International orthopaedics
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The purpose of this study was to investigate whether cement-augmented screw osteosynthesis results in stability comparable to conventional fixed-angle locking plate osteosynthesis using cadaveric bones to model a Sanders type 2B fracture. ⋯ The results of this study indicate that in our selected test set-up augmented screw osteosynthesis was significantly superior to the conventional fixed-angle locking plate osteosynthesis with respect to primary stability and ROM during cyclic testing.
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Meta Analysis Comparative Study
Meta-analysis of randomised controlled trials comparing unipolar with bipolar hemiarthroplasty for displaced femoral-neck fractures.
Unipolar and bipolar hemiarthroplasty (HA) are used to treat displaced femoral-neck fractures. However, which type is best for treating displaced femoral-neck fractures in elderly patients remains a subject for debate. Our aim was to review randomised controlled trials to establish which type provides superior clinical outcome for this patient population. ⋯ Unipolar and bipolar HA achieved similar clinical outcomes in patients with displaced femoral-neck fractures.
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Osteoporosis has been recognised as a public health concern for at least three decades but it has been relatively recent that the push has been for orthopaedic surgeons to take a more active role in the diagnosis and treatment of patients with decreased bone mineral density (BMD). Most often these patients are encountered after they have suffered a fracture making secondary prevention the area where orthopaedists may exert the greatest influence on patient care. The purpose of this article is to provide a succinct framework for the diagnosis and treatment of patients with decreased BMD. ⋯ Regardless of treatment course these are opportunities for the orthopaedic surgeon to intervene in the osteoporotic disease process and positively affect a patient's bone health. This article compiles the available literature on osteoporosis and presents it succinctly with the incorporation of both a diagnosis algorithm and treatment profile table. With the use of these two tools, orthopaedic surgeons everywhere should be able to take a more active role in their patients' bone health.
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Comparative Study
Surgical procedures in femoral neck fractures in Finland: a nationwide study between 1998 and 2011.
For femoral neck fractures, recent scientific evidence supports cemented hemiarthroplasty (HA) over uncemented HA and suggests that total hip arthroplasty (THA) should be performed more frequently. We report the current surgical trends in treating femoral neck fractures in Finland. ⋯ Between 2005 and 2011, the proportion of uncemented HA for femoral neck fractures increased markedly in Finland, while cemented HA and internal fixation declined. During this time, the use of THA nearly doubled. The current evidence-based guidelines for treatment of femoral neck fractures were mainly followed, but the increase in uncemented HA procedures contradicts recent scientific evidence.
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Comparative Study
Targeted pre-operative autologous blood donation: a prospective study of two thousand and three hundred and fifty total hip arthroplasties.
Pre-operative donation of autologous blood has been widely used in elective joint replacement procedures to avoid the risks of allogeneic blood transfusions. However, the high percentage of wasted autologous blood questions the general efficacy of pre-operative autologous blood donation (PABD) for all patients undergoing hip replacement. This study prospectively investigates the impact of a targeted pre-operative autologous blood donation protocol for anaemic patients on allogeneic and overall transfusion rates in 2,350 unilateral primary total hip arthroplasty procedures. ⋯ Targeted PABD reduces the need for allogeneic blood transfusion in anaemic patients and significantly reduces the overall number of transfusions compared to routine pre-operative autologous donation.