Comparison of locked plating and intramedullary nailing for periprosthetic supracondylar femur fractures after knee arthroplasty

This study aimed to compare the efficacy of two treatment modalities for periprosthetic supracondylar fractures. The results of intramedullary nailing in 7 patients and locked plating in 9 patients were reviewed retrospectively. Mean follow-up was 4.3 years (range : 1 to 13 years). One patient died on the first postoperative day. Union of the fracture was achieved in the other 15 patients, after a mean time of 3.86 months : 3.9 months (range : 3 to 6 months) in the locked plate group and 3.86 months (range : 3 to 5 months) in the intramedullary nail group (p = 0.96). Mean Knee Society Score was 78 points (range : 68 to 84 points) and mean total knee range of motion was 82 degrees (range 70 degrees to 90 degrees) with no significant differences between groups. Sagittal and coronal plane measurements were similar both in the early postoperative period and at the last follow-up. The two treatment modalities had similar results with a high success rate

Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation.

Midterm results of cementless total hip arthroplasty in patients with Crowe type IV congenital dislocation of the hip were evaluated. A modified oblique subtrochanteric shortening osteotomy was used in all patients. A cylindrical femoral stem was used in all patients to stabilize the osteotomy. Mean follow-up was 82 months in 20 hips of 16 patients. Mean Merle D'Aubigne pain score increased from 2.52 to 5.65 points, function score improved from 4.0 to 5.3 points, and mobility score improved from 3.95 to 5.35. Mean greater trochanter height relative to the estimated hip center was 6.8 +/- 2.0 cm preoperatively and -1 +/- 0.2 cm postoperatively. Complications were dislocations in 3 patients, which were successfully managed without redislocation and fracture of greater trochanter in 3 patients, which healed uneventfully in 2 but with residual Trendelenburg gait in one. Total hip arthroplasty with modified oblique subtrochanteric shortening osteotomy is an effective technique for the treatment for Crowe type IV hip dislocation

Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I-IIIA femoral defects

Introduction: The aim of this study was to analyze the survival of the Echelon (R) femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78.6%) patients, periprosthetic joint infection in 9 (12.9%) patients, periprosthetic fracture in 4 (5.7%) patients, and stem fracture in 2 (2.9%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45-86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7-63) preoperatively to 72 (43-96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems

The results of monoblock stem with step-cut femoral shortening osteotomy for developmentally dislocated hips

Introduction: The main objective of this study was to evaluate the midterm results of cementless THA with the use of monoblock stems combined with step-cut femoral shortening derotational osteotomy for DDH

Prevalence of anterior knee pain after patellar retention total knee arthroplasty: Comparison of patients with rheumatoid arthritis versus primary osteoarthritis

Objective: The aim of this study was to investigate whether there is an increased risk of anterior knee pain (AKP) after total knee arthroplasty (TKA) without patellar resurfacing in patients with rheumatoid arthritis (RA) versus primary osteoarthritis (OA)

Outcomes of salvage total hip arthroplasty after failed osteosynthesis for collum femoris fractures

BACKGROUND: This study is an investigation of the outcomes of salvage total hip arthroplasty (THA) to treat collum femoris fractures that resulted in complications or failure after osteosynthesis

Relationship of Postoperative Achilles Tendon Elongation With Plantarflexion Strength Following Surgical Repair.

Background: Little data exist regarding the adverse effects of Achilles tendon (AT) elongation after rupture repair on plantarflexion strength. This study aimed to investigate the effect of AT elongation measured using AT resting angle (ATRA) on the plantarflexion strength in patients with surgically treated acute AT rupture. Methods: A retrospective chart review was performed on 40 patients (15 female and 25 female) who underwent open operative repair due to an acute AT rupture. At the final follow-up, AT elongation was assessed using ATRA. Plantarflexion strength (peak torques and angle-specific torques) was measured using an isokinetic dynamometer. All variables were obtained from the operated and unoperated contralateral ankles of the patients. Results: The mean ATRA was greater in the operated ankles (mean, 57 degrees; range, 39-71 degrees) compared with the unoperated ones (mean, 52 degrees; range, 36-66 degrees; P = .009). Except the plantarflexion torque at 20 degrees of plantarflexion (P = .246), all the other angle-specific torques were lower in the operated ankles (P < .05). Peak flexion torque at 30 degrees/s was lower in the operated ankle (P = .002). A negative correlation was found between operated/unoperated (O/N) ATRA and O/N plantarflexion torque ratios at 0 degrees (r = -0.404; P = .01), 10 degrees (r = -0.399; P= .011), and 20 degrees (r = -0.387; P = .014). Conclusion: Postoperative AT elongation measured using ATRA may have a deleterious effect on the plantarflexion strength in patients with surgically treated acute AT rupture

Mid-term results of hindfoot arthrodesis with a retrograde intra-medullary nail in 24 patients with diabetic Charcot neuroarthropathy

Background and purpose - Hindfoot arthrodesis using retrograde intramedullary nailing assumes a critical role in limb salvage for patients with diabetic Charcot neuro-arthropathy (CN). However, this procedure is compelling and fraught with complications in diabetic patients. We report the mid-term clinical and radiological outcomes of retrograde intramedullary nailing for severe foot and ankle deformity in patients with diabetic CN. Patients and methods - Hindfoot arthrodesis was performed using a retrograde intramedullary nail in 24 patients (15 females) with diabetic Charcot foot. The mean age of the patients was 62 years (33-82); the mean follow-up was 45 months (24-70). The primary outcomes were rates of fusion, limb salvage, and complications. Results - The overall fusion rate was 23/24, and none of the patients needed amputation. The rate of superficial wound infection was 4/24, and no deep infection or osteomyelitis was observed postoperatively. Interpretation - For selected cases of diabetic CN with severe foot and ankle deformity, hindfoot arthrodesis using a retrograde intramedullary nail seems to be a good technique in achieving fusion, limb salvage, and avoidance of complications