Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2022
Randomized Controlled TrialProspective randomized comparison of bone transport versus Masquelet technique in infected gap nonunion of tibia.
The present prospective randomized study compared the bone transport technique (BT) and Masquelet technique (MT) in the treatment of infected gap non-union of the tibia. ⋯ The functional and bone results were comparable but more reliable in bone transport than the Masquelet technique. The fixator duration and incidence of non-union were higher in MT group. Ilizarov bone transport technique should be preferred in infected non-union of the tibia with bone loss upto 6 cm.
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Arch Orthop Trauma Surg · Aug 2022
ReviewUse of intramedullary locking nail for displaced intraarticular fractures of the calcaneus: what is the evidence?
Intramedullary locking devices (ILDs) have recently been advocated as a minimally invasive approach to manage displaced intraarticular calcaneal fractures (DIACFs), to minimise complications and improve outcomes. We reviewed clinical and biomechanical studies dealing with commercially available devices to identify their characteristics, efficacy and safety. ⋯ Level V - Review of Level III to V studies.
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Arch Orthop Trauma Surg · Aug 2022
ReviewSubsidence of a metaphyseal-anchored press-fit stem after 4-year follow-up: an EBRA-FCA analysis.
Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analyse) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless metaphyseal-anchored press-fit stem after 4-year follow-up. ⋯ Migration pattern of the metaphyseal-anchored stem and a low subsidence rate at final follow-up may predict a good long-term clinical result.
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Arch Orthop Trauma Surg · Aug 2022
ReviewPeriprosthetic fractures after medial unicompartmental knee arthroplasty: a narrative review.
On rare occasions, fractures of the tibial plateau may occur after uni-compartmental knee arthroplasty (UKA) and account for 2% of total UKA failures. The purpose of this narrative review is to identify and discuss potential risk factors that might lead to prevention of this invalidating complication. ⋯ Peri-prosthetic fracture is a rare, but troublesome event, which can lead to implant failure and revision surgery. Better knowledge of the multifactorial risk factors in association with a thorough surgical technique is key for prevention.
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Arch Orthop Trauma Surg · Aug 2022
Two-stage revision for periprosthetic joint infection in unicompartmental knee arthroplasty: clinical and radiological results.
Unicompartmental knee arthroplasty (UKA) has an infection rate of 0.1-0.8%. Despite the wide amount of literature about septic total knee arthroplasty management, few data are available for UKA infection treatment. The aim is to present the clinical and radiological outcomes along with complication rates of a series of septic UKA treated with two-stage exchange. ⋯ Mean age at surgery was 68.5 ± 9.1. All but two were medial UKA. The mean number of previous surgeries was 2.9 ± 1.9. The mean ROM, VAS, KSS and OKS of the entire population improved significantly (p < 0.01). Radiological analysis did not show any migration or implant loosening. Ten constrained condylar and six posterior stabilized prosthesis were finally implanted. One intraoperative pathogen isolation was recorded and managed with suppressive therapy and good final outcome. The implant survivorship free from infection was 100% at the final follow-up. The overall survival rate for any reason of revision was 100% CONCLUSION: According to our results, staged revision represents a reliable ad effective option in delayed and late UKA infections. This technique provides optimal clinical and radiological results with acceptable complication rates. To the best of our knowledge, this represent the widest case series on infected UKA managed with two-stage exchange.