International orthopaedics
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The purpose of this study was to determine the outcomes in patients treated with robotically assisted patello-femoral arthroplasty (PFA). ⋯ The early retrospective data for robotically-assisted PFA show encouraging results. Advantages of this technique include a smaller incision, faster rehabilitation, preservation of bone stock, and implantation without malalignment.
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Review Meta Analysis
Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.
The methods for pain control after total knee arthroplasty (TKA) vary and have been extensively studied in recent years. Femoral nerve block (FNB) is used as the standard method due to its effective pain control following TKA, but it may weaken the quadriceps strength. Adductor canal block (ACB) is a newly developing analgesic protocol with fast functional recovery and good pain control after TKA. A meta-analysis was conducted to try to find out if ACB is better than FNB in pain treatment and joint functional recovery after TKA. ⋯ ACB provide better ambulation ability, faster functional recovery and better pain control at rest after TKA compared to FNB. The use of ACB post TKA is worthy of being recommended to replace FNB as a standard analgesic protocol for pain treatment after TKA.
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Periprosthetic fractures (PPFs) after total knee arthroplasty (TKA), especially in patients with multiple revisions, remain challenging mainly due to bone quality and loss of bone stock. Megaprostheses, although providing immediate stability and weight bearing, are rarely used in this indication. The aim of the study was to provide a description of the surgical technique and evaluate the outcome of this technique with respectable published data. ⋯ Megaprostheses represent a valuable option in distal femoral PPFs type 3 according to Su et al., as well as proximal tibia PPFs type 1B according to Felix et al., with loose tibial components. Infection remains the most frequent nonmechanical complication. Prospective clinical studies are required to exactly define the outcome of this technique in PPFs; use of the Henderson classification system would allow comparison between megaprostheses in oncological and nononcological indications.
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To test whether a novel guide template we designed can facilitate accurate insertion of antegrade lag screws in the fixation of acetabular posterior column fractures. ⋯ Antegrade lag screws can be more accurately put into the posterior column of the acetabulum with the help of this navigation template.