Current Issue : April-June Volume : 2023 Issue Number : 2 Articles : 5 Articles
Background: This study aimed to propose a classification of acetabular defects in advanced-stage hip tuberculosis based on preoperative radiographs and intraoperative evaluation, thereby providing options for reconstructing each type of defect in hip arthroplasty. Materials and Methods: We conducted a prospective study with 45 patients with active hip tuberculosis at stage IV who were treated with a total hip replacement strategy. We collected the patients’ acetabular defect data from preoperative radiographs and intraoperative observations. The defects were classified into types based on defect severity and reconstructive complexity. The hip replacement outcomes were evaluated at least 12 months after the operation. Results: The classification system includes three types: type I: localized or extensive defects inside the acetabulum, not affecting the acetabular rim, medial wall, or columns. Type II: extensive defects inside the acetabulum, affecting the acetabular rim or (and) medial wall. Type III: extensive defects inside the acetabulum, causing the medial wall and the acetabular column to lose function. Each type has a corresponding reconstruction. The outcome includes that 41/45 patients had excellent results; 3/45 patients had good results. The patients had good results due to nerve and muscle damage caused by tuberculosis not related to the acetabular defects. Conclusion: This is a simple, practical classification system of acetabular defects in hip tuberculosis. The outcome of hip reconstruction using this classification was excellent without any cases of dislocation or protrusion....
Background: Fractures of the posterior process of the talus are rarely seen and frequently overlooked. In our study, anatomical observation and classification of the posterior process of the talus were carried out, and related imaging and finite element methods were combined. The study aimed to observe and provide anatomical data related to posterior process of talus in Asian adults and explore the potential relationships between the different types with fracture of posterior process of talus. Methods: Combined with the anatomical morphology and imaging data, the posterior process of talus was divided into four types, and the incidence and fracture situation were statistically analyzed. The finite element models of four different types of talus processes were established and verified, and the stress and strain were simulated and analyzed. Results: The total incidence of the posterior process of the talus was 97.47%. The proportions of the four types were neck-like 10.13%, flat 36.29%, pointy 12.66% and round blunt 38.39%. The overall incidence of bone cracks of the posterior process of the talus was 4.98%; the most common type was neck-like type. Compared with the value on the other types, the maximum von Mises stress increased by 67.66%, 83.90% and 111.18% on the neck-like posterior process of talus respectively. Conclusions: It is speculated that different types of the posterior process of the talus may be related to the probability of fracture, and it may be better to consider different treatment strategies for different types of fractures....
Background: Adipose tissue has recently gained growing interest in the treatment of osteoarthritis (OA). The aim of the present study was to evaluate the efficacy of a single injection of autologous micro-fragmented adipose tissue (aMFAT) associated with arthroscopy (cartilage debridement/meniscal regularization or selective meniscectomy/ micro-drilling) for symptomatic knee OA. Methods: This retrospective, single-center study included 49 patients (50 knees) affected by knee OA (radiographic Kellgren-Lawrence III-IV) treated with a single injection of autologous micro-fragmented adipose tissue and knee arthroscopy. Knee Injury and Osteoarthritis Outcome Score (KOOS) and subjective International Knee Documentation Committee (IKDC) score were the primary outcome measures and were collected at one and 2 years post-operatively. Patients were divided into clusters based on age, complexity of arthroscopic procedures and chondral lesion grade. Results: Four patients underwent knee replacement (8%). No major adverse events were reported. Minimal Clinically Important Difference (MCID) for KOOS and IKDC was reached by 84 and 74% of all cases at 1 year and by 80 and 76% at 2 years, respectively. High grade chondral lesions negatively affected the outcome at 2 years follow-up (p < 0.05 for IKDC, KOOS overall and 3 out of 5 subscales). Conclusion: The injection of micro-fragmented adipose tissue associated with arthroscopy demonstrated to be a safe and effective procedure for the treatment of knee OA, with a substantial improvement in IKDC and KOOS scores and without major complications....
Remarkable advancements in endoscopic spinal surgery have led to successful outcomes comparable to those of conventional open surgery with the benefits of less traumatization and postoperative spinal instability. Bilateral lumbar facet cysts are rarely found in the spinal canal. We report a rare case of L4–L5 bilateral lumbar facet cysts compressing the nerve root in a patient who presented with L5 radiculopathy. Endoscopic decompression and removal of the cysts without fusion were performed. Histopathology revealed synovial cysts. Postoperatively, the patient showed a total resolution of symptoms with sustained benefits at the final evaluation. No recurrence of pain and no further segmental instability were observed at the 1-year follow-up....
Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the Paediatric Surgery Unit of the University Hospital of Bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35; 66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35; 66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22; 41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37; 69.9%). The evolution was favourable without complications. Conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically....
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