Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2019
Sagittal profile has a significant impact on the explantability of well-fixed cemented stems in revision knee arthroplasty: a biomechanical comparison study of five established knee implant models.
Easy revisability is gaining increasingly in importance. The removal of well-fixed cemented stems is very demanding and is often associated with increased operative morbidity. Implant design may be here a decisive impact factor, and the best way to ascertain it is experimentally. Aim of this study is to assess different cemented stems of established knee revision implants in regard to their removal capability. ⋯ The longitudinal stem profile may have a primary impact on the explantability of well-fixed cemented shafts with conical designs showing superiority. Cross-sectional profile and surface roughness had here a less decisive influence on the explantability. Surgeons can choose proper implants and removal techniques depending on potential implant-associated revision risks and re-revisions to be expected.
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Arch Orthop Trauma Surg · Jul 2019
Observational StudyImpact of closed suction drainage after surgical fixation of acetabular fractures.
The purpose of the present study was to evaluate the prevalence of closed suction drainage after a Kocher-Langenbeck (K-L) approach for surgical fixation of acetabular fractures and to determine the impact of closed suction drainage on patient outcomes. ⋯ The use of closed suction drains for treatment of acetabular fractures using a K-L approach is associated with increased rates of blood transfusion and increased length of hospital stay, with no impact on surgical site infection rates. The results of this study suggest against routine drain usage in acetabular surgery.
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Arch Orthop Trauma Surg · Jul 2019
Weakening of the knee ligament complex due to sequential medial release in total knee arthroplasty.
The purpose of this study was to investigate the effects of sequential medial release on the stiffness and collateral stability of the ligament complex of the knee. Irrespective of the implantation technique used, varus deformity frequently requires release of the capsular ligament complex. Yet, no data are available on how stiffness and stability of the knee ligament complex are weakened by such release. ⋯ IV.
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Arch Orthop Trauma Surg · Jul 2019
Meta AnalysisIs intravenous tranexamic acid effective and safe during hip fracture surgery? An updated meta-analysis of randomized controlled trials.
The efficacy and safety of intravenous (IV) tranexamic acid (TXA) during hip fracture surgery remain controversial. This meta-analysis aimed to assess the efficacy of IV-TXA administration during hip fracture surgery for reducing the transfusion requirement and blood loss as well as its safety regarding the risk of thrombolysis. ⋯ Available evidence indicates that IV-TXA efficaciously reduces TBL and transfusion requirements during hip fracture surgery without significantly increasing the risk of TTEs including DVT.
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Arch Orthop Trauma Surg · Jul 2019
High complication and revision rates after total femoral replacement: a retrospective single center analysis of indication, function, and complication.
Total femoral replacement (TFR) is a limb salvage procedure performed for large bony defects. However, it is often associated with major complications and reduced function. Data on limb preservation rates and functional outcomes after TFR are limited. The primary objective of this study is to assess indications, functional outcomes, and complications after TFR. ⋯ TFR is a salvage procedure with limited functional outcome and high complication rates. Nevertheless, the majority of our cohort could be treated successfully with limb salvage.