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Journal of Orthopaedics and Traumatology

  1590-9921

 

 

Cơ quản chủ quản:  SPRINGER , Springer-Verlag Italia Srl

Lĩnh vực:
Medicine (miscellaneous)SurgeryOrthopedics and Sports Medicine

Các bài báo tiêu biểu

Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee
Tập 18 - Trang 91-106 - 2017
Bertrand Sonnery-Cottet, Matthew Daggett, Jean-Marie Fayard, Andrea Ferretti, Camilo Partezani Helito, Martin Lind, Edoardo Monaco, Vitor Barion Castro de Pádua, Mathieu Thaunat, Adrian Wilson, Stefano Zaffagnini, Jacco Zijl, Steven Claes
Purpose of this paper is to provide an overview of the latest research on the anterolateral ligament (ALL) and present the consensus of the ALL Expert Group on the anatomy, radiographic landmarks, biomechanics, clinical and radiographic diagnosis, lesion classification, surgical technique and clinical outcomes. A consensus on controversial subjects surrounding the ALL and anterolateral knee instability has been established based on the opinion of experts, the latest publications on the subject and an exchange of experiences during the ALL Experts Meeting (November 2015, Lyon, France). The ALL is found deep to the iliotibial band. The femoral origin is just posterior and proximal to the lateral epicondyle; the tibial attachment is 21.6 mm posterior to Gerdy’s tubercle and 4–10 mm below the tibial joint line. On a lateral radiographic view the femoral origin is located in the postero-inferior quadrant and the tibial attachment is close to the centre of the proximal tibial plateau. Favourable isometry of an ALL reconstruction is seen when the femoral position is proximal and posterior to the lateral epicondyle, with the ALL being tight upon extension and lax upon flexion. The ALL can be visualised on ultrasound, or on T2-weighted coronal MRI scans with proton density fat-suppressed evaluation. The ALL injury is associated with a Segond fracture, and often occurs in conjunction with acute anterior cruciate ligament (ACL) injury. Recognition and repair of the ALL lesions should be considered to improve the control of rotational stability provided by ACL reconstruction. For high-risk patients, a combined ACL and ALL reconstruction improves rotational control and reduces the rate of re-rupture, without increased postoperative complication rates compared to ACL-only reconstruction. In conclusion this paper provides a contemporary consensus on all studied features of the ALL. The findings warrant future research in order to further test these early observations, with the ultimate goal of improving the long-term outcomes of ACL-injured patients. Level of evidence Level V—Expert opinion.
Evaluating comorbidities in total hip and knee arthroplasty: available instruments
Tập 11 Số 4 - Trang 203-209 - 2010
Kristian Bjørgul, Wendy M. Novicoff, Khaled J. Saleh
Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology
- 2017
Umberto Tarantino, Giovanni Iolascon, Luisella Cianferotti, Laura Masi, Gemma Marcucci, Francesca Giusti, Francesca Marini, Simone Parri, Maurizio Feola, Cecilia Rao, Eleonora Piccirilli, Emanuela Basilici Zanetti, Noemi Cittadini, Rosaria Alvaro, Antimo Moretti, Dario Calafiore, Giuseppe Toro, Francesca Gimigliano, Giuseppina Resmini, Maria Luisa Brandi
Perspectives on metaphyseal conservative stems
Tập 9 Số 1 - Trang 49-54 - 2008
Francesco Falez, Filippo Casella, Gabriele Panegrossi, Fabio Favetti, C. Barresi
Abstract

Total hip replacement is showing, during the last decades, a progressive evolution toward principles of reduced bone and soft tissue aggression. These principles have become the basis of a new philosophy, tissue sparing surgery. Regarding hip implants, new conservative components have been proposed and developed as an alternative to conventional stems. Technical and biomechanical characteristics of metaphyseal bone-stock-preserving stems are analyzed on the basis of the available literature and our personal experience. Mayo, Nanos and Metha stems represent, under certain aspects, a design evolution starting from shared concepts: reduced femoral violation, non-anatomic geometry, proximal calcar loading and lateral alignment. However, consistent differences are level of neck preservation, cross-sectional geometry and surface finishing. The Mayo component is the most time-tested component and, in our hands, it showed an excellent survivorship at the mid-term follow-up, with an extremely reduced incidence of aseptic loosening (partially reduced by the association with last generation acetabular couplings). For 160 implants followed for a mean of 4.7 years, survivorship was 97.5% with 4 failed implants: one fracture with unstable stem, 1 septic loosening and 2 aseptic mobilizations. DEXA analysis, performed on 15 cases, showed a good calcar loading and stimulation, but there was significant lateral load transfer to R3–R4 zones, giving to the distal part of the stem a function not simply limited to alignment. Metaphyseal conservative stems demonstrated a wide applicability with an essential surgical technique. Moreover, they offer the options of a “conservative revision” with a conventional primary component in case of failure and a “conservative revision” for failed resurfacing implants.

Knee instruments and rating scales designed to measure outcomes
- 2012
E. Carlos Rodríguez-Merchán
The effect of zoledronate during bone healing
Tập 11 Số 1 - Trang 7-12 - 2010
Marcos Almeida Matos, Uenis Tannuri, Roberto Guarniero
Abstract Background

Bisphosphonates have become the treatment of choice for a variety of bone diseases in which excessive osteoclastic activity is an important pathologic feature. However, inhibition of osteoclastic activity could lead to inhibition of remodeling during bone healing or repair. The objective of this study is to investigate the effect of zoledronate (the most potent bisphosphonate) in the biological process of bone healing.

Methods

Thirty immature male rabbits were divided into two groups (control and experimental) of 15 animals each. Both groups were submitted to fibular osteotomy. Only in the experimental group a single dose of zoledronate was administered. After 1, 2, and 4 weeks, animals of both groups were euthanized and the osteotomy site was histomorphometrically evaluated. The associated parameters analyzed were tissue volume (TV), fractional trabecular bone volume (BV/TV), fractional woven bone volume (WoV/TV), fractional periosteal fibrous volume (FbV/TV), and medullary fibrous volume (MaV/TV).

Results

The first week of healing was characterized by small callus area (experimental group) and less periosteal fibrosis. The second week was characterized by a large quantity of woven bone and marked decrease in periosteal fibrosis in the two groups. In the control group there was also a significant increase in trabecular bone. The fourth week was characterized by increased amount of woven bone and trabecular bone in the experimental group; there was increased medullary fibrosis in the two groups, while there continued to be significantly less periosteal fibrosis in the experimental group.

Conclusions

Zoledronate does not prevent bone healing. However, the effect of zoledronate was characterized by accentuated stimulation of primary bone production and probably inhibition of remodeling, leading to retention of trabecular bone.

Expandable intramedullary nailing and platelet rich plasma to treat long bone non-unions
Tập 9 Số 3 - Trang 129-134 - 2008
Olimpio Galasso, Massimo Mariconda, Gaetano Romano, Nicola Capuano, Luigi Romano, Bruno Iannò, Carlo Milano
Abstract Background

Roentgenographic and functional outcomes of expandable self locking intramedullary nailing and platelet rich plasma (PRP) gel in the treatment of long bone non-unions are reported.

Materials and methods

Twenty-two patients suffering from atrophic diaphyseal long bone non-unions were enrolled in the study. Patients were treated with removal of pre-existing hardware, decortication of non-union fragments, and fixation of pseudoarthrosis with expandable intramedullary nailing (Fixion™, Disc’O Tech, Tel Aviv, Israel). At surgery, PRP was placed in the pseudoarthrosis rim.

Results

The thirteen-month follow-up showed 91% (20/22 patients) of patients attaining bony union. The average time to union was 21.5 weeks. No infection, neurovascular complication, rotational malalignment, or limb shortening >4 mm were observed. The healing rate of non-unions was comparable to that observed in previous studies but with a lower complication frequency.

Conclusions

The combined use of self locking intramedullary nailing and PRP in the management of atrophic diaphyseal long bone non-unions seems to produce comparable results with less complications than previously reported. Further data are warranted to investigate the single contribution of PRP gel and Fixion nail.

Relationship between the Charlson Comorbidity Index and cost of treating hip fractures: implications for bundled payment
Tập 16 Số 3 - Trang 209-213 - 2015
Daniel J. Johnson, Sarah E. Greenberg, Vasanth Sathiyakumar, Rachel V. Thakore, Jesse M. Ehrenfeld, William T. Obremskey, Manish K. Sethi
Dual mobility acetabular component in revision total hip arthroplasty for persistent dislocation: no dislocations in 50 hips after 1–5 years
Tập 16 Số 1 - Trang 15-20 - 2015
M. van Heumen, Petra J C Heesterbeek, Bart A Swierstra, Gijs G. van Hellemondt, Jon H. M. Goosen
Graft selection in arthroscopic anterior cruciate ligament reconstruction
- 2010
Emilio Romanini, Franca D’Angelo, Salvatore Masi, Ezio Adriani, Massimiliano Magaletti, Eleonora Lacorte, Paola Laricchiuta, Luciano Sagliocca, Cristina Morciano, Alfonso Mele