Publications by authors named "Lieven Vermuyten"

3 Publications

  • Page 1 of 1

Proximal femoral derotation osteotomy in children with CP : long term outcome and the role of age at time of surgery.

Acta Orthop Belg 2021 Mar;87(1):167-173

The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotated gait. This study provides quantitative evidence in support of the beneficial effect of FDO after long term follow up. Retrospective clinical and kinematic evaluation of 31 CP patients (55 operated limbs) pre-, 1 and 3 years postoperatively after proximal FDO was conducted for a minimal follow-up of 3 years. This group con- sisted of 20 men and 11 women, aged 10.68±3.31 years at the time of surgery. Minimum follow up was 3 years (3.16±0.53 years), with 22 patients (38 operated limbs) having an additional follow up at 5 years (5.02±0.49 years). Age at FU3 and FU5 was 14.06±3.52 years and 15.39±3.08 years respectively. A set of clinical and kinematic parameters were ana- lyzed and showed a significant correction of mean hip rotation and femoral anteversion after FDO. Further plotting of individual data comparing 3 or 5 year postoperative values to 1 year postoperative values showed no further significant changes, indicating sustained correction of internally rotted gait until end of our follow up. Plotting mean hip rotation in stance as well as kinematic knee parameters according to age grouped cohorts could not show age at time of surgery to be a significant factor in recurrence of internally rotated gait or preoperative disturbances of knee motion in the sagittal plane. This study provides quantitative evidence on the beneficial effect of FDO, a surgical technique to improve internally rotated gait in cerebral palsy patients with spastic diplegia. Pre- and postoperative clinical and kinematic para- meters are compared and results are discussed. Minimum follow up was 3 years with a mean follow up of 4.65±0.83 years. The effect of age at time of surgery on recurrence and kinematic parameters were studied.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2021

The effect of component alignment on clinical outcomes in fixed bearing unicompartmental knee arthroplasty.

Knee 2021 Mar 18;29:126-133. Epub 2021 Feb 18.

Department of Trauma and Orthopaedics, West Suffolk NHS Foundation Trust, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, United Kingdom.

Background: The aim of this study is to report component alignment in a series of ZUK fixed bearing unicompartmental knee arthroplasty (UKA) implants and compare this to clinical outcomes.

Methods: The radiographs, Knee Society Scores (KSS) and knee flexion of 223 medial UKAs were evaluated. The following alignment parameters were assessed; coronal and sagittalfemoral component angle (c-FCA and s-FCA), coronal and sagittal tibia component angle (c-TCA and s-TCA)and the coronal tibiofemoralangle (c-TFA). Each alignment parameter was grouped at consecutive 2.5° intervals, mean KSS and knee flexion was then compared between the interval groups.

Results: 96.4% of femoral components were between 7.5° of varus and valgus and 95.1% between 7.5° extension and 5° flexion. 89.6% of tibial components were between 7.5° of varus and 2.5° valgus and 97.3% between 2.5° and 15° flexion. There was no significant difference between the KSS or knee flexion between any of the incremental groups of component alignment. Mean c-TFA was 0.2 ± 3.0°, 92.4% were between -5° (varus) and 5° (valgus). KSS were significantly greater for two of the increments with slightly more varus. Linear regression analysis showed there was very weak correlation (R = 0.1933) between c-TFA and c-TCA.

Conclusions: The results of this study show that fixed bearing UKA components are forgiving to accommodate some variation in tibial and femoral component position without effecting clinical outcome scores or knee flexion. Limb alignment matters more than component position and knees with slight varus tibiofemoral alignment have better clinical scores than those with valgus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.knee.2021.01.012DOI Listing
March 2021

Olecranon fixation with two bicortical screws.

Bone Jt Open 2020 Jul 2;1(7):376-382. Epub 2020 Nov 2.

Department of Trauma and Orthopaedics, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK.

Aims: The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws.

Methods: Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension.

Results: Bicortical screw fixation was used to treat 17 olecranon fractures and ten osteotomies. The mean age of patients being treated for olecranon fracture and osteotomy were 48.6 years and 52.7 years respectively. Overall, 18% of olecranon fractures were classified as Mayo type I, 71% type II, and 12% type III. No cases of fracture or osteotomy required operative re-intervention. There were two cases of loss of fracture reduction which occurred in female patients ≥ 75 years of age with osteoporotic bone. In both cases, active extension and a functional range of movement was maintained and so the loss of reduction was managed non-operatively. For the fracture fixation cohort, at final follow-up mean elbow extension and flexion were -5 ± 5 and 136 ± 7, with a mean arc of motion of 131 ± 11.

Conclusion: This series has shown that patients regain near full range of elbow flexion-extension and complication rates are low following bicortical screw fixation of olecranon fractures and osteotomy.Cite this article: 2020;1-7:376-382.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1302/2633-1462.17.BJO-2020-0069.R1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659655PMC
July 2020