynovial giant cell tumor  anterior cruciate ligament  ACL reconstruction  pes anserinus  case study  and pigmented villonodular synovitis Résumé : Tenosynovial giant cell tumor (TGCT) is defined by the World Health Organization (WHO) as a family of lesions most often arising from the synovium of joints, bursae and tendon sheaths. It is composed of synovial- like mononuclear cells, admixed with multinucleate giant cells, foam cells, siderophages and inflammatory cells (1). It can have various clinical manifestations, and is therefore subdivided in a diffuse and a localized/ nodular subtype. Furthermore, the lesions can have an intra- or extra-articular location. The purpose of this paper is to present the case of a 41-year-old male suffering from multifocal extra- and intra-articular TGCT of the right knee, with involvement of the pes anserinus bursa and an anterior cruciate ligament (ACL) autograft respectively. The ACL reconstruction was performed 11 years prior to the diagnosis of the TGCT, using tendons harvested from the pes anserinus. Our case illustrates the risk of transferring TGCT from an extra- to intra-articular location during ACL reconstruction, when using tendons of a pes anserinus prone to develop this condition. To our knowledge, no similar case was published in the literature so far. Permalink : ./index.php?lvl=notice_display&id=102052

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Intra-articular injection of Platelet rich plasma versus Hyaluronic acid for moderate knee osteoarthritis / Medhat Sdeek in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 729-734 Titre : Intra-articular injection of Platelet rich plasma versus Hyaluronic acid for moderate knee osteoarthritis : a prospective, double-blind randomized controlled trial on 189 patients with follow-up for three years Type de document : texte imprimé Auteurs : Medhat Sdeek ; Dian Sabry ; Hisham El-Sdeek Année de publication : 2021 Article en page(s) : p. 729-734 Note générale : https://doi.org/10.52628/87.4.18 Langues : Anglais (eng) Mots-clés : Platelet-rich plasma  Hyaluronic acid  growth factors  intra-articular Résumé : Platelet-rich plasma injections have been proposed as an option for Conservative management of knee Osteoarthritis to provide symptomatic relief and also to delay the need for surgical intervention. Although almost all the current literatures provide some evidence on the benefits of this technique compared with Visco- supplementation, no studies have been performed to compare their Clinical outcomes. The purpose is to compare the Clinical outcomes provided by intra- articular injection of either Platelet rich plasma or Hyaluronic acid to treat knee Osteoarthritis. Study Design: Randomized Controlled Trial 200 Patients with a history of Symptomatic knee Osteo- arthritis (Kellgren-Lawrence grade 2 or 3) were randomized to undergo 3 blinded intra-articular in- jections of either Platelet rich plasma or Hyaluronic acid. The Interval between successive injections was 2 weeks. Patients were evaluated prospectively before the injection and then at 2, 6, 12, 24, 30 and 36 months. Evaluation was based on International Knee Documentation Committee (IKDC), Visual analog scale, VOMAC Score and the re- injection rate; 189 patients reached the final evaluation. Both platelet rich plasma and Hyaluronic acid were effective in improving knee Symptoms and functional status over time and remained stable over time up to 18 months Post-injection (No re-injection has been performed to any patient incorporated in this study during the first 18 months). The performed re-injections have been significantly lower in the PRP group. Both platelet rich plasma and Hyaluronic acid were effective in improving knee Symptoms and functional status over time and remained stable over time up to 18 months Post-injection. The rate of the required re-injections has been significantly lower in platelet rich plasma group. platelet rich plasma provide longer duration of symptomatic relief, longer duration of functional status improvement and lesser number of needed re-injections than Hyaluronic acid when the patients have been followed through 36 months. Permalink : ./index.php?lvl=notice_display&id=102053 [article] Intra-articular injection of Platelet rich plasma versus Hyaluronic acid for moderate knee osteoarthritis : a prospective, double-blind randomized controlled trial on 189 patients with follow-up for three years [texte imprimé] / Medhat Sdeek ; Dian Sabry ; Hisham El-Sdeek . - 2021 . - p. 729-734. https://doi.org/10.52628/87.4.18 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 729-734 Mots-clés : Platelet-rich plasma  Hyaluronic acid  growth factors  intra-articular Résumé : Platelet-rich plasma injections have been proposed as an option for Conservative management of knee Osteoarthritis to provide symptomatic relief and also to delay the need for surgical intervention. Although almost all the current literatures provide some evidence on the benefits of this technique compared with Visco- supplementation, no studies have been performed to compare their Clinical outcomes. The purpose is to compare the Clinical outcomes provided by intra- articular injection of either Platelet rich plasma or Hyaluronic acid to treat knee Osteoarthritis. Study Design: Randomized Controlled Trial 200 Patients with a history of Symptomatic knee Osteo- arthritis (Kellgren-Lawrence grade 2 or 3) were randomized to undergo 3 blinded intra-articular in- jections of either Platelet rich plasma or Hyaluronic acid. The Interval between successive injections was 2 weeks. Patients were evaluated prospectively before the injection and then at 2, 6, 12, 24, 30 and 36 months. Evaluation was based on International Knee Documentation Committee (IKDC), Visual analog scale, VOMAC Score and the re- injection rate; 189 patients reached the final evaluation. Both platelet rich plasma and Hyaluronic acid were effective in improving knee Symptoms and functional status over time and remained stable over time up to 18 months Post-injection (No re-injection has been performed to any patient incorporated in this study during the first 18 months). The performed re-injections have been significantly lower in the PRP group. Both platelet rich plasma and Hyaluronic acid were effective in improving knee Symptoms and functional status over time and remained stable over time up to 18 months Post-injection. The rate of the required re-injections has been significantly lower in platelet rich plasma group. platelet rich plasma provide longer duration of symptomatic relief, longer duration of functional status improvement and lesser number of needed re-injections than Hyaluronic acid when the patients have been followed through 36 months. Permalink : ./index.php?lvl=notice_display&id=102053

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The effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty / Raziya Savkin in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 735-744 Titre : The effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty Type de document : texte imprimé Auteurs : Raziya Savkin ; Nihal Buker ; Harun R. Güngör Année de publication : 2021 Article en page(s) : p. 735-744 Note générale : https://doi.org/10.52628/87.4.19 Langues : Anglais (eng) Mots-clés : knee arthroplasty  neuromuscular electrical stimulation  fast-track  physiotherapy  patient-reported outcomes  quadriceps muscle strength Résumé : This study aimed to investigate the effect of pre- operative neuromuscular electrical stimulation (NMES) on postoperative quadriceps muscle strength, functional status, and quality of life in patients with fast-track total knee arthroplasty (TKA). This prospective study was carried out at Orthopedics department from September 2017 to October 2018. A total of 40 patients were randomly divided into NMES (n=20) and control group (n=20). Patients in NMES group were asked to use home NMES device daily for 20 minutes, 5 times a day, for 6 weeks before surgery. The control group was placed on the 6-week waiting list for surgery without any preoperative intervention. Standard home exercise program was applied to both groups after discharge. The patients were evaluated baseline, preoperatively (6-weeks after baseline) and at the 4th and 12th weeks after surgery. Knee range of motion, quadriceps muscle strength, patient-reported (WOMAC and KOOS) and performance-based activity limitation (30-second chair-stand test, 40-meter fast-paced walk test, and stair-climb test) were evaluated at each visit. Preoperative NMES resulted in significant improve- ment in KOOS-function in daily living and WOMAC total score (p≤0.05) but had a non-significant trend toward to improve quadriceps muscle strength, KOOS-pain and -other symptoms, performance- based activity limitation, and quality of life scores (p>0.05). However, there was no significant difference between groups in the postoperative period (p>0.05). NMES has beneficial effects in terms of patient- reported and performance-based physical functions and quality of life in preoperative period ; however, it does not provide any additional benefit for post- operative outcomes in patients with fast-track TKA. Permalink : ./index.php?lvl=notice_display&id=102054 [article] The effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty [texte imprimé] / Raziya Savkin ; Nihal Buker ; Harun R. Güngör . - 2021 . - p. 735-744. https://doi.org/10.52628/87.4.19 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 735-744 Mots-clés : knee arthroplasty  neuromuscular electrical stimulation  fast-track  physiotherapy  patient-reported outcomes  quadriceps muscle strength Résumé : This study aimed to investigate the effect of pre- operative neuromuscular electrical stimulation (NMES) on postoperative quadriceps muscle strength, functional status, and quality of life in patients with fast-track total knee arthroplasty (TKA). This prospective study was carried out at Orthopedics department from September 2017 to October 2018. A total of 40 patients were randomly divided into NMES (n=20) and control group (n=20). Patients in NMES group were asked to use home NMES device daily for 20 minutes, 5 times a day, for 6 weeks before surgery. The control group was placed on the 6-week waiting list for surgery without any preoperative intervention. Standard home exercise program was applied to both groups after discharge. The patients were evaluated baseline, preoperatively (6-weeks after baseline) and at the 4th and 12th weeks after surgery. Knee range of motion, quadriceps muscle strength, patient-reported (WOMAC and KOOS) and performance-based activity limitation (30-second chair-stand test, 40-meter fast-paced walk test, and stair-climb test) were evaluated at each visit. Preoperative NMES resulted in significant improve- ment in KOOS-function in daily living and WOMAC total score (p≤0.05) but had a non-significant trend toward to improve quadriceps muscle strength, KOOS-pain and -other symptoms, performance- based activity limitation, and quality of life scores (p>0.05). However, there was no significant difference between groups in the postoperative period (p>0.05). NMES has beneficial effects in terms of patient- reported and performance-based physical functions and quality of life in preoperative period ; however, it does not provide any additional benefit for post- operative outcomes in patients with fast-track TKA. Permalink : ./index.php?lvl=notice_display&id=102054

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Treatment of open and comminuted mid-distal tibial fractures by bilateral external fixation combined with limited-internal fixation / Hongsuo Liang in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 745-750 Titre : Treatment of open and comminuted mid-distal tibial fractures by bilateral external fixation combined with limited-internal fixation Type de document : texte imprimé Auteurs : Hongsuo Liang ; Lin$ Li ; Jingye Yang Année de publication : 2021 Article en page(s) : p. 745-750 Note générale : https://doi.org/10.52628/87.4.20 Langues : Anglais (eng) Mots-clés : Tibial shaft fracture  External fixation  internal fixation Résumé : Open and comminuted mid-distal fractures often result from high-energy trauma, and a concomitant poor blood supply often leads to skin necrosis, infection, and bone union. To circumvent such complications, we used limited-reduction and bilateral-external fixators to treat open and comminuted mid-distal tibial fractures with compromised soft tissue. A retrospective series of 34 patients who had open and comminuted mid-distal tibial fractures and treated by bilateral-external fixators with limited-internal fixation were analyzed. Patients were followed for 10-25 months (mean: 12 months) post-treatment and osseous union was achieved in each case. The average union time was 16.3 weeks. Based on the Johner- Wruhs criteria, the retrospective series consisted of 21 ‘excellent’ cases, 8 ‘good’ cases, 4 ‘fair’ cases, and a ‘poor’ case. The total percentage of ‘excellent’ and ‘good’ cases of fracture recovery was 85.29%. Bilateral-external and limited-internal fixators pro- vided high bone union rate and excellent ankle-joint motion. Hence, it is an appropriate surgical approach for treating open and comminuted mid-distal tibial fractures with compromised soft tissue. Permalink : ./index.php?lvl=notice_display&id=102055 [article] Treatment of open and comminuted mid-distal tibial fractures by bilateral external fixation combined with limited-internal fixation [texte imprimé] / Hongsuo Liang ; Lin$ Li ; Jingye Yang . - 2021 . - p. 745-750. https://doi.org/10.52628/87.4.20 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 745-750 Mots-clés : Tibial shaft fracture  External fixation  internal fixation Résumé : Open and comminuted mid-distal fractures often result from high-energy trauma, and a concomitant poor blood supply often leads to skin necrosis, infection, and bone union. To circumvent such complications, we used limited-reduction and bilateral-external fixators to treat open and comminuted mid-distal tibial fractures with compromised soft tissue. A retrospective series of 34 patients who had open and comminuted mid-distal tibial fractures and treated by bilateral-external fixators with limited-internal fixation were analyzed. Patients were followed for 10-25 months (mean: 12 months) post-treatment and osseous union was achieved in each case. The average union time was 16.3 weeks. Based on the Johner- Wruhs criteria, the retrospective series consisted of 21 ‘excellent’ cases, 8 ‘good’ cases, 4 ‘fair’ cases, and a ‘poor’ case. The total percentage of ‘excellent’ and ‘good’ cases of fracture recovery was 85.29%. Bilateral-external and limited-internal fixators pro- vided high bone union rate and excellent ankle-joint motion. Hence, it is an appropriate surgical approach for treating open and comminuted mid-distal tibial fractures with compromised soft tissue. Permalink : ./index.php?lvl=notice_display&id=102055

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Morel-Lavallée lesion associated with atypical skin damage / Matteo Luisetto in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 751-754 Titre : Morel-Lavallée lesion associated with atypical skin damage : a case report Type de document : texte imprimé Auteurs : Matteo Luisetto ; Anaïs legrand ; Emile Vandromme Année de publication : 2021 Article en page(s) : p. 751-754 Note générale : https://doi.org/10.52628/87.4.21 Langues : Anglais (eng) Mots-clés : Morel-Lavallée lesion  skin damage  treatment  infection Résumé : A Morel-Lavallée lesion is a post-traumatic, soft tissue lesion that is little known and for which there is no standard treatment. This report describes the case of a 51-year-old man who presented with a large Morel-Lavallée lesion on the left calf that was not diagnosed on two visits to the emergency department. Given the deteriorating condition of the skin, we performed surgical drainage of the effusion because the skin was showing signs of major damage. Complications occurred following surgery, with cellulitis in the lower limb caused by Citrobacter Koseri, a gram-negative bacillus that is rarely implicated in soft tissue infections, and wound dehiscence. The purpose of our article is to present the difficulty involved in choosing the right treatment from among the many proposed in the literature, and to inform any practitioner working in an emergency setting about the existence of this often overlooked condition. Permalink : ./index.php?lvl=notice_display&id=102057 [article] Morel-Lavallée lesion associated with atypical skin damage : a case report [texte imprimé] / Matteo Luisetto ; Anaïs legrand ; Emile Vandromme . - 2021 . - p. 751-754. https://doi.org/10.52628/87.4.21 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 751-754 Mots-clés : Morel-Lavallée lesion  skin damage  treatment  infection Résumé : A Morel-Lavallée lesion is a post-traumatic, soft tissue lesion that is little known and for which there is no standard treatment. This report describes the case of a 51-year-old man who presented with a large Morel-Lavallée lesion on the left calf that was not diagnosed on two visits to the emergency department. Given the deteriorating condition of the skin, we performed surgical drainage of the effusion because the skin was showing signs of major damage. Complications occurred following surgery, with cellulitis in the lower limb caused by Citrobacter Koseri, a gram-negative bacillus that is rarely implicated in soft tissue infections, and wound dehiscence. The purpose of our article is to present the difficulty involved in choosing the right treatment from among the many proposed in the literature, and to inform any practitioner working in an emergency setting about the existence of this often overlooked condition. Permalink : ./index.php?lvl=notice_display&id=102057

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The mangled extremity / Martin Sharrock in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 755-760 Titre : The mangled extremity : assessment, decision making and outcomes Type de document : texte imprimé Auteurs : Martin Sharrock Année de publication : 2021 Article en page(s) : p. 755-760 Note générale : https://doi.org/10.52628/87.4.22 Langues : Anglais (eng) Mots-clés : Mangled extremity  amputation  limb salvage  decision making Résumé : The management of the mangled extremity continues to pose a significant challenge for ortho- paedic trauma surgeons. This article provides a comprehensive, up-to-date literature review on the assessment of complex limb injuries, and the variables that affect decision-making and outcomes in both limb salvage and amputation. Initial assessment involves using a systematic approach, saving life before limb, with early involvement of the relevant surgical specialities and multidisciplinary team. The decision to attempt limb salvage or perform amputation can be extremely difficult. Scoring systems can be used as a guide but should not be wholly relied upon; instead more emphasis should be placed on the surgeon’s experience, extent of soft tissue damage, and patient factors and wishes. Outcomes following amputation versus limb salvage are comparable, with some studies suggesting amputation may be favourable. It is important to advise patients and families on what treatment is in their best interest so they can make an informed decision, and this must utilise a multidisciplinary approach. Permalink : ./index.php?lvl=notice_display&id=102058 [article] The mangled extremity : assessment, decision making and outcomes [texte imprimé] / Martin Sharrock . - 2021 . - p. 755-760. https://doi.org/10.52628/87.4.22 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 755-760 Mots-clés : Mangled extremity  amputation  limb salvage  decision making Résumé : The management of the mangled extremity continues to pose a significant challenge for ortho- paedic trauma surgeons. This article provides a comprehensive, up-to-date literature review on the assessment of complex limb injuries, and the variables that affect decision-making and outcomes in both limb salvage and amputation. Initial assessment involves using a systematic approach, saving life before limb, with early involvement of the relevant surgical specialities and multidisciplinary team. The decision to attempt limb salvage or perform amputation can be extremely difficult. Scoring systems can be used as a guide but should not be wholly relied upon; instead more emphasis should be placed on the surgeon’s experience, extent of soft tissue damage, and patient factors and wishes. Outcomes following amputation versus limb salvage are comparable, with some studies suggesting amputation may be favourable. It is important to advise patients and families on what treatment is in their best interest so they can make an informed decision, and this must utilise a multidisciplinary approach. Permalink : ./index.php?lvl=notice_display&id=102058

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Safe zone for minimally invasive calcaneal osteotomy / Vasantha Kumar Ramsingh in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 761-764 Titre : Safe zone for minimally invasive calcaneal osteotomy : an MRI study Type de document : texte imprimé Auteurs : Vasantha Kumar Ramsingh ; George Hourston ; Sriram Srinivasan Année de publication : 2021 Article en page(s) : p. 761-764 Note générale : https://doi.org/10.52628/87.4.23 Langues : Anglais (eng) Mots-clés : Calcaneal osteotomy  safe zone  minimally invasive Résumé : Hindfoot deformities are often surgically corrected with calcaneal osteotomy. These are increasingly performed via a minimally invasive approach. Identifying a neurovascular “safe zone” for this approach is important in reducing iatrogenic injury. We aimed to identify a safe zone for minimally invasive calcaneal osteotomy without neurovascular injury. Three individuals independently assessed 100 con- secutive magnetic resonance imaging ankle studies. The distance of the medial neurovascular bundle from the level of the centre of the Achilles tendon insertion was measured. The points measured were centralised in three planes (axial, sagittal and coronal). The three sets of observations were statistically analysed with confidence intervals and intraclass correlation coefficient was calculated. The mean distance measured by the three observers were 22.91 mm (range 18.2-28.5 mm); 22.81 mm (range 18.7-26.7 mm); and 23.41 mm (range 19.2- 28.4 mm); overall mean 23.0 mm. The mean inter- observer variation was 1.1 mm. 95% confidence interval for observer 1 ranges from 22.45-23.25 mm, observer 2 ranges from 22.52-23.1 mm and observer 3 ranges from 22.97-23.65 mm. Overall 95% confidence interval ranges from 22.8-23.2 mm. Intraclass correlation coefficient for inter-observer reliability is 0.7, indicating strong agreement between the observers. This radiological study suggests an anatomical “safe zone” for minimally invasive medial calcaneal osteotomy is at least 18 mm (mean: 23 mm) from the level of insertion of the Achilles tendon. Individual variation between patients must be taken in to consideration during preoperative planning. Permalink : ./index.php?lvl=notice_display&id=102059 [article] Safe zone for minimally invasive calcaneal osteotomy : an MRI study [texte imprimé] / Vasantha Kumar Ramsingh ; George Hourston ; Sriram Srinivasan . - 2021 . - p. 761-764. https://doi.org/10.52628/87.4.23 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 761-764 Mots-clés : Calcaneal osteotomy  safe zone  minimally invasive Résumé : Hindfoot deformities are often surgically corrected with calcaneal osteotomy. These are increasingly performed via a minimally invasive approach. Identifying a neurovascular “safe zone” for this approach is important in reducing iatrogenic injury. We aimed to identify a safe zone for minimally invasive calcaneal osteotomy without neurovascular injury. Three individuals independently assessed 100 con- secutive magnetic resonance imaging ankle studies. The distance of the medial neurovascular bundle from the level of the centre of the Achilles tendon insertion was measured. The points measured were centralised in three planes (axial, sagittal and coronal). The three sets of observations were statistically analysed with confidence intervals and intraclass correlation coefficient was calculated. The mean distance measured by the three observers were 22.91 mm (range 18.2-28.5 mm); 22.81 mm (range 18.7-26.7 mm); and 23.41 mm (range 19.2- 28.4 mm); overall mean 23.0 mm. The mean inter- observer variation was 1.1 mm. 95% confidence interval for observer 1 ranges from 22.45-23.25 mm, observer 2 ranges from 22.52-23.1 mm and observer 3 ranges from 22.97-23.65 mm. Overall 95% confidence interval ranges from 22.8-23.2 mm. Intraclass correlation coefficient for inter-observer reliability is 0.7, indicating strong agreement between the observers. This radiological study suggests an anatomical “safe zone” for minimally invasive medial calcaneal osteotomy is at least 18 mm (mean: 23 mm) from the level of insertion of the Achilles tendon. Individual variation between patients must be taken in to consideration during preoperative planning. Permalink : ./index.php?lvl=notice_display&id=102059

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The effectiveness of a Botulinum Toxin A infiltration in the management of bicipital cramps after arthroscopic biceps tenotomy / Marieke Torrekens in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 765-769 Titre : The effectiveness of a Botulinum Toxin A infiltration in the management of bicipital cramps after arthroscopic biceps tenotomy Type de document : texte imprimé Auteurs : Marieke Torrekens ; Bert Vanmierlo ; Tom Van Isacker Année de publication : 2021 Article en page(s) : p. 765-769 Note générale : https://doi.org/10.52628/87.4.24 Langues : Anglais (eng) Mots-clés : bicipital cramping  LHBT  BTX-A  botox  tenotomy  shoulder arthroscopy  rotator cuff Résumé : A challenging complication of arthroscopic biceps surgery is the persistent painful cramping of the biceps. There is a paucity of data upon nonsurgical treatment of this debilitating complication. We pro- pose an intramuscular injection of botulinum toxin A (BTX-A) for painful bicipital cramping after tenotomy of the long head of the biceps brachii tendon (LHBT). Ten patients with a painful Popeye sign after tenotomy of LHBT, were treated with intramuscular injection of 100 IU of BTX-A. Mean patient age was 56 years and mean time from surgery to infiltration was 317 days. The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was obtained. Pain was objectified by a visual analogue scale (VAS). Patient satisfaction was described as excellent, good, satisfactory, or poor, three and six months after injection. Mean VAS prior to infiltration was 6.8 and decreased significantly to 2.6 at follow-up. Mean QuickDash was 54.04 prior to infiltration and decreased to 19.84 at follow-up. Patient satisfaction was excellent in 9 and good in 1 patient. We report a significant pain reduction and functional improvement following BTX-A infiltration as treatment of painful bicipital cramping after tenotomy of LHBT. Permalink : ./index.php?lvl=notice_display&id=102060 [article] The effectiveness of a Botulinum Toxin A infiltration in the management of bicipital cramps after arthroscopic biceps tenotomy [texte imprimé] / Marieke Torrekens ; Bert Vanmierlo ; Tom Van Isacker . - 2021 . - p. 765-769. https://doi.org/10.52628/87.4.24 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 765-769 Mots-clés : bicipital cramping  LHBT  BTX-A  botox  tenotomy  shoulder arthroscopy  rotator cuff Résumé : A challenging complication of arthroscopic biceps surgery is the persistent painful cramping of the biceps. There is a paucity of data upon nonsurgical treatment of this debilitating complication. We pro- pose an intramuscular injection of botulinum toxin A (BTX-A) for painful bicipital cramping after tenotomy of the long head of the biceps brachii tendon (LHBT). Ten patients with a painful Popeye sign after tenotomy of LHBT, were treated with intramuscular injection of 100 IU of BTX-A. Mean patient age was 56 years and mean time from surgery to infiltration was 317 days. The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was obtained. Pain was objectified by a visual analogue scale (VAS). Patient satisfaction was described as excellent, good, satisfactory, or poor, three and six months after injection. Mean VAS prior to infiltration was 6.8 and decreased significantly to 2.6 at follow-up. Mean QuickDash was 54.04 prior to infiltration and decreased to 19.84 at follow-up. Patient satisfaction was excellent in 9 and good in 1 patient. We report a significant pain reduction and functional improvement following BTX-A infiltration as treatment of painful bicipital cramping after tenotomy of LHBT. Permalink : ./index.php?lvl=notice_display&id=102060

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