Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2022
The knee position at tourniquet inflation does not affect the gap balancing during total knee arthroplasty.
The relationship between gap balancing and clinical outcome of total knee arthroplasty (TKA) has been researched. Tourniquet is widely used by most surgeons; however, there are little quantitative data about the gap depending on the tourniquet usage. We aimed to investigate whether the knee position at tourniquet inflation affected the gap measurement intra-operatively. ⋯ We postulated that the knee position at tourniquet inflation would affect the gap, which was refuted by our results. This shows that we can measure the gap without considering the knee position at tourniquet inflation.
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Arch Orthop Trauma Surg · Jul 2022
Preoperative paraspinal and psoas major muscle atrophy and paraspinal muscle fatty degeneration as factors influencing the results of surgical treatment of lumbar disc disease.
There is a growing number of publications highlighting sarcopenia and myosteatosis as poor prognosic factors for treatment results in oncological patients. The decrease in the cross-sectional area (CSA) of the multifidus muscle and muscle steatosis is associated with lumbar disc herniation and low back/limb pain. Nevertheless, no studies have analyzed the influence of the above parameters on patient satisfaction, pain decrease and return to daily activities. The aim of the study was to verify whether decreased preoperative CSA of the paraspinal and psoas major muscles and their fatty degeneration (myosteatosis) may influence the outcome of surgical treatment of lumbar disc disease (LDD). ⋯ The degree of fatty degeneration of the paraspinal muscles correlates with better outcomes 1 and 6 months after microdiscectomy.
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Arch Orthop Trauma Surg · Jul 2022
No increased injury incidence in the German Bundesliga after the SARS-CoV-2 virus lockdown.
The coronavirus lockdown in 2020 resulted in a worldwide suspension of professional sports. The first major professional football league to restart after the lockdown was the German Bundesliga. This study investigates whether the injury incidence increased after the restart of the season with only 9 days of regular preparation time and without any friendly matches in comparison to three control periods. ⋯ The period after the unexpected break in the 2019-2020 season due to the coronavirus lockdown and the rapid return to competition showed no increase in the injury rate compared to the pre-lockdown period and a lower injury rate than in the previous season final. The unintentional mid-season rest with its potential for physical recovery and individual fitness training seems to have had a positive effect on injury occurrence.
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High tibial osteotomy (HTO) is a valid and joint preserving surgical technique to treat medial degenerative osteoarthritis (OA) in young and active patients. A recent study shows that patients' expectations of osteotomy around the knee are high, but OA progression and potential conversion to a total knee arthroplasty (TKA) were underestimated. The aim of this study was to investigate surgeons' expectations of HTO and to compare the results to the patients' expectations and actual outcomes reported in the literature. ⋯ Surgeons' expectations of HTO are high but nevertheless different to the patients' expectations reported in the literature. Also, expectations for the delay/prevention of TKA differed regarding the experience of surgeons. While pain reduction represents one of the most important items for surgeons and patients, the expected outcome regarding the delay/prevention of a TKA and returning to sports differs to the patients' expectations and to the actual outcome reported in the literature. This should be considered when performing the preoperative informed consent.
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Arch Orthop Trauma Surg · Jul 2022
Orthopaedic residents' autonomy in hip fracture surgery: what is the effect on patient outcomes?
In the context of growing prevalence of hip fractures and hip fracture surgery in the elderly, it is unknown if surgical trainee autonomy in the operating room conflicts with optimal health care provision and safety of patients. We hypothesized that surgery performed solely by residents, without supervision or participation of an attending surgeon, can provide similar outcomes to surgery performed by trauma or joint reconstruction fellowship-trained orthopaedic surgeons. ⋯ Level III-retrospective cohort study.