Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2014

01.12.2014 | Knee

Differences in component and limb alignment between computer-assisted and conventional surgery total knee arthroplasty

verfasst von: Tsan-Wen Huang, Kuo-Ti Peng, Kuo-Chin Huang, Mel S. Lee, Robert Wen-Wei Hsu

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Marked coronal femoral bowing may bear a risk for mal-alignment of femoral component and reconstructed mechanical axis (MA) by using conventional instrumentations. The aim of this study was to investigate the usefulness of computer-assisted surgery–total knee arthroplasty (CAS-TKA) under this circumstance.

Methods

We retrospectively analyzed patients with osteoarthritic knee and marked coronal femoral bowing who underwent TKA at our institution. The CAS-TKA and the conventional techniques were compared by radiographic parameters in coronal and sagittal planes, and rotational alignment of femoral component was assessed by computed tomography (CT) scans. The Hospital for Special Surgery (HSS) and International Knee Society (IKS) scores were obtained for all patients preoperatively and at the last follow-up.

Results

A total of 65 knees were enrolled in this study. Twenty-eight TKAs implanted using a CT-free navigation system, and the remaining 37 TKAs implanted using the conventional technique. CAS-TKAs were more consistent than conventional TKAs in aiding proper postoperative MA and ideal alignments of femoral component in the coronal and sagittal planes. However, CAS-TKA group was not obtained at significantly higher rates of femoral component in axial plane. At a mean follow-up of 43 months, there was no significant difference in HSS and IKS scores between the groups.

Conclusions

Although CAS-TKA did not have superior functional outcomes in the short-term follow-up, proper coronal and sagittal alignment of femoral component and postoperative MA were obtained in patients with marked coronal femoral bowing. The long-term follow-up will be needed to clarify the eventual benefits.

Level of evidence

Retrospective comparative study, Level III.
Literatur
1.
Zurück zum Zitat Boonen B, Schotanus MG, Kerens B, van der Weegen W, van Drumpt RA, Kort NP (2013) Intra-operative results and radiological outcome of conventional and patient-specific surgery in total knee arthroplasty: a multicentre, randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 21:2206–2212PubMedCrossRef Boonen B, Schotanus MG, Kerens B, van der Weegen W, van Drumpt RA, Kort NP (2013) Intra-operative results and radiological outcome of conventional and patient-specific surgery in total knee arthroplasty: a multicentre, randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 21:2206–2212PubMedCrossRef
2.
Zurück zum Zitat Cheng T, Zhang G, Zhang X (2011) Imageless navigation system does not improve component rotational alignment in total knee arthroplasty. J Surg Res 171:590–600PubMedCrossRef Cheng T, Zhang G, Zhang X (2011) Imageless navigation system does not improve component rotational alignment in total knee arthroplasty. J Surg Res 171:590–600PubMedCrossRef
3.
Zurück zum Zitat Decking R, Markmann Y, Fuchs J, Puhl W, Scharf HP (2005) Leg axis after computer-navigated total knee arthroplasty: a prospective randomized trial comparing computer-navigated and manual implantation. J Arthroplasty 20:282–288PubMedCrossRef Decking R, Markmann Y, Fuchs J, Puhl W, Scharf HP (2005) Leg axis after computer-navigated total knee arthroplasty: a prospective randomized trial comparing computer-navigated and manual implantation. J Arthroplasty 20:282–288PubMedCrossRef
5.
Zurück zum Zitat Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12PubMed Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12PubMed
6.
Zurück zum Zitat Fang DM, Ritter MA, Davis KE (2009) Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty 24(6 Suppl):39–43PubMedCrossRef Fang DM, Ritter MA, Davis KE (2009) Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty 24(6 Suppl):39–43PubMedCrossRef
7.
Zurück zum Zitat Fehring TK, Mason JB, Moskal J, Pollock DC, Mann J, Williams VJ (2006) When computer-assisted knee replacement is the best alternative. Clin Orthop Relat Res 452:132–136PubMedCrossRef Fehring TK, Mason JB, Moskal J, Pollock DC, Mann J, Williams VJ (2006) When computer-assisted knee replacement is the best alternative. Clin Orthop Relat Res 452:132–136PubMedCrossRef
8.
Zurück zum Zitat Fu H, Wang J, Zhou S, Cheng T, Zhang W, Wang Q, Zhang X (2014) No difference in mechanical alignment and femoral component placement between patient-specific instrumentation and conventional instrumentation in TKA. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3115-1 Fu H, Wang J, Zhou S, Cheng T, Zhang W, Wang Q, Zhang X (2014) No difference in mechanical alignment and femoral component placement between patient-specific instrumentation and conventional instrumentation in TKA. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3115-1
9.
Zurück zum Zitat Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227PubMed Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227PubMed
10.
Zurück zum Zitat Hsu WH, Hsu RW, Weng YJ (2010) Effect of preoperative deformity on postoperative leg axis in total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 18:1323–1327PubMedCrossRef Hsu WH, Hsu RW, Weng YJ (2010) Effect of preoperative deformity on postoperative leg axis in total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 18:1323–1327PubMedCrossRef
11.
Zurück zum Zitat Huang TW, Hsu WH, Peng KT, Hsu RW, Weng YJ, Shen WJ (2011) Total knee arthroplasty with use of computer-assisted navigation compared with conventional guiding systems in the same patient: radiographic results in Asian patients. J Bone Joint Surg Am 93:1197–1202PubMedCrossRef Huang TW, Hsu WH, Peng KT, Hsu RW, Weng YJ, Shen WJ (2011) Total knee arthroplasty with use of computer-assisted navigation compared with conventional guiding systems in the same patient: radiographic results in Asian patients. J Bone Joint Surg Am 93:1197–1202PubMedCrossRef
12.
Zurück zum Zitat Huang TW, Hsu WH, Peng KT, Hsu RW (2011) Total knee replacement in patients with significant femoral bowing in the coronal plane: a comparison of conventional and computer-assisted surgery in an Asian population. J Bone Joint Surg Br 93:345–350PubMedCrossRef Huang TW, Hsu WH, Peng KT, Hsu RW (2011) Total knee replacement in patients with significant femoral bowing in the coronal plane: a comparison of conventional and computer-assisted surgery in an Asian population. J Bone Joint Surg Br 93:345–350PubMedCrossRef
13.
Zurück zum Zitat Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58:754–765PubMed Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58:754–765PubMed
14.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
15.
Zurück zum Zitat Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–839PubMedCrossRef Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–839PubMedCrossRef
16.
Zurück zum Zitat Kawahara S, Okazaki K, Matsuda S, Nakahara H, Okamoto S, Iwamoto Y (2014) Internal rotation of femoral component affects functional activities after tka-survey with the 2011 Knee Society score. J Arthroplasty. doi:10.1016/j.arth.2013.11.017 Kawahara S, Okazaki K, Matsuda S, Nakahara H, Okamoto S, Iwamoto Y (2014) Internal rotation of femoral component affects functional activities after tka-survey with the 2011 Knee Society score. J Arthroplasty. doi:10.​1016/​j.​arth.​2013.​11.​017
17.
Zurück zum Zitat Kim YH, Kim JS, Yoon SH (2007) Alignment and orientation of the components in total knee replacement with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br 89:471–476PubMedCrossRef Kim YH, Kim JS, Yoon SH (2007) Alignment and orientation of the components in total knee replacement with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br 89:471–476PubMedCrossRef
18.
Zurück zum Zitat Kim YH, Park JW, Kim JS (2012) Computer-navigated versus conventional total knee arthroplasty: a prospective randomized trial. J Bone Joint Surg Am 94:2017–2024PubMedCrossRef Kim YH, Park JW, Kim JS (2012) Computer-navigated versus conventional total knee arthroplasty: a prospective randomized trial. J Bone Joint Surg Am 94:2017–2024PubMedCrossRef
19.
Zurück zum Zitat Klein GR, Austin MS, Smith EB, Hozack WJ (2006) Total knee arthroplasty using computer-assisted navigation in patients with deformities of the femur and tibia. J Arthroplasty 21:284–288PubMedCrossRef Klein GR, Austin MS, Smith EB, Hozack WJ (2006) Total knee arthroplasty using computer-assisted navigation in patients with deformities of the femur and tibia. J Arthroplasty 21:284–288PubMedCrossRef
20.
Zurück zum Zitat Konigsberg B, Hess R, Hartman C, Smith L, Garvin KL (2014) Inter- and intraobserver reliability of two-dimensional CT scan for total knee arthroplasty component malrotation. Clin Orthop Relat Res 472:212–217PubMedCrossRef Konigsberg B, Hess R, Hartman C, Smith L, Garvin KL (2014) Inter- and intraobserver reliability of two-dimensional CT scan for total knee arthroplasty component malrotation. Clin Orthop Relat Res 472:212–217PubMedCrossRef
21.
Zurück zum Zitat Lasam MP, Lee KJ, Chang CB, Kang YG, Kim TK (2013) Femoral lateral bowing and varus condylar orientation are prevalent and affect axial alignment of TKA in Koreans. Clin Orthop Relat Res 471:1472–1483PubMedCentralPubMedCrossRef Lasam MP, Lee KJ, Chang CB, Kang YG, Kim TK (2013) Femoral lateral bowing and varus condylar orientation are prevalent and affect axial alignment of TKA in Koreans. Clin Orthop Relat Res 471:1472–1483PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Lizaur-Utrilla A, Sanz-Reig J, Trigueros-Rentero MA (2012) Greater satisfaction in older patients with a mobile-bearing compared with fixed-bearing total knee arthroplasty. J Arthroplasty 27:207–212PubMedCrossRef Lizaur-Utrilla A, Sanz-Reig J, Trigueros-Rentero MA (2012) Greater satisfaction in older patients with a mobile-bearing compared with fixed-bearing total knee arthroplasty. J Arthroplasty 27:207–212PubMedCrossRef
24.
Zurück zum Zitat Lützner J, Dexel J, Kirschner S (2013) No difference between computer-assisted and conventional total knee arthroplasty: five-year results of a prospective randomised study. Knee Surg Sports Traumatol Arthrosc 21:2241–2247PubMedCrossRef Lützner J, Dexel J, Kirschner S (2013) No difference between computer-assisted and conventional total knee arthroplasty: five-year results of a prospective randomised study. Knee Surg Sports Traumatol Arthrosc 21:2241–2247PubMedCrossRef
25.
Zurück zum Zitat Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 Press Fit Condylar posterior cruciate sacrificing total knee arthroplasties. J Arthroplasty 16:635–640PubMedCrossRef Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 Press Fit Condylar posterior cruciate sacrificing total knee arthroplasties. J Arthroplasty 16:635–640PubMedCrossRef
26.
Zurück zum Zitat Matziolis G, Adam J, Perka C (2010) Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement. Arch Orthop Trauma Surg 130:1487–1491PubMedCrossRef Matziolis G, Adam J, Perka C (2010) Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement. Arch Orthop Trauma Surg 130:1487–1491PubMedCrossRef
27.
Zurück zum Zitat Mizu-uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y (2008) The evaluation of post-operative alignment in total knee replacement using a CT-based navigation system. J Bone Joint Surg Br 90:1025–1031PubMedCrossRef Mizu-uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y (2008) The evaluation of post-operative alignment in total knee replacement using a CT-based navigation system. J Bone Joint Surg Br 90:1025–1031PubMedCrossRef
28.
Zurück zum Zitat Mullaji AB, Marawar SV, Mittal V (2009) A comparison of coronal plane axial femoral relationships in Asian patients with varus osteoarthritic knees and healthy knees. J Arthroplasty 24:861–867PubMedCrossRef Mullaji AB, Marawar SV, Mittal V (2009) A comparison of coronal plane axial femoral relationships in Asian patients with varus osteoarthritic knees and healthy knees. J Arthroplasty 24:861–867PubMedCrossRef
29.
Zurück zum Zitat Mullaji A, Shetty GM (2009) Computer-assisted total knee arthroplasty for arthritis with extra-articular deformity. J Arthroplasty 24:1164–1169PubMedCrossRef Mullaji A, Shetty GM (2009) Computer-assisted total knee arthroplasty for arthritis with extra-articular deformity. J Arthroplasty 24:1164–1169PubMedCrossRef
30.
Zurück zum Zitat Mullaji AB, Shetty GM, Lingaraju AP, Bhayde S (2013) Which factors increase risk of malalignment of the hip-knee-ankle axis in TKA? Clin Orthop Relat Res 471:134–141PubMedCentralPubMedCrossRef Mullaji AB, Shetty GM, Lingaraju AP, Bhayde S (2013) Which factors increase risk of malalignment of the hip-knee-ankle axis in TKA? Clin Orthop Relat Res 471:134–141PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Nagamine R, Miura H, Bravo CV, Urabe K, Matsuda S, Miyanishi K, Hirata G, Iwamoto Y (2000) Anatomic variations should be considered in total knee arthroplasty. J Orthop Sci 5:232–237PubMedCrossRef Nagamine R, Miura H, Bravo CV, Urabe K, Matsuda S, Miyanishi K, Hirata G, Iwamoto Y (2000) Anatomic variations should be considered in total knee arthroplasty. J Orthop Sci 5:232–237PubMedCrossRef
32.
Zurück zum Zitat Parratte S, Pagnano MW, Trousdale RT, Berry DJ (2010) Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 92:2143–2149PubMedCrossRef Parratte S, Pagnano MW, Trousdale RT, Berry DJ (2010) Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 92:2143–2149PubMedCrossRef
33.
Zurück zum Zitat Ritter MA, Davis KE, Meding JB, Pierson JL, Berend ME, Malinzak RA (2011) The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 93:1588–1596PubMedCrossRef Ritter MA, Davis KE, Meding JB, Pierson JL, Berend ME, Malinzak RA (2011) The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 93:1588–1596PubMedCrossRef
34.
Zurück zum Zitat Rodricks DJ, Patil S, Pulido P, Colwell CW Jr (2007) Press-fit condylar design total knee arthroplasty: fourteen to seventeen-year follow-up. J Bone Joint Surg Am 89:89–95PubMedCrossRef Rodricks DJ, Patil S, Pulido P, Colwell CW Jr (2007) Press-fit condylar design total knee arthroplasty: fourteen to seventeen-year follow-up. J Bone Joint Surg Am 89:89–95PubMedCrossRef
35.
Zurück zum Zitat Sassoon A, Nam D, Nunley R, Barrack R (2014) Systematic review of patient-specific instrumentation in total knee arthroplasty: new but not improved. Clin Orthop Relat Res. doi:10.1007/s11999-014-3804-6 PubMed Sassoon A, Nam D, Nunley R, Barrack R (2014) Systematic review of patient-specific instrumentation in total knee arthroplasty: new but not improved. Clin Orthop Relat Res. doi:10.​1007/​s11999-014-3804-6 PubMed
36.
Zurück zum Zitat Scott RD, Chmell MJ (2008) Balancing the posterior cruciate ligament during cruciate-retaining fixed and mobile-bearing total knee arthroplasty: description of the pull-out lift-off and slide-back tests. J Arthroplasty 23:605–608 PubMedCrossRef Scott RD, Chmell MJ (2008) Balancing the posterior cruciate ligament during cruciate-retaining fixed and mobile-bearing total knee arthroplasty: description of the pull-out lift-off and slide-back tests. J Arthroplasty 23:605–608 PubMedCrossRef
37.
Zurück zum Zitat Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A (2003) Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br 85:830–835PubMed Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A (2003) Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br 85:830–835PubMed
38.
Zurück zum Zitat Stronach BM, Pelt CE, Erickson JA, Peters CL (2014) Patient-specific instrumentation in total knee arthroplasty provides no improvement in component alignment. J Arthroplast. doi:10.1016/j.arth.2014.04.025 Stronach BM, Pelt CE, Erickson JA, Peters CL (2014) Patient-specific instrumentation in total knee arthroplasty provides no improvement in component alignment. J Arthroplast. doi:10.​1016/​j.​arth.​2014.​04.​025
39.
Zurück zum Zitat Taylor M, Barrett DS (2003) Explicit finite element simulation of eccentric loading in total knee replacement. Clin Orthop Relat Res 414:162–171PubMedCrossRef Taylor M, Barrett DS (2003) Explicit finite element simulation of eccentric loading in total knee replacement. Clin Orthop Relat Res 414:162–171PubMedCrossRef
40.
Zurück zum Zitat Thienpont E, Paternostre F, Pietsch M, Hafez M, Howell S (2013) Total knee arthroplasty with patient-specific instruments improves function and restores limb alignment in patients with extra-articular deformity. Knee 20:407–411PubMedCrossRef Thienpont E, Paternostre F, Pietsch M, Hafez M, Howell S (2013) Total knee arthroplasty with patient-specific instruments improves function and restores limb alignment in patients with extra-articular deformity. Knee 20:407–411PubMedCrossRef
41.
Zurück zum Zitat Thienpont E, Schwab PE, Fennema P (2014) A systematic review and meta-analysis of patient-specific instrumentation for improving alignment of the components in total knee replacement. Bone Joint J 96:1052–1061PubMedCrossRef Thienpont E, Schwab PE, Fennema P (2014) A systematic review and meta-analysis of patient-specific instrumentation for improving alignment of the components in total knee replacement. Bone Joint J 96:1052–1061PubMedCrossRef
42.
Zurück zum Zitat Vessely MB, Whaley AL, Harmsen WS, Schleck CD, Berry DJ (2006) Long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin Orthop Relat Res 452:28–34PubMedCrossRef Vessely MB, Whaley AL, Harmsen WS, Schleck CD, Berry DJ (2006) Long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin Orthop Relat Res 452:28–34PubMedCrossRef
44.
Zurück zum Zitat Wang JW, Wang CJ (2002) Total knee arthroplasty for arthritis of the knee with extra-articular deformity. J Bone Joint Surg Am 84:1769–1774PubMedCrossRef Wang JW, Wang CJ (2002) Total knee arthroplasty for arthritis of the knee with extra-articular deformity. J Bone Joint Surg Am 84:1769–1774PubMedCrossRef
45.
Zurück zum Zitat Wang JW, Chen WS, Lin PC, Hsu CS, Wang CJ (2010) Total knee replacement with intra-articular resection of bone after malunion of a femoral fracture: can sagittal angulation be corrected? J Bone Joint Surg Br 92:1392–1396PubMedCrossRef Wang JW, Chen WS, Lin PC, Hsu CS, Wang CJ (2010) Total knee replacement with intra-articular resection of bone after malunion of a femoral fracture: can sagittal angulation be corrected? J Bone Joint Surg Br 92:1392–1396PubMedCrossRef
46.
Zurück zum Zitat Weng YJ, Hsu RW, Hsu WH (2009) Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty. J Arthroplasty 24:668–673PubMedCrossRef Weng YJ, Hsu RW, Hsu WH (2009) Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty. J Arthroplasty 24:668–673PubMedCrossRef
47.
Zurück zum Zitat Woolson ST, Harris AH, Wagner DW, Giori NJ (2014) Component alignment during total knee arthroplasty with use of standard or custom instrumentation: a randomized clinical trial using computed tomography for postoperative alignment measurement. J Bone Joint Surg Am 96:366–372PubMedCrossRef Woolson ST, Harris AH, Wagner DW, Giori NJ (2014) Component alignment during total knee arthroplasty with use of standard or custom instrumentation: a randomized clinical trial using computed tomography for postoperative alignment measurement. J Bone Joint Surg Am 96:366–372PubMedCrossRef
48.
Zurück zum Zitat Yau WP, Chiu KY, Tang WM, Ng TP (2007) Coronal bowing of the femur and tibia in Chinese: its incidence and effects on total knee arthroplasty planning. J Orthop Surg (Hong Kong) 15:32–36 Yau WP, Chiu KY, Tang WM, Ng TP (2007) Coronal bowing of the femur and tibia in Chinese: its incidence and effects on total knee arthroplasty planning. J Orthop Surg (Hong Kong) 15:32–36
Metadaten
Titel
Differences in component and limb alignment between computer-assisted and conventional surgery total knee arthroplasty
verfasst von
Tsan-Wen Huang
Kuo-Ti Peng
Kuo-Chin Huang
Mel S. Lee
Robert Wen-Wei Hsu
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2014
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3331-8

Weitere Artikel der Ausgabe 12/2014

Knee Surgery, Sports Traumatology, Arthroscopy 12/2014 Zur Ausgabe

Arthropedia

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

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

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