Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2023
Ambulatory status after revision total hip arthroplasty in elective versus fracture indications.
To improve revision total hip arthroplasty (rTHA) prognosis and postoperative management, a better understanding of how non-elective and elective indications influence clinical outcomes is needed. We sought to compare ambulatory status, complication rates, and implant survival rates in patients who underwent aseptic rTHA for periprosthetic fracture or elective indications. ⋯ Compared to rTHA performed for elective aseptic indications, fracture rTHA patients had poorer early functional outcomes, with greater need for ambulatory aids and non-home discharge. However, these differences did not persist long term and did not portend increased infection or re-revision rates.
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Arch Orthop Trauma Surg · Nov 2023
ReviewFailure rates in surgical treatment in adults with bacterial arthritis of a native joint: a systematic review of 8,586 native joints.
Most adult cases of bacterial-septic-arthritis of a native joint are effectively managed with a single surgical debridement, but some cases may require more than one debridement to control the infection. Consequently, this study assessed the failure rate of a single surgical debridement in adults with bacterial arthritis of a native joint. Additionally, risk factors for failure were assessed. ⋯ A single surgical debridement fails to control bacterial arthritis of a native joint in approximately a quarter of all adult cases. Limited to moderate evidence exists that risk factors associated with failure are: synovial white blood cell count, sepsis, large joint infection, and the volume of irrigation. These factors should urge physicians to be especially receptive to signs of an adverse clinical course.
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Arch Orthop Trauma Surg · Nov 2023
ReviewDual-mobility total hip arthroplasty in patients younger than 55 years old: a systematic review.
Total hip arthroplasty (THA) is regarded as one of the most successful and cost-effective orthopedic procedures. However, THA is a surgical procedure with potential intraoperative and postoperative risks. Dislocation is one of the common postoperative complications and remains one of the main indications for THA revision. ⋯ The mean revision rate at twelve years was 11%. The mean value of Harris Hip Score increased from 50.9 pre-operatively to 91.6 after surgery. Dual mobility is a valid option for young patients with extended survivorship and low rates of instability and dislocation after primary THA.
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Arch Orthop Trauma Surg · Nov 2023
Randomized Controlled TrialHigher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty.
This was a prospective single-blinded study comparing the peri-operative opioid consumption and motor weakness for patients undergoing total hip arthroplasty (THA) with either a Quadratus Lumborum Type 3 Nerve Block (QLB) or a Paravertebral Nerve Block (PVB). ⋯ III, Non-randomized controlled cohort/follow-up study.