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Acta Orthop Belg 2020 Mar;86(1):166-174

The aim was to compare the outcome of a reversed shoulder arthroplasty with a latissiumus dorsi transfer without (LD-BB) or with bone block (LD+BB) in patients with rotator cuff-deficient shoulders and combined loss of active elevation and external rotation. Postoperative patients with LD+BB were not immobilized compared to 6 weeks of immobilization in patients with LD-BB. Clinical outcome was evaluated using the Constant Score, ADLER score and satisfaction rate. Read More

Acta Orthop Belg 2020 Mar;86(1):162-165

Heterotopic ossification is a well-known complication after orthopaedic surgical procedures, with a pre-dilection of the hip and elbow. Heterotopic ossification is a rare complication after shoulder arthroscopy and is rarely clinically significant. We report a case of a 65-year old Caucasian man with a slow and painful recovery after arthroscopic shoulder surgery encompassing rotator cuff repair, biceps tenotomy and acromioplasty, with recurrence of impingement symptoms unresponsive to conservative therapy (physiotherapy and one sub- acromial injection). Read More

Acta Orthop Belg 2020 Mar;86(1):151-161

Benign peripheral nerve tumours are rare lesions. The surgical treatment and clinical outcomes depend on the resectability. The aim of this retrospective study was to identify clinical or radiological features that may predict the surgical technique that should be used to improve clinical outcome. Read More

Acta Orthop Belg 2020 Mar;86(1):146-150

A retrospective survey on the long-term outcomes of both proximal row carpectomy (PRC) and scaphoidectomy with 4-corner arthrodesis (4CA) was conducted. Seventeen PRC and nine 4CA wrists were retrieved with a minimal follow-up of 9 years. Pain, satisfaction and disability were not significantly different. Read More

Acta Orthop Belg 2020 Mar;86(1):137-145

We performed a systematic review to find out the safety and efficacy of various procedures for isolated scaphotrapeziotrapezoid osteoarthritis. Eleven articles were included. The most common procedure was arthroplasty with pyrocarbon implant (28%), followed by resection of distal pole of scaphoid with proximal trapezium and trapezoid resection (18%). Read More

Acta Orthop Belg 2020 Mar;86(1):131-136

Outcomes of 66 Arpe prostheses in 50 patients treated for osteoarthritis of the trapeziometacarpal joint were investigated with a mean follow-up of ten years. Ten-year survival was 87% when failure was defined as implant removal followed by trapeziectomy and tendon interposition. Ten-year survival was 82% when revision of the cup was also considered as failure and it was 80% when replacement of the neck alone was also chosen as an endpoint. Read More

Acta Orthop Belg 2020 Mar;86(1):122-130

Trapeziectomy with ligament reconstruction and tendon interposition and trapeziometacarpal prosthesis are two commonly used procedures for first carpometacarpal joint osteoarthritis. The purpose of this study is to compare the short-term outcome of trapeziectomy with ligament reconstruction and tendon interposition to trapeziometacarpal prosthesis. Pubmed, Cochrane library and science direct database were searched with adequate search terms. Read More

Acta Orthop Belg 2020 Mar;86(1):115-121

Anterior inferior tibiofibular ligament (AITFL) lesion have been shown to result in proliferation of cicatricial tissue ; concomitant insufficiency of the anterior talofibular ligament (ATFL) and AITFL Lesion may cause anterolateral syndesmotic impingement in the ankle joint of runners. Twenty-two runners with suspected syndesmotic impingement after ankle sprain were included in the study. An MRI of the ankle joint was performed followed by arthroscopy. Read More

Acta Orthop Belg 2020 Mar;86(1):109-114

Total Ankle Replacement is a recognised treatment for end-stage ankle arthritis and an alternative to arthrodesis. This study reviews a single centre series of prospectively collected outcome measures to determine whether the Mobility performs better than the Scandinavian ankle replacement. The primary outcome measure was the survivorship. Read More

Acta Orthop Belg 2020 Mar;86(1):102-108

Closed reduction and percutaneous osteosynthesis is an alternative to the open procedure for articular fractures of distal tibia of children. 38 patients were retrospectively reviewed. The measured parameters were : the score of Gleizes and the discrepancies between preoperative radiographic and CT scan measurements and postoperative radiographs. Read More

Acta Orthop Belg 2020 Mar;86(1):95-101

In cases of chronic instability of the lateral ligament complex following an ankle sprain, operative stabilization should be considered when conservative treatment fails. The purpose of this study is to determine the outcome of a percutaneous stabilization of the lateral ligament complex with a gracilis tendon auto-graft, after an adjuvant arthroscopy of the ankle joint. We retrospectively reviewed the medical files of patients who underwent this surgery performed by the senior author. Read More

Acta Orthop Belg 2020 Mar;86(1):82-94

Aseptic loosening of total knee arthroplasty (TKA) components is one of the frequent reasons for early revision together with infection and instability. Aseptic loosening is usually preceded by the observation of radiolucent lines (RLL) on radiographs. Radiolucent lines have conventionally been considered a sign of osteolysis due to particles disease of either polyethylene or cement wear. Read More

Acta Orthop Belg 2020 Mar;86(1):77-81

Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears. However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to estimate this volume. Read More

Acta Orthop Belg 2020 Mar;86(1):69-76

The goal of this study was to present the results of an anatomical superficial medial collateral ligament (sMCL) reconstruction combined with reefing of the posteromedial capsule in a series of 10 patients with symptomatic valgus instability complaints in combined injuries of the knee. All patients under- went an sMCL reconstruction with reefing of the posteromedial capsule. If cruciate ligament insuf- ficiency was present, this was reconstructed as well. Read More

Acta Orthop Belg 2020 Mar;86(1):64-68

Culture of the causative infectious agent is the only definitive method of diagnosing septic arthritis and can be identified by culture of synovial fluid (SF) or by tissue cultures (TC) obtained at surgery. The aim of this study is to compare the cultures of joint needle aspiration (JNA) with tissue cultures obtained at surgery. 52 patients treated for a suspicion of a septic arthritis of the native knee were retrospectively reviewed. Read More

Acta Orthop Belg 2020 Mar;86(1):54-63

We sought to characterize the causative pathogens of prosthetic joint infections (PJIs), evaluate the trends in microbial etiologies, and identify potential risk factors for PJI. This was a retrospective study analyzing 70 patients with PJI following 3,253 total joint arthroplasties between 2011 and 2017. Staphylococci were the most common cause of infection (52. Read More

Acta Orthop Belg 2020 Mar;86(1):46-53

Polyaxial locking plate fixation is a widely performed treatment for femoral shaft, periprosthetic, and peri-implant fractures in elderly patients. This study's purpose was to compare patient outcomes following the open technique (OT) and less invasive techniques (LIT). Data were gathered from 44 patients with 46 fractures treated with polyaxial locking plate between 2010-2015. Read More

Acta Orthop Belg 2020 Mar;86(1):38-45

Direct anterior approach total hip arthroplasty (DAA- THA) has gained popularity in the last decades due to multiple advantages : reduced blood loss, muscle sparing, reduced pain, reduced dislocation rate, shorter hospital stay and faster recovery. However, initial studies have reported an unacceptable high intra-operative complication rate, especially during the learning curve. The complications and reoperations in a consecutive series of 356 DAA- THA's using a supine positioning on a regular OR table, without femoral hyperextension, were analysed retrospectively. Read More

Acta Orthop Belg 2020 Mar;86(1):33-37

To determine whether local infiltration analgesia by catheter infusion was superior to conventional analgesia in terms of postoperative pain control after THR. A randomized double-blind clinical trial was performed. There were four groups based on catheter placement and the infusion constituents : 1) Intraarticular catheter + anesthetics ; 2) Intraarticular catheter +placebo ; 3) Subfascial catheter + anesthetics ; 4) Subfascial catheter + placebo. Read More

Acta Orthop Belg 2020 Mar;86(1):28-32

Treatment of subtrochanteric fractures is challenging because of their typical displacement pattern. Use of circumferential cerclage wires can be added to intramedullary nailing to facilitate better anatomical reduction. Concerns exist regarding additional soft tissue damage and ischemia of the periosteum. Read More

Acta Orthop Belg 2020 Mar;86(1):22-27

Developmental dysplasia of the hip with a high dislocation may lead to severe hip pain and a marked shortening. Nerve palsy rates following THA in dysplastic hips have been reported as being higher by ten times or more compared to the general population. We report a new technique to perform THA in high congenital dislocations. Read More

Acta Orthop Belg 2020 Mar;86(1):17-21

The aim of this study was to evaluate the inter- and intraobserver reliability of a CT-based femoral anteversion measurement. 17 CT scans showing an abnormal anteversion on one side were presented to 6. Three measurements of all scans were obtained : two bilateral measurements and a third measurement with a flipped CT scan. Read More

Acta Orthop Belg 2020 Mar;86(1):10-16

Long-term evaluation of prosthetic joint infection treated with two-stage revision. Retrospective analysis of 102 periprosthetic infections treated with two-stage revision from 2010 to 2012 in Albenga hospital, Italy. During the second stage, samples for microbiological tests were collected. Read More

Acta Orthop Belg 2020 Mar;86(1):1-9

The purpose of this narrative review was to highlight the research on the influence of weather conditions on patients with osteoarthritis, the pathophysiological mechanisms and the therapeutic consequences. A search was conducted using the Pubmed, Medline and Web of Science databases. Barometric pressure, temperature and humidity are the weather conditions that are found to be correlated most to the worsening of pain complaints. Read More

Acta Orthop Belg 2019 Dec;85(4):545-553

The iliac osteotomy described by Dega in Poland, in 1969, is an acetabuloplasty that changes the acetabular configuration and its inclination. The aim of this work is to analyze a group of patients with DDH treated by combined open reduction and Dega transiliac osteotomy ,to evaluate the results and determine the advantages and disadvantages, as well as, assess the factors affecting the final outcome of such procedure. A prospective study was conducted during the period, from November 2010 to October 2014, on 39 hips, in 29 children, with neglected DDH after walking age, either diagnosed late or after failure to respond to previous non operative treatment. Read More

Acta Orthop Belg 2019 Dec;85(4):540-544

The majority of patients are pain free after total hip replacement, but some experience anterior hip pain due to iliopsoas impingement. There is evidence that a prominent or malpositioned cup may cause iliopsoas tendonitis. The purpose of this study was to determine whether oversizing the cup is a risk factor for postoperative groin pain. Read More

Acta Orthop Belg 2019 Dec;85(4):535-539

Perioperative hypothermia (below 36°C) has been associated with post-operative morbidity. The aim of this study was to determine the incidence of post-operative hypothermia in hip arthroscopy patients and factors affecting perioperative body temperature variation. A prospective audit of 50 consecutive patients undergoing hip arthroscopy for a variety of pathologies was carried out. Read More

Acta Orthop Belg 2019 Dec;85(4):525-534

Unstable trochanteric fractures and fractures with reverse obliquity pose difficulty in fixation. In recent years, intramedullary nails, for the treatment of comminuted and unstable intertrochanteric hip fractures, are becoming more popular relative to conventional, sliding hip screws. The purpose of our study was to evaluate the result of Trochanteric femoral nailing in comminuted, unstable Trochanteric femur fracture in terms of anatomical restoration and functional outcome. Read More

Acta Orthop Belg 2019 Dec;85(4):516-524

Antibiotic-loaded cement spacers are used in two- stage hip replacement. The aim of our study was to compare our results using a Spacer-G with previous results reported in the literature. From June 2002 to April 2010, all patients treated with a two-stage revision were retrospectively reviewed. Read More

Acta Orthop Belg 2019 Dec;85(4):510-515

The aim of this study was to review the incidence, management and outcome of isolated iliac wing fractures and to compare them with other type A, B and C fractures. From 2004 to 2015, the data of 547 patient with a pelvic fracture regarding age, gender, RTS, ISS, treatment, complications and mortality were analyzed and a comparison was made between iliac wing fractures and the other pelvic fractures. We encountered 30 isolated iliac wing fractures. Read More

Acta Orthop Belg 2019 Dec;85(4):502-509

We performed a prospective study on patients with acetabular fractures treated either with internal fixation either with arthroplasty comparing clinical outcomes, quality of life, economic resources and cost efficacy in the first five years after surgery. Demographic data, diagnosis, index treatment, costs and subsequent surgeries were recorded. Patients were requested to fulfill Merle d'Aubigné and EQ-5D-5L questionnaires. Read More

Acta Orthop Belg 2019 Dec;85(4):494-501

In this histologically controlled in vitro study, we evaluated the validity of plain radiography for the assessment of lateral knee joint cartilage degeneration (25 specimens). We examined the correlation between histological grade and radiography findings along with patient demographics. Our study indicated that the Mankin score had a significant inverse correlation with middle joint space width (JSW ; r=-0. Read More

Acta Orthop Belg 2019 Dec;85(4):484-493

The aim of this study was to prospectively compare different delivery forms, doses and combined application forms of TXA for the reduction of blood loss and prevention of the allogeneic blood transfusion in patients with TKA and evaluate the results. The study included patients with knee joint osteoarthritis who were unresponsive to conservative management and 168 patients met the inclusion criteria. They were divided into 5 groups randomly as, Control (1), Local (2), Systemic+short infusion (3), Systemic+long infusion (4) and Systemic+oral TXA (5). Read More

Acta Orthop Belg 2019 Dec;85(4):477-483

The purpose of this study was to assess the factors associated with high fibular head in symptomatic discoid lateral meniscus (DLM). Eighty-seven patients with complete DLM (discoid group) and 80 normal subjects (control group) were included prospectively. Plain X-rays and MRI were analyzed for level and angle of the fibular head and thickness and type of Wrisberg ligament. Read More

Acta Orthop Belg 2019 Dec;85(4):472-476

This study is aimed to compare the clinical and radiological differences between classic locked intra- medullary nailing (LIN) and blade expandable intra- medullary nailing (BEIN) at tibia shaft fractures. Operation time, exposing of radiation time and fracture healing times were recorded. Pain visual anolog scale (VAS), shortening of tibia and angulation of fracture line were compared. Read More

Acta Orthop Belg 2019 Dec;85(4):464-471

The aim of the study was to find out if ulnar shortening is effective to treat ulnar wrist pain and which factors influence outcome. Thirty-seven patients were evalua- ted with a mean follow-up of 4.5 years. Read More

Acta Orthop Belg 2019 Dec;85(4):459-463

This study presents a series of cases with surgically treated partial distal biceps tendon ruptures. The results of full distal biceps tendon rupture repair are also presented and a comparison is made between the two groups. Between 2001 and 2015, patients with partial and full ruptures of the distal biceps tendon were surgically repaired. Read More

Acta Orthop Belg 2019 Dec;85(4):448-458

The objectives of this study were to determine the clinical and radiologic outcome after headless compression screw fixation through the transolecranon approach in patients who had sustained Dubberley type 2 and 3 articular surface fractures of the distal humerus. Twenty-seven patients were included in the study. There were 23 Dubberley type 2 and 4 type 3 fractures. Read More

Acta Orthop Belg 2019 Dec;85(4):437-447

Radial head replacement or ORIF are established treatment options for Mason type-III and type-IV fractures. The aim of this study was to provide results for reconstruction of these complex fractures using fine-threaded K-wires. We present results after reconstruction of 15 Mason type-III and 8 Mason type-IV fractures. Read More

Acta Orthop Belg 2019 Dec;85(4):429-436

The purpose of this study is to evaluate radiological, clinical results and complication rates of dual plate fixation for severe metaphyseal comminuted fracture of proximal humerus. 21 patients who have proximal humerus fractures with impaired posteromedial buttress were enrolled. Fractures were treated with dual plate technique using Proximal Humeral Locking plate and Variable Angle Plate. Read More

Acta Orthop Belg 2019 Dec;85(4):421-428

The axilla is a region of clinical and surgical importance with plenty of anatomical variations. One of these is the presence of accessory muscles. The literature was reviewed in order to identify the different supernumerary muscles that are described in the axilla. Read More

Acta Orthop Belg 2019 Dec;85(4):412-420

This retrospective study evaluated the outcome after intramedullary nailing with the Rockwood Clavicle Pin (RCP) for acute displaced middle third clavicle fractures in adults. Of 84 included patients treated for this fracture 2003-2009, 66 (79%) were evaluated. Of these, 52 (79%) were re-examined, including fluoroscopy, while 14 patients (21%) were evaluated by mailed questionnaire. Read More

Acta Orthop Belg 2019 Dec;85(4):406-411

The purpose of this study was to compare prospecti- vely the radiographic and clinical results of patients treated with tightrope through either mini-open or percutaneous stabilization for acute AC joint injuries. Eighty patients were included in this study and were randomly divided into two groups. Group A included 40 injuries treated with mini-open repair. Read More

Acta Orthop Belg 2019 Dec;85(4):400-405

Abbreviations: MUA, manipulation under anesthesia ; FS, frozen shoulder ; SPADI, Shoulder Pain and Disability Score ; OSS, Oxford Shoulder Score ; NPRS, Numeric Paind Rating Scale. Manipulation under anesthesia is a well-established, but controversial, treatment for frozen shoulders. We will evaluate our results of manipulation and physiotherapy in stage two frozen shoulders. Read More

Acta Orthop Belg 2019 Dec;85(4):393-399

Factors associated with tendon degeneration have not been fully investigated. The purpose of this study was to identify factors associated with tendon degeneration in patients with rotator cuff tear. A total of 93 patients with a full-thickness rotator cuff tear (fRCT) were included in the study. Read More

Acta Orthop Belg 2019 Sep;85(3):387-391

The aim of the study is to evaluate the clinical effect of primary suture anchors repair in the treatment of deltoid ligament rupture associated with ankle fractures. 34 patients with acute deltoid ligament rupture associated with ankle fractures were selected between 2011 and 2014. Medial clear space (MCS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) were noted. Read More

Acta Orthop Belg 2019 Sep;85(3):381-386

The FlexitSystem implant is a novel implant used in open wedge high tibial osteotomy. A clinical safety study was performed. Retrospectively 50 patients were analyzed who were treated with an open wedge high tibial osteotomy and the new FlexitSystem implant, with a minimal follow-up of one year. Read More

Acta Orthop Belg 2019 Sep;85(3):373-380

Hamstring injury is the most common injury in European professional football. The purpose of this study was to provide insight into the content of hamstring injury prevention programmes in English and Belgian elite football teams. Fifteen premier league teams (10 from Belgium and 5 from England) completed a questionnaire on hamstring injury prevention. Read More

Acta Orthop Belg 2019 Sep;85(3):364-372

Simultaneous bilateral total knee arthroplasty (TKA) causes increased blood loss and increases the risk of venous thromboembolism. Tranexamic acid (TXA) is commonly used to minimize blood loss and transfusion requirements. However, the optimal regimen of TXA in single stage bilateral TKA is still not defined. Read More

Acta Orthop Belg 2019 Sep;85(3):360-363

The posteromedial horn of the medial meniscus is prone to injury, and repair of a tear in this portion of the medial meniscus is especially challenging for the arthroscopist. We present a novel technique that allows good management of the posterior horn of the medial meniscus, even in patients with tight medial compartments. This technique uses two standard portals (the anterolateral portal and the anteromedial portal) to conduct arthroscopic examination, and uses a third portal as the workhorse portal to manage the posterior region so that the posterior horn tear can be easily removed. Read More