Current Issue : January - March Volume : 2020 Issue Number : 1 Articles : 5 Articles
Objective: This study aimed to investigate the effectiveness of a three-dimensional strapping reduction in the treatment\nof patellar fractures.\nMethods: Between January 2015 and June 2017, a total of 56 patients were randomly allocated to the threedimensional\nstrapping reduction group (trial group) and towel clamp reduction group (control group). There\nwere no significant differences in age, gender, injury side, the interval time from injury to surgery, fracture\npattern, and cause of injury (P > 0.05). The operation time, fluoroscopy time, bone union time, postoperative\nHospital for Special Surgery (HSS) scores, and complications were recorded and analyzed.\nResults: All incisions achieved primary union. All patients in both groups completed a follow-up with an average of\n12.5 months (range 11-15 months). Both operation time and fluoroscopy time in the trial group were significantly\nshorter than those in the control group (P < 0.001). All patellar fractures achieved bone union, and there was\nno significant difference in bone union time between the two groups (P > 0.05). Bone nonunion, infection,\nand fixation failure were not found in both groups. HSS scores of the trial group������....
Purpose: Optimal type of prosthesis in total knee arthroplasty (TKA) remains controversial for young patients. The\nobjective of this meta-analysis is to compare cementless and cemented fixation in TKA.\nMethods: In this meta-analysis, we conducted electronic searches of PubMed, Embase, Cochrane Library, and Web\nof Science in December 2018. We collected randomized controlled trials (RCTs) comparing cementless and\ncemented TKA in young patients. The outcome measurements consisted of functional outcomes, Knee Society\nScore, range of motion, radiological outcomes, pain score, and complications. Stata 12.0 software was used for our\nmeta-analysis. Quality assessment for RCTs was conducted according to the Cochrane Handbook for systematic\nreview of interventions.\nResults: Four RCTs met our inclusion criteria with 255 patients in cemented groups and 229 patients in cementless\ngroups. The present meta-analysis indicated that there was a significant difference between the groups in terms of\nradiological outcomes and pain score. No significant difference was found regarding KSS, range of motion, or\ncomplications.\nConclusion: Cementless TKA was associated with superior outcomes in terms of radiological outcomes and pain\nscore compared with cemented fixation. We found no significant difference regarding the functional outcome or\naseptic loosening between groups. High-quality RCTs were still required for further investigation....
Lumbar spondylolysis is a relatively common condition that can cause a variety\nof clinical manifestations related to the lumbar spine. However, multilevel\nlumbar spondylolysis is rare and accounts for less than 6% of lumbar\nspondylolysis. We report a case of three-level lumbar spondylolysis with single-\nlevel spondylolisthesis. A 47-year-old woman presented to us with low\nback pain for 9 years that progressively worsened and the pain was exacerbated\nwith standing and walking. She was diagnosed with three-level lumbar\nspondylolysis at L3-5 and spondylolisthesis at L4. We performed posterolateral\nlumber fusion (PLF) and posterior lumbar interbody fusion (PLIF) surgery\nfor her. During the same period, pain recovery and fusion rate of the patient\nwere evaluated after surgery. The results were favorable and proved the\nefficacy of combining PLF and PLIF technique for treatment for three-level\nlumbar spondylolysis and single-level spondylolisthesis....
Background: Curettage is widely used in orthopedic oncology; the defect created frequently requires filling for\nmechanical and functional stability for the bones and adjacent joint. Allograft, bone graft substitute, and polymethyl\nmethacrylate (PMMA) are the most common substances used each with their benefits and drawbacks. The aim of\nthe study is to show that good functional result can be achieved with curettage and bone filler, regardless of type.\nMethods: A series of 267 cases were reviewed between 1994 and 2015 who received curettage treatment\nand placement of a bone filler. Endpoints included fracture, infection, cellulitis, pulmonary embolism, and\nparesthesia. Complication rates at our single institution were compared against literature values for three\nstudy cohorts: allograft, bone graft substitute, and PMMA bone fillers. Friedman test, Wilcoxon test, and Zscore\nfor two populations were used to compare our subset against literature values and between different\nbone filling types.\nResults: Our cases included 18 autografts, 74 allografts, 121 bone graft substitute, and 54 PMMA of which\nthe bulk of complications occurred. Our overall complication rate was 3.37%. Allograft has a complication rate\nof 1.35%, bone graft substitute of 4.13%, and PMMA of 5.56%. Other techniques did not yield any\ncomplications. Combination filling techniques PMMA + allograft and PMMA + bone graft substitute had\nsample sizes too small for statistical comparison. Statistical comparison yielded no significant difference\nbetween complications in any of the filling groups (P = 0.411).\nConclusions: Some has even argued that bone defects following curettage do not require bone filling for\ngood outcome. However, many structural or biologic benefits that aid in earlier return to functionality can be\nconferred by filling large bone defects. There was no significant difference in postoperative complication rates\nbetween allograft, bone graft substitute, and PMMA when compared at our institution and with literature\nvalues. Nevertheless, one complication with a large defect filled with allograft, requiring a subsequent\nreconstruction using vascularized fibular graft. Taking everything into account, we see bone graft substitute as\na suitable alternative to other bone filling modalities....
The simultaneous traumatic rupture of the patellar tendon and the quadricipital\ntendon is a rare lesion entity. We report the case of a bipolar rupture of\nthe extensor knee system in a young adult following sports traumatism.\nMagnetic Resonance Imaging allowed the assessment of associated lesions.\nThe management of this â??floatingâ? kneecap was surgical associated with rehabilitation.\nA functional assessment at 02 years of follow-up was performed.\nThe functional prognosis is related on the one hand to the difficulties of positioning\nof the patella and on the other hand to the associated lesions (meniscus-\nligamentous knee injuries)....
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