Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 6/2008

01.06.2008 | Original Article

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

verfasst von: Petri Sillanpää, MD, Ville M. Mattila, MD, PhD, Tuomo Visuri, MD, PhD, Heikki Mäenpää, MD, PhD, Harri Pihlajamäki, MD, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 6/2008

Einloggen, um Zugang zu erhalten

Abstract

Recently, medial patellofemoral ligament reconstruction has been emphasized for the treatment of patellar dislocation. This study compared the results of medial patellofemoral ligament reconstruction by adductor magnus tenodesis with distal patellar realignment in patients with recurrent patellar dislocation. Additionally, the development of patellofemoral osteoarthrosis was compared for these two procedures at a median 10-year followup. Between 1994 and 2000, 47 consecutive patients were treated for recurrent patellar dislocation by adductor magnus tenodesis (18 knees) or Roux-Goldthwait procedure (29 knees). Redislocations, subjective symptoms, and functional outcomes were evaluated. Magnetic resonance imaging was performed at followup. The incidence of patellar redislocation after surgery was 7% in the adductor magnus group and 14% in the Roux-Goldthwait group. Median Kujala scores were 88 for the adductor magnus group and 86 for the Roux-Goldthwait group. Magnetic resonance imaging revealed patellofemoral articular cartilage lesions in 22 knees (73.3%) at followup, including 14 (46.6%) with full-thickness cartilage loss. Radiographs revealed patellofemoral osteoarthritis in five patients in the Roux-Goldthwait group and in none of the patients in the adductor magnus group. Adductor magnus tenodesis is a reliable method to treat recurrent patellar dislocation. The medial patellofemoral ligament reconstruction seems to reduce the risk of osteoarthrosis compared with distal realignment surgery.
Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Aglietti P, Buzzi R, De Biase P, Giron F. Surgical treatment of recurrent dislocation of the patella. Clin Orthop Relat Res. 1994;308:8–17.PubMed Aglietti P, Buzzi R, De Biase P, Giron F. Surgical treatment of recurrent dislocation of the patella. Clin Orthop Relat Res. 1994;308:8–17.PubMed
2.
Zurück zum Zitat Aglietti P, Pisaneschi A, De Biase P. Recurrent dislocation of patella: three kinds of surgical treatment. Ital J Orthop Traumatol. 1992;18:25–36.PubMed Aglietti P, Pisaneschi A, De Biase P. Recurrent dislocation of patella: three kinds of surgical treatment. Ital J Orthop Traumatol. 1992;18:25–36.PubMed
3.
Zurück zum Zitat Ahlbäck S. Osteoarthrosis of the knee: a radiographic investigation. Acta Radiol Suppl. 1968;277:7–72. Ahlbäck S. Osteoarthrosis of the knee: a radiographic investigation. Acta Radiol Suppl. 1968;277:7–72.
4.
Zurück zum Zitat Ahmad CS, Stein BE, Matuz D, Henry JH. Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation: a review of eight cases. Am J Sports Med. 2000;28:804–810.PubMed Ahmad CS, Stein BE, Matuz D, Henry JH. Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation: a review of eight cases. Am J Sports Med. 2000;28:804–810.PubMed
5.
Zurück zum Zitat Arnbjornsson A, Egund N, Rydling O, Stockerup R, Ryd L. The natural history of recurrent dislocation of the patella: long-term results of conservative and operative treatment. J Bone Joint Surg Br. 1992;74:140–142.PubMed Arnbjornsson A, Egund N, Rydling O, Stockerup R, Ryd L. The natural history of recurrent dislocation of the patella: long-term results of conservative and operative treatment. J Bone Joint Surg Br. 1992;74:140–142.PubMed
6.
Zurück zum Zitat Avikainen VJ, Nikku RK, Seppanen-Lehmonen TK. Adductor magnus tenodesis for patellar dislocation: technique and preliminary results. Clin Orthop Relat Res. 1993;297:12–16.PubMed Avikainen VJ, Nikku RK, Seppanen-Lehmonen TK. Adductor magnus tenodesis for patellar dislocation: technique and preliminary results. Clin Orthop Relat Res. 1993;297:12–16.PubMed
7.
Zurück zum Zitat Brattstroem H. Shape of the intercondylar groove normally and in recurrent dislocation of patella: a clinical and x-ray-anatomical investigation. Acta Orthop Scand Suppl. 1964;68(suppl 68):1–148.PubMed Brattstroem H. Shape of the intercondylar groove normally and in recurrent dislocation of patella: a clinical and x-ray-anatomical investigation. Acta Orthop Scand Suppl. 1964;68(suppl 68):1–148.PubMed
8.
Zurück zum Zitat Bredella MA, Tirman PF, Peterfy CG, Zarlingo M, Feller JF, Bost FW, Belzer JP, Wischer TK, Genant HK. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol. 1999;172:1073–1080.PubMed Bredella MA, Tirman PF, Peterfy CG, Zarlingo M, Feller JF, Bost FW, Belzer JP, Wischer TK, Genant HK. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol. 1999;172:1073–1080.PubMed
9.
Zurück zum Zitat Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85(suppl 2):58–69.PubMed Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85(suppl 2):58–69.PubMed
10.
Zurück zum Zitat Chrisman OD, Snook GA, Wilson TC. A long-term prospective study of the Hauser and Roux-Goldthwait procedures for recurrent patellar dislocation. Clin Orthop Relat Res. 1979;144:27–30.PubMed Chrisman OD, Snook GA, Wilson TC. A long-term prospective study of the Hauser and Roux-Goldthwait procedures for recurrent patellar dislocation. Clin Orthop Relat Res. 1979;144:27–30.PubMed
11.
Zurück zum Zitat Conlan T, Garth WP Jr, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am. 1993;75:682–693.PubMed Conlan T, Garth WP Jr, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am. 1993;75:682–693.PubMed
12.
Zurück zum Zitat Crosby EB, Insall J. Recurrent dislocation of the patella: relation of treatment to osteoarthritis. J Bone Joint Surg Am. 1976;58:9–13.PubMed Crosby EB, Insall J. Recurrent dislocation of the patella: relation of treatment to osteoarthritis. J Bone Joint Surg Am. 1976;58:9–13.PubMed
13.
Zurück zum Zitat Disler DG, McCauley TR, Kelman CG, Fuchs MD, Ratner LM, Wirth CR, Hospodar PP. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy. AJR Am J Roentgenol. 1996;167:127–132.PubMed Disler DG, McCauley TR, Kelman CG, Fuchs MD, Ratner LM, Wirth CR, Hospodar PP. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy. AJR Am J Roentgenol. 1996;167:127–132.PubMed
14.
Zurück zum Zitat Drez D Jr, Edwards TB, Williams CS. Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy. 2001;17:298–306.PubMedCrossRef Drez D Jr, Edwards TB, Williams CS. Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy. 2001;17:298–306.PubMedCrossRef
15.
Zurück zum Zitat Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy. 1992;8:335–340.PubMedCrossRef Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy. 1992;8:335–340.PubMedCrossRef
16.
Zurück zum Zitat Gagliardi JA, Chung EM, Chandnani VP, Kesling KL, Christensen KP, Null RN, Radvany MG, Hansen MF. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1994;163:629–636.PubMed Gagliardi JA, Chung EM, Chandnani VP, Kesling KL, Christensen KP, Null RN, Radvany MG, Hansen MF. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1994;163:629–636.PubMed
17.
Zurück zum Zitat Garth WP Jr, DiChristina DG, Holt G. Delayed proximal repair and distal realignment after patellar dislocation. Clin Orthop Relat Res. 2000;377:132–144.PubMedCrossRef Garth WP Jr, DiChristina DG, Holt G. Delayed proximal repair and distal realignment after patellar dislocation. Clin Orthop Relat Res. 2000;377:132–144.PubMedCrossRef
18.
Zurück zum Zitat Goldthwait JE. Slipping or recurrent dislocation of the patella: with the report of eleven cases. American Journal of Orthopedic Surgery, Vol 1, pp 293–308, 1903. J Bone Joint Surg Am. 2003;85:2489. Goldthwait JE. Slipping or recurrent dislocation of the patella: with the report of eleven cases. American Journal of Orthopedic Surgery, Vol 1, pp 293–308, 1903. J Bone Joint Surg Am. 2003;85:2489.
19.
Zurück zum Zitat Hampson WG, Hill P. Late results of transfer of the tibial tubercle for recurrent dislocation of the patella. J Bone Joint Surg Br. 1975;57:209–213.PubMed Hampson WG, Hill P. Late results of transfer of the tibial tubercle for recurrent dislocation of the patella. J Bone Joint Surg Br. 1975;57:209–213.PubMed
20.
Zurück zum Zitat Han I, Chang CB, Lee S, Lee MC, Seong SC, Kim TK. Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. J Bone Joint Surg Br. 2005;87:1081–1084.PubMedCrossRef Han I, Chang CB, Lee S, Lee MC, Seong SC, Kim TK. Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. J Bone Joint Surg Br. 2005;87:1081–1084.PubMedCrossRef
21.
Zurück zum Zitat Hautamaa PV, Fithian DC, Kaufman KR, Daniel DM, Pohlmeyer AM. Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop Relat Res. 1998;349:174–182.PubMedCrossRef Hautamaa PV, Fithian DC, Kaufman KR, Daniel DM, Pohlmeyer AM. Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop Relat Res. 1998;349:174–182.PubMedCrossRef
22.
Zurück zum Zitat Hughston JC. Subluxation of the patella. J Bone Joint Surg Am. 1968;50:1003–1026.PubMed Hughston JC. Subluxation of the patella. J Bone Joint Surg Am. 1968;50:1003–1026.PubMed
23.
Zurück zum Zitat Insall J, Salvati E. Patella position in the normal knee joint. Radiology. 1971;101:101–104.PubMed Insall J, Salvati E. Patella position in the normal knee joint. Radiology. 1971;101:101–104.PubMed
24.
Zurück zum Zitat Iwano T, Kurosawa H, Tokuyama H, Hoshikawa Y. Roentgenographic and clinical findings of patellofemoral osteoarthrosis: with special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res. 1990;252:190–197.PubMed Iwano T, Kurosawa H, Tokuyama H, Hoshikawa Y. Roentgenographic and clinical findings of patellofemoral osteoarthrosis: with special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res. 1990;252:190–197.PubMed
25.
Zurück zum Zitat Jalovaara P, Seppanen-Lehmonen T, Lindholm RV. Krogius and Roux-Goldthwait operations for recurrent patellar dislocation. Acta Orthop Belg. 1988;54:380–383.PubMed Jalovaara P, Seppanen-Lehmonen T, Lindholm RV. Krogius and Roux-Goldthwait operations for recurrent patellar dislocation. Acta Orthop Belg. 1988;54:380–383.PubMed
26.
Zurück zum Zitat Juliusson R, Markhede G. A modified Hauser procedure for recurrent dislocation of the patella: a long-term follow-up study with special reference to osteoarthritis. Arch Orthop Trauma Surg. 1984;103:42–46.PubMedCrossRef Juliusson R, Markhede G. A modified Hauser procedure for recurrent dislocation of the patella: a long-term follow-up study with special reference to osteoarthritis. Arch Orthop Trauma Surg. 1984;103:42–46.PubMedCrossRef
27.
Zurück zum Zitat Kawahara Y, Uetani M, Nakahara N, Doiguchi Y, Nishiguchi M, Futagawa S, Kinoshita Y, Hayashi K. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee: correlation of MR and arthroscopic findings. Acta Radiol. 1998;39:120–125.PubMedCrossRef Kawahara Y, Uetani M, Nakahara N, Doiguchi Y, Nishiguchi M, Futagawa S, Kinoshita Y, Hayashi K. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee: correlation of MR and arthroscopic findings. Acta Radiol. 1998;39:120–125.PubMedCrossRef
28.
Zurück zum Zitat Koskinen SK, Rantanen JP, Nelimarkka OI, Kujala UM. Effect of Elmslie-Trillat and Roux-Goldthwait procedures on patellofemoral relationships and symptoms in patients with patellar dislocations. Am J Knee Surg. 1998;11:167–173.PubMed Koskinen SK, Rantanen JP, Nelimarkka OI, Kujala UM. Effect of Elmslie-Trillat and Roux-Goldthwait procedures on patellofemoral relationships and symptoms in patients with patellar dislocations. Am J Knee Surg. 1998;11:167–173.PubMed
29.
Zurück zum Zitat Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9:159–163.PubMedCrossRef Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9:159–163.PubMedCrossRef
30.
Zurück zum Zitat Laurin CA, Dussault R, Levesque HP. The tangential x-ray investigation of the patellofemoral joint: x-ray technique, diagnostic criteria and their interpretation. Clin Orthop Relat Res. 1979;144:16–26.PubMed Laurin CA, Dussault R, Levesque HP. The tangential x-ray investigation of the patellofemoral joint: x-ray technique, diagnostic criteria and their interpretation. Clin Orthop Relat Res. 1979;144:16–26.PubMed
31.
Zurück zum Zitat Maenpaa H, Huhtala H, Lehto MU. Recurrence after patellar dislocation: redislocation in 37/75 patients followed for 6–24 years. Acta Orthop Scand. 1997;68:424–426.PubMed Maenpaa H, Huhtala H, Lehto MU. Recurrence after patellar dislocation: redislocation in 37/75 patients followed for 6–24 years. Acta Orthop Scand. 1997;68:424–426.PubMed
32.
Zurück zum Zitat Maenpaa H, Lehto MU. Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med. 1997;25:213–217.PubMedCrossRef Maenpaa H, Lehto MU. Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med. 1997;25:213–217.PubMedCrossRef
33.
Zurück zum Zitat Maenpaa H, Lehto MU. Patellofemoral osteoarthritis after patellar dislocation. Clin Orthop Relat Res. 1997;339:156–162.PubMedCrossRef Maenpaa H, Lehto MU. Patellofemoral osteoarthritis after patellar dislocation. Clin Orthop Relat Res. 1997;339:156–162.PubMedCrossRef
34.
Zurück zum Zitat Marcacci M, Zaffagnini S, Iacono F, Visani A, Petitto A, Neri NP. Results in the treatment of recurrent dislocation of the patella after 30 years’ follow-up. Knee Surg Sports Traumatol Arthrosc. 1995;3:163–166.PubMedCrossRef Marcacci M, Zaffagnini S, Iacono F, Visani A, Petitto A, Neri NP. Results in the treatment of recurrent dislocation of the patella after 30 years’ follow-up. Knee Surg Sports Traumatol Arthrosc. 1995;3:163–166.PubMedCrossRef
35.
Zurück zum Zitat Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am. 1974;56:1391–1396.PubMed Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am. 1974;56:1391–1396.PubMed
36.
Zurück zum Zitat Muneta T, Sekiya I, Tsuchiya M, Shinomiya K. A technique for reconstruction of the medial patellofemoral ligament. Clin Orthop Relat Res. 1999;359:151–155.PubMedCrossRef Muneta T, Sekiya I, Tsuchiya M, Shinomiya K. A technique for reconstruction of the medial patellofemoral ligament. Clin Orthop Relat Res. 1999;359:151–155.PubMedCrossRef
37.
Zurück zum Zitat Nikku R, Nietosvaara Y, Aalto K, Kallio PE. Operative treatment of primary patellar dislocation does not improve medium-term outcome: a 7-year follow-up report and risk analysis of 127 randomized patients. Acta Orthop. 2005;76:699–704.PubMedCrossRef Nikku R, Nietosvaara Y, Aalto K, Kallio PE. Operative treatment of primary patellar dislocation does not improve medium-term outcome: a 7-year follow-up report and risk analysis of 127 randomized patients. Acta Orthop. 2005;76:699–704.PubMedCrossRef
38.
Zurück zum Zitat Niskanen RO, Paavilainen PJ, Jaakkola M, Korkala OL. Poor correlation of clinical signs with patellar cartilaginous changes. Arthroscopy. 2001;17:307–310.PubMedCrossRef Niskanen RO, Paavilainen PJ, Jaakkola M, Korkala OL. Poor correlation of clinical signs with patellar cartilaginous changes. Arthroscopy. 2001;17:307–310.PubMedCrossRef
39.
Zurück zum Zitat Nomura E. Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop. 1999;23:260–263.PubMedCrossRef Nomura E. Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop. 1999;23:260–263.PubMedCrossRef
40.
Zurück zum Zitat Nomura E, Inoue M, Kobayashi S. Long-term follow-up and knee osteoarthritis change after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med. 2007;35:1851–1858.PubMedCrossRef Nomura E, Inoue M, Kobayashi S. Long-term follow-up and knee osteoarthritis change after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med. 2007;35:1851–1858.PubMedCrossRef
41.
Zurück zum Zitat Nomura E, Inoue M, Osada N. Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc. 2005;13:510–515.PubMedCrossRef Nomura E, Inoue M, Osada N. Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc. 2005;13:510–515.PubMedCrossRef
42.
Zurück zum Zitat Nomura E, Inoue M, Osada N. Augmented repair of avulsion-tear type medial patellofemoral ligament injury in acute patellar dislocation. Knee Surg Sports Traumatol Arthrosc. 2005;13:346–351.PubMedCrossRef Nomura E, Inoue M, Osada N. Augmented repair of avulsion-tear type medial patellofemoral ligament injury in acute patellar dislocation. Knee Surg Sports Traumatol Arthrosc. 2005;13:346–351.PubMedCrossRef
43.
Zurück zum Zitat Rantanen J, Paananen M. Modified Hauser operation for patellar instability: immediate mobilization of 35 knees, a 5–8 year follow-up study. Acta Orthop Scand. 1996;67:455–458.PubMed Rantanen J, Paananen M. Modified Hauser operation for patellar instability: immediate mobilization of 35 knees, a 5–8 year follow-up study. Acta Orthop Scand. 1996;67:455–458.PubMed
44.
Zurück zum Zitat Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001;25:957–962.PubMedCrossRef Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001;25:957–962.PubMedCrossRef
45.
Zurück zum Zitat Schlenzka D, Schwesinger G. The height of the patella: an anatomical study. Eur J Radiol. 1990;11:19–21.PubMedCrossRef Schlenzka D, Schwesinger G. The height of the patella: an anatomical study. Eur J Radiol. 1990;11:19–21.PubMedCrossRef
46.
Zurück zum Zitat Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA. Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol. 1997;168:117–122.PubMed Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA. Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol. 1997;168:117–122.PubMed
47.
Zurück zum Zitat Steensen RN, Dopirak RM, Maurus PB. A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy. 2005;21:365–370.PubMedCrossRef Steensen RN, Dopirak RM, Maurus PB. A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy. 2005;21:365–370.PubMedCrossRef
48.
Zurück zum Zitat Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–49.PubMed Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–49.PubMed
Metadaten
Titel
Ligament Reconstruction versus Distal Realignment for Patellar Dislocation
verfasst von
Petri Sillanpää, MD
Ville M. Mattila, MD, PhD
Tuomo Visuri, MD, PhD
Heikki Mäenpää, MD, PhD
Harri Pihlajamäki, MD, PhD
Publikationsdatum
01.06.2008
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 6/2008
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0207-6

Weitere Artikel der Ausgabe 6/2008

Clinical Orthopaedics and Related Research® 6/2008 Zur Ausgabe

Symposium: Selected Papers Presented at the 2007 Meeting of the Musculoskeletal Tumor Society

Does the Second-generation Intercalary Humeral Spacer Improve on the First?

Case Report

Case Report

Symposium: Papers Presented at the 2007 Meeting of the Musculoskeletal Infection Society

Daptomycin Eluted From Calcium Sulfate Appears Effective Against Staphylococcus

Symposium: Papers Presented at the 2007 Meeting of the Musculoskeletal Infection Society

FDG-PET Imaging Can Diagnose Periprosthetic Infection of the Hip

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.