Orthopedic Reviews 2019-02-20T09:33:25+01:00 Emanuela Fusinato Open Journal Systems <p><strong>Orthopedic Reviews</strong> is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome.&nbsp;The journal publishes original articles, brief reports, reviews and case reports of general interest.</p> Effectiveness of lumbar orthoses in low back pain: Review of the literature and our results 2019-02-20T09:33:18+01:00 Cordelia Schott Sonja Zirke Jillian Marie Schmelzle Christel Kaiser Lluis Aguilar i Fernández <p>Back pain and diseases of the spine are today a health disorder of outstanding epidemiological, medical, and health economic importance. The cost of care for patients with lumbosciatic complaints are steadily increasing. Accordingly, the guidelines and treatments are constantly renewed. One concept is the orthotic care. In the following we want to give an overview of the literature and the effectiveness of lumbar orthoses in low back pain supplemented by our own data. A prospective randomized study with 230 patients, divided into three groups, each with two subgroups. Three Orthoses by the TIGGES-Zours GmbH were prescribed; a demountable two-step lumbar orthosis, three-step bridging orthosis and a four-step flexion orthosis modular system. Each were compared to the nonmodular equivalent. All six groups showed improvement in pain intensity and functional capacity at 6 and 12 weeks. The modular groups were found to have improvement in the frequency of use. The subjective effectiveness and sensitivity for the modular and non-modular groups was assessed as being good. In the literature, there are no clear guidelines for an orthotic supply. The studies do not seem to be meaningful and universal due to the difficult ascertainability of pain. There is a need for further research here. Nevertheless, the authors of this review are of the opinion that the implementation of trunk orthoses is void of side effects and beneficial to patients. The modular systems seem to have an advantage as well as higher patient satisfaction.</p> 2018-12-06T08:17:31+01:00 ##submission.copyrightStatement## Pharmacological treatment of knee osteoarthritis: Special considerations of the new German guideline 2019-02-20T09:33:13+01:00 Juergen Steinmeyer Fritjof Bock Johannes Stöve Jörg Jerosch Johannes Flechtenmacher <p>The pharmacological treatment of knee osteoarthritis (OA) is a purely symptomatic therapy, which often ensures that the mobility of the patient is successfully retained. This article refers to the recommendations and opinions regarding the pharmacotherapy of knee OA contained in the new guideline of the Association of the Scientific Medical Societies in Germany (AWMF), highlighting several important aspects and describing the considerations underlying the decision-making process. With this article it is hoped that therapeutic effectiveness can be realistically estimated, that any risks of medication errors and avoidable side effects can be reduced, and that further helpful measures can be taken into consideration.</p> 2018-12-12T10:54:11+01:00 ##submission.copyrightStatement## The 50 most cited articles about wrist surgery 2019-02-20T09:33:23+01:00 Nicola Piolanti Andrea Poggetti Anna Maria Nucci Agnese Nesti Stefano Marchetti Paolo Domenico Parchi Michelangelo Scaglione <p>The purpose was to establish a ranking of the 50 most cited articles about wrist surgery and analyse their features. Science Citation Index Expanded was used to identify the 50 most frequently cited orthopaedic journal articles written in English, searching for the topic “wrist surgery” in the subject category ‘‘Orthopaedics’’. Then, we analysed the number of citations, citation density, authorship, article institution, the year of publication, the country of origin of the article, name and impact factor of the journal, and publication type of the article. The 50 most cited articles were published in only 6 of the 74 journals included under the category “orthopaedics”. Citation count ranged from 256 for the first one to 67 for the 50th article. Most of them were written by American authors. These articles were published between 1991 and 2011. “Distal Radius Fractures” was the most common issue. This type of bibliographic analysis could be particularly useful for other young Authors who would like to improve their research in wrist and hand surgery and make their publications more citable and appreciated by the scientific community.</p> 2018-12-06T07:56:19+01:00 ##submission.copyrightStatement## Effect of intrasite vancomycin powder on development of epidural fibrosis 2019-02-20T09:33:20+01:00 Benjamin Clippinger Mark Ayzenberg Michael Narvaez Dillon Arango Corrado Minimo Joshua Pahys John Handal <p>Placement of vancomycin powder into the surgical wound prior to closure has been shown to reduce postoperative infections in spine surgery. This study examines the effect of vancomycin powder on formation of epidural fibrosis (EF). Twenty-two rats underwent a two-level lumbar laminectomy. A control group, a low-dose and a high dose vancomycin powder (applied prior to closure) group was formed. Rats were sacrificed at 30 days and a blinded fellowshiptrained pathologist evaluated the laminectomy segments for EF. 50% of the samples in the high-dose vancomycin group were EF grade 3, compared to 20% of the low-dose and 16.7% of control samples. The average fibrosis grade for the high dose, low dose and control groups were 2.4, 1.4 and 1.8, respectively. There were more grade 3 EF specimens in the high dose vancomycin group. While the average EF grade was also higher in this group, there was not a statistical difference compared with the other groups.</p> 2018-12-06T08:06:28+01:00 ##submission.copyrightStatement## Digital templating of rotating hinge revision and primary total knee arthroplasty 2019-02-20T09:33:17+01:00 Peter Savov Henning Windhagen Carl Haasper Max Ettinger <p>Preoperative digital templating in total knee arthroplastiy (TKA) is useful in predicting implant size, the level of bone resections and the need for special implants. This study should evaluate the templating of a rotating hinge prosthesis and the realization of the preoperative plan. Two observers with different experience levels templated 40 cases which received TKA and R-TKA using digital planning on standard preoperative x-rays. The examiners templated all cases independently and were blinded to the component sizes used intraoperatively. The kappa coefficient and Pearson coefficient were determined. The accuracy in predicting the correct implant size in revision TKA varied from 67,9% to 82,1% depending on the training level of the observer. The two observers show <em>moderate</em> and <em>substantial</em> correlation. The coefficient indicates a substantial agreement in between the two observers in templating revision TKA. The accuracy depends on the experience of the observer. In the cases were the templating was incorrect, the prosthesis was implanted smaller than the preoperative plan. With this knowledge very good results can be made with this prosthesis.</p> 2018-12-06T08:29:21+01:00 ##submission.copyrightStatement## Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients 2019-02-20T09:33:15+01:00 Sheyan J. Armaghani Zachary J. Grabel Catphuong Vu S. Tim Yoon <p>The purpose of this investigation was to evaluate the variations in the treatment of C1 fractures over time, by age group, and by geographic region using a nationwide database. The Nationwide Emergency Department Sample (NEDS) database was queried to identify patients ≥18 years who sustained C1 fracture from 2006-2012. Patients were filtered based on the intervention they received: collar, halo, or surgery. Regions of hospital used in analysis were defined as Northeast, Midwest, South, and West. Surgical intervention for C1 fracture increased from 27.1% of cases in 2006 to 55.4% of cases in 2012 (P&lt;0.001). The rate of collar treatment increased with increasing age. In contrast, rate of halo use decreased with increasing age. A greater proportion of patients in the Northeast were treated by collar compared to all other regions (P&lt;0.001). We can conclude that there is considerable variation in the treatment of C1 fractures with regards to age and geographic region. Surgical treatment of these fractures is increasing over time. Future considerations should be given to developing treatment guidelines to decrease variation and potentially create cost-savings.</p> 2018-12-06T08:49:52+01:00 ##submission.copyrightStatement## The reliability of remembered pre-operative patient-rated wrist and hand evaluation (PRWHE) scores 2019-02-20T09:33:25+01:00 Vilhjalmur Finsen Sigrun Hillesund Ida Fromreide <p>In clinical audits where pre-operative patient-rated wrist and hand evaluation (PRWHE) scores were not recorded, it would be useful if such scores could be recreated at the time of review. We recorded a PRWHE score during the last week before surgery for 143 patients. They were contacted after 21 months and asked to furnish a new PRWHE of the state they were in during the last week before surgery. 80 (56%) of the patients responded. The mean difference was 10 (SD: 20; SEM: 2) higher remembered pre-operative score. The limits of 95% agreement for individual scores were -29 and 50, while the 95% confidence interval of the mean was 6-15. If 10 is subtracted from the mean remembered preoperative score of a group of patients, the real pre-operative score will with 95% confidence be this score plus/minus 4. Remembered pre-operative PRWHE scores are far too inaccurate to be of value in individual patients. It may be possible to predict the mean real pre-operative PRWHE score in groups of patients with useful accuracy using the remembered pre-operative score.</p> 2018-12-06T00:00:00+01:00 ##submission.copyrightStatement## ERRATUM: Surgical treatment of a chronically fixed lateral patella dislocation in an adolescent patient 2019-02-20T09:33:11+01:00 Xinning Li Natalie M. Nielsen Hanbing Zhou Beth Ellen Shubin Stein Yvonne A. Shelton Brian D. Busconi <p>Due to a technical error, part of the surname of an author (<em>i.e.</em> Stein instead of Shubin Stein) was omitted in the original published version of this paper [Orthop Rev (Pavia). 2013;5:45-7. doi: 10.4081/or.2013.e9].</p> 2018-12-12T11:04:39+01:00 ##submission.copyrightStatement##