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1.
Arch Orthop Trauma Surg ; 144(3): 1055-1063, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38114740

ABSTRACT

INTRODUCTION: Until now, a treatment protocol for Achilles tendon re-rupture (ATRR) occurring in the postoperative period 5-12 weeks following primary Achilles tendon repair has not been established. We refer to this time frame as the subacute postoperative phase, and the objective of this study was to assess the efficacy of conservative treatment for subacute ATRR in this phase. MATERIALS AND METHODS: We conducted a retrospective review of 390 cases (385 patients) who had undergone primary Achilles tendon repair using the 4-strand Krachow method between January 2010 and August 2021. All patients were subjected to more than 12 months of follow-up and were categorized into two groups based on the presence of subacute ATRR: Group 1 comprised 370 cases without ATRR, while Group 2 comprised 20 cases with ATRR. Following confirmation of ATRR, we immediately applied a below-knee cast in an ankle plantar flexed position (25°-30°), followed by bracing according to the same rehabilitation plan used for the primary repair. After administering conservative treatment to the patients with ATRR, we compared several outcome parameters between the two groups, including isokinetic plantar flexion power measured using a dynamometer, time required for a single heel raise (t-SHR), time needed for ten repetitive SHRs (t-SHR10), Achilles Tendon Total Rupture Score (ATRS), and Foot and Ankle Ability Measure (FAAM) scores. The baseline timepoints for Groups 1 and 2 were the dates of the primary repair and the re-injury event. RESULTS: After primary Achilles tendon repair, subacute ATRR occurred in 5.1% of patients. There were no significant differences between the groups in terms of t-SHR and t-SHR10 (P = 0.281, 0.486). Similarly, the isokinetic dynamometer measurements revealed no significant differences in peak torque for plantar flexion at angular velocities of 30°/s and 120°/s, both in absolute values and as a percentage of the contralateral side, between the groups (P > 0.05 for each). However, ATRSs were significantly lower in Group 2 compared to Group 1 before 6 months (P < 0.05), as were FAAM-Activities of Daily Living scores at 6 months (P < 0.05). After 12 months, there were no significant differences in these scores between the two groups (both P > 0.05). CONCLUSION: Conservative treatment for subacute ATRR following primary Achilles tendon repair yields clinical outcomes comparable to those without ATRR. Therefore, we recommend that surgeons consider relying on the patient's natural healing capabilities rather than opting for aggressive surgical interventions, as expediting such operations may be unnecessary for subacute injuries.


Subject(s)
Achilles Tendon , Ankle Injuries , Tendon Injuries , Humans , Achilles Tendon/surgery , Achilles Tendon/injuries , Activities of Daily Living , Conservative Treatment , Treatment Outcome , Ankle Joint , Tendon Injuries/surgery , Tendon Injuries/rehabilitation , Rupture/surgery
2.
Int Orthop ; 45(6): 1455-1461, 2021 06.
Article in English | MEDLINE | ID: mdl-33459829

ABSTRACT

PURPOSE: Adhesive capsulitis of the hip (ACH) is likely that this condition had been previously encountered, but easily unrecognised. We investigated the clinical features of patients with ACH, the efficacy of ultrasound-guided intra-articular hydrodilatation, and the patients' prognosis. METHODS: We enrolled 84 patients (93 hips) who visited the outpatient clinic from August 2018 to November 2019. ACH was diagnosed by restricted range of motion and sharp pain when turning with the affected leg fixed on the ground. We evaluated patient demographics and associated intra-articular pathologies found on magnetic resonance angiography (MRA) images. Injections were performed twice at two week intervals with a mixture of 0.5% lidocaine (25 mL) and triamcinolone (40 mg; 1 mL) with capsular distension under ultrasound guidance. Patients were assessed before and after treatment using a visual analogue scale (VAS), hip disability and osteoarthritis outcome score (HOOS), hip range of motion (ROM), and distance from floor to knee (DFK) when sitting in the cross-legged position. RESULTS: On MRA, 18 patients had abnormal findings (eight labral tears, seven abductor tendinosis, three primary arthrosis). The mean VAS decreased from 7.1 ± 1.1 to 0.8 ± 0.9 after the last injection, and the HOOS improved in all subsets. The mean DFK decreased from 17.9 ± 4.8 to 9.7 ± 2.8 cm, and passive ROM showed improvement, especially in flexion and rotation. In seven patients, symptom recurrence was reported a mean of 4.1 months after the latest injection, but no independent risk factor for recurrence was identified. CONCLUSION: Based on these current observations, patients with ACH may receive relief from hip joint pain and experience improved function with a timely diagnosis and effective treatment.


Subject(s)
Bursitis , Shoulder Joint , Bursitis/drug therapy , Bursitis/therapy , Humans , Injections, Intra-Articular , Range of Motion, Articular , Shoulder Joint/diagnostic imaging , Treatment Outcome , Ultrasonography , Ultrasonography, Interventional
3.
Arch Orthop Trauma Surg ; 141(2): 225-233, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32388648

ABSTRACT

PURPOSE: Nonunion is the most frequent cause of reoperation and is associated with high morbidity after distal femur fracture (DFF). We examined the rates of nonunion requiring reoperation after fixation for DFF using a locking compression plate (LCP) or retrograde intramedullary nail (RIMN). METHODS: We included four studies comparing LCP and RIMN and 38 single-cohort studies reporting LCP or RIMN. In total, 2156 femurs were included and 166 non-unions were detected. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the four comparative studies and a proportional meta-analysis on the 38 articles to estimate the nonunion rate. We performed sensitivity analysis by comparing studies using LCP with less invasive surgical systems (LISS) with those that used RIMN. RESULTS: The pairwise meta-analysis showed a similar nonunion rate between the groups [odds ratio: 1.02; 95% confidence interval (CI) 0.94-1.11, p = 0.633]. According to proportional meta-analysis, the pooled prevalence of nonunion was 5% (95% CI 4-7) totally, 6% (95% CI 4-8) in the LCP group, and 4% (95% CI 2-6) in the RIMN group (heterogeneity: p = 0.105). According to the sensitivity analysis, there was no difference in the union rate. The pooled prevalence of nonunion from sensitivity analysis was 4 % (95% CI, 3-5); it was 4% (95% CI, 3-6) in LCP with LISS and was 4% (95% CI, 2-6) in RIMN group (heterogeneity: p = 0.941). CONCLUSION: Approximately 5% of patients who underwent LCP or RIMN fixation developed nonunion. Therefore, LCP and RIMN are effective DFF techniques and mastering one of them is essential.


Subject(s)
Bone Nails , Bone Plates , Femoral Fractures/surgery , Fracture Fixation, Internal , Postoperative Complications/epidemiology , Femur/surgery , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/instrumentation , Fracture Fixation, Internal/statistics & numerical data , Humans , Incidence
4.
Injury ; 48(10): 2201-2206, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28801201

ABSTRACT

INTRODUCTION: The purpose of this study was to demonstrate the effectiveness of controlled telescoping system for lateral hip pain caused by sliding of the blade following intramedullary nailing of trochanteric fractures. MATERIALS AND METHODS: A retrospective cohort study was performed to compare the controlled telescoping system (Compression Hip Nail; CHN) with the conventional sliding system (Proximal Femoral Nail Antirotation; PFNA) for trochanteric fractures. 74 cases in the PFNA group and 77 cases in the CHN group were included from two university hospitals in this study. All patients had a minimum of 12-month follow up period. Lateral hip pain was evaluated and operation time and blood loss during the surgery were measured. The fracture classification was evaluated. The quality of postoperative reduction and other complications after surgery were also evaluated and tip-apex distance (TAD), telescoping and lateral protrusion of the blade and lag screw were measured. RESULTS: The mean age was 78.5 years in the PFNA group and 74.7 years in the CHN group (p=0.25). The mean telescoping was 19.2mm in the PFNA group and 10.7mm in the CHN group (p<0.001). The mean length of lateral protrusion was 10.5mm in the PFNA group and 2.5mm in the CHN group (p<0.001). Twenty-eight patients in the PFNA group complained of lateral hip pain, whereas 12 patients in the CHN group did (p=0.002). These four variables showed statistically significant differences between the PFNA and CHN groups (p<0.05). The length of lateral protrusion was the only variable significantly related to lateral hip pain through multivariate logistic regression analysis (p=0.045). CONCLUSIONS: The degree of lateral protrusion was mainly related to lateral hip pain. Therefore, controlled telescoping would help to decrease lateral hip pain by decreasing the lateral protrusion beyond the lateral femoral cortex.


Subject(s)
Bone Nails , Fracture Fixation, Intramedullary , Hip Fractures/surgery , Pain, Postoperative/complications , Pain, Postoperative/diagnosis , Prosthesis Fitting/methods , Adult , Aged , Aged, 80 and over , Female , Fracture Fixation, Intramedullary/adverse effects , Hip Fractures/diagnostic imaging , Hip Fractures/physiopathology , Humans , Logistic Models , Male , Middle Aged , Pain, Postoperative/diagnostic imaging , Pain, Postoperative/physiopathology , Prosthesis Design , Prosthesis Failure , Prosthesis Fitting/adverse effects , Radiography , Retrospective Studies , Treatment Outcome
5.
Clin Orthop Surg ; 8(3): 243-8, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27583105

ABSTRACT

BACKGROUND: The Stoppa (intrapelvic) approach has been introduced for the treatment of pelvic-acetabular fractures; it allows easy exposure of the pelvic brim, where the bone quality is optimal for screw fixation. The purpose of our study was to investigate the surgical outcomes of unstable pelvic ring injuries treated using the Stoppa approach for stable anterior ring fixation. METHODS: We analyzed 22 cases of unstable pelvic ring injury treated with plate fixation of the anterior ring with the Stoppa approach. We excluded cases of nondisplaced rami fracture, simple symphyseal diastasis, and parasymphyseal fractures, which can be easily treated with other techniques. The average age of the study patients was 41 years (range, 23 to 61 years). There were 10 males and 12 females. According to the Young and Burgess classification, there were 12 lateral compression, 4 anteroposterior compression, and 6 vertical shear fracture patterns. The fracture location on the anterior ring was near the iliopectineal eminence in all cases and exposure of the pelvic brim was required for plate fixation. All patients were placed in the supine position. For anterior plate fixation, all screws were applied to the anterior ramus distally and directed above the hip joint proximally. Radiologic outcomes were assessed by union time and quality of reduction by Matta method. The Merle d'Aubigne-Postel score was used to evaluate the functional results. RESULTS: The average radiologic follow-up period was 16 months (range, 10 to 51 months). All fractures united at an average of 3.5 months (range, 3 to 5 months). According to the Matta method, the quality of reduction was classified as follows: 16 anatomical (73%) and 6 nearly anatomical (27%) reductions. There were no cases of screw or implant loosening before bone healing. The functional results were classified as 7 excellent (32%), 12 good (55%), and 3 fair (13%) by the Merle d'Aubigne-Postel score. There were no wound complications, neurovascular injuries, or other complications related to the surgical approach. CONCLUSIONS: Stable anterior ring fixation placed via the Stoppa approach can result in excellent reduction and stable screw fixation with a low complication rate.


Subject(s)
Fracture Fixation, Internal/methods , Hip Fractures/surgery , Pelvic Bones/surgery , Pelvis/surgery , Adult , Female , Fracture Fixation, Internal/adverse effects , Humans , Male , Middle Aged , Pelvic Bones/injuries , Pelvis/injuries , Retrospective Studies , Young Adult
6.
Geriatr Gerontol Int ; 16(3): 380-3, 2016 Mar.
Article in English | MEDLINE | ID: mdl-25810136

ABSTRACT

AIM: Acute cholecystitis is a medical complication that can develop in the postoperative period after hip surgery. However, few studies have examined this complication in elderly patients. Our aim was therefore to evaluate the incidence and clinical manifestations of acute cholecystitis after hip fracture in elderly patients. METHODS: Medical records and radiological studies of patients aged older than 65 years who underwent hip surgery for femoral neck or intertrochanteric fractures at a single hospital from April 2003 to March 2013 were reviewed retrospectively. We analyzed the type of cholecystitis (acalculous or calculous), clinical manifestations, fracture type (neck or trochanteric fracture), age, sex, body mass index, type of surgery, time to surgery, time from surgery to onset of acute cholecystitis and the timing of ambulation in acute cholecystitis cases. RESULTS: There were nine confirmed acute cholecystitis cases among 1211 hip fractures; thus, the incidence of acute cholecystitis within 2 months after hip fracture surgery was 0.74%. CONCLUSIONS: The incidence of acute cholecystitis was higher than we expected, and this condition can lead to more serious problems if overlooked. Acute cholecystitis as a medical complication after hip fracture was underestimated in previous studies. Furthermore, acute cholecystitis should be considered as a complication of hip fracture, not hip surgery, in the elderly. The present study does not imply that hip fracture causes acute cholecystitis, although elderly hip fracture patients are in an extremely debilitated state and are prone to developing acute cholecystitis.


Subject(s)
Cholecystitis, Acute/epidemiology , Cholecystitis, Acute/etiology , Hip Fractures/complications , Aged , Aged, 80 and over , Cholecystitis, Acute/diagnosis , Female , Humans , Incidence , Male , Retrospective Studies
7.
Injury ; 46(12): 2512-5, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26482481

ABSTRACT

BACKGROUND: We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. MATERIALS AND METHODS: Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. RESULTS: The union time was 10 weeks after surgery on average (range: 8-12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120-140). The mean Bostman score at last follow-up was 29.6 points (range: 28-30) and graded excellent in all cases. CONCLUSION: Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function.


Subject(s)
Fracture Fixation, Internal , Fracture Healing , Fractures, Bone/surgery , Fractures, Comminuted/surgery , Knee Joint/surgery , Patella/surgery , Adult , Aged , Bone Wires , Female , Fracture Fixation, Internal/methods , Fractures, Bone/diagnostic imaging , Fractures, Bone/physiopathology , Fractures, Comminuted/diagnostic imaging , Fractures, Comminuted/physiopathology , Humans , Knee Joint/physiopathology , Male , Middle Aged , Patella/diagnostic imaging , Patella/injuries , Practice Guidelines as Topic , Range of Motion, Articular , Retrospective Studies , Sutures , Treatment Outcome
8.
Arch Orthop Trauma Surg ; 135(6): 773-9, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25894000

ABSTRACT

Osteosynthesis using compression or locking plate following indirect fracture reduction and using a minimally invasive technique has been recommended for the surgical treatment of Vancouver B1 and C periprosthetic femoral fractures. Recent advancements in fracture healing emphasize the significance of the type of mechanical stability depending on fracture patterns and the importance of the preservation of the blood supply around the fracture sites. We report two cases of mechanical failure after internal fixation of periprosthetic femoral fractures despite adherence to the principles of fracture care. Both patients were treated conservatively with a thigh cuff cast due to other concurrent issues. Bone healing was successfully achieved in both cases as a result of the preservation of the tissues and the biology around the fractures during the initial operations. We present our experiences of conservative management together with the preservation of the biology around the fracture site, as viable alternative options for difficult and traumatic revision surgery in cases of failed periprosthetic fracture fixation procedures.


Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Casts, Surgical , Femoral Fractures/therapy , Fracture Fixation/methods , Periprosthetic Fractures/therapy , Aged , Female , Femoral Fractures/diagnostic imaging , Femoral Fractures/etiology , Fracture Healing , Humans , Male , Middle Aged , Periprosthetic Fractures/diagnostic imaging , Periprosthetic Fractures/etiology , Radiography
9.
Arch Orthop Trauma Surg ; 135(2): 235-242, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25552395

ABSTRACT

INTRODUCTION: The authors present clinical and radiographic results of minimal invasive plate osteosynthesis (MIPO) for three- or four-part fractures of the proximal humerus. PATIENTS AND METHODS: Twenty-six patients with three- or four-part proximal humeral fractures treated with the MIPO technique through the deltoid splitting approach were clinically and radiographically evaluated at a minimum of 12 months with an average of 20.1 months. The valgus-impacted type of three-part fracture was excluded to verify the results of the MIPO with unstable multifragmentary fractures of the proximal humerus. RESULTS: Twenty female patients and six male patients were included (mean age 67 years; range 18-90 years). No cases of nonunion were seen. The mean forward flexion, abduction, and external rotation were 145°, 119°, and 48°, respectively. The mean visual analog scale (VAS) for pain was 1.47 points. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 14.5 points, and the mean UCLA score was 29.6 points. The mean neck-shaft angle was 134°. Twenty-three patients had adequate medial support, and three patients did not have adequate medial support on initial postoperative radiographs. Five shoulders (19 %) developed complicated results. Two cases of proximal malposition of the plate (7.7 %) and two intra-articular screw penetrations (7.7 %) were observed. One case of osteonecrosis of the humeral head was identified at the final follow-up (3.8 %). CONCLUSION: The MIPO technique provides reliable radiologic and functional outcomes for three- and four-part proximal humeral fractures. Our results might support the use of MIPO for treating unstable multi fragmentary fractures of proximal humerus such as three- or four-part fractures to decrease osteonecrosis of humeral head.


Subject(s)
Fracture Fixation, Internal/methods , Shoulder Fractures/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Bone Plates , Bone Screws , Female , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures , Shoulder/surgery , Young Adult
10.
J Reconstr Microsurg ; 29(9): 571-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23757151

ABSTRACT

The authors investigated whether a remote postconditioning (remote post-con) procedure attenuated skeletal muscle ischemia/reperfusion (I/R) injury. We determined the optimal protocol of remote post-con and investigated its mechanism. Ischemia was induced for 3 hours in rat left hindlimb and three protocols of remote post-con were applied in right hindlimb just before the end of ischemia. The first (10-second group) involved two cycles of 10 seconds of occlusion followed by 10 seconds of reperfusion. The second (5-minute group) involved two cycles of 5 minutes of occlusion/reperfusion. The third (10-minute group) involved two cycles of 10 minutes of occlusion/reperfusion. In 5- and 10-minute groups, wet/dry ratio and muscle fiber edema were significantly lower than control group. Muscle contractility was preserved in 5- and 10-minute groups. An injection of 5-hydroxydecanoate (a specific blocker of mitochondrial ATP-sensitive K+ [mKATP] channels) impaired this effect. This study demonstrates that remote post-con preserves muscle contractility and reduces tissue edema and necrosis, possibly through the activation of mKATP channels. We suggest that two cycles of 5 minutes of occlusion followed by 5 minutes of reperfusion are optimal protocols of remote post-con in skeletal muscle I/R injury.


Subject(s)
Ischemic Postconditioning/methods , Muscle, Skeletal/blood supply , Potassium Channels/physiology , Reperfusion Injury/prevention & control , Adenosine Triphosphate/metabolism , Animals , Edema/prevention & control , Male , Mitochondria/metabolism , Muscle Contraction/physiology , Rats , Rats, Sprague-Dawley , Reperfusion Injury/physiopathology
11.
Orthopedics ; 36(4): 275-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23590768

ABSTRACT

Olecranon fractures are intra-articular injuries that require anatomic restoration of the articular surface. For most simple noncomminuted transverse olecranon fractures, tension band wire fixation can provide a stable construct to allow for early joint range of motion. However, in comminuted olecranon fractures, it is difficult to provide a sufficient buttress for impacted articular fragments using tension band wire fixation. Therefore, plate fixation is the standard fixation method, but wide skin exposure and symptomatic plate irritation on the skin are common complications. The authors' technique uses tension band wire fixation with miniplate augmentation for patients with comminuted olecranon fractures.


Subject(s)
Fracture Fixation, Internal/instrumentation , Fractures, Comminuted/surgery , Intra-Articular Fractures/surgery , Olecranon Process/surgery , Adult , Aged , Aged, 80 and over , Bone Plates , Bone Wires , Female , Fractures, Comminuted/diagnostic imaging , Humans , Intra-Articular Fractures/diagnostic imaging , Male , Middle Aged , Olecranon Process/diagnostic imaging , Olecranon Process/injuries , Radiography
12.
Orthopedics ; 35(2): e290-3, 2012 Feb 17.
Article in English | MEDLINE | ID: mdl-22310423

ABSTRACT

Because patients with metastatic bone disease may survive only 3 to 12 months, the goal of surgery for pathologic fractures is to attain rigid and durable internal fixation and immediate postoperative use of the upper extremity. Surgical options such as intramedullary nailing, plating, and insertion of prosthesis usually reinforced with bone cement have been proposed for pathological humeral fractures. We describe a 42-year-old man with a pathologic distal humeral fracture. The fracture location and lack of distal bone stock precluded the use of intramedullary nails. We performed minimally invasive plating by using a locking plate for bridging and stabilization of fracture. Minimally invasive plate osteosynthesis of the humeral shaft was developed to allow anterior plate and screw stabilization involving less soft tissue disruption and to theoretically improve healing rates and reduce complications, such as infection and iatrogenic radial nerve palsy. Plain radiographs showed stable consolidation of the fracture without screw loosening at the 7-month follow-up. Elbow range of motion was 120°, and the arm was stable without pain. Minimally invasive plate using a locking plate can provide stable fixation and allow early arm mobilization without protection and decrease the risk of operation-related complications, making it a useful surgical alternative in the treatment of pathologic humeral fractures.


Subject(s)
Bone Neoplasms/secondary , Bone Neoplasms/surgery , Bone Plates , Fracture Fixation, Internal/instrumentation , Humeral Fractures/surgery , Minimally Invasive Surgical Procedures/instrumentation , Adult , Bone Neoplasms/complications , Humans , Humeral Fractures/etiology , Male , Treatment Outcome
13.
Clin Orthop Surg ; 2(4): 214-20, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21119937

ABSTRACT

BACKGROUND: Aseptic loosening of cemented hip prostheses is recognized as a long-term problem, and especially in males and younger patients. Much energy has been focused on developing new prostheses that are designed for cementless fixation. We evaluated the performance of and periprosthetic bone response to a tapered, titanium, hydroxyapatite (HA)-coated femoral hip prosthesis at a minimum of 7 years of follow-up after treatment with primary total hip arthroplasty. METHODS: Seventy-eight patients and 86 hips were included in the study. There were 35 men and 43 women; the mean age at the time of the operation was 59 years (range, 41 to 81 years). We used a tapered, titanium (Ti6Al4V), HA-coated femoral implant. We evaluated the patients at a minimum of 7 years of follow-up after treatment with primary total hip arthroplasty. Clinical evaluation was performed using the scoring system and the hip scores were assigned according to the level of pain, the functional status and the range of motion. The patients who refused to return, but who did forward X-rays for review after being contacted were questioned by phone about the functional status of their hip. Radiographic follow-up was performed at six weeks, at three, six and twelve months and yearly thereafter. All the available radiographs were collected and assessed for implant stability, subsidence, osseointegration, osteolysis, stress shielding and evidence of periprosthetic lucency. RESULTS: Eighty-six hips (78 patients) were available for review at follow-up of greater than 7 years. In 11 of the 86 cases, acetabular failure required revision of the acetabular component, but the femoral stem survived and it was available for long-term evaluation. The radiographs were obtained at 7-year follow-up for another 20 hips, but the patients would not come in for the 7-year clinical evaluation. Therefore, a phone interview was conducted to assess any change in the functional status at a minimum of 7 years. CONCLUSIONS: The mechanical fixation of a tapered, titanium, HA-coated femoral implant was excellent in this study. This femoral design provided reliable osseointegration that was durable at a mean of 7 years follow-up.


Subject(s)
Arthroplasty, Replacement, Hip , Coated Materials, Biocompatible , Durapatite , Hip Prosthesis , Titanium , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Hip Joint/diagnostic imaging , Humans , Male , Middle Aged , Osseointegration , Prosthesis Design , Prosthesis Failure , Radiography
14.
Knee ; 15(4): 325-9, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18434161

ABSTRACT

Ganglion cysts of the posterior cruciate ligament (PCL) are uncommon lesions found incidentally on MRI and arthroscopy. Twenty patients (11 males and nine females) with the mean age of 35 years presenting with a variety of knee signs and symptoms were found to have PCL cysts on MRI. Out of these, thirteen patients (65%) had isolated symptomatic PCL cysts and seven patients had associated chondral and meniscal lesions. Eight out of the 20 patients (40%) gave a history of antecedent trauma. On arthroscopy, the majority of the cysts were situated at the midsubstance of the ligament with inter-cruciate distension and no involvement of the substance of the ligament. The content of the cysts varied with the majority having yellowish viscous fluid and three containing serous and bloody fluid. All cysts were successfully treated arthroscopically through standard anterior, posteromedial and posterolateral portals with no signs of recurrence on MRI at a mean followup of 24 months. PCL cysts may clinically mimic meniscal or chondral lesions and preoperatively, MRI is essential for the diagnosis of ganglion cysts arising from the PCL. Ganglion cysts of the PCL can be successfully treated arthroscopically using standard portals.


Subject(s)
Ganglion Cysts/diagnosis , Ganglion Cysts/surgery , Posterior Cruciate Ligament , Adolescent , Adult , Arthroscopy , Cohort Studies , Female , Ganglion Cysts/etiology , Humans , Male , Middle Aged , Range of Motion, Articular , Retrospective Studies , Treatment Outcome
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