Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2022
Perioperative blood transfusions in hip and knee arthroplasty: a retrospective assessment of combined risk factors.
Accurate identification of patients at risk of blood transfusion can reduce complications and improve institutional resource allocation. Probabilistic models are used to detect risk factors and formulate patient blood management strategies. Whether these predictors vary among institutions is unclear. We aimed to identify risk factors among our patients who underwent total hip (THA) or knee (TKA) arthroplasty, and combine these predictors to improve our model. ⋯ Level 3, retrospective cohort study.
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Arch Orthop Trauma Surg · Aug 2022
Changes in the femoral osteotomy level coefficient and neck shaft angle during limb lengthening with an intramedullary magnetic nail.
The intramedullary magnetic IM nail enables bone graduated distraction. Proximal femur osteotomies for ante grade IM lengthening nails have a tendency towards varus-procurvatum malalignment. We examined the effect of the level of the osteotomy and of trochanteric versus piriformis entry points on the neck shaft angle (NSA) during lengthening with the PRECICE IM magnetic nail. ⋯ Proximal femur lengthening with the PRECICE IM nail significantly reduced the NSA and might cause Varus deformity. The level of osteotomy by OLC did not influence the amount of NSA reduction. The trochanteric entry points have a greater tendency to reduce the NSA compared to the piriformis entry points.
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Arch Orthop Trauma Surg · Aug 2022
Bone impaction grafting and anti-protrusio cages in high-grade acetabular defects: a 22-year single centre experience.
Report clinical and radiological long-term follow-up (FU) outcome of bone impaction grafting (BIG) and anti-protrusio cage (APC) technique in hip revision surgery. ⋯ Impaction grafting with femoral head and APC is an effective technique for treating high-grade acetabular defects. APC reconstructs the hip centre of rotation, avoiding loading forces on the underlying bone graft that can be correctly integrated. At long-term FU, satisfactory clinical results, not strictly correlated to radiological signs of integration, were observed; Paprosky type III B reported worse results in terms of graft resorption and a greater migration of the APC.
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Arch Orthop Trauma Surg · Aug 2022
Preoperative radiographic parameters in the case of using a narrow-version femoral implant in total knee arthroplasty.
Recently, total knee arthroplasty (TKA) designs that allow the use of narrow-version femoral implants have been introduced to avoid femoral overhang. The purpose of this study was to investigate the frequency of the use of narrow-version femoral implants and identify the difference in radiographic parameters between using a narrow-version femoral implant and a standard-version femoral implant in TKA. ⋯ In the narrow-version femoral implant group, the ML dimension and the mean modified aspect percentage ratio were smaller than in the standard-version femoral implant group. A smaller modified aspect percentage ratio of the distal femur in preoperative radiographs could predict the need for narrow-version femoral implants in TKA. It was suggested that the cut-off point could be suggested as 135.4% for Anthem TKA design and 133.3% for Persona TKA design. These radiographic parameters are cost-effective and easily applicable for planning a TKA.A smaller modified aspect percentage ratio of the distal femur in preoperative radiographs could predict the need for narrow-version femoral implants in TKA. The cut-off point was 135.4% for Anthem TKA design and 133.3% for Persona TKA design.
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Arch Orthop Trauma Surg · Aug 2022
K-line in patients with cervical ossification of the posterior longitudinal ligament: relationship with change in sagittal cervical curvature and laminoplasty outcomes.
To analyze how K-line is related to change in sagittal cervical curvature and laminoplasty outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL). ⋯ K-line negativity and lordosis < 7° may predict kyphosis after laminoplasty in patients with OPLL. The cervical curvature in patients with OPLL tends towards kyphosis and anteversion after laminoplasty, which contributes to the reduced clinical effect of the procedure.