Université Claude Bernard Lyon 1, Villeurbanne, France
Centre de Références des IOA Complexes de Lyon, CRIOAc Lyon, Lyon, France
StaPath team, Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
Education and Clinical Officer of the ESCMID Study Group for Non-traditional Antibacterial Therapy (ESGNTA)
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Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium
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Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium
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). Although the biofilm is a well-known problem in MSIs, the increasing incidence of antimicrobial resistance (AMR) is potentially even more worrisome. The most frequently isolated pathogen in MSI is Staphylococcus aureus (30–42%) ( 8 ). Despite a decrease
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Biomechatronics Group, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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, 2 63% of amputees suffer from one or more skin problems that lead to daily routine activity limitations in one third of these patients. 3 Around 70% of amputees develop phantom limb pain (PLP) or residual limb pain (RLP), 4 14.5% of
Division of Orthopaedics and Trauma Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
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Faculty of Medicine, University of Berne, Berne, Switzerland
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tip ( 101 , 102 , 104 ). The long-term results of the Lord and AML stems and the problems encountered at revision led to the creation of the TriLock stem, introduced in 1981 ( 105 ). The porous coating was limited to the proximal area, in order to
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Modular neck (MN) implants can restore the anatomy, especially in deformed hips such as sequelae of development dysplasia.
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Early designs for MN implants had problems with neck fractures and adverse local tissue, so their use was restricted to limited indications.
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Results of the latest generation of MN prostheses seem to demonstrate that these problems have been at least mitigated.
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Given the results of the studies presented in this review, surgeons might consider MN total hip arthroplasty (THA) for a narrower patient selection when a complex reconstruction is required.
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Long MN THA should be avoided in case of body mass index > 30, and should be used with extreme caution in association with high offset femoral necks with long or extra-long heads. Cr-Co necks should be abandoned, in favour of a titanium alloy connection.
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Restoring the correct anatomic femoral offset remains a challenge in THA surgeries.
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MN implants have been introduced to try to solve this problem. The MN design allows surgeons to choose the appropriate degree and length of the neck for desired stability and range of motion.
Cite this article: EFORT Open Rev 2021;6:751-758. DOI: 10.1302/2058-5241.6.200064
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Long bone non-unions represent a serious clinical and socioeconomical problem due to the prolonged episodes, frequent sequelae, and variable treatment effectiveness.
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Bone grafts, classically involving the autologous iliac crest graft as the ‘gold standard’ bone graft, enhance bone regeneration and fracture healing incorporating osteoconductive and/or osteoinductive/osteogenic capacity to the non-union under treatment.
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Structural alternatives to autologous bone grafts include allografts and bone substitutes, expanding the available stock but loosing biological properties associated with cells in the graft.
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Biological alternatives to autologous bone grafts include bone marrow concentration from iliac crest aspiration, bone marrow aspiration from reaming of the diaphyseal medullary canal in the long bones, and isolated, expanded mesenchymal stem cells under investigation.
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When the combination with natural and synthetic bone substitutes allows for larger volumes of structural grafts, the enhancement of the biological regenerative properties through the incorporation of cells and their secretoma permits to foresee new bone grafting solutions and techniques.
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Graft size in hamstring autograft anterior cruciate ligament (ACL) surgery is an important factor directly related to failure. Most of the evidence in the field suggests that the size of the graft in hamstring autograft ACL reconstruction matters when the surgeon is trying to avoid failures.
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The exact graft diameter needed to avoid failures is not absolutely clear and could depend on other factors, but newer studies suggest than even increases of 0.5 mm up to a graft size of 10 mm are beneficial for the patient. There is still no evidence to recommend the use of grafts > 10 mm.
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Several methods – e.g. folding the graft in more strands – that are simple and reproducible have been published lately to address the problem of having an insufficient graft size when performing an ACL reconstruction. Due to the evidence presented, we think it is necessary for the surgeon to have them in his or her arsenal before performing an ACL reconstruction.
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There are obviously other factors that should be considered, especially age. Therefore, a larger graft size should not be taken as the only goal in ACL reconstruction.
Cite this article: EFORT Open Rev 2018;3:93-97. DOI: 10.1302/2058-5241.3.170038
School of Medicine, Universidad de La Laguna, Tenerife, Spain
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School of Medicine, Universidad de La Laguna, Tenerife, Spain
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University of Basel, Basel, Switzerland
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School of Medicine, Universidad de Sevilla, Sevilla, Spain
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Osteoporotic ankle fractures result from mechanical forces that would not ordinarily result in fracture, known as ‘low-energy’ trauma, such as those equivalent to a fall from a standing height or less.
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Osteoporotic ankle fractures in frail patients are becoming more and more frequent in daily practice and represent a therapeutic challenge for orthopaedic surgeons.
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The main problems with frail patients are the poor condition of the soft tissues around the ankle, dependence for activities of daily living and high comorbidity.
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The decision to operate on these patients is complex because conservative treatment is poorly tolerated in unstable fractures and conventional open reduction and internal fixation is associated with a high rate of complications.
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The authors conducted a narrative review of the literature on primary tibiotalocalcaneal nailing of ankle fractures in frail patients and categorized the different factors to consider when treatment is indicated for this conditon. Difficulty of ambulation, age over 65 years old, deteriorated baseline state and instability of the fracture were the most frequently considered factors.
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Finally, the authors propose an easy and quick clinical scoring system to help in the decision-making process, although further comparative studies are required to explore its validity.
Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
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Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
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knee or hip problems, not being able to walk further than the corner of the street due to back problems, or not being able to hold a grandchild due to problems of the wrist or shoulder is not life-threatening, such as other (chronic) diseases (e
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particle-producing implant that destroys the surrounding skeleton and soft tissues. Early identification of potential problems will save much unnecessary operative activity or the use of massive implants to fill large, avoidable, defects. Registry data can
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demanding and emotional relationship with his students whom, he freely admitted, he did not hesitate to bully, because he wanted to get the best out of them. This did not prevent him from worrying about a family or a personal problem after having reprimanded
