Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2023
Patient satisfaction, joint stability and return to sports following simple elbow dislocations: surgical versus non-surgical treatment.
While conservative management is commonly promoted for simple elbow dislocations, the importance of primary surgical treatment in these injuries is still undetermined. The objective of this study was to report patient-reported outcome measures (PROMs), return to sports (RTS) and joint stability using ultrasound in patients following conservative or surgical treatment after simple elbow dislocation. ⋯ Therapeutic study, Level III.
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Arch Orthop Trauma Surg · Mar 2023
Impaction bone grafting for segmental acetabular defects: a biomechanical study.
Implant loosening is the most common indication for revision after total hip arthroplasty and is associated with progressive bone destruction. Contained defects can be treated with impaction bone grafting (IBG). Segmental defects are successfully restored with metal augmentation. Considering the increasing number of hip arthroplasty cases in young patients, it would appear sensible to reconstruct the bone stock for future revisions by biological bone defect reduction. The data on the treatment of segmental defects with IBG without additional stabilization are lacking. ⋯ IBG did not show inferior biomechanical properties in segmental type IIB defect angles up to 80°, compared to cups without defects.
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Arch Orthop Trauma Surg · Mar 2023
Femoral condyle resurfacing using an inlay metal implant: low revision rate of 266 patients in a 5-10 years follow-up.
To assess the clinical outcome and survival of an inlay resurfacing prosthesis for focal femoral condyle chondral and osteochondral defects. ⋯ Level IV, retrospective case series.
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Arch Orthop Trauma Surg · Mar 2023
Spacer exchange in persistent periprosthetic joint infection: microbiological evaluation and survivorship analysis.
The purposes of this study were to determine demographics and characteristics of patients who underwent spacer exchange for persistent infection in the setting of two-stage arthroplasty for periprosthetic joint infection, to describe the microbiology of pathogens involved, to analyze survivorship free from infection in these patients. ⋯ Surgeons should be aware that subjects necessitating spacer exchange often present multiple comorbidities, previous staged revision failures, soft-tissue impairment and difficult to treat infection. In these patients, spacer exchange provides good clinical results and infection eradication, preventing arthrodesis or amputation.
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Arch Orthop Trauma Surg · Mar 2023
Can extant comorbidity indices identify patients who experience poor outcomes following total joint arthroplasty?
It is uncertain if generic comorbidity indices commonly used in orthopedics accurately predict outcomes after total hip (THA) or knee arthroplasty (TKA). The purpose of this study was to determine the predictive ability of such comorbidity indices for: (1) 30-day mortality; (2) 30-day rate of major and minor complications; (3) discharge disposition; and (4) extended length of stay (LOS). ⋯ ASA and mCCI are good models for predicting 30-day mortality after THA and TKA. However, similar to ECM and mFI-5, these generic comorbidity risk-assessment tools do not adequately predict 30-day postoperative outcomes or in-hospital metrics. This highlights the need for an updated, data-driven approach for standardized comorbidity reporting and risk assessment in arthroplasty.