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Oper Orthop Traumatol 2019 Mar 18. Epub 2019 Mar 18.

Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.

Objective: Complete visualization of the articular surface in comminuted uni- or bicondylar tibial plateau fractures as a prerequisite for anatomical reconstruction to reduce the risk of posttraumatic osteoarthritis.

Indications: Unicondylar lateral or medial as well as bicondylar intra-articular tibial plateau fractures with central and/or dorsal fracture lines; comminuted destruction of the medial or lateral tibial plateau with dislocation of >2 mm.

Contraindications: Critical soft tissue in the approach area, femoral condylar fracture, intraligamentous ruptures of the medial or lateral ligaments or the posterolateral corner. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 18. Epub 2019 Mar 18.

Trauma and Orthopaedics, Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK.

Purpose: To describe a surgical technique in correcting valgus deformity during total knee replacement and evaluate medium-term clinical outcomes.

Methods: This was a retrospective consecutive series of total knee replacement for severe valgus deformity of patients who underwent a lateral ligament complex release with a sliver osteotomy of the lateral femoral condyle with a minimum 1-year follow-up and recording objective and patient-reported outcome measures.

Results: Twenty-three patients (25 knees) were included with median follow-up of 5 years (range 1-15 years) and average age 67. Read More

J Arthroplasty 2019 Feb 25. Epub 2019 Feb 25.

The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China.

Background: Procedure of the femur is extremely challenging during total hip arthroplasty (THA) for Hartofilakidis type C developmental dysplasia of the hip. The main purpose of this study is to compare the clinical effectiveness of proximal femoral reconstruction (PFR) with subtrochanteric transverse osteotomy (STO).

Methods: Between 2006 and 2015, 33 primary THAs in 26 patients were performed with PFR and 16 hips in 13 patients underwent STO. Read More

Eklem Hastalik Cerrahisi 2019 Apr;30(1):38-45

Department of Orthopedics and Traumatology, Bağcılar Training and Research Hospital, 34100 Bağcılar, İstanbul, Turkey.

Objectives: This study aims to describe our standardized method for evaluating the tension of reduction around the hip joint during open reduction in patients with developmental dysplasia of the hip (DDH).

Patients And Methods: We retrospectively evaluated 67 pediatric patients (8 males, 59 females; mean age 21.9±11. Read More

JBJS Essent Surg Tech 2014 Dec 23;3(4):e20. Epub 2013 Oct 23.

KR Hospital, Periyanaickenpalayam, Mettupalayam Road, Coimbatore 641 020, India.

Introduction: The lateral parapatellar approach provides direct access to the pathological area in a valgus knee deformity and allows sequential titrated release of contracted lateral soft tissues during total knee arthroplasty.

Step 1 Preoperative Planning: Differentiate the flexible and fixed components of the valgus deformity by clinical and radiographic examination.

Step 2 Expansile Lateral Arthrotomy: Open the knee joint from the lateral side by coronal z-plasty of the lateral retinaculum, oblique lateral tenotomy of the quadriceps tendon, and iliotibial band release. Read More

JBJS Essent Surg Tech 2014 Dec 9;3(4):e19. Epub 2013 Oct 9.

School of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan. E-mail address:

Introduction: A combined procedure including open reduction, femoral shortening osteotomy, and an acetabular procedure is often necessary to obtain a desirable result in children of walking age who have a high-riding hip dislocation.

Step 1 Surgical Approach: A careful approach to the femoral head and acetabulum is required to avoid injury to nerves, vessels, and cartilage.

Step 2 Explore The Hip Joint: Make sure to find the true acetabulum and remove all obstacles to femoral head reduction. Read More

Biomed Res Int 2019 6;2019:6021271. Epub 2019 Feb 6.

Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

Background And Purpose: The Salter innominate osteotomy has been an effective method to treat the developmental dysplasia of hip (DDH) over the past decades; however, several postoperative complications and deficiencies were reported. In this study, we evaluated outcome of a newly modified Salter osteotomy in patients presenting with DDH.

Methods: We reviewed retrospectively 76 patients (90 hips) with DDH aged ≥ 18 months, who underwent open reduction and a modified osteotomy by a single surgeon. Read More

J Arthroplasty 2019 Feb 15. Epub 2019 Feb 15.

Complex Joint Reconstruction Center, Hospital for Special Surgery, New York City, NY.

Background: Antibiotic cement spacers are used during 2-stage revision total hip arthroplasty for prosthetic joint infection. Complications including dislocation and periprosthetic fracture have been reported but a large cohort comparing spacer design features is lacking. We aimed to determine if spacer design is associated with perioperative complications. Read More

J Knee Surg 2019 Mar 15. Epub 2019 Mar 15.

Department of Orthopaedics, Capital Medical University, Xuanwu Hospital, Beijing, China.

The objectives of our study were to evaluate (1) patellar height changes when the knee axis correction was < 15 degrees and (2) the clinical effect after open wedge high tibial osteotomy (OWHTO). Sixty-nine patients (69 knees) undergoing OWHTO between January 2016 and June 2017 were enrolled in this prospective study. All patients underwent OWHTO using a three-dimensional (3D)-printed patient-specific instrument. Read More

Knee Surg Relat Res 2019 Mar;31(1):61-66

Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

Restoration of neutral mechanical alignment of the lower limb is an important factor in the treatment of unicompartmental arthrosis. Traditionally, medial opening wedge high tibial osteotomy has been widely performed to correct varus malalignment with unicompartmental arthrosis. However, an ideal indication for the high tibial osteotomy is the knee with metaphyseal tibial varus malalignment. Read More

PLoS One 2019 14;14(3):e0213590. Epub 2019 Mar 14.

Department of Trauma- and Hand Surgery Medical Faculty, Heinrich-Heine-University, Duesseldorf Moorenstraße 5, Duesseldorf, Germany.

Cerament (Bonesupport Holding, Lund, Sweden) is a bioresorbable synthetic bone substitute consisting of calcium sulfate and hydroxyapatite which is successfully used as a bone graft in bone defects or in delayed and non-unions after fractures. Besides, calcium sulfate/ hydroxyapatite (CAS/HA) could have, attributed to its composition and osteoinductive properties, have great importance in the treatment of bone infections with critical size defects (CSD). Aim of the study was to evaluate the effects of antibiotic infused CAS/HA on inflammation and bone healing in an implant-associated osteitis mice model. Read More

Bull Hosp Jt Dis (2013) 2019 Mar;77(1):53-56

Legg-Calve-Perthes disease is a multifactorial process that can lead to debilitating femoral head deformity in children. Management can range from conservative (such as nonweightbearing protocols), bracing (such as A frames), to more invasive measures involving surgical interventions. First described by Axer in 1965, the varus derotational osteotomy (VDRO) has been a staple in the surgical management of Perthes disease. Read More

Curr Rev Musculoskelet Med 2019 Mar 12. Epub 2019 Mar 12.

Boston Children's Hospital, Boston, MA, USA.

Purpose Of Review: To review slipped capital femoral epiphysis (SCFE), with a focus on new insights into its etiology and evolving methods of operative fixation.

Recent Findings: The epiphyseal tubercle and its size during adolescence are paramount to understanding the mechanism of SCFE. In chronic stable SCFE, the epiphysis rotates about the tubercle protecting the lateral epiphyseal vessels from disruption. Read More

J Orthop Sci 2019 Mar 7. Epub 2019 Mar 7.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Anterior localization of the necrotic lesion was recently proposed as an important factor for the occurrence of collapse even in medially located osteonecrosis of the femoral head (ONFH). We examined the effects of the anterior boundary of the necrotic lesion on progressive collapse after varus osteotomy for ONFH.

Methods: We reviewed the outcomes of 31 hips in 27 patients with ONFH treated by transtrochanteric curved varus osteotomy (CVO) from 2000 to 2012 with a mean follow-up of 10. Read More

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019834362

Department of Orthopaedics and Traumatology, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Purpose:: Fibrous dysplasia (FD) of the proximal femur can result in severe deformity and disability. The results of surgical management in such situations have been reported to be poor. We present a novel, five-step surgical treatment to correct proximal femoral deformity in FD. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 9. Epub 2019 Mar 9.

Hospital for Special Surgery, 525 E 70th Street, New York, NY, 10021, USA.

Purpose: The purpose of this study was to assess the physeal safety associated with the use of an epiphyseal femoral socket for paediatric medial patellofemoral ligament (MPFL) reconstruction.

Methods: Fifty-four knees in 49 skeletally immature patients underwent physeal-sparing MPFL reconstruction performed by 1 surgeon at a tertiary care academic medical centre from 2007 to 2016. A femoral socket distal to the femoral physis was used for graft fixation in all the patients. Read More

Acta Chir Orthop Traumatol Cech 2019 ;86(1):23-32

Ortopedická klinika 1. lékařské fakulty Univerzity Karlovy, Institutu postgraduálního vzdělávání ve zdravotnictví a Nemocnice Na Bulovce, Praha.

PURPOSE OF THE STUDY To evaluate the results of treatment of acute and chronic severe slips of slipped capital femoral epiphysis. The tested hypothesis was that the results will be comparable with the methods using surgical hip dislocation. MATERIAL AND METHODS In the period 1996-2014, 26 patients were treated for severe slips ( >60°). Read More

J Pediatr Orthop 2019 Apr;39(4):181-186

Pediatric Orthopedics Unit, Ha-Emek Hospital, Afula, Israel.

Background: Femoral neck lengthening and transfer of the greater trochanter were introduced by Morscher as treatment for patients with coxa breva and overgrowth of the greater trochanter. In this study we evaluated intermediate and long-term results of this operation.

Methods: We reviewed clinical and radiographic results of 18 patients (20 hips) who were treated by Morscher osteotomy. Read More

J Orthop Res 2019 Mar 6. Epub 2019 Mar 6.

Osaka University Graduate School of Medicine, Osaka, Japan.

In this computed tomography (CT) morphological study we describe the way the proximal femoral morphology differs with worsening degrees of developmental dysplasia of the hip (DDH) and describe gender differences in patients with DDH. 49 male patients with DDH were matched with 49 females with DDH, using age and the Crowe classification of DDH severity. The femoral length, anteversion, neck-shaft angle, offset, neck length, canal-calcar ratio, canal flare index, lateral center-edge angle, alpha angle, pelvic tilt and pelvic incidence were measured for each patient on their pre-operative CT scans, prior to total hip arthroplasty surgery. Read More

Dev Med Child Neurol 2019 Mar 4. Epub 2019 Mar 4.

Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.

Aim: To evaluate the long-term outcome of selective dorsal rhizotomy (SDR) on gait and the influence of previous femoral derotation osteotomy (FDO).

Method: In a retrospective cohort study of 29 children (16 females, 13 males) with spastic diplegic cerebral palsy, 14 children received FDO before SDR, whereas 15 children with moderate or near-normal internal femoral rotation during gait received only SDR. Three-dimensional gait data were obtained pre-FDO, pre-SDR, 1 year post-SDR, and 3 to 5 years post-SDR, to study the Gait Profile Score (GPS), pelvic tilt, and knee and hip kinematics. Read More

Orthopade 2019 Mar 1. Epub 2019 Mar 1.

Orthopädische Klinik, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Deutschland.

Pelvic and femoral osteotomies can be a challenge even for experienced orthopedic surgeons. Residual metal may complicate the insertion of the endoprosthesis in some cases. Sometimes, the anatomical modification of the previous osteotomy complicates the total hip replacement. Read More

J Arthroplasty 2019 Jan 7. Epub 2019 Jan 7.

Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Department of Orthopaedic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia; Research Foundation, Perth Orthopaedic and Sport Medicine Centre, West Perth, Western Australia, Australia.

Background: Intraoperative femur fractures are a common complication of revision hip arthroplasty. This study examined the use of a prophylactic cable in stopping a crack from propagating beyond the cable.

Methods: Seventy sheep femora were prepared. Read More

Chin J Traumatol 2019 Jan 29. Epub 2019 Jan 29.

Department of Orthopedics, Lady Hardinge Medical College, New Delhi 110001, India.

Purpose: Reduction and fixation in femoral neck fracture in young patients have a problem of nonunion requiring additional procedure like valgus osteotomy but fixation devices are technically difficult for inexperienced surgeons. We aims to assess the results of valgus osteotomy in femoral neck fracture in our setup.

Methods: We report a series of 20 patients of higher Pauwel's angled fracture of femoral neck fracture presenting late wherein for valgus osteotomy was added to reduction fixation secured with a commonly available 135° dynamic hip screw and plate. Read More

J Knee Surg 2019 Mar 1. Epub 2019 Mar 1.

Department of Orthopaedic Surgery, University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System (NUHS), Singapore, Singapore.

Distal femoral varus osteotomies have been novelly described in the recent years to be successful in the management of patellofemoral instability with genu valgum. However, these publications are limited to case reports and small case series and no published literature have attempted to analyze them in totality. The current review aims to pool together these small case series to evaluate the outcomes and complications of distal varus femoral osteotomies when performed for patellofemoral instability. Read More

J Exp Orthop 2019 Feb 28;6(1):10. Epub 2019 Feb 28.

ICATME, Hospital Universitari Dexeus, UAB, Carrer de Sabino Arana, 5, Barcelona, 08028, Spain.

Background: High tibial osteotomy is an established and helpful treatment for unicompatimental osteoarthritis associated with varus deformity. However, asupratubercle high tibial osteotomy leads to a decrease in patellar height making the technique not suitable in case of concomitant patella baja. Moreover, this kind of osteotomy can change in situ forces at patellofemoral joint and the lateral patellar tilt. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 28. Epub 2019 Feb 28.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.

Purpose: As indications for hip arthroscopy continue to expand, its efficacy in patients with more complex deformities of the hip, such as those with acetabular dysplasia, remains controversial. The purpose of this systematic review is to identify the predictors of failed hip arthroscopy in dysplastic hips and to propose a standardize prognostic sub-classification of dysplasia.

Methods: This systematic review was performed in accordance with the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Read More

Spine (Phila Pa 1976) 2019 Feb 5. Epub 2019 Feb 5.

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Study Design: Observational, anatomical, cadaveric study OBJECTIVE.: To investigate the origins, courses, and distributions of the lumbar arterial branches in relation to the spinal nerves using Japanese cadavers.

Summary Of Background Data: Lumbar arterial branches to the spinal nerves can be damaged during posterior lumbar column osteotomy, leading to neurological complications. Read More

Clin Orthop Relat Res 2019 Feb 6. Epub 2019 Feb 6.

H. D. Thomas-Aitken, J. E. Goetz, K. N. Dibbern, Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA H. D. Thomas-Aitken, J. E. Goetz, K. N. Dibbern, R. W. Westermann, M. C. Willey, T. S. Brown, Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.

Background: Older patients (> 30 years) undergoing periacetabular osteotomy (PAO) to delay THA often have inferior patient-reported outcomes than younger adult patients (< 30 years). It is unclear how patient age affects hip morphology, mechanics, or patient-reported outcome scores.

Questions/purposes: (1) Is increased patient age associated with computationally derived elevations in joint contact stresses? (2) Does hip shape affect computationally derived joint contact stresses? (3) Do computationally derived joint contact stresses correlate with visual analog scale (VAS) pain scores evaluated at rest in the clinic at a minimum of 1 year after surgery?

Methods: A minimum of 1 year of clinical followup was required for inclusion. Read More

Knee 2019 Feb 19. Epub 2019 Feb 19.

Orthopädische Chirurgie München, Steiner Strasse 6, 81369 München, Germany.

Background: The aim was to investigate the clinical results after autologous chondrocyte implantation (ACI) at the patella in a mid- to long-term course, and whether trochlear dysplasia has an influence on the outcome.

Methods: Inclusion criteria were ACI for focal patella cartilage defects and preoperative magnetic resonance imaging (MRI). Patients with previous trochleoplasty or osteotomy have been excluded. Read More

Clin Orthop Relat Res 2018 Sep;476(9):1762-1770

Department of Orthopedics, Second Affiliated Hospital of Zhejiang University School of Medicine/Orthopedics Research Institute of Zhejiang University, Zhejiang, China.

Background: Pelvic ring reconstruction after resection of pelvic malignancies or aggressive benign tumors remains challenging, especially when the tumor invades periacetabular bone, resulting in a Type II resection as classified by Enneking and Dunham (removal of part or all of the acetabulum). Although numerous treatment approaches are in use, none is clearly superior to the others. An alternative involving use of the ipsilateral proximal femur as an autograft has not been well characterized, so we present our preliminary experience with this approach. Read More

Trauma Case Rep 2019 Apr 8;20:100172. Epub 2019 Feb 8.

Orthopaedic Department, Universidade Federal de Minas Gerais, Ave Prof. Alfredo Balena 190, Belo Horizonte, Minas Gerais 30130100, Brazil.

An osteochondral fracture of the posterolateral tibial plateau associated with an anterior cruciate ligament (ACL) injury in a 24-year-old boy is reported. Anterior cruciate ligament rupture is accompanied by bone contusions resulting from the impact of the posterolateral tibial plateau on the anterior part of the lateral femoral condyle. The osteochondral fracture of the posterolateral tibial plateau matched the site where the bone bruise is observed. Read More

Hip Int 2019 Jan;29(1):NP1-NP5

1 Department of Orthopaedic Surgery, Adult Reconstruction, Austral University Hospital, Buenos Aires, Argentina.

Introduction:: Historically the removal of fractured stems was associated with complex revision and loss of bone stock. This study describes a minimally invasive procedure for extraction of the distal part of a broken cemented stem that does not compromise the bone stock and results with the cement-in-cement reconstruction technique.

Materials And Method:: 7 patients with an average age of 74 years who underwent total hip replacement (THR) revision for fracture of femoral stems were included. Read More

Am J Sports Med 2019 Jan;47(1):112-122

Child and Young Adult Hip Preservation Program, Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.

Background:: Controversy surrounds the classification and treatment of hips with a lateral center-edge angle (LCEA) between 18° and 25°. It remains undetermined as to whether periacetabular osteotomy (PAO) or arthroscopic surgery is best used to treat this patient population.

Hypothesis:: Patients with hip pain and mild or borderline acetabular dysplasia defined by an LCEA between 18° and 25° have different features of acetabular and femoral morphology, as determined by other relevant radiographic measures assessing the anterior and posterior acetabular walls, anterior coverage of the femoral head by the acetabulum, and femoral head and neck junction sphericity. Read More

Am J Sports Med 2019 Jan;47(1):123-130

American Hip Institute, Westmont, Illinois, USA.

Background:: Appropriate patient selection is critical when hip arthroscopy is considered in the setting of borderline dysplasia (BD). It is presumable that excessive femoral anteversion (EFA) and BD may contraindicate arthroscopy.

Hypothesis:: Patients with combined EFA and BD (EFABD) demonstrate significantly inferior short-term outcomes after arthroscopic labral preservation and capsular closure when compared with a similar control group with normal lateral coverage and femoral anteversion. Read More

J Surg Orthop Adv 2018 ;27(4):329-334

Department of Orthopaedic Surgery, Sports Medicine, and Shoulder Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; e-mail:

The goal of orthopaedic treatment in chronic poliomyelitis is to address the functional impairments resulting from muscular imbalances and bony deformities. The most common knee deformity is a flexion contracture seen in the sagittal plane. Inappropriate or overcorrections of these deformities can have devastating long-term consequences. Read More

J Surg Orthop Adv 2018 ;27(4):325-328

Department of Orthopaedic Surgery, University of Illinois at Chicago.

The goal of this study was to define the course of the popliteal artery (PA) and determine any variability among different patient demographics; by identifying risk factors for injury, surgeons can decrease patient morbidity and mortality. Ninety-four adult magnetic resonance imaging studies of the knee were reviewed. In extension, the artery is at most 7. Read More

Vet Surg 2019 Feb 17. Epub 2019 Feb 17.

Laboratory of Biomechanics and Applied Anatomy, Koret School of Veterinary Medicine, Rehovot, Israel.

Objective: To evaluate the effect of tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTA) on craniocaudal stability of the cranial cruciate ligament (CCL) deficient stifle at 3 joint angles.

Study Design: Ex vivo biomechanical study.

Sample Population: Eight stifles from 4 dogs. Read More

Med Eng Phys 2019 Feb 14. Epub 2019 Feb 14.

Biomechanics and Sport Engineering Group, Biomedical Engineering Department, Amirkabir University of Technology, Hafez Ave., Tehran, Iran.

Varus misalignment of the hip-knee-ankle angle causes greater loads on the medial compartment of the knee and increases the risk of developing knee osteoarthritis. High tibial osteotomy is a surgical method where the load-bearing axis is shifted laterally. The purpose of this study is to define a subject-specific three-dimensional multibody model of the knee to investigate the effect of osteotomy on cartilages and menisci during the stance phase of gait. Read More

J Knee Surg 2019 Feb 14. Epub 2019 Feb 14.

Department of Orthopaedic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.

Rotational malalignment between the femoral and tibial components in total knee arthroplasty (TKA) can affect clinical outcomes, but there is no consensus on how to best determine tibia tray orientation. The posterolateral corner-locked (PLCL) technique may be a new method. This study aims to assess the applicability of this technique in a Chinese population. Read More

J Pediatr Orthop 2019 Feb 11. Epub 2019 Feb 11.

Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.

Background: Retrograde percutaneous pinning often involves intra-articular pin placement. Classic teaching has cautioned about the risk of septic arthritis with intra-articular pins, although an incidence has not been reported for this complication. The purpose of this study was to determine the incidence of pin tract infections and septic arthritis following retrograde percutaneous pinning of the distal femur. Read More

Eur J Orthop Surg Traumatol 2019 Feb 13. Epub 2019 Feb 13.

II. University Department of Orthopaedic and Trauma Surgery, University Hospital Bratislava, Antolska 11, 851 07, Bratislava, Slovak Republic.

Introduction: The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem.

Methods: We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49. Read More

Hip Int 2018 Nov;28(2_suppl):73-77

1 Orthopaedic and Traumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Background:: The new double-conical tapered stem is a novel cementless modular system, which is indicated for both primary and revision surgeries. It has been designed with different angles at the proximal (5°) and distal sections (1° 36') in order to obtain optimal fixation by proximal and distal fit and fill of the femoral canal.

Aim:: The aim of this prospective study was to evaluate the short-term clinical and radiographic outcomes of primary and revision hip surgery with the new double-conical stem. Read More

J Knee Surg 2019 Feb 12. Epub 2019 Feb 12.

Limb Lengthening and Complex Reconstruction Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.

Blood loss remains a significant source of morbidity and mortality in orthopaedic surgery, with transfusions associated with an increased risk of infection, length of stay, delayed rehabilitation, and significantly increased hospitalization costs. The purpose of this study was to assess whether the use of tranexamic acid (TXA) is effective in reducing postoperative blood loss in patients undergoing distal femoral osteotomy (DFO). A retrospective review was performed of all patients undergoing DFO by a single surgeon from 2010 to 2017, with a change in protocol occurring in 2014, after which all patients received TXA. Read More

J Orthop Case Rep 2018 Sep-Oct;8(5):86-88

Department of Orthopedics and Trauma, CHUV Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland.

Introduction: Osteogenesis imperfecta (OI)-related femoral neck fractures are rare. This is rarely described in the literature. This article presents a way to surgically treat such a fracture. Read More

J Orthop Case Rep 2018 Sep-Oct;8(5):50-53

Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center, Hamburg-Eppendorf, Martinistraße, 52, 20246 Hamburg, Germany.

Introduction: Morquio A syndrome or mucopolysaccharidosis type IVA (MPS IVA) is a progressive lysosomal storage disorder caused by an N-acetylgalactosamine-6-sulfatase deficiency. The abnormal metabolism of glycosaminoglycans among other medical problems leads to various skeletal disorders caused by a dysfunction of endochondral ossification of epiphyseal cartilage. Severe hip dysplasia is common and can lead to pain and impaired mobility. Read More

Arch Orthop Trauma Surg 2019 Feb 8. Epub 2019 Feb 8.

Department of Trauma Surgery, University Hospitals Leuven, 3000, Leuven, Belgium.

Introduction: Re-establishing anatomic rotational alignment of shaft fractures of the lower extremities remains challenging. Clinical evaluation in combination with radiological measurements is important in pre- and post-surgical assessment. Based on computed tomography (CT), a range of reference values for femoral torsion (FT) and tibial torsion (TT) have historically been reported, which require standardization to optimize the significant intra- and inter-observer variability. Read More

J Knee Surg 2019 Feb 8. Epub 2019 Feb 8.

Department of Orthopedics and Traumatology, Klinikum Bamberg, Bamberg, Germany.

This article provides an overview of symptomatic torsional deformities of the lower extremity, and operative treatment techniques are described in detail. A definition of torsion versus rotation as well as information to physical examination and the relevance of radiological evaluation is given. Based on current literature and the own personal experience of the authors in osteotomies, surgical techniques at the proximal and at the distal femur, as well as at the tibia are presented. Read More

J Arthroplasty 2019 Jan 17. Epub 2019 Jan 17.

Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, South Korea.

Background: This study compared the rates of plain radiographs and computed tomography (CT) for detecting lateral hinge fractures and to evaluate factors affecting lateral hinge fractures in patients following medial opening-wedge high tibial osteotomy (MOWHTO).

Methods: This prospective study included 59 patients (65 knees) undergoing MOWHTO for primary medial compartment osteoarthritis with a 2-year follow-up between 2013 and 2016. Clinical and radiographic evaluations were performed using Knee Society Score and Western Ontario and McMaster Universities Arthritis Index, and we calculated the hip-knee-ankle angle, weight-bearing line ratio, lateral distal femoral angle, medial proximal tibial angle, posterior tibial slope, osteotomy gap height, and osteotomy gap filling rate. Read More

J Biomater Appl 2019 Feb 7:885328219825568. Epub 2019 Feb 7.

1 Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.

Biodegradable magnesium (Mg) alloys exhibit improved mechanical properties compared to degradable polymers while degrading in vivo circumventing the complications of permanent metals, obviating the need for surgical removal. This study investigated the safety and efficacy of Mg-Y-Zn-Zr-Ca (WZ42) alloy compared to non-degradable Ti6Al4V over a 14-week follow-up implanted as pins to fix a full osteotomy in rat femurs and as wires wrapped around the outside of the femurs as a cerclage. We used a fully load bearing model allowing implants to intentionally experience realistic loads without immobilization. Read More

Am J Sports Med 2019 Mar 7;47(3):543-551. Epub 2019 Feb 7.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Background:: Previous studies on periacetabular osteotomy (PAO) reported complication and reoperation rates of 5.9% and 10%, respectively. Hip arthroscopy is increasingly utilized as an adjunct procedure to PAO to precisely treat associated intra-articular pathology. Read More