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Unicompartmental knee arthroplasty vs high tibial osteotomy for knee osteoarthritis:A comparison of clinical and radiological outcomes

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World Journal of Orthopedics 2024年第5期15卷 444-456页

作者： Frederick William Wyatt Oday Al-Dadah Translational and Clinical Research Institute Faculty of Medical SciencesNewcastle UniversityNewcastle Upon Tyne NE24HHUnited Kingdom Department of Trauma and Orthopaedic Surgery South Tyneside District HospitalSouth Shields NE340PLUnited Kingdom

BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients wi

关键词： Arthroplasty osteotomy Medial compartment Osteoarthritis Knee alignment Patient reported outcome measures

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Clinical outcomes of triceps reflecting anconeus pedicle and olecranon osteotomy approach for distal humerus intercondylar fractures

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World Journal of Orthopedics 2024年第6期15卷 570-577页

作者： Rohit Ailani Sanjeev Kumar Bhuyan Brejesh Kumar Prasad Amit Kumar Namrata Dawani Department of Orthopaedics Lovee Shubh HospitalLucknowUttar Pradesh 226002India Department of Orthopaedics Gauhati Medical CollegeGuahati 781032India Department of Orthopaedics ESIC Medical College and HospitalFaridabadHaryana 121001India Department of Orthopaedics All India Institute of Medical SciencesKalyaniWest Bengal 741245India Department of Obstetric and Gynecology Kannauj Medical CollegeKannaujUttar Pradesh 209732India

BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.

关键词： Elbow joint Humeral fracture osteotomy Internal Fracture fixation

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osteotomy Protocol for Implant Insertion of One Day Biotech: One Drill, One Implant

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Open Journal of Stomatology 2024年第5期14卷 255-277页

作者： Jin Hwan Kim Jaehyun Song Jaegyun Choi Jose Francisco Ballester Ireh Kim Santiago Jose Ballester Private Practice Seul South Korea Private Practice Valencia Spain Seul South Korea

Background: Four factors determine the quality of an implantology kit: 1) Heat generated by the drills;2) Morphology of the osteotomy according to the diameter of the implant;3) Efficiency of collecting autologous bone;and 4) osteotomy execution time. Materials and Methods: This article examines the heat produced by drills during osteotomy, focusing on the effect of the following factors: drilling technique;volume of autologous bone harvested;drilling time;implant primary stability;and the percentage of osseointegrated implants after primary healing. Discussion: The four factors mentioned above are analyzed based on the data obtained for sequential, biological, and One Drill milling techniques. Conclusions: 1) One Drill is the fastest technique for performing the osteotomy;2) All techniques stay within the biological temperature range of living bone, with the lowest increase in temperature achieved using One Drill with irrigation;3) The bone harvested showed no statistically significant differences between biological milling and the One Drill technique, both far superior to the sequential technique;and 4) There is no statistically significant difference in the number of osseointegrated implants among the three techniques analyzed.

关键词： Dental Implant Bur Primary Stability Drilling Time osteotomy Irrigation Bone Collected

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Knee Osteoarthritis Progression after Distal Femur Closing Wedge osteotomy

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Open Journal of Orthopedics 2024年第4期14卷 187-199页

作者： Ferdinand Nyankoué Mebouinz Khalifa Fall Kennedy Muluem Justine Raphaela Nyekel Moustapha Niane Alioune Badara Gueye Daniel Handy Eone Charles Valerie Kinkpé Department of Surgery and Specialties The Faculty of Medicine and Biomedical Sciences The University of Yaound&#233 I Yaound&#233 Cameroon Department of Orthopedic and Trauma Surgery Cheikh Anta Diop University of Dakar Dakar Senegal Department of Surgery and Specialties The Faculty of Medicine and Pharmaceuticals Sciences The University of Douala Douala Cameroon

Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.

关键词： Knee Osteoarthritis Progression osteotomy Distal Femur

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osteotomy combined with the trephine technique for invisible implant fracture:A case report

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World Journal of Clinical Cases 2022年第16期10卷 5479-5486页

作者： Liang-Wen Chen Min Wang Hai-Bin Xia Dong Chen Department of Oral Implantology School and Hospital of StomatologyWuhan UniversityWuhan 430079Hubei ProvinceChina

BACKGROUND Implant fracture is one of the most serious mechanical complications of dental implants.Conventional treatment necessitates visibility of the apical portion of the fractured implant,whereas for deep and invisible implant fractures,the traditional trephine method has been ineffective.Surgical removal of the marginal bone to expose the fracture surface would be a time-consuming and extensively damaging procedure.Here,we propose a novel technique to address invisible implant fractures.CASE SUMMARY A 50-year-old woman was referred to our department with the chief complaint that her right mandibular implant tooth had fallen out 3 mo earlier.Cone-beam computed tomography examination showed an implant fracture with a fracture surface 5.1 mm below the crestal ridge.The patient was treated with osteotomy combined with the trephine technique to expose the surgical field and remove the implant.The invisible fractured implant was successfully removed,with minimal trauma.A modified Wafer technique-supported guided bone regeneration treatment was then administered to restore the buccal bone wall and preserve the bone mass.Six months later,fine regenerative bone and a wide alveolar crest in the edentulous area were observed,and a new implant was placed.Four months later,restoration was completed using a cemented ceramic prosthesis.Clinical and radiographic examinations 12 mo after loading fulfilled the success criteria.The patient reported no complaints and was satisfied.CONCLUSION osteotomy combined with the trephine technique can be effectively used to address deep and invisible implant fractures.

关键词： Dental implant Invisible implant fracture osteotomy Explanation trephine Transformed Wafer technique Case report

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osteotomy Techniques for Spinal Deformity

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Chinese Medical Journal 2016年第21期129卷 2639-2641页

作者： Wen-Hao Hu Yan Wang Department of Orthopedics Chinese People's Liberation Army General Hospital Beijing 100853 China

The aging population has led to increasing number of patients with spinal deformities.Such deformities can be congenital,idiopathic,or inflammatory in origin and can be functionally and psychologically debilitating.Os... 详细信息

关键词： Congenital Abnormalities Balance osteotomy Spine

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Hip survival rate in the patients with avascular necrosis of femoral head after transtrochanteric rotational osteotomy: a systematic review and meta-analysis

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Chinese Medical Journal 2019年第24期132卷 2960-2971页

作者： Ying-Xing Xu Yuan-Zhong Ren Zhi-Ping Zhao Ying-Zhen Wang Teng Wang Tao Li Department of Joint Surgery The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266003China Qingdao University QingdaoShandong 266071China Medical Department Qingdao UniversityQingdaoShandong 266071China

Background:The clinical outcome of transtrochanteric rotational osteotomy(TRO)for osteonecrosis of the femoral head(ONFH)remains controversial,and the promising clinical results of several Japanese studies could not be reproduced in American and European studies.Trying to solve controversies on TRO for ONFH rising from apparently conflicting studies,a meta-analysis was conducted to assess the 5-and 10-year hip survival rates(with conversion to artificial joint replacement and radiographic failure as endpoints)after TRO.Methods:All eligible studies were searched in seven comprehensive databases including PubMed,Web of Science,Embase,Cochrane Library,VIP Database,China Knowledge Resource Integrated Database,and Wan Fang Database prior to June 2019.The outcomes evaluated were 5-and 10-year hip survival rates after TRO.The odds ratio and risk difference for the noncomparative binary data with the 95%confidence intervals(CIs)were calculated for each outcome.The included studies were assessed for methodologic bias and potential reasons for heterogeneity were explored.Results:Nineteen studies of TRO for ONFH were eligible for this meta-analysis according to inclusion criteria.Based on the previous report,two calculation methods(Methods 1 and 2)were adopted in this meta-analysis.Furthermore,we performed a subgroup analysis of the 5-and 10-year hip survival rates(Method 1)after TRO for ONFH:Asian sub-population and non-Asian subpopulation.Taking conversion to artificial joint replacement as the endpoint,5-and 10-year hip survival rates(Method 1)after TRO for ONFH in the Asian population were 0.86(95%CI=0.82–0.89)and 0.72(95%CI=0.65–0.78),respectively,and 5-and 10-year hip survival rates after TRO for ONFH in the non-Asian population were 0.55(95%CI=0.43–0.67)and 0.42(95%CI=0.28–0.55),respectively.The 5-and 10-year hip survival rates(Method 2)after TRO for ONFH were 0.90(95%CI=0.79–0.95)and 0.89(95%CI=0.81–0.94),respectively.Taking radiographic failure as the endpoint,5-and 10-year hip survival rates after TRO for ONFH wer

关键词： Meta-analysis Osteonecrosis Femoral head Hip osteoarthritis Joint preserving treatments Transtrochanteric rotational osteotomy Survival rate

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A modified posterior wedge osteotomy with interbody fusion for the treatment of thoracolumbar kyphosis with Andersson lesions in ankylosing spondylitis:a 5-year follow-up study

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Chinese Medical Journal 2020年第2期133卷 165-173页

作者： Hong-Yu Wei Chun-Ke Dong Yu-Ting Zhu Jun Zhou Ping Yi Feng Yang Ming-Sheng Tan Department of Orthopaedic Surgery China-Japan Friendship HospitalBeijing 100029China Graduate School Beijing University of Chinese MedicineBeijing 100029China Department of Education China-Japan Friendship HospitalBeijing 100029China

Background:Andersson lesions(ALs),also known as spondylodiscities,destructive vertebral lesions and spinal pseudarthrosis,usually occur in patients with ankylosing spondylitis(AS).Inflammatory and traumatic causes have been proposed to define this lesion.Different surgical approaches including anterior,posterior,and combined anterior and posterior procedure have been used to address the complications,consisting of mechanical pain,kyphotic deformity,and neurologic deficits.However,the preferred surgical procedure remains controversial.The aim of this study was to illustrate the safety,efficacy,and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in AS.Methods:From June 2008 to January 2013,23 patients(18 males,5 females)at an average age of 44.8 years(range 25–69 years)were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our department.All sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the followup period.Assessment of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading system.Ankylosing spondylitis quality of life(ASQoL)and visual analog scale(VAS)scores were performed to evaluate improvements in daily life function and back pain pre-operatively and post-operatively.Paired t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric comparisons.The radiographic data change was evaluated by repeated measure analysis of variance.Results:The mean operative duration was 205.4 min(range 115–375 min),with an average blood loss of 488.5 mL(range 215–880 mL).Radiographical and clinical outcomes were assessed after a mean of 61.4 months of follow-up.The VAS back pain and ASQoL scores improved significantly in all patients(7.52±1.31 vs.1.70±0.70,t=18.30,P<0.001;13.87±1.89 vs.7.22±1.24,t=18.53,P<0.001,respectively).The thoracolumbar kyp

关键词： Ankylosing spondylitis Andersson lesions Kyphosis Modified posterior wedge osteotomy

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Varus ankle arthritis: a modified operation with a novel osteotomy and lateral hinge plate fixation technique

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Chinese Medical Journal 2019年第24期132卷 2998-3000页

作者： Xiao-Hui Gu Xin-Ji Chen Chao Sun Jian-Zhong Zhang Zong-Ping Luo Drthopaedic Institute Department of OrthopaedicsThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215007China Department of Orthopaedic Surgery Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical CollegeHangzhouZhejiang 310014China Department of Orthopedics The Second Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325027China Department of Orthopedics Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China

Ankle arthritis is a disease characterized by degeneration of articular cartilage,which is always accompanied with pain,decreased mobility,and varus deformity.Supramalleolar osteotomy is a reliable techniques in the treatment of arthritis.It can correct deformities at the distal tibia and normalize the load-bearing axis,and thereby reduce the unusual compression to the articular cartilage,alleviate pain,and improve functionality.The shortcomings include the frequent intra-operative fluoroscopy and no early exercise or weight-bearing.What is more,in the process of distracting the tibia after osteotomy,the separation of contralateral cortical bone often occurs.Takeuchi et al[1]reported that fracture and disruption of the lateral cortex would result in distinct instability to the osteotomy.Miller et al[2]noted that this complication contributed to the loss of angular correction,implant failure,delayed union even non-union of the osteotomy.In this study,we reported a modified osteotomy with a preshaped plate and novel osteotomy to overcome these shortcomings.

关键词： osteotomy operation union

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The height of the osteotomy and the correction of the kyphotic angle in thoracolumbar kyphosis

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Chinese Medical Journal 2008年第19期121卷 1906-1910页

作者： HAO Chou-kuan LI Wei-shi CHEN Zhong-qiang Department of Orthopaedics Peking University Third HospitalBeijing 100083 China

Background This study investigated the relationship between the height of osteotomy and the correction of the kyphotic angle during posterior closing wedge osteotmy with instrumentation and the spinal osteotomy with cage inserting into the intervertebral gap and closing posteriorly by a single posterior approach in thoracolumbar kyphosis, and using this relationship as the basis of the preoperative design. Methods From April 1996 to June 2007, 30 thoracolumbar kyphosis patients with complete medical records and clear X-ray photograms have undergone operation. Of these 30 cases, 16 cases underwent posterior closing wedge osteotmy with instrumentation while the height of the osteotomy and the correction of the angle have been measured; 14 cases underwent spinal osteotomy with cage inserting into the intervertebral gap and closing posteriorly by a single posterior approach while the height of the osteotomy, the height and the place of the cage and the correction of the angle were also measured. A simple geometrical model was simulated to calculate the relationship between the height of the oeteotomy and the correction of the angle and these results are finally compared with the data coming from the actual measuring by the Wilcoxon statistic method. Results The distribution of data from the 16 cases by posterior closing wedge osteotomy with instrumentation was as such： 9 male and 7 female, the mean age was 49.2 years （range 38--70）, the kyphosis improved from an average of 30° （range 15°--45°） preoperatively to 4° （range -26°--30°） postoperatively, the kyphosis was corrected on average 2.5-0 per 1 mm in the height of the osteotomy. The results from the simple geometrical model were that the mean of the correction of the angle per 1 mm was 2.2°. As a result, there was no significant difference （P 〉0.05） when comparing the measurement collected with the result simulated from the geometric model. The distribution of data from the 14 cases by spinal osteotomy with cage inserting into the intervertebral gap and closing po

关键词： kyphosis osteotomy operative therapy

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