this retrospective study shows the clinical and radiological importance of meniscal repair. Successful results in this study were associated with younger age and earlier repair using inside-out technique. Furthermore, increased success was seen in meniscal repairs performed in association with ACL reconstruction.
Leg length is restored by HRA and THA. A difference remains in offset after HRA although we attribute this to intentional medialisation of the acetabular cup.
The aim of this study was to assess the applicability and ability of preoperative templating to restore femoral offset and hip length with a calcar-guided short-stem implant design in total hip arthroplasty through the direct anterior approach. Preoperative measurements were performed of femoral offset, hip length, and stem size and compared with the perioperative placed prosthesis in 100 patients undergoing primary total hip replacement through direct anterior approach. Additionally, the pre- and postoperative femoral offset and hip length were compared to evaluate the ability to restore the offset and hip length with this kind of femoral short stem. With an acceptance of 1 size difference pre- and postoperatively, a 94% accuracy of predicting the size of the calcar-guided short stem was achieved with templating. Femoral offset was within means of 5 mm in 82.2% of the patients. Postoperative hip length was within 6 mm in 90% of the patients compared with the preoperative length.The use of preoperative templating for total hip arthroplasty with calcar-guided short-stem implants was proven to be a useful tool to predict the definite implanted size of the femoral prosthesis. Our results show that this new stem design does not significantly differ from previous reported outcomes with other stem designs and is competent to restore the femoral offset and hip length within clinical acceptable range.
Level of evidence Level 3 retrospective case study.
A biomechanical in vitro study was performed on 16 fresh frozen cadaver forearms to investigate the role of the transverse carpal ligament (TCL) in carpal stability.The distance between the scaphoid and hamate was measured, as a reference for the length of the TCL. Distances were recorded in both loaded and unloaded conditions after gradual sectioning of the transverse carpal ligament, the palmar scapholunate, long radiolunate ligament and radioscapholunate ligament.The largest increase in spread of the carpal bones (55% of total spread) was noted after loading with the ligament intact. Thereafter, sectioning of the TCL resulted in a further 32.9% increase in the distance between the scaphoid and the hamate.We conclude that the intact carpal bones‐ligament complex displays some elasticity. Progressive sectioning of the TCL ligament under loading further opens the palmar arch.Nevertheless it appears that the carpal arch will still retain reasonable intrinsic stability even without an intact TCL.
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