Hip Resurfacing Implant Orientation Analysis: A Comparison of a Computer-Added Design Technique and Computed Tomography.

BACKGROUND: Accurate acetabular component orientation in hip resurfacing is mandatory. The aim of this study is to analyze if interpretation of pelvic radiographs with computer-added design (CAD) software is comparable to computed tomography (CT) in measurement of acetabular anteversion and inclination of a Birmingham Hip Resurfacing (BHR) hip. METHODS: A consecutive series of 49 patients (50 hips) who underwent hip resurfacing arthroplasty between 2005 and 2007 with the BHR system were retrospectively included. The surgical procedure was performed by 1 orthopedic surgeon in the beginning of his learning curve. Computer-added design software was used to measure acetabular component orientation on an anteroposterior pelvic radiograph. These measurements were compared with CT measurements. We calculated the correlation between the CAD software and CT analysis. The degree of underestimation or overestimation was determined, and a Bland-Altman plot was created to visualize the agreement between CAD software and CT results. RESULTS: We analyzed 50 BHR hips with mean inclination of 54.6° and 55.6° and mean anteversion of 24.8° and 13.3° measured by CT and CAD, respectively. Pearson correlation coefficient for inclination was 0.69 (P < .001) and for anteversion 0.81 (P < .001). Computer-added design showed a mean underestimated anteversion of 11.6° (P < .001). There was no significant underestimation or overestimation of inclination with CAD analysis compared to CT measurements. CONCLUSION: The CAD software is useful to assess acetabular inclination in hip resurfacing but underestimates anteversion.

A systematic literature review of the Profix in primary total knee arthroplasty.

Despite more than a decade of use, there are currently no comprehensive reviews summarising clinical results with the Profix Total Knee System in primary total knee arthroplasty. Searching the PubMed and Google Scholar databases revealed 17 potentially relevant Profix manuscripts. After author review and exclusion of studies not meeting predetermined variables, 8 manuscripts were selected. Knee Society data were provided in all 8 and implant survival data in 4. Data for 987 patients (1152 knees) were available. The overall estimated implant survival was 98.6% at 5 years and 94.2% at 10 years with revision for any reason as an endpoint, and 100% at both time points with radiographic loosening as an endpoint. Mean/median preoperative Knee Society knee scores improved from 39.2/24.7 at baseline, to 91.4/92.1 at the last postoperative follow-up visit. Good medium-to long-term clinical results can be expected with the Profix in primary total knee arthroplasty.

[Traumatic atlas fracture in a child following fall on head]. / Traumatisch atlasletsel na een val op het hoofd bij een kind.

An 8-year-old girl presented at the Accident & Emergency Department with torticollis and neck pain after falling on her head from a climbing frame. A computed tomography scan revealed a Gehweiler type 1 avulsion fracture combined with widening of an anatomically variant single anterior synchondrosis. The child was successfully treated with halter traction, painkillers and bed rest. Physicians should look out for upper cervical spine injury in children who sustained a cranial axial load injury. Differential diagnosis between pain-reactive muscular torticollis and atlantoaxial rotatory subluxation is essential. Children presenting with posttraumatic torticollis require a conventional or dynamic computed tomography scan.

Outcome of open versus endoscopic approach for the surgical treatment of carpal tunnel syndrome.

The authors retrospectively evaluated two comparable groups of patients who underwent either open (103 patients) or endoscopic decompression (86 patients) of the carpal tunnel with the two portal technique. There were 95 patients available for follow-up in the open group and 79 in the endoscopic group. The average follow-up period was 38 months (range: 12 to 60). Each patient received a questionnaire in order to determine if there was any difference in severity of symptoms and functional status, patient satisfaction and time to return to activities of daily living. The questionnaire also focused on complications and on readiness to undergo the same operation again. There was no significant difference between the two techniques in any of the outcome measurements.