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Joris De Schutter - One of the best experts on this subject based on the ideXlab platform.
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how correctly does an Intramedullary Rod represent the longitudinal tibial axes
Clinical Orthopaedics and Related Research, 2002Co-Authors: Kathleen Denis, Geert Van Ham, Johan Bellemans, Luc Labey, Jos Vander Sloten, Remi Van Audekercke, Georges Van Der Perre, Joris De SchutterAbstract:In a robot-assisted procedure for preparing the tibia in total knee arthroplasty, developed in the authors’ laboratory, an Intramedullary Rod is used to register the tibia. In 18 formalin-fixed tibias, the difference in orientation was calculated between the Intramedullary Rod and several longitudin
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How correctly does an Intramedullary Rod represent the longitudinal tibial axes
Clinical orthopaedics and related research, 2002Co-Authors: Kathleen Denis, Geert Van Ham, Johan Bellemans, Luc Labey, Jos Vander Sloten, Remi Van Audekercke, Georges Van Der Perre, Joris De SchutterAbstract:In a robot-assisted procedure for preparing the tibia in total knee arthroplasty, developed in the authors' laboratory, an Intramedullary Rod is used to register the tibia. In 18 formalin-fixed tibias, the difference in orientation was calculated between the Intramedullary Rod and several longitudinal tibial axes used in clinical practice. This was done using roentgenstereophotogrammetric analysis. Three tibial axes and two insertion techniques were considered. In three-dimensional space, small differences between the axes are observed. The results showed a high standard deviation, indicating the importance of anatomic differences. In the frontal plane, the difference in orientation between Rod and tibial axes never exceeded +/- 2 degrees. In the sagittal plane, the observed differences were larger. Significant differences between the considered axes appeared. The results of the two insertion techniques were not significantly different. Because an Intramedullary Rod frequently is used for alignment of the tibia in conventional surgery, these results also are valuable for conventional surgery. In the current study, the accuracy of the Intramedullary alignment is examined, without influences of the sawing procedure. Moreover, the study is not limited to the frontal plane; the total accuracy in three-dimensional space, and the accuracy in the frontal and the sagittal planes were studied.
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accuracy study on the registration of the tibia by means of an Intramedullary Rod in robot assisted total knee arthroplasty
Transactions of the 46th Annual Meeting of the Orthopaedic Research Society, 2000Co-Authors: Geert Van Ham, Kathleen Denis, Johan Bellemans, Luc Labey, Jos Vander Sloten, Georges Van Der Perre, Remy Van Audekercke, Joris De SchutterAbstract:Group α (°) s(°) α (°) s(°) α (°) s(°) 3D 1.36 0.94 2.16 1.35 2.85 1.19 F 0.51 0.99 0.51 0.99 -0.10 1.24 1 S -0.14 1.30 1.67 1.66 -1.60 2.51 3D 1.69 0.97 2.60 1.27 1.88 0.78 F 0.21 1.12 0.21 1.12 -0.87 0.69 2
I. H. Choi - One of the best experts on this subject based on the ideXlab platform.
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Locking Plate Placement with Unicortical Screw Fixation Adjunctive to Intramedullary Rodding in Long Bones of Patients with Osteogenesis Imperfecta
The Journal of bone and joint surgery. American volume, 2015Co-Authors: Tae Joon Cho, Moon Seok Park, Kang Lee, Won Joon Yoo, I. H. ChoiAbstract:Intramedullary Rodding has been the mainstay of long-bone stabilization in osteogenesis imperfecta. However, in some cases, Intramedullary Rodding cannot provide adequate fixation because of a lack of rotational control and thin diameter of long bones. We have applied adjunctive unicortical locking plate fixation in selected cases of osteogenesis imperfecta to address these biomechanical issues. Thirty-seven bone segments of twenty-four patients with osteogenesis imperfecta (ten type III, nine type IV, three type I, and two type V), in which unicortical locking plate fixation was applied adjunctive to Intramedullary Rodding and was later removed after union had been achieved, were the study subjects. The mean patient age at the time of surgery was 15.5 years (range, 6.2 to 39.8 years). Medical records and follow-up radiographs were reviewed to evaluate healing, complications, and the fates of screw holes after plate removal. All fractures or osteotomies healed completely. Locking plates were removed postoperatively at a mean time (and standard deviation) of 1.8 ± 0.9 years (range, 0.3 to 3.8 years). In seven of the thirty-seven cases, fractures through the screw hole occurred; all of these were treated conservatively. In eighteen of nineteen cases that were followed for more than a year after plate removal without screw hole-related complication, screw holes healed and were no longer visualized by radiography. Unicortical locking plate fixation effectively supplements Intramedullary Rod fixation in selected cases of osteogenesis imperfecta. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.
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Fracture in long bones stabilised by telescopic Intramedullary Rods in patients with osteogenesis imperfecta
The Journal of bone and joint surgery. British volume, 2011Co-Authors: Tae Joon Cho, Ji-beom Kim, Jae Won Lee, Kyoung Min Lee, Moon Seok Park, Woon Joon Yoo, Chin Youb Chung, I. H. ChoiAbstract:We investigated the fracture-free survival of long bones stabilised by a telescopic Intramedullary Rod (TIMR) in patients with osteogenesis imperfecta with respect to the remodelling status of fracture or osteotomy sites and TIMR regions, in order to identify risk factors for fracture. A total of 44 femora and 28 tibiae in 25 patients with a mean age of 5.0 years (1.9 to 10.5) at presentation were studied. There were six patients with Sillence type I, five with type III, 13 with type IV and one with type V osteogenesis imperfecta. All received bisphosphonate treatment at the same stage during the mean follow-up of 7.3 years (0.5 to 18.1). The fracture-free survival was estimated at 6.2 years (95% confidence interval 5.1 to 7.3) by Kaplan-Meier analysis. More than half the fracture or osteotomy sites remained in a less-remodelled state at the latest follow-up or time of fracture. Of the 33 fractures, 29 (87.9%) occurred in long bones containing a less-remodelled site, and these fractures were located at this site. The relative fracture risk at the Rod tip was significantly greater than in any other TIMR region (p < 0.001), and this was higher in bone segments having a less-remodelled site. This study shows a persistent fracture risk in TIMR-stabilised long bones, especially at less-remodelled fracture or osteotomy sites and at the Rod tip.
Nizar N. Mahomed - One of the best experts on this subject based on the ideXlab platform.
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Fixation of segmental subtrochanteric fractures. A biomechanical study.
Clinical orthopaedics and related research, 1996Co-Authors: W. J. Kraemer, T. Hearn, J. N. Powell, Nizar N. MahomedAbstract:Segmental subtrochanteric fractures have been associated with high rates of malunion, nonunion, and implant failure. Although the use of second generation Intramedullary nails with proximal interlocking in the femoral head has been advocated for these fractures, shaft fractures at the tip of short second generation Intramedullary Rod nails in clinical studies raise concerns about the mechanical suitability of these implants. No biomechanical data are available on the strength of fixation and mode of failure of these newer implants. This study compares the strength and failure mode of segmental subtrochanteric fractures stabilized with 3 current implants. Eighteen anatomic specimen femurs were obtained. The 3 implants tested were the Russell-Taylor reconstruction nail, a short Intramedullary hip screw, and a long Intramedullary hip screw. Each femur was instrumented and a segmental subtrochanteric fracture was created. The femurs were loaded in a Materials Testing System. The strength of the reconstruction nail group (2869 +/- 210 N) was significantly greater than for the short Intramedullary Rod hip screw (2330 +/- 490 N), and the long Intramedullary Rod hip screw (2181 +/- 244 N). The failure modes for the implants were: screw cut out of the femoral head for the reconstruction nail; fracture of the femoral shaft for the short Intramedullary hip screw, and implant bending for the long Intramedullary hip screw. This study suggests that the reconstruction nail is the superior implant for segmental subtrochanteric fractures of those tested. Implant bending and shaft fractures at lower loads make the 2 Intramedullary Rod hip screw implants less suitable.
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Fixation of segmental subtrochanteric fractures : A biomechanical study : Topics in lower limb trauma
Clinical Orthopaedics and Related Research, 1996Co-Authors: W. J. Kraemer, T. Hearn, J. N. Powell, Nizar N. MahomedAbstract:Segmental subtrochanteric fractures have been associated with high rates of malunion, nonunion, and implant failure. Although the use of second generation Intramedullary nails with proximal interlocking in the femoral head has been advocated for these fractures, shaft fractures at the tip of short second generation Intramedullary Rod nails in clinical studies raise concerns about the mechanical suitability of these implants. No biomechanical data are available on the strength of fixation and mode of failure of these newer implants. This study compares the strength and failure mode of segmental subtrochanteric fractures stabilized with 3 current implants. Eighteen anatomic specimen femurs were obtained. The 3 implants tested were the Russell-Taylor reconstruction nail, a short Intramedullary hip screw, and a long Intramedullary hip screw. Each femur was instrumented and a segmental subtrochanteric fracture was created. The femurs were loaded in a Materials Testing System. The strength of the reconstruction nail group (2869 ± 210 N) was significantly greater than for the short Intramedullary Rod hip screw (2330 + 490 N), and the long Intramedullary Rod hip screw (2181 ± 244 N). The failure modes for the implants were : screw cut out of the femoral head for the reconstruction nail ; fracture of the femoral shaft for the short Intramedullary hip screw, and implant bending for the long Intramedullary hip screw. This study suggests that the reconstruction nail is the superior implant for segmental subtrochanteric fractures of those tested. Implant bending and shaft fractures at lower loads make the 2 Intramedullary Rod hip screw implants less suitable.
Kathleen Denis - One of the best experts on this subject based on the ideXlab platform.
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how correctly does an Intramedullary Rod represent the longitudinal tibial axes
Clinical Orthopaedics and Related Research, 2002Co-Authors: Kathleen Denis, Geert Van Ham, Johan Bellemans, Luc Labey, Jos Vander Sloten, Remi Van Audekercke, Georges Van Der Perre, Joris De SchutterAbstract:In a robot-assisted procedure for preparing the tibia in total knee arthroplasty, developed in the authors’ laboratory, an Intramedullary Rod is used to register the tibia. In 18 formalin-fixed tibias, the difference in orientation was calculated between the Intramedullary Rod and several longitudin
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How correctly does an Intramedullary Rod represent the longitudinal tibial axes
Clinical orthopaedics and related research, 2002Co-Authors: Kathleen Denis, Geert Van Ham, Johan Bellemans, Luc Labey, Jos Vander Sloten, Remi Van Audekercke, Georges Van Der Perre, Joris De SchutterAbstract:In a robot-assisted procedure for preparing the tibia in total knee arthroplasty, developed in the authors' laboratory, an Intramedullary Rod is used to register the tibia. In 18 formalin-fixed tibias, the difference in orientation was calculated between the Intramedullary Rod and several longitudinal tibial axes used in clinical practice. This was done using roentgenstereophotogrammetric analysis. Three tibial axes and two insertion techniques were considered. In three-dimensional space, small differences between the axes are observed. The results showed a high standard deviation, indicating the importance of anatomic differences. In the frontal plane, the difference in orientation between Rod and tibial axes never exceeded +/- 2 degrees. In the sagittal plane, the observed differences were larger. Significant differences between the considered axes appeared. The results of the two insertion techniques were not significantly different. Because an Intramedullary Rod frequently is used for alignment of the tibia in conventional surgery, these results also are valuable for conventional surgery. In the current study, the accuracy of the Intramedullary alignment is examined, without influences of the sawing procedure. Moreover, the study is not limited to the frontal plane; the total accuracy in three-dimensional space, and the accuracy in the frontal and the sagittal planes were studied.
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accuracy study on the registration of the tibia by means of an Intramedullary Rod in robot assisted total knee arthroplasty
Transactions of the 46th Annual Meeting of the Orthopaedic Research Society, 2000Co-Authors: Geert Van Ham, Kathleen Denis, Johan Bellemans, Luc Labey, Jos Vander Sloten, Georges Van Der Perre, Remy Van Audekercke, Joris De SchutterAbstract:Group α (°) s(°) α (°) s(°) α (°) s(°) 3D 1.36 0.94 2.16 1.35 2.85 1.19 F 0.51 0.99 0.51 0.99 -0.10 1.24 1 S -0.14 1.30 1.67 1.66 -1.60 2.51 3D 1.69 0.97 2.60 1.27 1.88 0.78 F 0.21 1.12 0.21 1.12 -0.87 0.69 2
P L Schoenecker - One of the best experts on this subject based on the ideXlab platform.
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Use of an Intramedullary Rod for the treatment of congenital pseudarthrosis of the tibia. Surgical technique.
The Journal of bone and joint surgery. American volume, 2005Co-Authors: Matthew B Dobbs, M M Rich, J Eric Gordon, Deborah A Szymanski, P L SchoeneckerAbstract:The treatment of congenital pseudarthrosis of the tibia remains difficult and controversial. The purpose of this study was to evaluate the long-term results of a technique consisting of excision of the pseudarthrosis, autologous bone-grafting, and insertion of a Williams Intramedullary Rod into the tibia. Twenty-one consecutive patients with congenital pseudarthrosis of the tibia were managed with this technique between 1978 and 1999, and the results were retrospectively reviewed. The mean age of the patients at the time of the latest follow-up was 17.2 years (range, seven to twenty-five years), and the mean duration of postoperative follow-up was 14.2 years (range, three to twenty years). Initial consolidation occurred in eighteen of the twenty-one patients. Refracture occurred in twelve patients; five fractures healed with closed treatment, five healed after an additional surgical procedure, and two ultimately required amputation. Ten patients had an ankle valgus deformity after tibial union. Eleven patients had a residual limb-length discrepancy of >2 cm; six required a contralateral distal femoral and/or proximal tibial epiphyseodesis, two had a tibial lengthening, and one used a shoe-lift. Five patients had an amputation: two, because of a recalcitrant fracture; two, because of a limb-length discrepancy (6 and 9 cm); and one, because of a chronic lower-extremity deformity. This technique pRoduced a satisfactory long-term functional outcome in sixteen of twenty-one patients and should be considered for the management of congenital pseudarthrosis of the tibia.
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Use of an Intramedullary Rod for treatment of congenital pseudarthrosis of the tibia. A long-term follow-up study.
The Journal of bone and joint surgery. American volume, 2004Co-Authors: Matthew B Dobbs, M M Rich, J Eric Gordon, Deborah A Szymanski, P L SchoeneckerAbstract:Background: The treatment of congenital pseudarthrosis of the tibia remains difficult and controversial. The purpose of this study was to evaluate the long-term results of a technique consisting of excision of the pseudarthrosis, autologous bone-grafting, and insertion of a Williams Intramedullary Rod into the tibia. Methods: Twenty-one consecutive patients with congenital pseudarthrosis of the tibia were managed with this technique between 1978 and 1999, and the results were retrospectively reviewed. The mean age of the patients at the time of the latest follow-up was 17.2 years (range, seven to twenty-five years), and the mean duration of postoperative follow-up was 14.2 years (range, three to twenty years). Results: Initial consolidation occurred in eighteen of the twenty-one patients. Refracture occurred in twelve patients; five fractures healed with closed treatment, five healed after an additional surgical procedure, and two ultimately required amputation. Ten patients had an ankle valgus deformity after tibial union. Eleven patients had a residual limb-length discrepancy of >2 cm; six required a contralateral distal femoral and/or proximal tibial epiphyseodesis, two had a tibial lengthening, and one used a shoe-lift. Five patients had an amputation: two, because of a recalcitrant fracture; two, because of a limb-length discrepancy (6 and 9 cm); and one, because of a chronic lower-extremity deformity. Conclusions: This technique pRoduced a satisfactory long-term functional outcome in sixteen of twenty-one patients and should be considered for the management of congenital pseudarthrosis of the tibia. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
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management of lower extremity deformities in osteogenesis imperfecta with extensible Intramedullary Rod technique a 20 year experience
Journal of Pediatric Orthopaedics, 1998Co-Authors: Scott J Luhmann, John J Sheridan, Ann M Capelli, P L SchoeneckerAbstract:Twelve patients (seven boys, five girls) who had osteogenesis imperfecta were treated with an extensible-Rod system in 21 femurs and 15 tibias. Indications for use of extensible Rods were multiple fractures, long-bone deformity prohibiting bracing and ambulation, and significant remaining linear growth. The average patient age at the time of placement of the extensible Rods was 6 + 8 years (range, 2 + 4-10 + 10). Six femurs were treated with overlapping Rush Rods; Bailey-Dubow Rods were used in the remaining femurs and in all tibias. The average length of follow-up was 5 + 9 years (range, 2 + 0-3 + 2). Preoperatively, four of the 12 patients had never walked; postoperatively, all were ambulators with varying levels of assistance. Fourteen complications occurred, 12 of which required operative revision of the extensible Rods. The average time between primary extensible Rodding and revision was 5 + 1 years. No complications have occurred to date related to the use of overlapping Rush Rods. No growth disturbance resulted from the use of the extensible-Rod systems.
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Use of an Intramedullary Rod for the treatment of congenital pseudarthrosis of the tibia.
The Journal of bone and joint surgery. American volume, 1992Co-Authors: D J Anderson, P L Schoenecker, J J Sheridan, M M RichAbstract:The use of an Intramedullary Rod as described by Williams, combined with implantation of an autogenous bone graft, resulted in union of an established congenital pseudarthrosis of the tibia in nine of ten patients. One patient needed additional bone-grafting before union occurred. The average age at the time of the operation was five years and three months. A Rod of the appropriate length was inserted at the site of the non-union, antegrade through the distal part of the tibia and the hindfoot and then retrograde through the proximal fragment. This resulted in splinting of the tibia, ankle, and subtalar joints. Solid osseous union occurred an average of six months after the procedure in all ten patients. Five patients had a refracture of the tibia after the initial consolidation. Three of the five needed one or more additional operative procedures; one was managed with a cast; and one patient, who had been followed for four years before the refracture, did not return for treatment of the refracture. As is the plan with this method of treatment, the distal part of the tibia grew off the Rod and the distal tip of the Rod was located proximal to the foot and ankle, or it was located more proximally than it had been at the operation, in six patients. The Rod was removed from three patients. At an average of six years, all ten patients were able to walk without pain.