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Rehabilitation and patient satisfaction following a modified anterolateral approach for implantation of a total hip replacement (THR) were reviewed following 72 consecutive cases. The Harris Hip and merle d'Aubigné Scores were recorded at 6 and 12 weeks postoperatively. The patient's satisfaction with regard to the surgical result and the need for analgesia for mobilization were recorded. Rehabilitation was assessed by postoperative crutch use. Significant improvements of the Harris Hip and merle d'Aubigné scores were demonstrated. All patients thought their surgical outcome was good or better. 2 patients needed pain medicine on an irregular basis and 4 patients used crutches at 12 weeks. This study demonstrates patient satisfaction and satisfactory rehabilitation following a modified anterolateral approach for minimally-invasive implantation of THR.

Introduction: To reduce complications, a minimally invasive technique for the treatment of dislocated intraarticular fractures of the calcaneus was used. Therefore previously described closed reduction and internal fixation techniques were combined and modified. Materials and methods: Sixty-seven out of 92 calcaneal fractures could be retrospectively evaluated with an average follow-up time of 5.7 years (minimum 210 years follow-up). For radiographic evaluation, plain radiographs and CT scans were obtained. The Zwipp score was used for clinical evaluation. Sanders type II, III and IV fractures were diagnosed. Results: Length of surgery averaged 61 min (range 20175 min). The incidence of subtalar arthritis was correlated to the severity of fracture. Böhler’s angle was restored in 70.1% (47 of 67) of the cases. On the last follow-up evaluation the average Zwipp score was 130 points (range 48186 points). The majority (77.7%) of patients were content with their treatment result. The rate of significant complications was 6.5%. Discussion: Compared to open techniques the presented minimally invasive technique showed comparable results with a low rate of serious complications and is a viable alternative for the treatment of intraarticular, dislocated calcaneal fractures. peerReviewed

In rotator cuff repair, strong and long-lasting suturing techniques that do not require additional implants are needed. This study examines the ultimate load to failure and the Young’s modulus at the suture–tendon interface for a novel single-loop knot stitch and double-loop knot stitch. These values are compared to those of the modified Mason–Allen stitch. Twenty-four infraspinatus muscles with tendons were dissected from porcine shoulders (twelve Goettingen minipigs). The preparations were randomly allocated to three groups of eight samples. Load-to-failure testing of the single-loop knot stitch, the double-loop knot stitch and the mMAS were performed using a Zwick 1446 universal testing machine (Zwick-Roell AG, Ulm, Germany). The highest ultimate load to failure for the three techniques occurred with the double-loop knot stitch with a median value of 382.2 N (range 291.8–454.2 N). These values were significantly higher than those of the single-loop knot stitch, which had a median value of 259.5 N (range 139.6–366.3 N) and the modified Mason–Allen stitch, which had a median value of 309.3 N (range 84.55–382.9 N). The values of the single-loop knot stitch and the modified Mason–Allen stitch did not differ significantly. Regarding the Young’s modulus, no significant differences were found between the double-loop knot stitch with a median value of 496.02 N/mm² (range 400.4–572.6 N/mm²) and the modified Mason–Allen stitch with 498.5 N/mm² (range 375.5–749.2 N/mm²) with respect to the stiffness of the suture–tendon complex. The median value for the Young’s modulus of the single-loop knot stitch of 392.1 N/mm² (range 285.7–510.6 N/mm²) was significantly lower than those of the double-loop knot stitch and modified Mason–Allen stitch. This in vitro animal study demonstrated that both the single-loop knot stitch and the double-loop knot stitch have excellent ultimate load-to-failure properties when used for rotator cuff repair. The introduced single-loop knot stitch and double-loop knot stitch offer an alternative to other common used stitch techniques in rotator cuff repair.

Minimally invasive hip approaches decrease soft tissue damage but reduce the view of the operating field. The combination of minimally invasive approaches with navigation techniques can resolve this conflict. A modified anterolateral approach was used for minimally invasive implantation of hip endoprostheses, in combination with a navigation technique. A newly developed femoral clamp was used in the study, which allowed a secure fixation of the navigation reference frame without compromising the visibility of the small incision. The results included short skin incisions and hip joint muscle reservation, with only a moderate increase in operating times.

Although navigation achieves better alignment results in total knee arthroplasty (TKA), it is generally assumed that navigation also needs more time and effort than conventional surgeries. After optimizing the treatment procedure of navigated TKA, the operation times needed for navigated surgeries were documented and compared with the average time of conventional surgeries, registered before the introduction of the navigation system. Sixty consecutive patients for uncemented TKAs were included in the navigated series. Results show an average of 49 minutes for the navigated surgeries, which is less than the average of the manual surgeries. For all patients, alignment was within 3° varus/valgus postoperatively, and the mean Knee Society Score improved from 25 points preoperatively to 83 points 6 weeks postoperatively.