RESUMEN
Up to 100,000 total knee arthroplasties are performed annually in Germany resulting in an increasing number of revision operations. Different underlying causes might preclude the reimplantation of an endoprosthesis, and knee arthrodesis represents the alternative of first choice to above-knee amputation. The most common indications for arthrodesis are the infected knee arthroplasty with defects of the extensor mechanism, soft tissue and bone defects, and persisting infection. Several procedures of arthrodesis have been introduced and should be well adapted to the individual situation of the patient. The results--especially related to quality of life--are encouraging and should facilitate the demanding decision if a total joint reimplantation is not reasonable.
Asunto(s)
Artrodesis/métodos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Inestabilidad de la Articulación/etiología , Inestabilidad de la Articulación/prevención & control , Prótesis de la Rodilla/efectos adversos , Infecciones Relacionadas con Prótesis/cirugía , Reimplantación/métodos , Terapia Recuperativa/métodos , Humanos , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina , Pronóstico , Infecciones Relacionadas con Prótesis/etiología , Resultado del TratamientoRESUMEN
Fractures of the lower leg due to skiing accidents remain an important concern. Few studies have focussed on the special demands of professional athletes who sustain these injuries. We present our experience with three cases of lower leg fractures in competitive professional downhill skiers and discuss management and treatment concepts. We performed limited reamed compression nailing in all the patients presented because it offers the advantages of high mechanical stability and optimized fragment apposition. Plate osteosynthesis of the fibula is not required in most typical fractures. All patients resumed ski training. Two of them returned to World Cup. Only one achieved her pre-injury World Cup level of performance and success. In conclusion, a successful return for professional skiers with lower leg fractures is feasible using an optimized treatment strategy.