Reconstruction of mechanical leg axis using non-modular cemented hinged prosthesis in complex primary total knee arthroplasty.

Purpose: Modular cementless knee arthroplasty systems are capable of precise reconstruction of the mechanical axis. However, they are considered more susceptible to complications. In contrast, non-modular cemented systems are said to be more forgiving and show good long-term results.

Conservative management of proximal hamstring avulsion: A clinical study.

Introduction: The management of proximal hamstring tear (PHT) is debated and consensus regarding recommended measures and individual treatment regimens is lacking. The present investigation evaluated the efficacy of a conservative management of partial and complete PHT.

Methods: The present observational study was conducted following the STROBE statement.

Incidence of Secondary Osteoarthritis after Primary Shoulder and Knee Empyema and Its Risk Factors.

Empyema of the joint is an orthopedic emergency that is associated with a prolonged healing process despite adequate surgical and medical therapy. The risk of developing postinfectious osteoarthritis (OA) after successfully treated joint empyema is unknown. Both incidence and risk factors are important for prognostication and would therefore be clinically relevant for the selection of an adequate infectious therapy as well as for the individual follow-up of patients.

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4.

Purpose: The purpose of this study was to find out whether the torsions of the femur and tibia are dependent on the coronal plane alignment of the knee (CPAK) type.

Methods: Five hundred patients (1000 legs) were included, who received a whole leg standing three-dimensional (3D) radiograph using EOS imaging (EOS Imaging, Paris, France). SterEOS software was used for digital reconstruction.

Optimized reamer geometry for controlled reaming of the proximal femur.

Preparation of the femoral proximal medullary cavity by reaming is essential for intramedullary nail osteosynthesis and hip revision arthroplasty. The use of reamers sometimes exerts high torsional forces on the bone. Design and direction of rotation of the reamer are potential influencing factors.

Tranexamic acid in pertrochanteric fractures: a retrospective analysis of perioperative outcomes after fixation with a proximal femoral nail.

Background: Treatment of pertrochanteric femoral fractures is often associated with significant blood loss. It has already been demonstrated that the administration of tranexamic acid (TXA) for endoprosthetic procedures reduces blood losses and leads to a decreased frequency of postoperative complications. The aim of this study is to demonstrate whether the administration of TXA as part of osteosynthesis treatment for pertrochanteric fractures using a proximal femoral nail reduces perioperative blood losses and haemorrhage-related complications.

Knee Arthrodesis Affects Gait Kinematics More in the Ankle Than in the Hip Joint.

No gold standard exists for treating persistent periprosthetic knee infections. Knee arthrodesis represents one treatment concept for extensive bone defects and extensor system insufficiencies. It has already been shown that knee arthrodesis leads to a significant reduction in one's quality of life.

[Osteotomy close to the knee joint in adults].

Osteotomy close to the knee joint in cases of axial deformities or in the context of corrective interventions is still an elementary component of the spectrum of orthopedic surgery. The precise localization and analysis of the pathology are crucial in order to restore approximate physiological loading conditions by means of a suitable osteotomy procedure. Thus, above all, the medial open-wedge tibial osteotomy has become established as a standard procedure for the treatment of knee osteoarthritis caused by extra-articular tibial varus deformity.

[Bone defect management in revision knee arthroplasty].

Background: In 2019, 124,677 primary total knee arthroplasties and 14,462 revision TKA were performed in Germany. This corresponds to a percentage of 11.6%.

Cones and sleeves present good survival and clinical outcome in revision total knee arthroplasty: a meta-analysis.

Purpose: The fixation of revision total knee arthroplasties (rTKA) tends to be difficult, leading to a reduction in implant survival. One option for achieving a more stable anchorage is to use metaphyseal cones and sleeves. The objective of the present paper is to provide a current comparative meta-analysis on survival and clinical results of cones vs.

[Knee realignment osteotomy in adults].

Background: Nowadays, osteotomy near the knee joint for axial deformities has become an indispensable surgical procedure for joint preservation in the orthopaedic-surgical spectrum. The exact localization and analysis of the deformity are crucial to restoring physiological loading conditions of the entire leg by means of a suitable osteotomy.

Procedures: Thus, above all, the medial "open-wedge" osteotomy has established itself as a standard procedure for the treatment of gonarthrosis caused by varus malalignment.

Irreducible Ankle Fracture Due to Incarceration of the Long Flexor Tendons Together With the Neurovascular Bundle in the Tibial Fibular Interosseous Space: A Case Report and Short Literature Review.

Ankle fracture dislocations with frustrating attempts at closed reduction are a rare traumatic entity. We present a case of an irreducible ankle fracture due to incarceration of all the flexor tendons including the neurovascular bundle in the tibial fibular interosseous space; to date, only one such case has been published in the literature. A computed tomography scan in both bone and soft tissue windows was necessary to clarify the structures that were inhibiting repositioning.

Tranexamic acid is toxic on human chondrocytes, .

The aim of this study was to examine toxic effects of tranexamic acid (TXA) on the viability of human chondrocytes. Our hypothesis was that TXA damages human chondrocytes. Chondrocytes were cultured from donated human knee joints.

Effect of additional distal femoral resection on flexion deformity in posterior-stabilized total knee arthroplasty.

Purpose: Flexion deformity after total knee arthroplasty (TKA) is associated with poor function and dissatisfaction and should, therefore, be avoided. In the case of preoperative flexion deformity, an increased distal resection of the femur may be necessary. The degree of resection required has only been determined for cruciate-retaining (CR) prostheses to date and varies considerably from study to study.

Anchoring of a Kinked Uncemented Femoral Stem after Preparation with a Straight or a Kinked Reamer.

Objective: To investigate a stem-adjusted preparation of the femur with a kinked reamer and to determine whether this approach results in higher primary stability of a kinked stem than straight reaming of the intramedullary canal.

Methods: Ten cementless stems with a kinked design were implanted in synthetic femurs after preparation of the femoral canal with 2 different reamer designs (straight reaming [SR] group vs kinked reaming [KR] group). The specimens were analyzed using CT to determine the anchoring length and examined with a mechanical testing system to establish their axial stiffness, torsional stiffness, and migration distance after 10 000 gait cycles.

The Proximal and Distal Femoral Canal Geometry Influences Cementless Stem Anchorage and Revision Hip and Knee Implant Stability.

Although cementless revision arthroplasty of the hip has become the gold standard, revision arthroplasty of the distal femur is controversial. This study evaluated the anchoring principles of different femoral revision stem designs in extended bone defect situations, taking into account the anatomical conditions of the proximal and distal femur, and the resulting primary stability. Cementless press-fit stems of 4 different designs were implanted in synthetic femurs.

Anchoring and resulting primary stability of a kinked compared to a straight uncemented femoral stem.

Introduction: The number of revision hip arthroplasties being performed is growing and implantation of a cementless stem has become established as the gold standard. For producing a primary stability, the press-fit procedure is the method of choice, but also can be achieved by multiple-point impactions. Specific femoral stems should follow the anatomical shape and provide a more extensive anchorage.