International orthopaedics
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Comparative Study
The risk of dislocation after total hip arthroplasty for fractures is decreased with retentive cups.
Total hip arthroplasty (THA) has been efficacious for treating hip fractures in healthy older patients. However, in those patients with fractures a widely variable prevalence of dislocation has been reported, partly because of varying durations of follow up for this specific end-point. The purpose of the present study was to determine the cumulative risk of dislocation in these patients with fractures and to investigate if retentive cups decrease the risk of dislocation. ⋯ With standard cups the incidence of dislocation is highest in the first year after arthroplasty and then continues at a relatively constant rate for the life of the arthroplasty. Patients at highest risk are old female patients and those with a diagnosis of neurologic disease. Retentive cups in these patients are an effective technique to prevent post-operative hip dislocation.
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Persistent displacement of ankle fractures increases the stresses on the articular cartilage and leads to degenerative arthritis. Correction of the ankle mortise restores the normal ankle biomechanics and should prevent the development of degenerative joint disease. ⋯ Corrective osteotomy of fibular malunion produces considerable improvement provided that the patient does not have significant degenerative changes before surgery. The use of athrodiastasis of the ankle as a secondary procedure may be of value to improve the outcome.
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Randomized Controlled Trial Meta Analysis
Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials.
Patella resurfacing or nonresurfacing in total knee arthroplasty remains controversial. The aim of this study was to evaluate the efficacy of patellar resurfacing through an evaluation of the current literature. ⋯ The available evidence indicates that patellar resurfacing reduces the risk of reoperation after total knee arthroplasty. Patellar resurfacing patients may make a difference in long-term follow-up (five or more 5 years) of Knee Society scores. In other aspects, the benefit of patellar resurfacing is limited. Additionally, more carefully and scientifically designed randomised controlled trials are required to further prove the claim.
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Randomized Controlled Trial
Design and application of nickel-titanium olecranon memory connector in treatment of olecranon fractures: a prospective randomized controlled trial.
We carried out this study to test the efficacy of the olecranon memory connector (OMC) in olecranon fractures. ⋯ The study showed that OMC could be an effective alternative to treat olecranon fractures.
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Comparative Study
Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients.
Adverse events associated with the use of bone cement for fixation of prostheses is a known complication. Due to inconclusive results in studies of hip fracture patients treated with cemented and uncemented hemiprostheses, this study was initiated. ⋯ We found increased mortality for the cemented hemiprosthesis the first post-operative day compared to uncemented procedures. This increased risk is closely related to patient comorbidity estimated by the patient's ASA score.