Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2023
Augmented reality through head-mounted display for navigation of baseplate component placement in reverse total shoulder arthroplasty: a cadaveric study.
To achieve an optimal clinical outcome in reverse total shoulder arthroplasty (RSA), accurate placement of the components is essential. The recently introduced navigation technology of augmented reality (AR) through head-mounted displays (HMD) offers a promising new approach to visualize the anatomy and navigate component positioning in various orthopedic surgeries. We hypothesized that AR through HMD is feasible, reliable, and accurate for guidewire placement in RSA baseplate positioning. ⋯ Augmented reality seems feasible and reliable for baseplate guidewire positioning in reverse total shoulder arthroplasty. The achieved values were accurate.
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Arch Orthop Trauma Surg · Jan 2023
Influence of hindfoot alignment on postoperative lower limb alignment in medial opening wedge high tibial osteotomy.
We have experienced unexpected under-correction after medial opening wedge high tibial osteotomy (MOWHTO). Although the tibia was corrected accurately, the postoperative mechanical axis (MA) was less than 57%. The purpose of this study was to evaluate the relationship between hindfoot alignment and postoperative lower limb alignment, and to reveal whether hindfoot alignment affects lower limb alignment after MOWHTO. Our hypothesis was that hindfoot alignment influences the postoperative MA in MOWHTO. ⋯ Therapeutic level III, retrospective study.
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Arch Orthop Trauma Surg · Jan 2023
Mid-term results of medial open-wedge high tibial osteotomy based on radiological grading of osteoarthritis.
To evaluate the mid-term results of medial open-wedge high tibial osteotomy (OWHTO) based on Kellgren-Lawrence (KL) grades. ⋯ Mid-term results of OWHTO significantly improved. However, clinical score in the KL-3 group was lower than that in the KL-1 and KL-2 groups; radiological OA progression was a risk factor in KL-3.
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Arch Orthop Trauma Surg · Jan 2023
Approximately 41% of knees have a looser gap in full extension than in 20° flexion after Oxford unicompartmental arthroplasty.
In Oxford unicompartmental knee arthroplasty (OUKA), the flexion and extension gaps should be adjusted to prevent mobile-bearing dislocation. The extension gap is recommended to be evaluated in the 20° flexion position to avoid underestimation due to tension of the posterior capsule. However, we have become aware of a looser gap in full extension than in 20° flexion in some instances. ⋯ Approximately 41% of knees have a looser gap in full extension than in 20° flexion after OUKA. Further investigation is needed to better understand which extension gap should be used in such cases, and to find the contributing factors in loose full extension gap other than the size of the last spigot.
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Arch Orthop Trauma Surg · Jan 2023
Perfusion of the proximal scaphoid pole: correlation between preoperative ge-MRI and intraoperative findings.
Gadolinium enhanced MRI (ge-MRI) is considered as gold standard for perfusion evaluation in case of scaphoid nonunion (SNU). However, its clinical value and specificity is still not clearly evaluated. This study compares preoperative ge-MRI-based perfusion assessment and intraoperative proximal pole (PP) perfusion after scaphoid reconstruction by vascularized bone grafts. In addition, the postoperative osseous consolidation (OC) was correlated to intraoperative perfusion findings. ⋯ The sensitivity and specificity of ge-MRI for detection/ exclusion of malperfusion/avitality of the PP was lower than expected. Therewith, the intraoperative assessment of PP perfusion regains a high value in decision-making for the appropriate graft. We recommend preservation of the dorsal radial vascular plexus initially until the vascularity of the proximal pole has been estimated. Patient education for all contingencies and retraction options should be obtained.