Abstract:
OBJECTIVE:Debridement and irrigation of the knee joint and the donor site to reduce the amount of bacteria and to remove bacterial enzymes and inflammatory cytokines in cases with infection after replacement of the anterior cruciate ligament (ACL). INDICATIONS:Proven infection, suspected infection. CONTRAINDICATIONS:High anesthesiological risk. SURGICAL TECHNIQUE:The therapy of infections after ACL reconstruction depends on the different stages as described by Gächter. In stage I and II, arthroscopic debridement and irrigation (about 10 l) of all compartments is performed. Several biopsies for microbiological analysis are obtained during surgery. Broad-spectrum antibiotic therapy started immediately after surgery. Once the resistance of the bacteria is known, antibiotic therapy may be changed according to the results. When pain, swelling, elevated CRP, or white blood cells persists, arthroscopic irrigation is repeated. In stage III, a complete arthroscopic synovectomy is performed. When the graft is intact, it is left in situ. Resection is performed in case of graft insufficiency, tunnel malplacement, or persistent infection. When the bone tunnels are affected, they should be debrided. In stage IV with osteolysis, an arthrotomy with open debridement may be required. The surgical therapy can be supported with the application of local antibiotics. REHABILITATION:Redon drainage is left in situ until the next irrigation is performed, control of wound and laboratory results, passive exercises, physiotherapy, systemic antibiotic therapy. RESULTS:Between 2008 and 2013, we treated 13 patients with an infection after replacement of the ACL. In all cases, complete healing was achieved. In 4 cases, the graft was resected. In 2 patients, arthrofibrosis developed and arthrolysis was required.
journal_name
Oper Orthop Traumatoljournal_title
Operative Orthopadie und Traumatologieauthors
Petersen W,Herbort M,Höynck E,Zantop T,Mayr Hdoi
10.1007/s00064-013-0262-3subject
Has Abstractpub_date
2014-02-01 00:00:00pages
63-74issue
1eissn
0934-6694issn
1439-0981journal_volume
26pub_type
临床试验,杂志文章abstract:OBJECTIVE:Realignment of medially deviated lesser toes II-IV via subligamentous transfer of the extensor digitorum brevis tendon to treat painful toe disorders. INDICATIONS:Flexible medial malalignment of the lesser toes II-IV attributed to transverse instability of the metatarsophalangeal joint. CONTRAINDICATIONS:Co...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-009-1608-8
更新日期:2009-03-01 00:00:00
abstract::Erratum to: Oper Orthop Traumatol 2017 https://doi.org/10.1007/s00064-017-0513-9 The article was wrongly published under the article type "Review". Please note that the article is an "Original Paper".The publisher apologizes to the authors and …. ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 已发布勘误
doi:10.1007/s00064-018-0565-5
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Callus distraction of the femur or tibia with an intramedullary distractor, which lengthens mechanically through alternating rotations of at least 3 degrees. INDICATIONS:Femoral or tibial shortening between 20 and 80 mm. Angular and rotational deformities can be corrected at the osteotomy site. CONTRAINDICA...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-005-1123-5
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Tibial tubercle osteotomy facilitates access to the knee joint without excessive tension of the extensor apparatus with the lateral parapatellar approach and the medial parapatellar approach in case of contracture or revision arthroplasty. INDICATIONS:Inadequate exposure of the knee joint with the lateral pa...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0079-x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Lengthening of the lower limb with or without correction of angular deformity using an intramedullary nail with new correction strategies to restore or maintain a normal mechanical axis and orientation of the joints compared to traditional strategies using external fixation. Postsurgical lengthening will occu...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-009-1709-4
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Acetabular fractures pose a great surgical challenge for orthopedic trauma surgeons. We believe that the Stoppa approach with an iliac window extension, previously described as a modified Stoppa approach is adequate for the majority of acetabular fractures excluding those with predominant posterior wall invol...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0093-z
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Revision of loose cups of total hip arthroplasties. Implantation and solid fixation of a cementless press-fit cup to restore painless joint function. INDICATIONS:Loose cups of total hip arthroplasties. Reimplantation of a prosthetic cup after removal of an infected total hip arthroplasty. CONTRAINDICATIONS:...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-008-1238-6
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:Reduction and retention of an acromioclavicular (AC) joint dislocation with a button/suture augmentation cerclage (Flip tack, Karl Storz, Tuttlingen, Germany). INDICATIONS:Dislocation of the AC joint (Rockwood III and V). Chronic instabilities in combination with autogenous replacement of the coracoclavicula...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-010-3004-4
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVES:Restoration of extension in the metacarpophalangeal joints of the fingers as well as in the interphalangeal joint of the thumb by transfer of the superficial flexor tendons of the long and ring fingers (flexor digitorum superficialis III and IV). INDICATIONS:The indications for surgery are substantial loss ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-012-0204-5
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:The so-called ankle block represents a local anesthesia form which enables easy performance of all surgical procedures of the foot and ankle. INDICATIONS:Interventions distal to the medial and lateral malleoli. CONTRAINDICATIONS:Acute and chronic infections in the area of injection; allergy to the local ane...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00064-019-00634-x
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Biological augmentation and stabilization of high-grade bone defects with structural allografts from donor femur halfs. INDICATIONS:Severe bone defects with aseptic loosening of hip prosthesis, periprosthetic femoral fracture or non-union, possibly even in cases of a healed infection. CONTRAINDICATIONS:Loca...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-013-0274-z
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Arthroscopic capsular release for refractory shoulder stiffness to recreate active and passive shoulder joint mobility. INDICATIONS:Adhesive capsulitis of the shoulder (primary and secondary frozen shoulder) after receiving at least 3 months of conservative treatment. CONTRAINDICATIONS:Boney-related stiffen...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0284-x
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:An anatomically preformed approach to the posterior tibial plateau is described. In avulsion fractures of the posterior cruciate ligament (PCL), the aim is to restore stability of the knee joint with functional treatment, while in posterior shearing tibial plateau fractures the aim is to restore anatomical do...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0255-2
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Early diagnosis and rapid closed reduction under arthrographic control to initiate retention in a new position during the interval of maximum subsequent maturation power. This allows a (nearly) physiological ripening of the femoral head and acetabulum (AC) with restoration of the congruence of the joint partn...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0237-4
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Pain reduction in the affected proximal interphalangeal joint (PIP joint) by synovectomy, loose body extraction, dorsal arthrolysis. INDICATIONS:Therapy-resistant synovitis in rheumatoid arthritis (RA), early stage primary and secondary degenerative arthritis, loose bodies, capsular contracture. CONTRAINDIC...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-017-0506-8
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Safe and definitive stabilization of fully displaced, unstable fractures of the humerus which cannot be fixed conservatively; plaster cast: subcapital humerus fractures, fractures of the shaft, and supracondylar fractures. INDICATIONS:These depend on two major factors: first, on the morphology (strongly disp...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-008-1409-5
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:Stabilization of the ulnohumeral joint against rotation and shear forces, preserving flexion and extension movements, in order to safeguard the healing of the collateral ligaments. INDICATIONS:Persistent instability of the elbow joint in 90 degrees flexion following elbow dislocation, particularly in the ant...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-006-1161-7
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Knee flexion is increased by detachment of contracted quadriceps muscle from the pelvis and femur in combination with arthrolysis of the knee. INDICATIONS:Flexion contracture of the knee caused by extraarticular changes of quadriceps muscle (fibrosis, soft-tissue damage, infection, fracture). Failed intraart...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0286-8
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Indirect decompression of the spinal canal and the neuroforamina by means of interspinous process distraction and limitation of extension movements. Reduction of forces acting on the posterior joint structures of a functional spinal unit (posterior anulus, facet joints, intervertebral discs). INDICATIONS:Pri...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-010-9042-5
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Reconstruction of the medial patellofemoral ligament with autologous tendon augmentation and soft tissue fixation at the patellar insertion with resorbable suture material. INDICATIONS:Patellofemoral instability due to insufficiency of the medial passive stabilizers and dysplastic trochlea. CONTRAINDICATION...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-015-0428-2
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:Insertion of a small joint arthroscope into the proximal and distal parts of the distal radioulnar joint (DRUJ) allows visualization of the proximal pouch of the DRUJ, the joint surfaces of the sigmoid notch and the ulnar head, the convexity of the ulnar head and the proximal ulnar-sided surface of the triang...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-014-0312-5
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Correction of recurrent dislocation of the patella in children using a semitendinosus tenodesis and a double breasting of the medial retinaculum. INDICATIONS:Recurrent lateral patellar sub- or dislocation in skeletally immature patient. Patella alta with recurrent subluxation of the patella. Patella disloca...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/BF02593985
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:Restoration of anatomy of the joint surface of the tibial plateau in posttraumatic deformity. INDICATIONS:Malunions of the tibial plateau with significant intra-articular depression and/or steps. CONTRAINDICATIONS:Local or systemic infection, critical soft tissues in the area of planned incisions; advanced ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-020-00671-x
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To regain stability of the proximal carpal row after scapholunate ligament rupture in order to avoid osteoarthritis and carpal collapse. INDICATIONS:As additional therapy in scapholunate ligament repair especially in patients with static, but reducible scapholunate malalignment. CONTRAINDICATIONS:Fixed scap...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-009-1907-0
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:Salvage of the respective extremity. Standardized approach to adequate soft-tissue coverage (isolated severe soft-tissue trauma) and preconditioning for fracture healing (in complex trauma) as a basis for functional restoration. Limitation of secondary soft-tissue loss. Prevention of infection. INDICATIONS:I...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00064-010-8045-6
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. INDICATIONS:Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously f...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-016-0457-5
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Arthrodesis of the proximal interphalangeal joint of fingers in a functional and pain-free position. INDICATIONS:Primary and secondary osteoarthritis, traumatic joint destruction, posttraumatic malposition, instability, joint destruction due to infection, irreparable extensor and/or flexor tendon lesion, rec...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-016-0471-7
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Reconstruction of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligament in patients with chronic lateral ankle instability. INDICATIONS:Symptomatic chronic lateral ankle instability. CONTRAINDICATIONS:Bony malalignment, advanced arthritic changes of the ankle joint, diabetic foot syndrome. SUR...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0126-7
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To make a transtibial stump as long as possible, free from local and phantom pain with a maximum of terminal load bearing. In order to preserve the knee joint, an ultra-short tibial stump of 5-6 cm may be indicated. INDICATIONS:A hindfoot amputation level is not possible to achieve. CONTRAINDICATIONS:In amp...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0040-z
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:Simultaneous arthrodesis of ankle and subtalar joints and, at the same sitting, correction of axial malalignment of hindfoot, treatment of bony defects and of sequelae of circulatory disturbances after multiple previous interventions. Internal stabilization with a short distal femur nail. Restitution of a pai...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-005-1137-7
更新日期:2005-10-01 00:00:00