Is TKA with computer-assisted navigation associated with less blood loss? A comparative study between computer-navigated and conventional method.

The aim of this study is to evaluate whether computer-assisted navigated TKA reduces perioperative blood loss. Patients were randomly divided into 2 groups and underwent either a conventional TKA (n = 40) or a TKA with computer-assisted navigation (n = 40). Perioperative blood loss was evaluated by laboratory parameters, postoperative drain output and number of required transfusions.

Is prophylaxis for heterotopic ossification with radiation therapy after THR associated with early loosening or carcinogenesis?

Introduction: Heterotopic ossification may develop after major hip surgeries, thus preventive strategies including radiation therapy and non steroid anti-inflammatory drugs are commonly employed. There are certain concerns regarding the effects of radiation therapy on implant loosening and carcinogenesis. Our study aims to evaluate whether radiation therapy results in implant loosening or radiation-induced tumours in the long term.

Custom-made femoral implants in total hip arthroplasty due to congenital disease of the hip: a review.

Congenital disease of the hip (CDH) is a common reason for the development of secondary osteoarthritis at the hip joint and the need for total hip arthroplasty (THA). The distorted femoral anatomy in patients with CDH in combination with soft tissue considerations and leg length discrepancy complicate the procedure of THA and this sometimes precludes the implantation of classical industry designed femoral stems. In such cases a customised femoral implant must be used in order to optimise the fit of the stem to the femur, to improve strain distribution and to reconstruct hip biomechanics.

Modified porous tantalum rod technique for the treatment of femoral head osteonecrosis.

Aim: To study a modified porous tantalum technique for the treatment of osteonecrosis of the femoral head.

Methods: The porous tantalum rod was combined with endoscopy, curettage, autologous bone grafting and use of bone marrow aspirates from iliac crest aspiration in 49 patients (58 hips) with a mean age of 38 years. The majority of the patients had idiopathic osteonecrosis, followed by corticosteroid-induced osteonecrosis.

Long Term Outcomes of Total Hip Arthroplasty With Custom Made Femoral Implants in Patients With Congenital Disease of Hip.

We evaluated the outcomes of total hip arthroplasty in 67 patients (86 hips) with congenital hip disease and excessive abnormal anatomy of the proximal femur with the use of custom-made femoral stems. The design of the stem was based on CT data following the principles of CAD-CAE-CAM technique. No serious complications attributed to the femoral stem were seen.

Flow cytometry as a diagnostic tool for identifying total hip arthroplasty loosening and differentiating between septic and aseptic cases.

Purpose: Implant loosening represents one of the major factors of total hip arthroplasty (THA) failure. The purpose of this study was to identify specific markers indicative of septic and aseptic loosening in patients that underwent THA.

Methods: Flow cytometry was performed in blood samples of 20 patients with loosening (10 septic/10 aseptic).

Long Term Outcomes of Total Hip Arthroplasty in Young Patients under 30.

Background: We aimed to report outcomes of total hip arthroplasty (THA) in very young patients under the year of 30.

Methods: Thirty patients (45 hips) with various indications for THA were retrospectively reviewed radiologically and clinically and analyzed regarding survival, reasons of failure, factors associated with outcomes and postoperative complications.

Results: Within a mean follow-up time of 116 months the 10-year survival rate was 90.

Low-grade central osteosarcoma of distal femur, resembling fibrous dysplasia.

We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One month after the first X-ray, clinical and imaging deterioration was evident. Open biopsy revealed fibrous dysplasia.

Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture: a study with a minimum follow-up of 15 years.

Objectives: To evaluate the long-term outcome after surgical management of posterior hip dislocations associated with posterior wall acetabular fracture and to depict prognostic factors that may affect surgical results.

Design: Retrospective review.

Setting: Level I trauma center.

Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques.

Introduction: With the advances and improvement of computer-assisted surgery devices, computer-guided pedicle screws insertion has been applied to the lumbar, thoracic and cervical spine. The purpose of the present study was to perform a systematic review of all available prospective evidence regarding pedicle screw insertion techniques in the thoracic and lumbar human spine.

Materials And Methods: We considered all prospective in vivo clinical studies in the English literature that assessed the results of different pedicle screw placement techniques (free-hand technique, fluoroscopy guided, computed tomography (CT)-based navigation, fluoro-based navigation).

Diagnostic and treatment modalities in nonunions of the femoral shaft: a review.

Nonunions of the femoral shaft represent a treatment challenge for the orthopaedic surgeon and a serious socioeconomic problem for the patient. Inadequate fracture stability, insufficient blood supply, bone loss or presence of infection are the main reasons for the development of a nonunion. Careful classification and exclusion of infection are crucial for the choice of the proper treatment alternative.

Bifocal pyomyositis in a 3-year-old child with eczema: a case report.

Pyomyositis is an infection of the skeletal muscles, resulting in a pus-filled abscess. Immunodeficiency of the patient is considered to play an important role in pathogenesis. We report a case of a 3-year-old child, who presented with multifocal pyomyositis in the gastrocnemius muscle, extending to the posterior muscles of the thigh.

Low grade fibromyxoid sarcoma: a case report and review of the literature.

Low grade fibromyxoid sarcoma (LGFMS) is a distinctive variant of fibrosarcoma with a high metastasizing potential and sometimes long interval between tumour presentation and metastasis. We present the case of a 50-year-old male who developed a large mass in the posterior aspect of his lower left thigh. The tumor was excised with preservation of the neurovascular structures surrounded by the mass.

Shoulder reanimation in posttraumatic brachial plexus paralysis.

Introduction: Posttraumatic brachial plexus paralysis invariably involves the upper roots leading to paralysis of the shoulder region musculature. Early neurotisation of the suprascapular and the axillary nerve should be one of the priorities in plexus reconstruction in order to reanimate the shoulder.

Patients And Methods: From 1998 to 2007, 78 patients with posttraumatic brachial plexus palsy were operated in our department.

Endoscopic versus open carpal tunnel release.

Purpose: This study compared endoscopic carpal tunnel release with the conventional open technique with respect to short- and long-term improvements in functional and clinical outcomes.

Methods: We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Of these patients, 37 underwent the endoscopic method according to Chow and 35 were assigned to the open method.

Misdiagnosed bilateral C5-C6 dislocation causing cervical spine instability: a case report.

Introduction: The diagnosis of cervical spine injuries remains a significant problem in many blunt trauma patients. Correct and early diagnosis of these injuries is imperative as delayed or missed diagnoses result in increased morbidity and mortality.

Case Presentation: A 57-year-old Caucasian woman presented with a misdiagnosed bilateral C5-C6 dislocation one month after a fall and head injury, without clearance of the cervical spine in her previous visits to two physicians and having already started physiotherapy sessions, despite the presence of pain in the clinical examination.

Migration of the trabecular metal monoblock acetabular cup system.

Fifty-one primary total hip arthroplasties were performed using Trabecular Metal Monoblock Acetabular Cup System (Zimmer Inc, Warsaw, IN). In a 2-year prospective study, its behavior was closely monitored by clinical, radiologic, and component migration assessment by Ein-Bild-Röntgen-Analyse method. There were no complications.

Application of the Endomodel rotating hinge knee prosthesis for knee osteoarthritis.

One hundred thirty-six knees were treated with the Endomodel rotating hinge knee prosthesis as primary total knee arthroplasty (TKA). The indications for surgery included osteoarthritis (110 knees), rheumatoid arthritis (18 knees), and osteonecrosis (8 knees). Patients were divided into four study groups according to follow-up duration.

Total hip and knee arthroplasty for juvenile rheumatoid arthritis.

We performed 23 total hip and knee arthroplasties (15 total hip and 8 total knee arthroplasties) in 18 children with juvenile rheumatoid arthritis between 1984 and 2001. The mean age at surgery was 17.8 years (range 13 to 24 years).

Total hip arthroplasty in children with juvenile chronic arthritis: long-term results.

From 1984 to 2002, 20 total hip arthroplasties in children with juvenile chronic arthritis were performed in the authors' department. All patients had polyarticular disease. Average age of patients was 15.

Decompressive surgery for degenerative lumbar spinal stenosis: long-term results.

We report the outcome of 50 patients with degenerative lumbar spinal stenosis who were treated surgically by spinal decompression between 1984 and 1995. Their mean age at the time of surgery was 59.9 (45-77) years and the mean follow-up was 11.