Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2023
Randomized Controlled TrialProgressive lateralization and constant hip geometry in children with DDH, NDH, and LCPD following hip reconstructive surgery: a cohort study of 73 patients with a mean follow-up of 4.9 years.
Pelvic and femoral osteotomies have been effective methods to treat developmental dysplasia of the hip (DDH), neurogenic dislocation of the hip (NDH), and Legg-Calvé-Perthes disease (LCPD). The aim of this study was to evaluate the mid-term results after hip reconstruction in children with DDH, NDH, and LCPD. ⋯ Evidence level: Level IV, case series.
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Arch Orthop Trauma Surg · Mar 2023
Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study.
To our knowledge, no papers have reported the results of robotic-assisted surgery for sequential bilateral Total Knee Arthroplasty (TKA). Indeed, sequential bilateral TKA present several benefits, as one single anesthesia, surgical episode, hospitalization, and rehabilitation. The purpose of our study was to evaluate peri-operative outcomes and compare the complication rates, clinical outcomes, and implant positioning of sequential bilateral TKA performed with a robotic-assisted system versus a conventional technique. ⋯ Despite a longer operative time, the peri-operative parameters of sequential bilateral TKA were similar between robotic and conventional techniques. Further, sequential bilateral raTKA was at least as safe as a conventional technique, without additional risk of medical complications.
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Arch Orthop Trauma Surg · Mar 2023
Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery.
Prior to revision of total hip arthroplasty (THA), low-grade chronic periprosthetic joint infection (PJI) is often difficult to diagnose. We aimed to determine the diagnostic accuracy of open incisional tissue biopsy for the prediction of PJI prior to THA revision in cases with culture-negative or dry tap joint aspirates. ⋯ Open tissue biopsy performed in cases with culture-negative or inconclusive synovial fluid aspirates prior to revision of THA has limited diagnostic accuracy for the prediction of PJI. The procedure does not reliably close the diagnostic gap in a substantial number of cases. In this difficult patient population, risk of an open procedure may outweigh benefits and alternative less invasive methods should be considered for the preoperative diagnosis of PJI.
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Arch Orthop Trauma Surg · Mar 2023
Complete blood platelet and lymphocyte ratios increase diagnostic accuracy of periprosthetic joint infection following total hip arthroplasty.
Systemically, changes in serum platelet to lymphocyte ratio (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte (MLR) represent primary responses to early inflammation and infection. This study aimed to determine whether PLR, PVR, NLR, and MLR can be useful in diagnosing periprosthetic joint infection (PJI) in total hip arthroplasty (THA) patients. ⋯ III, case-control retrospective analysis.
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Arch Orthop Trauma Surg · Mar 2023
Meta AnalysisIs there any clinical advantage of capsular repair over capsular resection for total hip arthroplasty? An updated systematic review and meta-analysis.
Although several surgical approaches, with or without capsular repair, can be used during total hip arthroplasty (THA), there is no clear evidence that capsular repair provides a clinical advantage post-surgery, regardless of surgical approach. This systematic review and meta-analysis evaluated whether capsular repair using various surgical approaches provides a clinical advantage over capsular resection post-THA. ⋯ The current meta-analysis suggests that capsular repair leads to lower dislocation rates and a better HHS after THA.