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  • Church posted an update 1 year, 1 month ago

    ical difference in the length of stay and ROM after 72 h in the two groups.

    Total hip arthroplasty (THA) is the standard procedure for post-traumatic osteoarthritis (OA) of the hip after acetabular fracture. However, it is not as simple as a primary THA, challenging the surgeon with anatomical deformity and intra and postoperative complications. In the current literature, there is a lack of studies reporting long-term results. May ceramic-on-ceramic (CoC) bearings provide good clinical and radiological outcomes at a long-term follow-up in patients undergoing THA following acetabular fracture?

    We retrospectively analyzed 68 patients (mean age 47years [range 22-75)] who underwent cementless modular neck stem THA, all implants CoC bearings (50 previously operatively treated and 18 non-operatively treated) after a specific CT study protocol at our Institute since 2000-2008. SU6656 Clinical outcomes, prosthetic components’ osseointegration, survival rate, and reasons for revision were analyzed. Minimum clinical and radiological follow-up was 10years.

    HHS improved significantly after surgeroverweight patients because of the high risk of fracture. CoC bearings in THAs in post-traumatic OA after acetabular fracture showed good results despite the fact that specific ceramic-related issues have to be considered.

    The high survival rate may be related to CoC no osteolysis and no infections were reported. Also acetabular cup loosening incidence was sensibly lower (1.47%) among loosening rate described by other authors. Clinical and radiological outcomes were decent, probably due to modular prosthesis design. Modular necks are a solution which can help achieving a proper functional reconstruction of the hip (offset, center of rotation), but should be avoided in young and overweight patients because of the high risk of fracture. CoC bearings in THAs in post-traumatic OA after acetabular fracture showed good results despite the fact that specific ceramic-related issues have to be considered.

    Eight hundred and fifty-eight consecutive osteotomies around the knee joint were analyzed retrospectively to detect intra- and early postoperative complications in a period of 4weeks postoperative. Indications for osteotomy were unilateral gonarthritis or torsional deformities resulting in femoropatellar instability or anterior knee pain.

    Etiology of deformity, technique and mode of correction and level of osteotomy were registered. Complications were detected and divided in minor complication (superficial wound infection, and deep-vein thrombosis) and major complication (compartment syndrome, deep infection, and vascular lesion).

    Fifteen major (1.7%) and 17 minor complications (2.0%) were detected 5 vascular lesions (0.58%), 4 compartment syndromes (0.47%) and 6 deep infections (0.70%), 14 superficial wound infections (1.6%) and 3 deep-vein thrombosis (0.35%). In posttraumatic osteotomies and continuous corrections, risk for a superficial wound infection was significantly higher and with osteoclasia riLCW and torsional corrections) have to kept in mind. There is no difference in frequency of complications between HTO and supracondylar osteotomies. Risk for superficial wound infection is higher in posttraumatic osteotomies and with continuous corrections. Osteoclasia contains a higher risk for vascular lesion compared to oscillating saw.

    Proximal femur fractures are associated with an increased mortality rate in the elderly. Early weight-bearing presents as a modifiable factor that may reduce negative postoperative outcomes and complications. As such, we aimed to compare non-weight-bearing, partial-weight-bearing and full weight-bearing cohorts, in terms of risk factors and postoperative outcomes and complications.

    We retrospectively reviewed our database to identify the three cohorts based on the postoperative weight-bearing status the day of surgery from 2003 to 20014. We collected data on numerous risk factors, including age, cerebrovascular accident (CVA), pulmonary embolism (PE), surgical fixation method and diagnosis type. We also collected data on postoperative outcomes, including the number of days of hospitalization, pain levels, and mortality rate. We performed a univariate and multivariate analysis; P < 0.05 was the significant threshold.

    There were 186 patients in the non-weight-bearing group, 127 patients in the partial-ion, appropriate expectations and standardizations should be set since age and type of diagnosis act as significant predictors of weight-bearing status.

    Kaplan fibers (KF) have been described as connections between the iliotibial band and the distal femur. They are divided into two distinct structures, proximal (PKF) and distal (DKF) fibers, which may participate in the control of the rotatory knee stability. Their anatomical characteristics have not been investigated completely, in particular with respect to reconstruction procedures. The aim was to determine their anatomical characteristics and their morphological variation.

    Twenty-one nonpaired fresh frozen human cadaveric knees (from whole leg) were used for the analysis of PKF and DKF through an anterolateral approach. The anatomical relationships between the adjacent anterolateral structures were reported and anatomical characteristics of PKF and DKF (thickness, width and length) measured at 50° knee flexion under different rotational conditions (neutral NR, Internal at 5Nm IR applied with a dynamometric torque rig). Bony ridges of PKF and DKF were measured.

    PKF and DKF and their respective bony ridges were individually identified in all knees studied (n = 21). The PKF and DKF were proximal and posterior to the lateral femoral epicondyle, respective distances 49.20 ± 7.38 and 27.54 ± 7.69mm. DKF were thicker (p < 0.001), wider (p < 0.001) and longer (p < 0.001) than the PKF, regardless of the tibial rotation applied. Tensioning of KF was achieved in IR with a decrease in thickness and width, alongside fiber lengthening (p < 0.001).

    PKF and DKF are distinct and constant anatomical structures of the lateral compartment of the knee, whose anatomical characteristics and their tensioning in IR presume a function of controlling rotational knee stability.

    PKF and DKF are distinct and constant anatomical structures of the lateral compartment of the knee, whose anatomical characteristics and their tensioning in IR presume a function of controlling rotational knee stability.

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