Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2013
Review Meta Analysis Comparative StudyTotal knee replacement following high tibial osteotomy versus total knee replacement without high tibial osteotomy: a systematic review and meta analysis.
Currently, there is no consensus as to whether total knee replacement(TKR) following high tibial osteotomy(HTO) provides similar postoperative outcomes as compared to TKR without previous HTO. Previous studies have provided limited evidence to small sample sizes and methodological inappropriateness. ⋯ Systematic review and meta analysis suggested that TKR following HTO provides similar outcomes as compared to TKR without previous HTO. Therefore, a previous HTO does not negatively influence a future TKR, though the conversion process of HTO to TKR is technically challenging. Systematic review also identified paucity in prospective and long term studies.
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Arch Orthop Trauma Surg · Nov 2013
Simultaneous and staged bilateral total hip arthroplasty: a Danish nationwide study.
Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days readmissions and 90 days mortality after BSTHA and BTHA on a nationwide basis. ⋯ If patients are carefully selected for BSTHA, the procedure appears to be safe when combined with a fast-track protocol in Denmark. We found significantly lower readmission rates and shorter total LOS in the BSTHA group compared with the BTHA groups, potentially reflecting selection bias. The results should stimulate to evaluate BSTHA in a randomised controlled trial or a detailed prospective, large multicenter study with a fast-track protocol regarding morbidity, convalescence and mortality.
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Arch Orthop Trauma Surg · Nov 2013
Randomized Controlled Trial Comparative StudyPeriarticular infiltration for pain relief after total hip arthroplasty: a comparison with epidural and PCA analgesia.
Epidural and intravenous patient-controlled analgesia (PCA) are established methods for pain relief after total hip arthroplasty (THA). Periarticular infiltration is an alternative method that is gaining ground due to its simplicity and safety. Our study aims to assess the efficacy of periarticular infiltration in pain relief after THA. ⋯ In our study periarticular infiltration was clearly superior to PCA with morphine after THA, providing better pain relief and lower opioid consumption postoperatively. Infiltration seems to be equally effective to epidural analgesia without having the potential side effects of the latter.
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Arch Orthop Trauma Surg · Nov 2013
Implementation of a co-managed Geriatric Fracture Center reduces hospital stay and time-to-operation in elderly femoral neck fracture patients.
To evaluate changes in hospital length-of-stay and time-to-operation of older hip fracture patients before and after the foundation of a co-managed Geriatric Fracture Center (GFC). ⋯ A co-managed GFC offering an organized fracture program for the elderly can reduce hospital length-of-stay and time-to-operation in hip fracture patients. A significant effect can be observed within the first year after establishment of a GFC.
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Arch Orthop Trauma Surg · Nov 2013
MRI after unicondylar knee arthroplasty: rotational alignment of components.
This pilot study used magnet resonance imaging (MRI) to analyse the rotation of medial unicondylar knee arthroplasty (UKA) components and assessed how accurately the results could be reproduced. ⋯ MRI allows good reproducible rotation analysis via the femoral epicondyles for both femoral and tibial UKA implants. For the tibia, the tibial tuberosity, the eminentia and the tibial epicondyles in particular were shown to be less reliable. The dorsal epicondyles seem to be most suitable for the tibial component.