Minimally invasive surgery in orthopedic surgery:
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2009
|
| Schriftenreihe: | Orthopedic clinics of North America
40,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XV S., S. 441 - 568 zahlr. Ill., graph. Darst. |
| ISBN: | 1437712533 9781437712537 |
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| adam_text | Titel: Minimally invasive surgery in orthopedic surgery
Autor: Maffulli, Nicola
Jahr: 2009
Minimally Invasive Surgery in Orthopedic Surgery
Contents
Preface xjij
Nicola Maffulli
Dedication xv
Minimally Invasive Carpal Tunnel Release 441
Paolo Cellocco, Costantino Rossi, Stefano El Boustany, Gian Luca Di Tanna,
and Giuseppe Costanzo
We prospectively compared the safety and effectiveness of mini-incision (group A)
and a limited open technique (group B) for carpal tunnel release (CTR) in 185 consec¬
utive patients operated between November 1999 and May 2001, with a 5-year min¬
imum follow-up. Patients in Group A had a minimally invasive approach ( 2 cm
incision), performed using the KnifeLight (Stryker, Kalamazoo, Michigan) instrument.
Patients in Group B had a limited longitudinal incision (3-4 cm). Patient status was
evaluated with an Italian modified version of the Boston Carpal Tunnel questionnaire,
administered preoperatively and at 19, 30, and 60 postoperative months. Mini-inci¬
sion CTR showed advantages over standard technique in early recovery, pillar pain,
and recurrence rate. The recovery period after mini-incision is shorter than after
standard procedure.
Percutaneous CT-Guided Vertebroplasty in the Management of Osteoporotic Fractures
and Dorsolumbar Metastases 449
Andrea L. Pizzoli, Lodovico Renzi Brivio, Roberto Caudana, and Enrico Vittorini
Percutaneous vertebroplasty (PVP) is a minimally invasive, image-guided procedure
consisting of an injection of acrylic cement into a vertebral body to reinforce the
compressed segment and achieve pain relief. The use of PVP is a minimally invasive
option in the treatment of osteoporotic or metastatic vertebral collapses. Our per¬
sonal experience, using a CT-guided technique, confirms the efficacy and safety
of PVP with a lower risk for complications compared with conventional fluoroscopic
approaches because of a precise placement of the instruments in the vertebral body
and an early detection of small cement leakages.
Thoracoscopy for Minimally Invasive Thoracic Spine Surgery 459
Umile Giuseppe Longo, Nicola Papapietro, Nicola Maffulli, and Vincenzo Denaro
Thoracoscopy has been used worldwide for many years by thoracic surgeons. De¬
spite a long learning curve and technical demands of the procedure, thoracoscopy
has several advantages, including better cosmesis, adequate exposure to all levels
of the thoracic spine from T2 to L 1, better illumination and magnification at the site
of surgery, less damage to the tissue adjacent to the surgical field, less morbidity
when compared with standard thoracotomy in terms of respiratory problems,
pain, blood loss, muscle and chest wall damages, consequent shorter recovery
time, less postoperative pulmonary function impairment, and shorter hospitalization.
Good results at short- and medium-term follow-up need to be confirmed at long-
term follow-up. I
Contents
Vertebroplasty and Kyphoplasty: Reasons for Concern? 465
Luca Denaro, Umile Giuseppe Longo, and Vincenzo Denaro
Two different minimally invasive percutaneous vertebral augmentation methods for
cement application into the vertebral body for the management of symptomatic
compression fractures without neurologic impairment have been developed,
namely, vertebroplasty and kyphoplasty. In vertebroplasty, polymethylmethacrylate
cement is injected percutaneously into a collapsed vertebral body. Kyphoplasty in¬
volves placing an inflatable bone tamp percutaneously into a vertebral body. The in¬
flation of the bone tamp with fluid allows restoration of vertebral height and
correction of the kyphosis. After deflation, the cavity that has been produced is filled
by injection of polymethylmethacrylate. This article provides an overview of the state
of the art in vertebroplasty and kyphoplasty, discussing the indications, techniques,
results, and pitfalls.
TheAnterolateral Minimally Invasive Approach for Total Hip Arthroplasty: Technique,
Pitfalls, and Way Out 473
Erhan Basad, Bernd Ishaque, Henning Sturz, and Jorg Jerosch
Different approaches for the hip have been developed for minimally invasive surgery
in total hip arthroplasty. The goal of minimally invasive surgery is to reduce invasive-
ness to skin, muscles, and bone and improve recovery time after total hip arthro¬
plasty. This article describes the technique of a minimally invasive approach to
the hip from the anterolateral direction step by step and includes preoperative set¬
tings and pitfalls.
Minimally Invasive Total Knee Arthroplasty: A Systematic Review 479
Anil Khanna, Nikolaos Gougoulias, Umile Giuseppe Longo, and Nicola Maff ulli
The concept of minimally invasive total knee arthroplasty surgery evolved to reduce
quadriceps muscle strength loss and improve clinical outcome following total knee
replacement. We performed a systematic review of the published literature on Min¬
imally Invasive Total Knee Arthroplasty (MITKA) and analyzed the reported surgical
outcomes. Twenty-eight studies published from January 2003 to June 2008 that met
the inclusion criteria were evaluated using the modified Coleman Methodology
Score (CMS). At a mean CMS of 60, most studies reporting on outcome of MITKA
are of moderate scientific quality. Patients undergoing MITKA tend to have de¬
creased postoperative pain, rapid recovery of quadriceps function, reduced blood
loss, improved range of motion (mostly reported as a short-term gain) and shorter
hospital stay compared with patients undergoing standard total knee arthroplasty.
These benefits, however, need to be balanced against the incidence of increased
tourniquet time and increased incidence of component malalignment in the MITKA
group. So far, the evidence based knowledge regarding results of MITKA comes
from prospective studies of moderate quality with short follow up periods. Multicen-
ter studies with longer follow-ups are needed to justify the long-term advantages of
MITKA over standard total knee arthroplasty.
Minimally Invasive Surgery of the Achilles Tendon 491
Nicola Maffulli, Umile Giuseppe Longo, Francesco Oliva, Mario Ronga, and Vincenzo Denaro
Minimally invasive surgical techniques for pathologies of the Achilles tendon (AT)
hold the promise to decrease perioperative morbidity, allow faster recovery times,
shorten hospital stays, and improve functional outcomes when compared with
open procedures, which can lead to difficulty with wound healing because of the
Contents
tenuous blood supply and increased chance of wound breakdown and infection.
This article presents recent advances in the field of minimally invasive AT surgery
for tendinopathy, acute ruptures, and chronic tears. All of the techniques described
in this article are inexpensive and do not require highly specialized equipment and
training. Future randomized controlled trials are required to address the issue of
the comparison between open versus minimally invasive AT surgery.
Minimally Invasive Osteosynthesis of Distal Tibial Fractures Using Locking Plates 499
Mario Ronga, Chezhiyan Shanmugam, Umile Giuseppe Longo, Francesco Oliva,
and Nicola Maffulli
The management of distal tibia fractures can be challenging because of the scarcity
of soft tissue, their subcutaneous nature, and poor vascularity. Classic open reduc¬
tion and internal plate fixation require extensive soft tissue dissection and periosteal
stripping, with high rates of complications. Minimally invasive plating techniques re¬
duce iatrogenic soft tissue injury and damage to bone vascularity and preserve the
osteogenic fracture hematoma. Locking plates (LPs) have the biomechanical prop¬
erties of internal and external fixators, with superior holding power because of fixed
angular stability through the head of locking screws, independent of friction fit. In this
review, the rationale for the use of LPs and a description of the technique of mini¬
mally invasive LP osteosynthesis of distal tibia fractures are presented.
Percutaneous Hallux Valgus Surgery: A Prospective Multicenter Study of 189 Cases 505
Thomas Bauer, Christophe de Lavigne, David Biau, Mariano De Prado, Stephen Isham,
and Olivier Laffenetre
Distal first metatarsal osteotomies have been indicated for the correction of mild-to-
moderate hallux valgus deformity. The aim of this study was to assess the clinical
and radiographic results of the distal Reverdin-lsham first metatarsal osteotomy
with use of a percutaneous procedure after a minimum 1-year followup. One hun¬
dred eighty-nine feet in 168 consecutive subjects were included in the present pro¬
spective multicenter study. A radiographic and clinical assessment using the
American Orthopaedic Foot and Ankle Society s (AOFAS) hallux-metatarsophalan-
geal-interphalangeal scale was performed for all the subjects with a minimum
1 -year follow-up. One hundred fifty six subjects (87%) were satisfied or very satisfied
with the outcome of the procedure. The median postoperative AOFAS score was 93
points. Subjects averaged a loss 17% of first metatarsophalangeal joint motion. The
median hallux valgus angle and intermetatarsal angle improved from 28 and 13
preoperatively, to 14° and 10° postoperatively, respectively. Percutaneous correc¬
tion of mild-to-moderate hallux valgus deformity with the Reverdin-lsham osteoto¬
my of the first metatarsal enables us to achieve clinical and radiographic results
comparable to other percutaneous or open distal metatarsal osteotomies after
1-year follow-up.
Bosch Osteotomy and Scarf Osteotomy for Hallux Valgus Correction 515
Nicola Maffulli, Umile Giuseppe Longo, Francesco Oliva, Vincenzo Denaro,
and Cristiano Coppola
Minimally invasive distal metatarsal osteotomies are becoming broadly accepted for
correction of hallux valgus. We compared the duration of surgery, the length of hos¬
pital stay, the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the
Foot and Ankle Outcome Score (FAOS) in 36 patients who underwent a minimal in- ,
cision subcapital osteotomy of the first metatarsal with 36 matched patients who {
had hallux valgus corrected by a scarf technique. The minimum follow-up was j
Contents
2.1 years (mean, 2.5 years; range, 2.1-3.2 years). Patients having the osteotomy had
similar AOFAS and FAOS scores with less operating time and earlier discharge. Less
operative time may benefit the patients, and earlier discharge has financial implica¬
tions for the hospital.
Minimally Invasive HalluxValgus Correction 525
Francesco Oliva, Umile Giuseppe Longo, and Nicola Maffulli
The most common complication following minimally invasive surgery (MIS) foot pro¬
cedures is recurrence of the deformity, likely a direct consequence of incorrect se¬
lection of the procedure, incorrect surgical technique, or underestimated healing
time of the osteotomy. This article describes our surgical MIS for hallux valgus cor¬
rection, including the postoperative management, and reviews the literature on MIS
for hallux valgus correction. The reports on such techniques are few, and mainly
case series are reported. More adequately planned and executed randomized pro¬
spective clinical trials are needed. Historical attempts, indications, preferred surgical
techniques, and complications are discussed.
From Mini-Invasive to Non-Invasive Treatment Using Monopolar Radiof requency:
The Next Orthopaedic Frontier 531
Terry L. Whipple
Tendinopathy arises from a failed tendon healing process. Current non-invasive
therapeutic alternatives are anti-inflammatory in nature, and outcomes are unpre¬
dictable. The benefit of invasive alternatives resides in the induction of the healing
response. A new technology that uses non-invasive monopolar capacitive coupled
radiofrequency has demonstrated the ability to raise temperatures in tendons and
ligaments above 50°C, the threshold for collagen modulation, tissue shrinkage
and recruitment of macrophages, fibroblasts, and heat shock protein factors, with¬
out damaging the overlying structures, resulting in activation of the wound healing
response. Monopolar capacitive-coupled radiofrequency offers a new non-invasive
choice for tendinopathies and sprained ligaments. It does not interfere with subse¬
quent surgical procedures should they become necessary.
Minimally Invasive Computer-Navigated Total Knee Arthroplasty 537
Nicola Biasca, Thomas-Oliver Schneider, and Matthias Bungartz
Modern computerized knee navigation systems aid surgeons both in the conven¬
tional and in the minimally invasive approach to optimize mechanical and rotational
alignments of the components in all three planes to avoid any malrotation and/or any
errors in coronal, sagittal, and axial alignments. The advantages of minimally inva¬
sive total knee arthroplasty can be achieved without loss of accuracy. There is in¬
creasing evidence of a positive correlation between accurate mechanical
alignment after total knee arthroplasty and functional as well as quality-of-life patient
outcomes.
Index 565
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| spelling | Minimally invasive surgery in orthopedic surgery guest ed. Nicola Maffulli Philadelphia, PA Saunders 2009 XV S., S. 441 - 568 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Orthopedic clinics of North America 40,4 Orthopedic Procedures Orthopedic surgery (DE-588)1071861417 Konferenzschrift gnd-content Maffulli, Nicola edt Orthopedic clinics of North America 40,4 (DE-604)BV000001089 40,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=018694309&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Minimally invasive surgery in orthopedic surgery |
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| title_exact_search | Minimally invasive surgery in orthopedic surgery |
| title_full | Minimally invasive surgery in orthopedic surgery guest ed. Nicola Maffulli |
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| title_full_unstemmed | Minimally invasive surgery in orthopedic surgery guest ed. Nicola Maffulli |
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