Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2023
Randomized Controlled TrialGap balanced adjusted mechanical alignment versus measured resection mechanical alignment: a randomised controlled trial.
Alignment goals in total knee replacement (TKR) is a topical subject. This study compares the short-term functional outcomes and patient reported outcome measures (PROMs) of two philosophies for knee arthroplasty alignment: measured resection (MR) and an individualised alignment philosophy, with the tibia mechanically aligned and an instrumented gap balancer (GB) to align the femur in both flexion and extension. ⋯ Individualised alignment philosophy utilising a GB technique did not demonstrate an improvement in the primary outcome measure quadriceps peak torque. Improvement was seen in the GB group in PROM pain scores that was significant, both statistically and clinically, out to at least 1 year. Gains that were seen in functional assessment with GB, although significant at some time points, were no longer significant at 1 year and no difference was seen in quads strength. Compared to a MR technique, the individualised GB technique appears to confer some improvement in pain, ROM and some functional tests following TKR in the short-term.
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Arch Orthop Trauma Surg · Apr 2023
Predictive factors for the bone union disorder of intramedullary screw fixation in proximal fifth metatarsal bone fractures.
Although intramedullary screw fixation likely leads to successful union of Jones fractures compared to that of nonoperative treatments, bony union disorder after surgical treatment remains to be elucidated. ⋯ Level 4, case series.
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Arch Orthop Trauma Surg · Apr 2023
Characteristics of pedicle screw misplacement using freehand technique in degenerative scoliosis surgery.
This study aimed to estimate the accuracy of pedicle screw (PS) placement in degenerative scoliosis surgery, characterize a patient population with PS misplacement, and analyze the association between misplaced PS vector and lumbar coronal curve. ⋯ The accuracy of PS insertion in the thoracic to lumbar spine was high in DS surgery, but the need for care was highlighted in the transitional vertebra.
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Arch Orthop Trauma Surg · Apr 2023
The role of serum D-Dimer for the diagnosis of periprosthetic shoulder infection.
D-Dimer was recently identified as an additional biomarker in the diagnosis of hip and knee periprosthetic joint infection (PJI). Currently, there is only one study in literature dealing with the role of D-Dimer in the diagnosis of shoulder PJI. The purpose of this study was, therefore, to validate the sensitivity and specificity of D-Dimer in detecting shoulder PJI. ⋯ Diagnostic level II.
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Arch Orthop Trauma Surg · Apr 2023
Does the COVID-19 personal protective equipment impair the surgeon's performance?
Despite increasing vaccination rates, new viral variants of SARS-CoV-2 (severe acute respiratory syndrome coronavirus type 2) are advancing the COVID 19 (coronavirus disease 2019) pandemic and continue to challenge the entire world. Surgical care of SARS-CoV-2 positive patients requires special protective measures. We hypothesized that "COVID-19" personal protective equipment (PPE) during surgery of SARS-CoV-2 positive or potentially positive patients would negatively affect the surgeon and thus the surgical outcome. ⋯ Level I.