André Spranger - Academia.edu (original) (raw)

Papers by André Spranger

$Research paper thumbnail of Chemical neurolysis for the conservative treatment of hip fractures$

Pain management, Jun 28, 2024

European Journal of Orthopaedic Surgery & Traumatology

Orthopedic Research Online Journal, 2019

A 77-year-old female patient referred to our hospital due to an early postoperative complication:... more A 77-year-old female patient referred to our hospital due to an early postoperative complication: the intra-pelvic acetabular cup migration after primary hip arthroplasty. The patient had no relevant medical history. The x-rays showed intrapelvic protusio of the prosthetic cup (Figure 1).

Journal of Bone Joint Surgery British Volume, May 1, 2011

Introduction: Hip Surgical Dislocation (SHD) according the technique described by Ganz et al. is ... more Introduction: Hip Surgical Dislocation (SHD) according the technique described by Ganz et al. is a safe and powerful tool to access intra-articular hip pathology in adults. Some indications may also arise in younger patients to correct slipped capital femoral epiphysis or femoral neck deformities Materials and Methods: From 2004 to 2008 we have selected 45 patients on whom the procedure was done to treat femoroacetabular impingement (FAI). The average follow up time is 3 years, and patient mean age 26 years. The indications for SHD were: mixed FAI in 26 cases, pure cam FAI in 6 cases and pure pincer FAI in 13 cases. 42 hips where graded as Tonnis 0 and 2 as Tonnis 1. All patients where evaluated according to the non arthritic hip score (NAHS – McCarthy et all) before and after the surgery at 3, 6, 12, 24 and 36 months. Osyrix ® software was used to measure radiographic parameters. The numeric variables where treated using SPSS for windows (paired t student test). Surgical Technique: In all 45 cases we did SHD, acetabular and/or femoral head neck junction trimming and labrum refixation. In half cases an anterior step trochanteric osteotomy was done and in 7 cases additional relative neck lengthening was performed. Results: The average alfa angle measured in the standard crosstable view x ray was 72° before surgery and 36° after surgery (p=0,0001). The NAHS before surgery was 40,8 average: 9,71 – pain; 6,9 – symptoms; 9 – function and 6,9 – activities and after surgery 76,38 average (p= 0,0001) 17,5 – pain (p= 0,0001); 12,9 – symptoms (p= 0,0001); 16 - function (p= 0,0001) and 14,9 - activities (p= 0,0001). All patients improved motion, specially flexion, internal rotation (p= 0,0001). The results did not differ significantly in the patients who had a trochanteric anterior step osteotomy. One patient had a total hip replacement for ongoing osteoartrithis We had no avascular necrosis so far and no neurovascular damage. Trochanteric screw removal was done in 3 cases for local irritation. We had 2 capsule adhesions, released shortly after using arthroscopy. Conclusions: SHD is a demanding technique with full access to femoral head and acetabular deformities as well as cartilage or labral tears. It can be done safely with a low complication rate. The best results are achieved in young patients without degenerative cartilage and significant labrum changes. Hip degenerative changes contraindicates this procedure. Modification of trochanteric osteotomy does not seem to influence results

Journal of Case Reports and Images in Oncology

Introduction: A primary malignant giant-cell tumor of bone (PMGCT) is an extremely rare disease a... more Introduction: A primary malignant giant-cell tumor of bone (PMGCT) is an extremely rare disease and usually presents with a better prognosis than its secondary counterpart does (secondary malignant giant-cell tumor of bone or SMGCT). Case Report: We present a case of a highly atypical PMGCT of the proximal left tibia, with extremely fast progression, pathological fracture, fungation, and patient death. Conclusion: This clinical case is an example of the most extreme and aggressive biological behavior that could arise with a PMGCT. These usually have a better prognosis than most, among malignant giant-cell tumors. This case highlights the need for a low threshold of suspicion for malignant transformation when giant-cell tumors have an unusual presentation.

DOAJ: Directory of Open Access Journals - DOAJ, Dec 29, 2021

Bone marrow edema syndrome is a rare disease with an unknown etiology, self-limited and usually a... more Bone marrow edema syndrome is a rare disease with an unknown etiology, self-limited and usually associated with an indolent course, which can also generate severe pain with tremendous functional impairment. The authors present a case of a 19-year-old female patient with a progressive, non-traumatic and unrelentless pain involving both knees, requiring persistently walking aids and analgesic drugs. The imaging studies showed a bilateral distal femur and proximal tibia bone marrow edema in the magnetic resonance imaging. Finally, and after an extensive investigation without any abnormal findings, a bone marrow edema syndrome diagnosis was established, with a spontaneous regression of the clinical and imaging presentation. One year after the initial complaints the patient is fully recovered, without pain or medication, presenting an MRI showing complete regression of the initial findings. Despite the rarity of this entity, being aware of its existance and clinical manifestations is crutial to allow a proper diagnosis. The case herein presented is, to our understanding, pragmatic regarding bone marrow edema syndrome presentation and clinical course.

JBJS Case Connector, 2020

Case: A 60-year-old man presented with left hip pain, and a radiograph showed reduced joint space... more Case: A 60-year-old man presented with left hip pain, and a radiograph showed reduced joint space. During the surgical procedure for a total hip replacement, a proximal femur mass was identified and biopsy was subsequently interpreted as grade 2 chondrosarcoma. A wide resection was needed, but he developed local recurrence after 2 years and was treated with an external hemipelvectomy. Conclusions: Chondrosarcoma does not always present with a classical clinical picture or imaging, and it can be misdiagnosed. Practitioners should be highly suspicious of malignant disease as a cause for hip pain even if there is no direct indication of a neoplasm such as chondrosarcoma.

Acta orthopaedica Belgica, 2016

While accumulating data on the direct anterior approach to total hip arthroplasty (THA) have demo... more While accumulating data on the direct anterior approach to total hip arthroplasty (THA) have demonstrated clinical benefit and durable results, there is little data that exists on patient-centered outcomes and satisfaction when comparing simultaneous bilateral procedures with staged arthroplasty. The aim of this study was to determine whether simultaneous bilateral THA and staged arthroplasty result in equivalent early (1) patient-centered outcomes and patient satisfaction; while maintaining acceptable rates of (2) objective clinical outcome scores, (2) complication rates; and (3) radiographic results. In retrospective review, 41 patients who underwent bilateral one-stage THA were compared to 44 patients who underwent staged bilateral THA during the same time period. The minimum clinical follow up was two years. Generic (EQ-VAS and EuroQoL-5D index) and condition-specific (Oxford Hip Score) instruments were used to assess patient-reported outcomes. Other variables included length of...

Case Reports in Orthopedics, 2019

Introduction. Pipkin fractures are rare events and usually occur as a consequence for high-energy... more Introduction. Pipkin fractures are rare events and usually occur as a consequence for high-energy trauma. Surgery to obtain anatomical reduction and fixation is the mainstay treatment for the majority of these injuries; nonetheless, controversy exists regarding the best surgical approach. Description of the Case. We present the case of a 41-year-old male, which sustained a type II Pipkin fracture following a motorcycle accident. In the emergency department, an emergent closed reduction was performed, followed by surgery five days later. Using a surgical hip dislocation, a successful anatomical reduction and fixation was performed. After three years of follow-up, the patient presented with a normal range of motion, absent signs for avascular necrosis or posttraumatic arthritis, but with a grade II heterotopic ossification. Discussion. Safe surgical hip dislocation allows full access to the femoral head and acetabulum, without increasing the risk for a femoral head avascular necrosis ...

Introduction: There are several complications associated with spinal cord injury. The authors pro... more Introduction: There are several complications associated with spinal cord injury. The authors propose to evaluate the complications developed during hospitalization of tetraplegic patients treated in our institution. Materials and Methods: The clinical and imaging records of 20 tetraplegic patients operated between 1995 and 2007 were evaluated (14 men and 6 women; mean age 31.5 years; 16 submitted to surgery using anterior cervical approach, 4 using posterior approach; 8 did steroids protocol during 24h and 12 during 48h; 9 patients were operated less than 48h after trauma and 11 patients after). Results: Mean hospitalization time was 47.4 days (men 48.9 d, women 23.4 d; anterior approach 50.25 d, posterior approach 39 d; corticosteroids during 24h 34.3 d, 55.3 d in those who did 48h; time until surgery 48h 54.5 d). 100% of patients developed respiratory tract infections. 56.3% of patients developed urinary tract infections (33% in patients doing corticosteroids during 24h, 70% in t...

EFORT Open Reviews

Giant cell tumour of bone (GCT) is a relatively rare, locally aggressive benign neoplasm observed... more Giant cell tumour of bone (GCT) is a relatively rare, locally aggressive benign neoplasm observed in the long bone epiphyseal-metaphyseal regions of young adults. The optimal treatment strategy for these tumours remains controversial, and a huge amount of contradictory data regarding the functional and oncological outcomes can be found. Therefore, we performed a systematic review intended to investigate the functional and oncological outcomes after surgical treatment of GCTs arising around the knee, namely in the distal femur and proximal tibia. A trend towards better oncological control was found using wide resections, nonetheless, curettage-based techniques achieve a highly acceptable recurrence rate with overall better knee function. A slight advantage favouring proximal tibia GCTs regarding the Musculoskeletal Tumor Society (MSTS) score was also observed. Prospective studies comparing groups of more homogeneous patients, tumours, and treatment options should be developed to obta...

Acta reumatologica portuguesa, 2021

We present the case of a 32-year-old man with a diagnosis of type-III osteogenesis imperfecta who... more We present the case of a 32-year-old man with a diagnosis of type-III osteogenesis imperfecta who developed a telangiectatic osteosarcoma in the proximal right tibia. An above-knee amputation was performed and after one-year follow-up, pulmonary metastatic lesions were detected on the thoracic CT scan. Palliative chemotherapy was proposed and to date the patient is still living and is under medical treatment. The association between osteogenesis imperfecta and osteosarcoma is rare. There are only ten confirmed reports of this unusual situation, but to our knowledge this is the first case reported with a telangiectatic osteosarcoma arising in this particular setting.

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Objective : Chronic osteomyelitis of the tibia is a difficult treatment entity. We present this c... more Objective : Chronic osteomyelitis of the tibia is a difficult treatment entity. We present this case for the challenge it presented and the opportunity to reflect on the therapeutic options taken at various stages of treatment. Description A patient is presented who underwent Ilizarov trifocal bone transport following 10 cm excision of the tibial shaft for the treatment of a tíbia pathologic fracture in the context of chronic osteomyelitis. The docking site fractured and infected. A new Ilizarov aparatus was aplied with fibular osteotomy and correction of varus aligmnent, with sucessful result. Comentários: Under these circumstances infection caried a high risk of failure of this complex reconstruction. Fibular osteotomy played an importante role achieving sucess.