Background: Currently, periarticular knee joint osteotomies are an integral part of the treatment of early arthritic deformities in the knee joint.
Diagnostics: Analysis of the deformity is performed with a standardized full-leg standing x‑ray of both legs, as well as a lateral x‑ray of the knee joint that includes 2/3 of the proximal tibial shaft. An MRI examination of the knee joint is obtained to assess the articular cartilage, the ligaments and menisci.
Background: Computer-assisted surgery (CAS) can act as an intraoperative ruler in high tibial osteotomy (HTO) to visualize continuously the leg during surgery.
Questions: The aim of the study is to evaluate the accuracy of CAS with respect to preoperative planning and postoperative deviation from the planned leg axis in HTO. In addition, the influence of surgeon experience as well as operation time and perioperative complications are analyzed.
Background: The increasing use of fluoroscopy-based surgical procedures and the associated exposure to radiation raise questions regarding potential risks for patients and operating room personnel. Computer-assisted technologies can help to reduce the emission of radiation; the effect on the patient's dose for the three-dimensional (3-D)-based technologies has not yet been evaluated.
Questions/purposes: We determined the effective and organ dose in dorsal spinal fusion and percutaneous transsacral screw stabilization during conventional fluoroscopy-assisted and computer-navigated procedures.
J Bone Joint Surg Am
June 2010
Background: Elastic stable intramedullary nailing has become a popular treatment for pediatric long-bone fractures. However, early limb malalignment and length differences may occur in children with femoral fractures who are managed with this procedure.
Methods: We prospectively followed sixty-eight children (mean age, 5.
Navigation systems track objects with precision expressed as root mean square equalling even up to 0.15 mm. Application of navigation system combined with imaging technique makes surgical operations less invasive, which results in the reduced risk of infection, smaller scar and a shorter time of rehabilitation.
View Article and Find Full Text PDFIn this study, we present a new 2.5-dimensional ultrasonic navigation system for measuring axes, lengths, and torsions preoperatively, intraoperatively, and postoperatively. The system comprises an ultrasound unit with a 5-MHz linear probe (TELEMED Echoblaster 128; Telemed, Vilnius, Lithuania) and a navigation system (OrthoPilot; B.
View Article and Find Full Text PDFBackground: Torsional malalignment and mechanical axis deviation (MAD) are worrisome complications after nailing of distal femoral fractures. Variable, sometimes contradictory, reports about these problems have been published.
Methods: In a retrospective nonrandomized study, 41 patients (mean age, 44.
Seventy-three children (48 boys and 25 girls; mean age, 5.7 years) with unilateral femoral or tibial shaft fractures were treated using elastic intramedullary nails at the authors' institution. There were 61 simple type A fractures (84%) and 12 wedge type B fractures (16%).
View Article and Find Full Text PDFSeveral techniques for knee fusion have been described with success rates ranging from 29% to 100%, with worse results occurring in patients with joint sepsis. We treated 21 patients with persistent infections using knee arthrodesis with a hybrid Ilizarov frame at our institution. There were 13 men and eight women ranging from 21 to 75 years (mean, 49.
View Article and Find Full Text PDFObjective: The objectives of this study are to design and evaluate a CT-free intra-operative planning and navigation system for high tibial opening wedge osteotomy. This is a widely accepted treatment for medial compartment osteoarthritis and other lower extremity deformities, particularly in young and active patients for whom total knee replacement is not advised. However, it is a technically demanding procedure.
View Article and Find Full Text PDFThe indications for physiotherapy after supracondylar humeral fractures in children are not clear in the literature, even in the presence of an active or passive limitation of elbow joint motion. The authors therefore performed a prospective randomized study to assess the effectiveness of physiotherapy in improving the elbow range of motion after such fractures. The authors studied two groups of 21 and 22 children with supracondylar humeral fractures Felsenreich types II and III, all without associated neurovascular deficits.
View Article and Find Full Text PDFHigh tibial osteotomy is a widely accepted treatment of medial compartment osteoarthritis as well as other lower extremity deformities. However, it is a technically demanding procedure. The lack of exact intraoperative real time control of the mechanical axis often results in postoperative malalignments, which is one reason for poor long term results.
View Article and Find Full Text PDF