International orthopaedics
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Multicenter Study
Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implant materials.
In recent guidelines, smoking is reported as a factor increasing the risk of surgical site infection (SSI). The accurate analysis of the literature shows that this recommendation relies on low level of evidence in orthopaedic surgery with material implantation (arthroplasty components or implants for internal fixation). This study aimed to assess the attributable risk of smoking on organ/space SSI in orthopaedic surgery with implants. ⋯ This is the first large prospective report of a significant association between smoking and organ/space SSI in orthopaedic surgery with implants.
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Comparative Study
Screw placement in percutaneous acetabular surgery: gender differences of anatomical landmarks in a cadaveric study.
Percutaneous reduction and periarticular screw implantation techniques have been successfully introduced in acetabular surgery. The advantages of this less invasive approach are attenuated by higher risks of screw misplacement. Anatomical landmarks are strongly needed to prevent malplacement. This cadaver study was designed to identify reliable anatomical osseous landmarks in the pelvic region for screw placement in acetabular surgery. Gender differences were specifically addressed. ⋯ The findings emphasise the relevance of osseous landmarks in acetabular surgery. By adhering to easily identifiable structures, screw placement can be safely performed. Significant gender differences must be taken into consideration during preoperative planning.
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Randomized Controlled Trial
Efficacy and complications of open and minimally invasive surgery in acute Achilles tendon rupture: a prospective randomised clinical study--preliminary report.
Surgical treatment of an acute Achilles tendon rupture can effectively reduce the risk of re-rupture, but it increases the probability of surgical complications. We postulated that a minimally invasive surgical treatment might reduce the number of complications related to open surgery and improve the functional results. ⋯ After a two year follow-up period, we found no significant differences in clinical outcomes between groups treated with traditional open surgery or minimally invasive surgery.
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The need for perioperative blood management measures aimed at improving patient outcomes and reducing allogenic blood transfusion (ABT) is increasingly recognised. Our study aim is to create an algorithm to predict and manage the need for blood transfusion in patients with hip fractures. ⋯ An algorithm and a simple clinical tool were devised to predict and manage the need for a blood transfusion within 72 hours of admission in patients with hip fractures.
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Comparative Study
Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation.
The purpose of this study was to evaluate reconstruction of the medial patellofemoral ligament (MPFL) using the double-bundle anatomical or single-bundle isometric procedure with respect to the patients' clinical outcomes. ⋯ Single- and double-bundle reconstruction of the MPFL can both effectively restore patella stability and improve knee function. However, outcomes in the follow-up period showed that the double-bundle surgery procedure was much better than in single-bundle surgery.