Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2020
Minimum 5-year follow-up outcomes for one-stage posterior instrumentation without neurosurgery intervention for correction of scoliosis associated with Chiari I malformation and syringomyelia.
Traditionally, the common belief has been that, all patients with Chiari I malformation (CM-1) and syringomyelia (SM) undergoing a neurosurgical procedure even if they are neurologically asymptomatic. As the pathology of CM-1 and SM has become better understood, the traditional concepts have been challenged. The objective of this study was to investigate the minimum 5-year follow-up clinical outcomes of surgical treatment of patients with scoliosis associated with CM-1 and SM and to evaluate the necessity of neurosurgical intervention before corrective surgery. ⋯ Our minimum 5-year follow-up outcomes showed that in a distinct patient population of neurologically asymptomatic individuals with CM-1, SM and progressive scoliosis, posterior instrumented spinal deformity surgery can be safely done without neurosurgical interverventions with the help of preoperative flexibility evaluation and intraoperative neuromonitoring.
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Arch Orthop Trauma Surg · Oct 2020
Short-term outcome of double-shelled braces in neuromuscular scoliosis.
Scoliosis in patients with neuromuscular disease is a common issue and leads to secondary impairment. It is thus important to help such patients to regain and retain best possible stability to improve their quality of life. One option is the double-shelled brace (DSB). The aim of this study was to provide information on the degree of correction when using a DSB on patients with neuromuscular scoliosis. ⋯ Short-term corrections with a double-shelled brace in neuromuscular scoliosis present an average improvement of one fourth of the lumbar and thoracic Cobb angles and, independent of age, sex, movement disorder, shape or type of the curve. Only spasticity has an influence on the lumbar scoliosis outcome.
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Arch Orthop Trauma Surg · Oct 2020
Maximal flexion and patient outcomes after TKA, using a bicruciate-stabilizing design.
Physiological motion after total knee arthroplasty (TKA) should result in a large range of motion, which would lead to good clinical outcomes. An adjusted design of a bicruciate-stabilizing TKA was developed to reproduce physiological motion. The aim of this study was to (1) investigate the maximal knee flexion of this knee system, 1 year post-operatively; (2) determine the clinical and functional improvement and compare the outcomes between patients with and without high maximal flexion; and (3) evaluate the adverse events. ⋯ Prospective cohort study, Level II.
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Arch Orthop Trauma Surg · Oct 2020
Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study.
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA). ⋯ GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.
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Arch Orthop Trauma Surg · Oct 2020
ReviewClinical outcome of bi-unicompartmental knee arthroplasty for both medial and lateral femorotibial arthritis: a systematic review-is there proof of concept?
Unicompartmental knee arthroplasty (UKA) is a well-accepted treatment for isolated unicompartmental osteoarthritis (OA) of the knee. In previous literature, it has been suggested that bi-unicompartmental knee arthroplasty (bi-UKA) which uses two UKA implants in both the medial and lateral compartments of the same knee is a feasible and viable option for the treatment of knee OA. Given the advantages of UKA treatment, it is warranted to review the literature of bi-UKA and discuss the evidence in terms of implant selection, indications, surgical techniques, and outcomes, respectively. ⋯ Both simultaneous and staged bi-UKA has demonstrated good functional outcomes. However, the volume and level of evidence in general is low for studies captured in this review, and the data on long-term outcomes remain limited. The present review indicates that bi-UKA is a feasible and viable surgical option for bicompartmental femorotibial OA in carefully selected patients.