Acta Orthopaedica Belgica
Not a member yet
578 research outputs found
Sort by
Spontaneous posterior shoulder dislocation as the first symptom of a Charcot arthropathy
No full textNeuroarthropathy or Charcot disease is a destructive joint pathology. Upper limb involvement is unusual and often due to syringomyelia. We reported a patient with spontaneous posterior right shoulder dislocation. Thereafter, she presented a quick joint destruction evoking a Charcot shoulder disease after excluding infectious and rheumatologic diseases. Explorations of this Charcot disease lead to the discovery and treatment of syringomyelia. A conservative management of her shoulder neuro-arthropathy has been proposed to the patient.Shoulder involvement in Charcot disease is unusual: only 5% of cases. 18 cases have been reported in English literature. Two theories try to explain Charcot disease: neuro-vascular and neuro-traumatic. There is no efficient treatment for Charcot shoulder disease but it can be prevented by surgical treatment of syringomyelia.Charcot shoulder is a rare and morbid disease for which conservative treatment is recommended because of disappointing results of arthroplasty and arthrodesis
Effects of cement anchors with screw holes for cementing a liner into a stable, cementless acetabular metal shell: A laboratory study
No full textA mechanical study was conducted on the shell-cement interface in order to construct an acetabular metal shell, and to fix a polyethylene liner with the bone cement. Six types of models were tested. All cementations were performed under the similar conditions. The “lever out” test was conducted 3 times for each group in order to measure the dissociation strength. The average dissociation strength values were 11.5 N·m for those without screw holes; 33.6, 34.7, and 78.7 N·m for those with single holes at 1-, 3-, and 6-mm depth, respectively; and 41.3 and 101.1 N·m for the different configurations with three holes at 3-mm depth. The strength of adhesion increased with the use of a cement anchor and with increased lengths and numbers of anchors. The application of a cement anchor with a screw hole is clinically useful for increasing the mechanical strength of the shell-cement interface
Functional results of microsurgical thumb reconstruction using the Morrison wrap-around technique according to level of amputation
No full textThe thumb contributes approximately 40 percent of hand function. In the case of an amputation, where replantation/revascularisation is impossible, a reconstruction should be planned as the second best treatment. Morrison described in 1980 the technique of a wrap-around partial great toe transfer. According to Morrison, the technique is best suited for reconstruction of the thumb distal to the metacarpophalangeal joint (MCPJ). In this study, we retrospectively report on 10 thumb reconstructions using the wraparound flap from the great toe. Functional results according to the level of amputation are compared. We found in our limited series, that although better results are achieved when the amputation was distal to the MCPJ, the ‘wraparound’ reconstruction technique still yielded acceptable functional results and outcome in amputation levels through or proximal to the MCP
A prospective randomized study comparing the direct anterior approach in the lateral decubitus position versus the standard posterolateral approach for total hip arthroplasty
No full textBackground: This prospective randomized study was conducted to compare the early clinical, laboratory and radiological outcomes between patients who underwent the LDAA or the posterolateral approach (PLA) for THA.Methods: Seventy-two patients were randomly divided into two groups. The patients in one group accepted THA via the LDAA, and the patients in the other group accepted THA via the PLA. Results: Compared with the PLA, the LDAA offered the benefits of shorter incision (P < 0.001), less intraoperative blood loss (P < 0.001), less postoperative drainage (P < 0.001), and shorter length of stay (P < 0.001). In addition, the LDAA caused lower levels of creatine kinase, C-reactive protein, and myoglobin and higher levels of postoperative hemoglobin. The LDAA group received a lower score (P < 0.001) in the visual analogue scores and a higher score (P < 0.001) in the Harris hip scores. However, the LDAA required a longer operation time than the PLA (P < 0.001).Conclusions: Our results showed that LDAA is more minimally invasive and associated with a faster functional recovery
Suture Anchors For Primary Deltoid Ligament Repair Associated With Acute Ankle Fractures
No full textBackground: To evaluate the clinical effect of primary suture anchors repair in the treatment of deltoid ligament rupture.Patients and Methods: 34 patients with acute deltoid ligament rupture associated with ankle fractures were selected between 2011 and 2014. Medial clear spaces (MCSs), American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scales (VASs) of injured ankles were noted from stress radiographs. The mean follow-up was 28.4 (range, 22-35) months.Results: The mean AOFAS score was 89.7 (range, 85-94) at the postoperative 6-month follow-up, and 92.7 (range, 88-95), 93.3 (range, 90-95), and 92.6 (range, 90-95) at the 12-month, 24-month, and final follow-up. The mean MCS is (9.10±4.99) mm before and (3.71±0.33) mm after surgery in stress radiographs. With the numbers available, statistical analysis showed statistical difference in terms of MCS of the ankle joints (P <0.05). At the postoperative final follow-up, the mean MCS of injured ankle is (3.74±0.32) mm in stress radiographs, and (3.65±0.17) mm of uninjured contralateral ankle. Statistical significance was defined as P >0.05.Conclusion: Using suture anchors in the primary repair of deltoid ligament rupture can achieve satisfactory outcomes
Pulsed electric fields reduce bacterial attachment to stainless steel plates
No full textThe purpose of this study was to evaluate the capacity of pulsed bilateral electric fields to control bacterial attachment on stainless steel plates. Previously sterilized circular metal plates of stainless steel were submerged in a liquid medium with a known concentration of Staphylococcus epidermidis and incubated for 1 hour at 36ºC while a 200 Hz pulsed electric field of 18 V/cm was applied for 2.5 µseg and then sonicated for 5 minutes in 10 ml of saline. Three different models were cultured and compared: 1) negatively-charged plate, 2) positively-charged plate, and 3) control plate without electric current. A total of 39 metal plates were processed. The median adherence in the control group and the electric field group was 312 CFU/mm2 and 16,2 CFU/mm2 respectively (p< 0.001, reduction of 95% of bacterial attachment). Bilateral pulsed electric field is able to reduce bacterial attachment on stainless steel plates in in vitro conditions
Clinical results of cervical disc replacement with the Baguera C prosthesis after two years follow-up
No full textPurposeWe studied pain, neurological, and functional outcomes of one and two-levels cervical arthroplasties using a semi-constrained prosthesis for symptomatic cervical degenerative discopathies. MethodsRetrospective analysis of 95 patients in a multicentric registry over 2 years FU.ResultsImplant-related complications, subsequent surgery and neurological deterioration were not observed. After two years, improvement of > 20% of the NDI was observed in 81.8%, of > 20% of the neck pain in 75.5% and of 20% in arm pain in 77.6%. A > 15% QOL improvement (SF 36 questionnaire) was recorded in 76.5% (physical) and in 77,6% (mental).ConclusionsGreater benefits of cervical arthroplasty were observed in patients under 50 without previous surgeries and with preoperative NDI > 30%, confirming a safe and effective techniqu
Flexor pollicis longus tendon rupture after volar wrist plating: reconstruction with palmaris longus interposition graft.
No full textRupture of the flexor pollicis longus tendon is a rare complication after volar plating of distal radius fractures. Several surgical treatment options have been proposed but postoperative results are not well documented. The authors retrospectively studied the clinical outcome of 4 patients after flexor pollicis longus tendon reconstruction with a palmaris longus interposition graft. Minimal follow-up was 12 months. Mean active interphalangeal joint flexion (44°) and thumb opposition (Kapandji 8/10) were significantly reduced compared to the opposite side. Mean power grip (32 kg) and key pinch strength (8kg) of the operated hand were comparable to the contralateral hand. The mean Visual Analogue Scale for pain was 2.5/10. The mean DASH score was 14 points. Although flexion and opposition of the thumb did not return to normal after surgery, patients reported excellent functional results.
THE EFFICACY OF 1,2- INTERCOMPARTMENTAL SUPRARETINACULAR ARTERY PEDICLED VASCULARISED BONE GRAFT FOR SCAPHOID PROXIMAL END NON-UNION AND AVASCULAR NECROSIS
No full text Purpose:To show the efficacy of 1,2-intercompartmental supraretinacular artery pedicled vascularised bone graft in treatment of scaphoid non-union with concomitant proximal end avascular necrosis retrospectively. Methods:Twentytwo cases of scaphoid nonunion with concomitant proximal end avascular necrosis were evaluated. Radiographic evaluation was made with radiographs, computed tomography, and magnetic resonance imaging. Clinical evaluation was made according to the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Mayo wrist score, and the Short Form-36. Results:Union was achieved in 18 81.8%. The mean age was 31.13±5.29 years and the mean follow-up was 34.95±16.87 months. The median wrist flexion-extension range was 123.5° (100°-144°) preoperatively and 128° (82°-146°) postoperatively. The median radial-ulnar deviation was measured as 41.5° (24°-55°) preoperatively and 42° (24°-58°) postoperatively. The dominant hand was measured as 92% (p=0.061) grip strength compared to the healthy side and the non-dominant side as 74% (p=0.012). Improvement was observed in all patients in SF-36,DASH,Mayo score and in patients with union (p<0.001).Conclusion:The radiological and clinical results of this study showed that 1,2- intercompartmental supraretinacular artery pedicled vascularised bone graft is an effective method in the treatment of scaphoid nonunion with concomitant proximal end avascular necrosis.
Efficacy of Wallis interspinous dynamic stabilization implant in the treatment of primary lumbar disc herniation: A prospective randomised controlled trial
No full textPurpose:To investigate the efficacy of Wallis implant after lumbar discectomy compared with discectomy alone for patients with primary lumbar disc herniation.Methods: A total of 77 patients with primary lumbar disc herniation were randomly assigned to receive posterior lumbar discectomy combined with (n =40, Wallis group) or without (n =37, control group) Wallis implantation. The primary outcomes were Visual Analogue Scale (VAS), Japanese Orthopedics Association (JOA) score and Oswestry Disability Index (ODI). The secondary outcomes were intervertebral disc height (DH), range of motion (ROM) of operated segments, complications and the time of surgery.Results: No significant difference was found between the two groups for the VAS, JOA and ODI scores at 1 week after treatment (P>0.05). Wallis group had better scores than that for control group at 12 months (P<0.05) and last follow-up time (P<0.05). Wallis group had higher DH than that for the control group at each follow-up moment (P<0.001).Conclusion: Combination treatment may provide benefits comparable to lumbar discectomy alone for patients with lumbar disc herniation by restoring the intervertebral disc height and preserving limited motion of the spine