Radiographic and clinical outcome of tibial plateau fractures treated with bone allograft.

Background: To determine the clinical outcome of patients who had been treated with bone allografts during open reduction and internal fixation (ORIF) of tibial head fractures.

Methods: Patients who suffered a medial, lateral, or bicondylar fracture of the tibial plateau and underwent surgical treatment by open reduction and internal fixation (ORIF) using human femoral head bone allografts were included. Patients were invited to provide information for the following: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol Five Dimension score (EQ-5D), Lower Extremity Functional Scale (LEFS) and Parker Mobility Score.

A Prospective Assessment of Knee Arthroscopy Skills Between Medical Students and Residents-Simulator Exercises for Partial Meniscectomy and Analysis of Learning Curves.

Background: The Covid-19 pandemic has created the largest disruption of education in history. In a response to this, we aimed to evaluate the knee arthroscopy learning curve among medical students and orthopaedic residents.

Methods: An arthroscopy simulator was used to compare the learning curves of two groups.

Subsidence of a metaphyseal-anchored press-fit stem after 4-year follow-up: an EBRA-FCA analysis.

Purpose: Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analyse) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless metaphyseal-anchored press-fit stem after 4-year follow-up.

Methods: Applying a retrospective study design, we reviewed all consecutive patients who between 2012 and 2017 received a cementless Accolade II press-fit stem at our Department.

Migration characteristics of the Corail hydroxyapatite-coated femoral stem-a retrospective clinical evaluation and migration measurement with EBRA.

Purpose: Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analysis) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless press-fit stem after two years follow-up. Stem type and postoperative gap between collar and femur were evaluated as a risk factor.

Impact of the Covid-19 Pandemic on Orthopaedic and Trauma Surgery - A Systematic Review of the Current Literature.

Background/aim: The Coronavirus disease 2019 (COVID-19) has led to significant disruptions in various medical specialties. We herein aimed to provide a systematic review of the published literature on the impact by the Covid-19 pandemic on orthopaedic and traumatological care by focusing on the number of clinical visits, surgeries and reasons for consultation.

Materials And Methods: The published literature was reviewed using PubMed.

Injuries to the anterolateral ligament are observed more frequently compared to lesions to the deep iliotibial tract (Kaplan fibers) in anterior cruciate ligamant deficient knees using magnetic resonance imaging.

Purpose: To determine the accuracy of detection, injury rate and inter- and intrarater reproducibility in visualizing lesions to the anterolateral ligament (ALL) and the deep portion of the iliotibial tract (dITT) in anterior cruciate ligament (ACL) deficient knees.

Methods: Ninety-one consecutive patients, out of those 25 children (age 14.3 ± 3.

Variation of BMP2 Concentration and Its Activity in Bone Grafts Obtained from Patients Undergoing Hip Replacement Surgery.

Aim: Bone morphogenetic protein 2 (BMP2) is a member of a subgroup of the transforming growth factor beta superfamily and triggers various signaling events which in turn stimulate chondrogenesis, osteogenesis, angiogenesis and extracellular matrix remodeling leading to fracture healing. In this study, we quantified the concentration of BMP2 in fresh human bone grafts obtained from 40 patients undergoing hip replacement surgery. Besides the concentration, the activity of the detected BMP2 was also investigated.

Does the type of surgical approach affect the clinical outcome of total knee arthroplasty?

Background: The aim of the study was to investigate the issue of medial midvastus (MMV) vs. medial parapatellar (MPP) approaches in total knee arthroplasty (TKA). It was hypothesized that the two surgical approaches would produce significantly different results with respect to patient-reported knee score outcome (hypothesis 1), short-term postoperative range of motion (ROM) (hypothesis 2), long-term postoperative ROM (hypothesis 3) and prosthesis survival (hypothesis 4).

Linear Anterior-Posterior Computed Tomography Parameters Used to Quantify Trochlear Dysplasia Are More Reliable Than Angular Measurements.

Purpose: (1) To evaluate the reliability of 9 commonly used quantitative parameters of the trochlear morphology on computed tomography (CT) and (2) to analyze for differences in the reliability regarding patient subgroups (patellofemoral instability [PFI] vs non-PFI).

Methods: A retrospective analysis of lower-limb CT scans performed between August 1996 and February 2013 was performed. The CT scans of all patients with PFI and 30 randomly selected cases without a history of PFI (non-PFI) were included.

Good mid-term results with the trident peripheral self-locking cup: a clinical evaluation and migration measurement with EBRA.

Introduction: The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by means of Einzel-Bild-Roentgen-Analyse (EBRA) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 2 mm within 4 years after surgery. In this study, we performed a migration analysis of an uncemented peripheral self-locking (PSL) press-fit cup after 4 years follow-up.

The reversed dynamic patellar apprehension test mimics anatomical complexity in lateral patellar instability.

Purpose: To develop a dynamic physical examination test that functionally simulates actual patellar instability events and that mimics the range of patellar stabilizer insufficiency in an individual patient.

Methods: Seventy-eight consecutive patients (male/female 35/43; mean age 22 ± 7 years) with recurrent lateral patellar instability and 35 controls (male/female 16/19; mean age 31 ± 14 years) were prospectively evaluated using the reversed dynamic patellar apprehension test (ReDPAT). Anatomical predisposition was assessed according to Dejour's classification of trochlear dysplasia, tibial tuberosity-trochlear groove distance, tibial tuberosity-posterior cruciate ligament distance, patellar height, and varus/valgus malalignment.

Temporary postoperative treatment with compartment-unloading knee braces or wedge insoles does not improve clinical outcome after partial meniscectomy.

Purpose: To investigate whether temporary postoperative compartment-unloading therapy after arthroscopic partial meniscectomy (APM)-with either knee braces or wedge insoles-leads to superior clinical outcome as compared to controls. This difference in clinical outcome was tested in the form of two knee scores, physical activity and general health outcome over the first postoperative year.

Methods: Sixty-three patients who underwent arthroscopic partial meniscectomy (APM) were randomized to one of the following three groups: 12 weeks postoperative knee compartment-unloading therapy with either a knee brace (brace group) or wedge insoles (insole group) or no specific postoperative therapy (control group).

Two-year gait analysis controls of the minimally invasive total hip arthroplasty by the direct anterior approach.

Background: The purpose of the study was to determine the long-term functional outcome of two hip approaches by gait analysis. Patients were selected by prospective randomization, and operated on either by the anterolateral approach or by a minimally invasive direct anterior approach.

Methods: 33 patients (17 anterolateral approach; 16 direct anterior approach) were analyzed using a Vicon 870 system.

Patella Height Correlates With Trochlear Dysplasia: A Computed Tomography Image Analysis.

Purpose: The aim of this study was to investigate the position of the patella relative to the trochlea for a possible correlation with radiologic parameters characterizing the form of the trochlea.

Methods: The computed tomography scans of 36 cases with patellofemoral instability and 30 without (mean age, 24.7 ± 6.

Maximum lifetime body mass index is the appropriate predictor of knee and hip osteoarthritis.

Introduction: In light of inconsistencies in the literature, this study aimed to investigate the relationship between obesity (current and historic) and osteoarthritis (OA) of the knee or hip.

Materials And Methods: We examined 99 people (knee OA, hip OA and controls), age > 50 years, in a case-control study. The current weight, height and waist circumference were measured on site, and detailed weight changes over their lifetime were based on questionnaires and standardized interviews.

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography.

Purpose: De-rotational osteotomies are indicated in patients with pathologic femoral torsion. However, there is disagreement whether an osteotomy should be performed proximally or distally. Conventionally only the total torsion is measured, which does not allow differentiation between a torsional deformity located in the proximal or distal metaphysis or the diaphysis.

The use of tibial tuberosity-trochlear groove indices based on joint size in lower limb evaluation.

Purpose: The correlation between tibial tuberosity-trochlear groove distance (TT-TG) and joint size, taking into account several different parameters of knee joint size as well as lower limb dimensions, is evaluated in order to assess whether TT-TG indices should be used in instead of absolute TT-TG values.

Methods: This study comprised a retrospective analysis of knee CT scans, including 36 cases with patellofemoral instability (PFI) and 30 controls. Besides TT-TG, five measures of knee joint size were evaluated in axial CT slices: medio-lateral femur width, antero-posterior lateral condylar height, medio-lateral width of the tibia, width of the patella and the proximal-distal joint size (TT-TE).

Guidelines for Treatment of Lateral Patella Dislocations in Skeletally Mature Patients.

The incidence of lateral patella dislocations is high, particularly in young females. Beside traumatic cases, many patients present with specific anatomical factors that predispose to lateral patella dislocations (torsional abnormalities of the femur or the tibia, trochlea dysplasia, patella alta, etc). It is of utmost importance to correct those pathologic factors during concomitant procedures as isolated reconstructions of the medial patellofemoral ligament would fail in the presence of severe anatomic risk factors.

High Femoral Anteversion Is Related to Femoral Trochlea Dysplasia.

Purpose: To investigate the possible relation between femoral anteversion (AV) and trochlear morphology.

Methods: Among 560 available lower-limb computed tomography (CT) scans, those with previous fracture, arthroplasty, or osteotomy were excluded and 40 cases were randomly selected. The following 4 lines were determined from the CT scans: 1 through the center of the femoral head and neck; 1 through the lesser trochanter and the center of the femoral shaft; 1 as a tangent to the dorsal part of the distal femur, just above the gastrocnemius insertion; and 1 as a tangent to the posterior condyles.

Driving abstinence is necessary after lumbar spinal fusion: a prospective cohort study.

Purpose: Studies on driving safety after lumbar spinal procedures are rare. Previous studies solely reported on a) driving reaction time (DRT) after lumbar nerve root blocks, b) DRT after discectomy and c) preliminary DRT findings after lumbar fusion.

Methods: DRT was assessed with a driving simulator as described before.

Effect of hip braces on brake response time: Repeated measures designed study.

Background: The question whether or not a patient with a hip brace should drive a car is of obvious importance because the advice given to patients to resume driving is often anecdotal as few scientific data are available on this specific subject.

Objectives: To assess driving ability (brake response time) with commonly used hip braces.

Study Design: Repeated measures design.

Changes in the Chemical Quality of Bone Grafts During Clinical Preparation Detected by Raman Spectroscopy.

Methodology: We determined the content of amide I, amide III, PO4, CO3, and CH2 in samples of fresh bone, bone frozen at -80°C thawed once, bone after two freeze-thaw cycles, and chemically cleaned bone chips. A total of 750 Raman spectra were collected per sample group and the derived quantitative values compared statistically by one-way ANOVA.

Results: We found statistically significant differences between the investigated sample groups differing in their treatment already after one freeze-thaw cycle and as well after multiple freeze-thaw cycles, and/or chemical cleaning.

Knee Extensor Strength and Gait Characteristics After Minimally Invasive Unicondylar Knee Arthroplasty vs Minimally Invasive Total Knee Arthroplasty: A Nonrandomized Controlled Trial.

Background: In light of the existing lack of evidence, it was the aim of this study to compare gait characteristics and knee extensor strength after medial unicondylar knee arthroplasty (MUKA) with those after total knee arthroplasty (TKA), given the same standardized minimally invasive surgery (MIS) approach in both groups.

Methods: Patients scheduled for MIS-MUKA or MIS-TKA as part of clinical routine were invited to participate. A posterior cruciate ligament-retaining total knee design was used for all MIS-TKA.

Effect of surgical shoes on brake response time after first metatarsal osteotomy--a prospective cohort study.

Background: The aim of this study is to assess patients' driving ability when wearing surgical shoes following right-sided first metatarsal osteotomy.

Methods: From August 2013 to August 2015, 42 consecutive patients (mean age 54.5 years) with right-sided hallux valgus deformity underwent first metatarsal osteotomy.