Search Results

You are looking at 1 - 2 of 2 items for

  • Author: Ahmed Mabrouk x
Clear All Modify Search
Ahmed Mabrouk Mid Yorkshire Teaching Hospitals, Yorkshire, United Kingdom
Institut du mouvement et de l’appareil locomoteur, Marseille, France

Search for other papers by Ahmed Mabrouk in
Google Scholar
PubMed
Close
,
Jae-Sung An Institut du mouvement et de l’appareil locomoteur, Marseille, France

Search for other papers by Jae-Sung An in
Google Scholar
PubMed
Close
,
Kristian Kley Orthoprofis Hannover, Hannover, Germany

Search for other papers by Kristian Kley in
Google Scholar
PubMed
Close
,
Komal Tapasvi The Orthopaedic Speciality Clinic, Pune, India

Search for other papers by Komal Tapasvi in
Google Scholar
PubMed
Close
,
Sachin Tapasvi The Orthopaedic Speciality Clinic, Pune, India

Search for other papers by Sachin Tapasvi in
Google Scholar
PubMed
Close
, and
Matthieu Ollivier Institut du mouvement et de l’appareil locomoteur, Marseille, France

Search for other papers by Matthieu Ollivier in
Google Scholar
PubMed
Close

  • Varus knees with associated cartilage pathologies are not uncommon scenarios that present to orthopaedic surgeons.

  • There is no agreement on the ideal management of varus knees with concomitant cartilage pathology.

  • Through a literature review, the authors tried to answer three main questions:

  • On October 2022, OVID MEDLINE, EMBASE, and COCHRANE databases were searched. Clinical studies reporting on clinical, radiologic, or macroscopic cartilage regeneration following either isolated knee osteotomy or concomitant osteotomy and a cartilage procedure were reviewed.

  • Despite controversies, the literature demonstrated favourable outcomes of combined knee osteotomy and a cartilage procedure in patients with substantial deformity and cartilage defects.

  • Isolated high tibial osteotomy may induce cartilage regeneration in several scenarios and severities of concomitant malalignment and cartilage defects.

  • There are recommendations that knee osteotomy should be added to a cartilage procedure when an extra-articular deformity of > 5° is detected.

  • Some studies report good outcomes for combining a knee osteotomy with cartilage grafting, but they lack a control group of isolated osteotomy.

  • There is still scarce of evidence on the influence of osteotomies on cartilage regeneration and the outcomes of concomitant osteotomy and different cartilage procedures vs isolated osteotomies.

  • With advanced statistical evaluation (artificial intelligence, machine learning) of big datasets, more answers and better results will be delivered.

Open access
Johannes D Bastian Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Search for other papers by Johannes D Bastian in
Google Scholar
PubMed
Close
,
Silviya Ivanova Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Search for other papers by Silviya Ivanova in
Google Scholar
PubMed
Close
,
Ahmed Mabrouk Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, United Kingdom

Search for other papers by Ahmed Mabrouk in
Google Scholar
PubMed
Close
,
Peter Biberthaler Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

Search for other papers by Peter Biberthaler in
Google Scholar
PubMed
Close
,
Pedro Caba-Doussoux Servicio de Cirugía Ortopédica y Traumatología, Hospital 12 de Octubre, Madrid, España

Search for other papers by Pedro Caba-Doussoux in
Google Scholar
PubMed
Close
, and
Nikolaos K Kanakaris Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, United Kingdom
Major Trauma Centre, Leeds Teaching Hospitals NHS Trust, University of Leeds, United Kingdom

Search for other papers by Nikolaos K Kanakaris in
Google Scholar
PubMed
Close

  • Segmental femoral fractures represent a rare but complex clinical challenge. They mostly result from high-energy mechanisms, dictate a careful initial assessment and are managed with various techniques. These often include an initial phase of damage control orthopaedics while the initial manoeuvres of patient and soft tissue resuscitation are employed.

  • Definitive fixation consists of either single-implant (reconstruction femoral nails) or dual-implant constructs. There is no consensus in favour of one of these two strategies.

  • At present, there is no high-quality comparative evidence between the various methods of treatment. The development of advanced design nailing and plating systems has offered fixation constructs with improved characteristics.

  • A comprehensive review of the existing evidence with a step-by-step description of these different definitive fixation strategies based on three case examples was conducted. Furthermore, the rationale for using single vs dual-implant strategy in its case is presented with supportive references.

  • The prevention of complications relies mainly on the strict adherence to basic principles of fracture fixation with an emphasis on careful preoperative planning, the quality of the reduction, and the application of soft tissue-friendly surgical methods.

Open access