Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2022
Perioperative complications in osteotomies around the knee: a study in 858 cases.
Eight hundred and fifty-eight consecutive osteotomies around the knee joint were analyzed retrospectively to detect intra- and early postoperative complications in a period of 4 weeks postoperative. Indications for osteotomy were unilateral gonarthritis or torsional deformities resulting in femoropatellar instability or anterior knee pain. ⋯ Osteotomy around the knee is a safe procedure in the treatment of unicompartmental gonarthritis in terms of intra- and postoperative complications. Major complications are rare. Pit falls for compartment syndromes (LCW and torsional corrections) have to kept in mind. There is no difference in frequency of complications between HTO and supracondylar osteotomies. Risk for superficial wound infection is higher in posttraumatic osteotomies and with continuous corrections. Osteoclasia contains a higher risk for vascular lesion compared to oscillating saw.
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Arch Orthop Trauma Surg · May 2022
Rotation osteotomy of the distal femur influences coronal femoral alignment and the ischiofemoral space.
Despite the fact that osteotomies around the knee represent well-established treatment options for the redistribution of loads and forces within and around the knee joint, unforeseen effects of these osteotomies on the remaining planes and adjacent joints are still to be defined. It was, therefore, the aim of this study to determine the influence of a distal femoral rotation osteotomy on the coronal limb alignment and on the ischiofemoral space of the hip joint. ⋯ Supracondylar external rotation osteotomy of the femur leads to valgisation of the coronal limb alignment and increases the ischiofemoral space. This is resultant to the reorientation of the femoral antecurvature and the femoral neck. When planning a rotational osteotomy of the lower limb, this should be appreciated and may also aid in the decision regarding osteotomy site.
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Arch Orthop Trauma Surg · May 2022
No implant, no solution, lost cases to surgery: orthopedic trauma triage for surgery in an NGO hospital in Sierra Leone.
In low-income countries (LIC), international surgeons face the fact that there are patients they cannot treat. The goal of this study was to identify and analyze patients lost to treatment. ⋯ One quarter of the patients did not receive the surgical treatment needed. Besides acquisition of implants, surgical skills and expertise could be a solution for this issue. Nevertheless, these skills must be passed to local surgeons.
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Arch Orthop Trauma Surg · May 2022
Review Meta AnalysisOutcomes and complications of the INFIX technique for unstable pelvic ring injuries with high-velocity trauma: a systematic review and meta-analysis.
The pelvic INFIX technique has been proposed as a useful alternative to symphyseal plating for management of unstable pelvic ring injuries. The minimally invasive nature of the procedure, shorter operative time and less perioperative blood loss have been purported as potential advantages. ⋯ The INFIX technique can be considered as a viable alternative to symphyseal plating for unstable pelvic ring injuries. It has the advantages of shorter operative times and less blood loss, along with comparable functional outcomes, when compared to plating. Overall, good functional outcomes can be expected. However, well-designed, multi-center randomized controlled trials are needed to conclusively prove the benefit of this technique.
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Arch Orthop Trauma Surg · May 2022
Review Meta AnalysisMidterm results of modern patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis: systematic review and meta-analysis of comparative studies.
Both Patellofemoral Arthroplasty (PFA) and Total Knee Arthroplasty (TKA) are accepted surgical options for end-stage isolated patellofemoral osteoarthritis (PFOA). We performed a systematic review and meta-analysis to compare outcomes of PFA and TKA by evaluation of the patient-reported outcome measures (PROMs). ⋯ PFA seems to be a viable alternative to TKA for treatment of isolated PFOA in appropriately selected patients. PFA showed less postoperative inpatient time and blood loss with similar PROMs to the TKA. Moreover, it is an economically beneficial joint-preserving procedure.