ABSTRACT
Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.
Subject(s)
Rotator Cuff , Superficial Back Muscles , Tears , Tendon Transfer , TendonsABSTRACT
Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.
Subject(s)
Rotator Cuff , Superficial Back Muscles , Tears , Tendon Transfer , TendonsABSTRACT
PURPOSE: The purpose of this study is to evaluate the clinical and radiological result in patients who got salvage re-fixation for the failed fixation of pertrochanteric fracture retrospectively. MATERIALS AND METHODS: Between 1992 and 2009, 21 patients who could be followed-up for more than 1 year after salvage re-fixation for the failed fixation of pertrochanteric fracture were enrolled in this study. There were 16 men and 5 women. The mean age was 53 years (19-84 years) at the index surgery and the mean follow-up was 6.4 years. We evaluated the clinical and radiographic results and postoperative complications. RESULTS: Walking ability and pain were improved in all cases and the mean leg length discrepancy was improved from 2.5 cm (0-10 cm) preoperatively to 1 cm (0-4 cm) at the latest follow-up. Nineteen patients (90.5%) out of 21 patients achieved bony union at the final evaluation and the mean union time was 4 months (3-7 months). There were 2 cases of non-union who had not received bone graft as a complication. CONCLUSION: The clinical and radiological results of the salvage re-fixation for the failed fixation of pertrchanteric fracture were satisfactory in our study. Secure component fixation for the mechanical stability and proper bone graft for the improvement of bone biology are mandatory to improve the result.
Subject(s)
Female , Humans , Male , Biology , Femur , Follow-Up Studies , Leg , Transplants , WalkingABSTRACT
PURPOSE: We wanted to report on the outcomes of using a strut allograft and extensively porous-coated femoral stems in revision total hip arthroplasty that was performed due to extensive femoral bone loss. MATERIALS AND METHODS: Between 1998 and 2005, we performed 167 consecutive revision total hip arthroplasties. Among them, twelve cementless femoral revision surgeries with a strut allograft and extensively porous-coated stems were retrospectively reviewed. The average follow up was 4.6 years. The average age at the time of the index revision was 55.9 years. The reasons for the revisions were periprosthetic fracture due to extensive osteolysis in 5 hips and aseptic loosening in 7 hips. RESULTS: The Harris hip score improved from a mean of 40.8 points before revision surgery to a mean of 85.1 points at the latest follow up. Radiographic evidence of bony stable stems were present in 11 hips and a fibrous stable stem was present in 1 hip. Moderate stress-shielding was noticed in one hip. Nonunion of the allograft was observed in 1 hip due to deep infection. To date, no significant wear or osteolysis has been observed. CONCLUSION: Revision total hip arthroplasty with a strut allograft and an extensively porous-coated femoral stem for treating cases of extensive femoral bone loss seems to be a reasonable choice. However, the concerns related to stress shielding, the difficulties in re-revisions and the complications associated with an allograft will require longer term follow up.