Abstract:
:Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of (predictive) biomarkers is considered as a major contribution for the future.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Lohmann CH,Hameister R,Singh Gdoi
10.1016/j.otsr.2016.06.021subject
Has Abstractpub_date
2017-02-01 00:00:00pages
S75-S81issue
1Sissn
1877-0568pii
S1877-0568(16)30192-Xjournal_volume
103pub_type
杂志文章,评审abstract:INTRODUCTION:Talar fracture is rare. Treatment is surgical for neck and/or body fractures with displacement. The aims of the present study were to collect epidemiological data on talar fractures, and to assess the impact of trauma via various functional scores and radiographic impact in the medium term. HYPOTHESIS:Dis...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2021.102835
更新日期:2021-01-29 00:00:00
abstract:BACKGROUND:Fractures of the distal radius only rarely give rise to complications in the immediate postoperative period. Combined median and ulnar nerve palsy is a complication that can be missed by the surgeon. MATERIALS AND METHODS:Three cases diagnosed early after surgery are reported here. The patients were 15, 16,...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.04.026
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Developing criteria for assessing patellofemoral kinematics is crucial to understand, evaluate, and monitor patellofemoral function. The objective of this study was to assess a sequential 3D analysis method based on biplanar radiographs, using an in vitro protocol. HYPOTHESIS:Biplanar radiography combined w...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.07.017
更新日期:2015-11-01 00:00:00
abstract::The management of combined loss of skin coverage and bone substance in the lower third of the leg is problematic. A recommended sequential strategy associates removal of infected tissue and coverage followed by treatment of the bone defect. We report a technique without microsurgery, using Masquelet's induced membrane...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.rcot.2010.02.001
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Proximal median nerve (MN) neuropathy represents 1% of upper-limb compressive neuropathies. The literature reports two clinical presentations, depending on the location of the entrapment: pronator teres (PT), and anterior interosseous nerve (AIN) syndrome. HYPOTHESIS:There is no correlation between symptoms...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2021.102825
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Hip dislocation is one of the most frequent complications of total hip replacement. The direction of dislocation matters. Most dislocations are posterior; anterior dislocation remains rare and its treatment is controversial. STUDY OBJECTIVES:To clinically and radiologically evaluate the outcomes of the cons...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.08.003
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:Chronic scapholunate instability can lead to functional deficits and radiocarpal osteoarthritis. A number of procedures, namely scapho-trapezio-trapezoid (STT) fusion, scaphocapitate (SC) fusion or soft tissue reconstruction procedures, aim to improve function while protecting the wrist from osteoarthritis...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2010.11.006
更新日期:2011-04-01 00:00:00
abstract::We report the case of a 72-year-old woman in whom a mega wrist prosthesis was used to reconstruct the distal radius after en-bloc resection of a giant cell tumour. Three years later, her pain score was 2/10 and motion ranges were 20° of flexion, 70° of extension, 70° of pronation, 60° of supination, 20° of radial devi...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2013.04.001
更新日期:2013-09-01 00:00:00
abstract:INTRODUCTION:Pelvic fractures are responsible for genito-urinary injuries in 25% of cases. The objective of this study was to assess the severity and psychological impact of erectile dysfunction in patients with pelvic ring fractures. HYPOTHESIS:Unstable pelvic fractures are associated with erectile dysfunction and de...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.01.026
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:Conventional radiography using an anteroposterior view of the acromioclavicular (AC) joint is the gold standard for evaluating arthritic degeneration. OBJECTIVE:Based on a standardised AP view of the AC joint, the objective of this study was to determine whether this radiographic view is reliable and repr...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.08.008
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:This is a Phase IV, national, multicentre, retrospective study to observe the real-world use of rhBMP-2 in France. HYPOTHESIS:There was no statistical hypothesis, the statistical analyses were descriptive in nature. PATIENTS AND METHODS:Data was collected from patient medical files in 10 French spinal cent...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.otsr.2019.04.023
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:Freiberg's disease is osteonecrosis of the dorsal side of a metatarsal head. The gold-standard surgical treatment is the osteotomy procedure first described by Gauthier. HYPOTHESIS:Gauthier osteotomy for Freiberg's disease will restore the joint space and lead to long-term clinical improvement. A retrospe...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.07.010
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The optimal approach for the fixation of coronoid process fractures is unknown. We present the advantages and the clinical effect of the pronator teres and the flexor carpi radialis interval approach for the treatment of ulna coronoid process fractures. METHODS:The patients, who had operative treatment of c...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.04.004
更新日期:2020-05-14 00:00:00
abstract::The hip is the joint most exposed to orthopaedic complications in cerebral palsy (CP), which is the main cause of spasticity in paediatric patients. The initial immaturity of the hip allows the forces applied by the spastic and retracted muscles to displace the femoral head, eventually causing it to dislocate. The ris...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2018.03.018
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Anterior cervical fusion is widely used to treat spinal injuries. Radiological evidence of disc abnormalities may develop on either side of the fused segment, raising concern about the potential for inducing adjacent-segment disease. Here, we report the long-term clinical, functional, and radiological outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.02.003
更新日期:2014-06-01 00:00:00
abstract::Locked pubic symphysis is a rare form of pelvic injury. It occasionally occurs after a lateral compression injury of the pelvis. We described an overlapping pubic symphysis dislocation that was locked into the contralateral obturator foramen. To the best of our knowledge, there are about seventeen similar cases report...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2012.08.008
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The WOSI (Western Ontario Shoulder Instability Index) is a self-administered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder instability, as well as to measure the effect of an intervention on any particular patient. It is validated and is reliabl...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2013.09.007
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:The reference surgical treatment for unstable posterior pelvic fracture is percutaneous iliosacral screw fixation, isolated or in association with other techniques. As there is a risk of passage outside the bone when performing screw fixation under fluoroscopy, new image-guidance techniques have been devel...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2013.03.002
更新日期:2013-06-01 00:00:00
abstract::Burnout corresponds to a state of exhaustion (emotional, physical, mental) that can result in complete psychological and/or physical breakdown. Burnout is a result of how our society has evolved. A recent phenomenon, it affects all strata of society, all corporations, and all countries. Physicians are not immune to it...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2019.04.029
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Various surgical techniques have been described to set the rotational alignment of the tibial baseplate during total knee arthroplasty. The self-positioning method ("self-adjustment") aligns the tibial implant according to the rotational alignment of the femoral component which is used as a reference after...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.05.006
更新日期:2011-11-01 00:00:00
abstract::We report a case of vertebral malformation associated with diplomyelia believed to be a type II split cord malformation. Cervicothoracic level cases are exceptional. This article reports the case of an 11-year-old boy with no neurological symptoms who had not undergone surgery. The diagnosis was made during pregnancy ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.07.012
更新日期:2009-11-01 00:00:00
abstract::Management of lower limb fractures in children involves many approaches, spanning from conservative treatment to open reduction and internal fixation. A number of intermediate treatments have also been shown to be effective, notably skeletal traction. However, each of these techniques has its own advantages and disadv...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.05.016
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:In case of failure of non-operative treatment of isolated supraspinatus tear, tendon surgery can improve shoulder function and alleviate pain. The present study hypothesis was that isolated supraspinatus repair shows good healing, with improved clinical results. MATERIALS AND METHODS:A prospective multice...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.08.007
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Total disc replacement (TDR) has existed since 1984 but is not covered by the French national healthcare system (Sécurité Sociale). The present study assessed clinical outcomes, and also pre-, peri- and postoperative treatment costs. HYPOTHESIS:Surgical management of low back pain (LBP) provides medical a...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.04.004
更新日期:2011-09-01 00:00:00
abstract:INTRODUCTION:Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management. HYPOTHESIS:There is no difference in funct...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.10.010
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. HYPOTHESIS:Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. AIM OF THE STUDY...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.02.014
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Arthroscopic subacromial decompression (acromioplasty) is widely held to be effective, although pain may persist after the procedure. The objective of this study was to evaluate the proportion of patients with residual pain (i.e., the failure rate) after isolated subacromial decompression and to look for pre...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2014.09.006
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:In spinal deformity surgery, iatrogenic spinal cord injury is the most feared complication. Intraoperative monitoring (IOM) of the spinal cord assesses its functional integrity and allows significant reduction of the rate of spinal cord injury. HYPOTHESIS:In case of severe IOM alert, lesional level diagnosi...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.09.021
更新日期:2017-02-01 00:00:00
abstract:INTRODUCTION:Numerous techniques of anterior cruciate ligament (ACL) reconstruction associated to extra-articular tenodesis (EAT) have been described, but there have been few comparative studies, especially in terms of complications and revision procedures. The present study sought to compare two ACL reconstruction tec...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.10.019
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Previous research suggests that patient-reported outcomes plateau by one year after total knee replacement (TKR). Analysis of trajectories to date has predominately been based on changes in median/mean scores over the first post-operative year, rather than variability in trajectory patterns over the longer...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.08.014
更新日期:2019-11-01 00:00:00