Musculoskeletal surgery
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Musculoskeletal surgery · Dec 2020
Review Meta AnalysisHospitalization length, surgical duration, and blood lost among the approaches for total hip arthroplasty: a Bayesian network meta-analysis.
Despite the numerous studies, there is no consensus concerning the best approach for total hip arthroplasty (THA), and debates are ongoing. The purpose of this study was to perform a Bayesian network meta-analysis (NMA) comparing several approaches for primary THA. The focus was on peri-operative outcomes: surgical duration, total estimated blood loss, and length of the hospitalization. ⋯ The posterolateral approach reported shorter surgical duration and hospitalization length. Concerning the analysis of total estimated blood loss, no significant result was obtained. Data must be considered in the light of the limitations of the present study.
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Musculoskeletal surgery · Apr 2020
ReviewMetaphyseal cones and sleeves in revision total knee arthroplasty: Two sides of the same coin? Complications, clinical and radiological results-a systematic review of the literature.
Revision total knee arthroplasty (rTKA) is increasing of relevance in orthopaedic surgeon daily practice and this trend is likely to continue in the years ahead. The aim of this systematic review of English literature is to summarize and compare indications, complications, clinical and radiological results of metaphyseal cones and sleeves in management of bone loss in rTKA. Retrospective or prospective studies with at least 1 year of follow-up (FU) were included. ⋯ The aseptic survivorship of the implants was 97.3% in cones group and 97.8% in sleeves group. Metaphyseal cones and sleeves represent a viable option in management of type IIb and III AORI bone defects in aseptic and septic TKAr with overlapping survival rate. Further high-quality long-term studies would better clarify complications, clinical and radiological results of these promising techniques in revision total knee arthroplasty.
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Musculoskeletal surgery · Apr 2020
ReviewMetaphyseal cones and sleeves in revision total knee arthroplasty: Two sides of the same coin? Complications, clinical and radiological results-a systematic review of the literature.
Revision total knee arthroplasty (rTKA) is increasing of relevance in orthopaedic surgeon daily practice and this trend is likely to continue in the years ahead. The aim of this systematic review of English literature is to summarize and compare indications, complications, clinical and radiological results of metaphyseal cones and sleeves in management of bone loss in rTKA. Retrospective or prospective studies with at least 1 year of follow-up (FU) were included. ⋯ The aseptic survivorship of the implants was 97.3% in cones group and 97.8% in sleeves group. Metaphyseal cones and sleeves represent a viable option in management of type IIb and III AORI bone defects in aseptic and septic TKAr with overlapping survival rate. Further high-quality long-term studies would better clarify complications, clinical and radiological results of these promising techniques in revision total knee arthroplasty.
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Musculoskeletal surgery · Dec 2019
Systematic review of the outcome of cemented versus uncemented total hip arthroplasty following pelvic irradiation.
The objective of this study is to evaluate the outcomes of total hip arthroplasty (THA) in patients with radiation-related changes to the bone, and specifically whether there is a difference in outcomes between cemented and uncemented acetabular components. ⋯ Overall outcomes appear to be better for uncemented THAs in post-radiotherapy patients, with a significantly lower rate of aseptic loosening and an appreciable (but not statistically significant) reduction in revision rate. The best outcomes seem to be associated with the use of acetabular reinforcement across both cemented and uncemented groups, but further work is needed to evaluate this.
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Musculoskeletal surgery · Apr 2019
Meta AnalysisReconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review.
Acetabular revision especially in the presence of severe bone loss is challenging. There is a paucity of literature critiquing contemporary techniques of revision acetabular reconstruction and their outcomes. The purpose of this study was to systematically review the literature and to report clinical outcomes and survival of contemporary acetabular revision arthroplasty techniques (tantalum metal shells, uncemented revision jumbo shells, reinforced cages and rings, oblong shells and custom-made triflange constructs). ⋯ The most common postoperative complication reported in all groups was dislocation. This review confirms successful acetabular reconstructions using diverse techniques depending on the type of bone loss and highlights key features and outcomes of different techniques. In particular, oblong cups and tantalum shells have successful survivorship.