[Prevention of venous thromboembolism in musculoskeletal surgery].

Musculoskeletal surgery is associated with a high risk of venous thrombosis and pulmonary embolism. The introduction of direct oral anticoagulants (DOAK) has broadened the possibilities for prevention of venous thromboembolism in the course of orthopedic and trauma surgery. Addressing this recent development, the Austrian Societies of Orthopedics and Orthopedic Surgery (ÖGO), Trauma Surgery (ÖGU), Hematology and Oncology (OeGHO) and of Anaesthesiology, Reanimation und Intensive Care Medicine (ÖGARI) have taken the initiative to create Austrian guidelines for the prevention of thromboembolism after total hip and knee replacement, hip fracture surgery, interventions at the spine and cases of minor orthopedic and traumatic surgery.

[Consensus diagnosis and therapy of soft tissue sarcoma].

Soft tissue sarcomas are heterogeneous tumours and relatively uncommon. There have been advances over the past years concerning pathology, clinical behaviour, diagnosis strategies and the treatment. To summarize these advances as well as making it public is one of the goals of the following consensus guidelines.

The history of the anterior approach to the hip.

The anterior approach is a safe, reliable, and feasible technique for total hip arthroplasty, permitting optimal soft tissue preservation. Since Hueter first described this interval, many surgeons have approached the hip anteriorly to perform a myriad of surgical procedures. The anterior approach allows optimal muscle preservation, and it is a truly internervous approach to the hip.

[Minimally invasive total hip arthroplasty via direct anterior approach].

Objective: Minimally invasive total hip arthroplasty via direct anterior approach aims at reducing soft-tissue damage, diminishing blood loss and postoperative pain, shortening stay in hospital, accelerating rehabilitation, and keeping scars small.

Indications: The technique is suitable for primary and secondary osteoarthritis as well as fractures of the femoral neck. Complex distortions of the proximal femur should be exempted.

A double offset broach handle for preparation of the femoral cavity in minimally invasive direct anterior total hip arthroplasty.

A direct anterior approach is in use for minimally invasive total hip arthroplasty. This approach uses an intermuscular and internerval plane between the sartorius, rectus femoris, and tensor fasciae latae. Although preparation of the acetabulum and implantation of the acetabular component is an easy task with the available instruments, preparation of the femoral canal through this single incision is more demanding.

The frontal pelvic plane provides a valid reference system for implantation of the acetabular cup: spatial orientation of the pelvis in different positions.

Background: The frontal pelvic plane has traditionally served as the reference plane for implantation of the acetabular cup during total hip arthroplasty, with referencing performed with the patient supine on the operating table. During daily activities in an upright position, the frontal pelvic plane changes from a horizontal to a vertical orientation. If this change in orientation is accompanied by a substantial change in pelvic inclination angle, it would mean that the use of the frontal pelvic plane as a reference plane for implantation of the acetabular cup would not be valid for proper alignment of the cup.

Assessment of talar flattening in adult idiopathic clubfoot.

Background: The radius/length (R/L) ratio was developed to evaluate the convexity of the talar dome in idiopathic clubfoot. However, the index has not been tested for its reliability and reproducibility.

Methods: The R/L ratio was determined by three independent observers on the radiographs of 21 adult patients with idiopathic clubfoot and 30 adult subjects with normal feet.

Reproducible assessment of radiolucent lines in total knee arthroplasty.

The Knee Society Total Knee Arthroplasty Radiographic Evaluation and Scoring System was introduced to encourage uniform reporting of radiographic outcome. However, the method for evaluation of radiolucent lines has been shown to be unreliable. Because it has been shown that reducing the complexity of classification systems increases reliability and reproducibility, we questioned whether a simplification of the Radiographic Evaluation and Scoring System would improve reliability and reproducibility.

Malformation of the acetabular fossa as a cause of intrapelvic injury in total hip arthroplasty: a report of 2 cases.

We report 2 cases of bone defects of the acetabulum. The first case was a patient who underwent a total hip arthroplasty. An intraoperative bleeding occurred because of an injury of an intrapelvic artery.

High-dose-rate intraoperative brachytherapy (IOHDR) using flab technique in the treatment of soft tissue sarcomas.

Background: Adjuvant radiotherapy has been shown to improve local control in patients with soft tissue sarcoma. Additional brachytherapy represents a means of enhancing the therapeutic ratio, as biological and dosimetric advantage over single external-beam irradiation (EBRT) can be expected. High-dose-rate intraoperative brachytherapy (IOHDR) as a boost therapy should therefore be able to further diminish the rate of local recurrence even when performing marginal resection.

Eosinophilic granuloma of the bone: ultrasonographic imaging.

Eosinophilic granuloma is a rare disease of unknown aetiology that affects the bones. Two cases of eosinophilic granuloma are presented. Ultrasonographic, CT and histopathological findings are described.

Differentiation of malignant and benign musculoskeletal tumors: combined color and power Doppler US and spectral wave analysis.

Purpose: To assess the use of combined color Doppler ultrasonography (US), power Doppler US, and spectral wave analysis (SWA) in differentiating malignant and benign musculoskeletal tumors.

Materials And Methods: Seventy-nine musculoskeletal tumors (34 malignant, 45 benign) were examined with color and power Doppler US and SWA. Two radiologists independently assessed US images and SWA findings.