Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2014
The effect of renal function on surgical outcomes of intracapsular hip fractures with osteosynthesis.
Chronic kidney disease (CKD) affects many physiologic systems, including bone quality, nutrition, and cardiovascular condition. Femoral neck fractures in patients on dialysis are associated with frequent complications and a high risk of mortality. However, the effect of CKD on clinical outcomes of patients with hip fractures treated with osteosynthesis remains unclear. ⋯ Prognostic studies, Level III.
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Arch Orthop Trauma Surg · Jan 2014
Total knee arthroplasty after high tibial osteotomy: a registry-based case-control study of 1,036 knees.
Total knee arthroplasty (TKA) after high tibial osteotomy (HTO) is a technically demanding procedure, and concerns have been raised that previous HTO might compromise the outcome of TKA. The aims of the study were to assess the survivorship of TKA after HTO and to determine whether the survivorship is similar to that of primary TKA without previous HTO. ⋯ Previous studies have described technical difficulties during the TKA procedure after HTO, but they have found no adverse effects on the outcome. Our study supports previous research, and despite the slightly higher revision rate, TKA after HTO provides satisfactory results when compared to routine primary TKAs.
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Arch Orthop Trauma Surg · Jan 2014
Fibrin sealants or cell saver eliminate the need for autologous blood donation in anemic patients undergoing primary total knee arthroplasty.
Reducing allogeneic blood transfusions remains a challenge in total knee arthroplasty. Patients with preoperative anemia have a particularly high risk for perioperative blood transfusions. ⋯ While PABD proved to be the most cost-effective treatment option in anemic patients, fibrin sealants and cell saver show similar reduction in allogeneic transfusion rates compared to controls. The combination of fibrin sealants and PABD is not cost-effective and increases the number of wasted units.
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Arch Orthop Trauma Surg · Jan 2014
Ten-year follow-up on Dutch orthopaedic blood management (DATA III survey).
Hip and knee arthroplasties are frequently complicated by the need for allogeneic blood transfusions. This survey was conducted to assess the current use of perioperative blood-saving measures and to compare it with prior results. ⋯ Currently, just as in 2007, the majority of Dutch orthopaedic departments uses erythropoietin, normothermia and postoperative autologous retransfusion with hip and knee arthroplasty. Intraoperative retransfusion is used mainly with hip revision arthroplasty. Other effective blood management modalities such as tranexamic acid have not been widely implemented.
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Arch Orthop Trauma Surg · Jan 2014
Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head.
The aim of this study was to investigate the effectiveness of core decompression in combination with a nano-hydroxyapatite/polyamide 66 (n-HA/PA66) rod and a porous bioglass bone graft for the treatment of osteonecrosis of the femoral head (ONFH). ⋯ Core decompression combined with the implantation of a n-HA/PA66 rod and a bioglass bone graft can significantly decrease hip pain, improve hip function, and prevent the collapse of the femoral head in patients with ONFH. As the effectiveness of this approach appears to vary with Steinberg stage, we suggest that this treatment procedure may be suitable for patients with early to middle stage ONFH.