The mid-term survival of cemented, uncemented, and hybrid fixation of the ACS mobile bearing total knee arthroplasty.

Background: Till today, Cemented Fixation in Total Knee Arthroplasty (TKA) is significantly more used than Hybrid or Uncemented Fixation. The purpose of this study was to compare Cemented, Uncemented and Hybrid Fixation of the ACS Mobile Bearing TKA at Mid-term follow-up.

Methods: This study was an extended data report of our prospective single-center, single-blinded randomized controlled clinical trial comprising 105 patients.

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements.

Background: The ceramic coated implant (CCI) Evolution was a third-generation implant design used in approximately 2000 total ankle replacements (TARs) between 2003 and 2016. Because this implant was abandoned, long-term follow-up studies are lacking.

Methods: All patients undergoing TAR using a CCI prosthesis between 2004 and 2012 were included for analysis.

A Child with a Painful Foot: How to Get a Definitive Diagnosis.

This case report describes an 8-year-old healthy boy with a retained wooden foreign body in his 4 metatarsal bone of his right foot. He was presented several months after the initial trauma, stepping into a toothpick, had occurred. He was operated in our hospital, and the wooden toothpick was removed.

Dynamic trial fitting of the cup in press-fit total hip arthroplasty, a feasibility study.

Trial fitting of the cup during total hip arthroplasty (THA) is done by trial cups, which do not resemble the real press-fit obtained by the definitive implant. Our goal is to judge feasibility of the X-pander® in clinical practice ; a device developed to mimic the real press-fit obtained by the definitive cup, to ensure satisfactory press-fit. In this feasibility study 45 experienced orthopaedic surgeons from 7 European countries filled in a structured survey after 78 primary THA and 31 revision surgeries, using the X-pander instead of traditional trial cups.

Ten-year revision rates of contemporary total ankle arthroplasties equal 22%. A meta-analysis.

Background: The National Institute for Health and Care Excellence criterion for hip replacements is a (projected) revision rate of less than 5% after 10 years. No such criterion is available for ankle prostheses. The objective of the current study is to compare survival rates of contemporary primary ankle prostheses to the hip-benchmark.

Lower revision rates for cemented fixation in a long-term survival analysis of three different LCS designs.

Background: In primary Total Knee Arthroplasty (TKA), it is still not clear if cemented or uncemented fixation has the best long-term survival. The Low Contact Stress (LCS) mobile-bearing (MB) knee system was introduced in 1977. The aim of this study is to investigate the long-term survival of this design with a minimum of 15-year follow-up.

The influence of hydroxyapatite coating on continuous migration of a Zweymuller-type hip stem: a double-blinded randomised RSA trial with 5-year follow-up.

Background And Purpose: Adding hydroxyapatite to a stem to enhance ingrowth is a matter of debate, even less is known about the long-term effect on stability by adding hydroxyapatite (HA). Continuous migration in the first 2-5 years is an indicator of failed osteointegration or pending failure, enhancing the risk of loosening within 10 years after initial surgery. We performed a double-blinded randomised RSA trial with 5-year follow-up, to compare and analyse migration characteristics of the hydroxyapatite uncoated (HA-) and hydroxyapatite coated (HA+) Zweymuller-type hip stem.

Ceramic-on-ceramic ceramic-on-polyethylene, a comparative study with 10-year follow-up.

Background: In press-fit total hip arthroplasty (THA) ceramic-on-ceramic (CoC) bearings are a potential for overcoming the wear that is seen in ceramic-on-polyethylene (CoPE) bearings, and can lead to wear-induced osteolysis, resulting in loosening of the implant. However, CoC bearings show disadvantages as well, such as squeaking sounds and being more fragile, which can cause ceramic head or liner fracture. Because comparative long-term studies are limited, the objective of this study was to determine the long-term difference in wear, identify potential predictive factors for wear, investigate radiological findings such as osteolysis, and evaluate clinical functioning and complications between these bearings.

What is the role of cemented fixation in total knee arthroplasty? The two-year results of a randomized RSA controlled trial.

Aims: For many designs of total knee arthroplasty (TKA) it remains unclear whether cemented or uncemented fixation provides optimal long-term survival. The main limitation in most studies is a retrospective or non-comparative study design. The same is true for comparative trials looking only at the survival rate as extensive sample sizes are needed to detect true differences in fixation and durability.

Highly cross-linked versus conventional polyethylene inserts in total hip arthroplasty, a five-year Roentgen stereophotogrammetric analysis randomised controlled trial.

Background: Polyethylene (PE) particles produced by wear of the acetabular insert are thought to cause osteolysis and thereby aseptic loosening of the implant in total hip arthroplasty (THA). As highly cross-linked polyethylene (HXLPE) is presumed to give lower wear rates, studies are needed to confirm this.

Aim: To compare the wear of REXPOL, a HXPLE, with conventional PE within the first five years after implantation using Roentgen stereophotogrammetric analysis (RSA).

Dynamic trial fitting by an expanding trial cup does not jeopardize primary acetabular component stability.

Background: Trial fitting of the acetabular component in uncemented total hip replacement is traditionally done by trial cups. Since trial cups do not resemble the real press-fit obtained by the definitive cup, a dynamic trial inserter, called the X-pander ®, was developed to mimic the real amount of press-fit. However, the concern is raised of losing the initial press-fit by using the X-pander® due to pre-expansion of the acetabulum.

The migration pattern and initial stability of the Optimys short stem in total hip arthroplasty: a prospective 2-year follow-up study of 33 patients with RSA.

Background And Purpose: The consensus that bone stock preservation and optimal restoration of offset and leg length is important in total hip arthroplasty is now widespread, especially for young and active patients. Short stems seem promising in this aspect, though implant stability is still of concern. This study looked at the migration pattern of the Optimys short stem through RSA analysis.

Influence of Preoperative Tibiotalar Alignment in the Coronal Plane on the Survival of Total Ankle Replacement: A Systematic Review.

Background: It remains controversial whether significant preoperative tibiotalar varus and valgus deformity should be contraindications for total ankle replacement (TAR). The primary aim of this systematic review was to analyze the influence of preoperative tibiotalar varus and valgus alignment on the survival of TAR.

Methods: The databases MEDLINE and Embase were searched from onset through September 2018.

Long-term Follow-up Results of Buechel-Pappas Ankle Arthroplasty.

Background: Total ankle replacement (TAR) is gaining popularity as a treatment option for ankle osteoarthritis. Long-term implant survival is a critical outcome to determine the success of the TAR implant. The Buechel-Pappas (BP) implant is a second-generation mobile bearing implant.

Ankle fusion after failed ankle replacement in rheumatic and non-rheumatic patients.

Background: With longer follow-up, survival rate of total ankle replacements (TAR) diminishes. It is therefore important to have a reliable fall-back option in case of failed TAR. Revision arthroplasty is often impossible because of loss of bonestock or infection.

Does the Lever Sign Test Have Added Value for Diagnosing Anterior Cruciate Ligament Ruptures?

Background: Diagnosing an anterior cruciate ligament (ACL) rupture based on a physical examination remains a challenge for both surgeons and physical therapists. The lever sign test was developed to overcome the practical limitations of other tests and to optimize diagnosis. An evaluation of the measurement properties of the lever sign test is needed to make adequate interpretations in practice.

Does hydroxyapatite coating enhance ingrowth and improve longevity of a Zweymuller type stem? A double-blinded randomised RSA trial.

Introduction: An ongoing discussion is whether using a hydroxyapatite coating enhances the ingrowth and longevity of a femoral stem in total hip arthroplasty. The best way to predict speed of ingrowth and long-term outcome is by evaluating micromotion by radiostereometric analysis. To study the effect of hydroxyapatite (HA) coating on the migration of the SL-PLUS hip stem, we performed a prospective double blind randomised controlled trial comparing the early migration of the hydroxyapatite (HA)-coated SL-PLUS stem compared to the Standard (non-coated) SL-PLUS stem.

Eponymous terms in anterior shoulder stabilization surgery.

Unlabelled: Shoulder dislocation and its treatment are probably as old as time. Surgical treatment has gained acceptance recently, especially in recurrent cases. Within roughly the last 100years, numerous treatment strategies have been developed and questions elucidated regarding the entity of shoulder instability.

Biographical background and origin of common eponymous terms in orthopedic surgery: anatomy and fractures in knee surgery.

An eponym is a person after whom an eponymous term is named. These eponymous terms are easy shorthand in communication between surgeons. Therefore, they are often used and hard to eradicate.

Eponymous hip joint approaches.

After the low friction arthroplasty by John Charnley was no longer confined to specialized hospitals but commonplace in the general orthopedic practice, the issue remained how to most optimally reach the hip. The names of the authors of these approaches remain in a lot of cases connected to the approach. By evaluating the original articles in which the approaches are described we ascertain the original description and technique.

Eponyms in elbow fracture surgery.

Eponyms are common in medicine and in orthopaedic surgery. For future reference and historical considerations, we present common eponyms in elbow fracture surgery. We describe in short the biography of the name giver and give, where possible, the original description on which the eponym was based.

A new snowboard injury caused by "FLOW" bindings: a complete deltoid ligament and anterior talofibular ankle ligament rupture.

We present a case of a snowboard injury that caused a combination of a complete deltoid and anterior talofibular ligament rupture, without bony or syndesmotic injury. Initial surgical repair for both ligaments was performed. We describe the etiology of this injury to demonstrate the cause and existence of medial and lateral ankle ligament rupture without osseous and syndesmotic involvement and to create awareness of these types of injuries.