Tibial tray cementation is not necessary for knee revision with titanium metaphyseal sleeves: a mid-term prospective study in AORI 2B defects.

PURPOSE: Metaphyseal fixation with porous titanium sleeves in revision knee surgery provides mechanical support to the implant, promotes biological fixation, and has shown satisfactory short- and mid-term results. Cement is commonly used to fix the tibial tray to the epiphyseal area. The objective of this study is to determine whether cement should be used to achieve fixation of the tibial tray with the hypothesis that metaphyseal sleeves would provide enough axial and rotational stability making cementation unnecessary. MATERIAL AND METHODS: Prospective study of 60 patients undergoing knee replacement surgery with metaphyseal sleeves in type 2B defects in femur and tibia. Patients were divided into two groups according to the use of cement on the tibial component. Analysis included the American Knee Society Score (KSS) knee and functional scales, the Western Ontario and McMaster Universities (WOMAC) index, the Short Form 12 (SF-12) health survey, and radiographic assessment with a maximum follow-up of 5 years. RESULTS: No statistically significant differences were found between the two groups in any of the parameters assessed. CONCLUSION: Metaphyseal sleeves showed a 100% survivorship at five years of followup. There were no differences in clinical and radiographic outcomes at five years of follow-up depending on whether or not cement was used for tibial platform fixation. Cementation of the tibial tray would therefore not be required to achieve satisfactory mid-term results. LEVEL OF EVIDENCE: Level II: prospective cohort study. Therapeutic.

Resultados medidos con captura de movimiento en las fracturas de húmero proximal tratadas mediante osteosíntesis con placa bloqueada / Results measured by means of a motion capture system in proximal humerus fractures treated by osteosynthesis with locking plate

Objetivo: Evaluar los resultados de las fracturas de húmero proximal tratadas mediante osteosíntesis con placa empleando captura de movimiento y escalas funcionales. Material y método: Estudio retrospectivo de 47 pacientes mayores de 65 años, tratados mediante osteosíntesis con placa bloqueada en el mismo centro, desde enero de 2010 a diciembre de 2014. Tras un seguimiento mínimo de 2 años, se realizó una evaluación de los resultados obtenidos mediante 2 escalas funcionales (Constant-Murley y Quick DASH) y una escala de calidad de vida (EQ-5D). Para analizar el balance articular de forma objetiva se empleó un sistema de análisis cinemático con cámaras y sin marcadores. Resultados: La edad media fue 74,85 años. Los resultados funcionales expresados mediante la puntuación media fueron: Constant-Murley, 70,06 puntos; Quick DASH, 35,74 puntos; y EQ-5D, 6,79 puntos. Los arcos de movilidad medios fueron: flexión, 111,49°; extensión: 24,13°; abducción: 109,40°; aducción: 15,13°; rotación externa: 38,96° y rotación interna: 49,28°. Se encontró correlación estadística entre las 2 escalas funcionales y de ambas con la EQ-5D. También se advirtió correlación estadística entre los movimientos estudiados con las escalas funcionales (excepto rotación externa) y con la escala de calidad de vida (excepto flexión y rotación externa). Conclusión: La osteosíntesis con placa bloqueada en las fracturas de húmero proximal del anciano obtiene unos buenos resultados funcionales y de calidad de vida. El uso de sistemas de captura de movimiento permite una medición más objetiva de estos resultados y puede ser una herramienta útil en la valoración funcional de esta patología

Objective: To evaluate the results after locking plate internal fixation of proximal humerus fractures by means of a motion capture system, and functional scales. Material and method: Retrospective study of a cohort of 47 elderly patients undergoing surgery from January 2010 to December 2014. After a minimum follow-up of two years, two functional scales (Constant-Murley and Quick DASH), and a quality of life scale (EQ-5D) were used for clinical evaluation. For objective evaluation of the range of motion a kinematic marker-free analysis with cameras was performed. Results: The average age was 74.85 years. Average functional scores were: Constant-Murley 70.06 points, Quick DASH 35.74 points and EQ-5D 6.79 points. The average range of motion was: flexion, 111.49°; extension: 24.13°; abduction: 109.40°; adduction: 15.13°; external rotation: 38.96°, and internal rotation: 49.28°. Correlation was found between the two functional scales, between them and the EQ-5D, and between range of motion and functional scales (except for external rotation) as well as between range of motion and EQ-5D (except for flexion and external rotation). Conclusion: Locking plate osteosynthesis in proximal humerus fragility fractures achieved good functional and quality of life scores. Motion capture systems can be a useful tool for the functional assessment of shoulder pathology allowing an objective evaluation of range of motion

Results measured by means of a motion capture system in proximal humerus fractures treated by osteosynthesis with locking plate. / Resultados medidos con captura de movimiento en las fracturas de húmero proximal tratadas mediante osteosíntesis con placa bloqueada.

OBJECTIVE: To evaluate the results after locking plate internal fixation of proximal humerus fractures by means of a motion capture system, and functional scales. MATERIAL AND METHOD: Retrospective study of a cohort of 47 elderly patients undergoing surgery from January 2010 to December 2014. After a minimum follow-up of two years, two functional scales (Constant-Murley and Quick DASH), and a quality of life scale (EQ-5D) were used for clinical evaluation. For objective evaluation of the range of motion a kinematic marker-free analysis with cameras was performed. RESULTS: The average age was 74.85 years. Average functional scores were: Constant-Murley 70.06 points, Quick DASH 35.74 points and EQ-5D 6.79 points. The average range of motion was: flexion, 111.49°; extension: 24.13°; abduction: 109.40°; adduction: 15.13°; external rotation: 38.96°, and internal rotation: 49.28°. Correlation was found between the two functional scales, between them and the EQ-5D, and between range of motion and functional scales (except for external rotation) as well as between range of motion and EQ-5D (except for flexion and external rotation). CONCLUSION: Locking plate osteosynthesis in proximal humerus fragility fractures achieved good functional and quality of life scores. Motion capture systems can be a useful tool for the functional assessment of shoulder pathology allowing an objective evaluation of range of motion.