Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Long-term survivorship of an exchangeable-neck hip prosthesis with a Ti-alloy/Ti-alloy neck-stem junction.
Breakage of exchangeable-neck (EN) and adverse local tissue reactions (ALTRs) to neck-stem junction (NSJ) damage products are responsible for increasing the revision rate of EN hip prostheses. We investigated the survivorship of an EN hip prosthesis including a NSJ with both components made of titanium alloy (Ti-alloy/Ti-alloy) to assess whether, and to what extent, EN breakage and NSJ damage affected implant survivorship. ⋯ The present incidence of EN breakage or ALTR is lower than those reported in other studies evaluating EN hip prosthesis survivorship. This study suggests that (i) the risk of EN breakage is reduced by limiting the use of long-offset configurations in heavy patients and (ii) Ti-alloy/Ti-alloy NSJ damage products do not promote ALTR nor significantly alter the rate of implant loosening. Since design decisions and implant configuration determine the NSJ strength, the NSJ strength in working conditions must be thoroughly investigated to proper define the clinical indications for any EN design.
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Arch Orthop Trauma Surg · Jun 2023
Proximal humeral bone loss in stemless shoulder arthroplasty: potential factors influencing bone loss and a new classification system.
Proximal humeral bone loss in total shoulder arthroplasty (TSA) is more frequent than in hemiarthroplasty. Factors such as age, gender, inclination angle, and radiolucent lines may also contribute. Additionally, current bone loss grading systems are often not sensitive enough to detect slight bone changes, especially at the medial calcar where bone loss is commonly observed. This study uses a new, more detailed bone loss grading system to evaluate factors that could influence bone loss at the proximal humerus. ⋯ Results showed gender had the greatest influence on bone loss after stemless shoulder arthroplasty. Furthermore, both patients with or without bone loss can expect similar clinical outcomes with the stemless prosthesis used in this study. Lastly, the new grading system is simple and straightforward to use.
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Arch Orthop Trauma Surg · Jun 2023
No influence of posterior tibial slope change on outcomes after cruciate-retaining total knee arthroplasty: a prospective cohort study.
To investigate whether the functional outcomes were affected by the change in posterior tibial slope (PTS) after using a predetermined PTS for primary cruciate-retaining total knee arthroplasty (CR-TKA). ⋯ The PTS change between preoperative and postoperative has no influence on the functional outcomes using a CR-TKA. A standardized PTS regardless of the native is a reliable procedure for primary CR-TKA.
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Arch Orthop Trauma Surg · Jun 2023
Arthroscopic-assisted robotic bi-unicompartmental knee arthroplasty: a pilot cadaveric study.
Although bicondylar arthroplasty showed great functional results, it encounters some difficulties to be performed routinely. On the other hand, arthroscopic techniques tend to replace open surgical techniques in sports medicine but strive to be developed in the field of arthroplasty. This study aimed to assess the feasibility of a micro-invasive bi-compartmental knee arthroplasty using both arthroscopic and robotic technologies (A-BiUKA). ⋯ Associated arthroscopic and robotic technologies allows to perform Bi-UKA procedure using a quad sparing mini-invasive approach. Clinical prospective studies have to confirm the feasibility and the clinical outcomes of this surgery.
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Arch Orthop Trauma Surg · Jun 2023
Is new always better: comparison of the femoral neck system and the dynamic hip screw in the treatment of femoral neck fractures.
Hip fractures in the elderly population are common and the number of patients is rising. For young and geriatric patients with undisplaced fractures osteosynthesis is the primary type of treatment. The dynamic hip screw (DHS) is around for many years and proved its value especially in displaced fractures. Since 2018 the femoral neck system (FNS) is available as an alternative showing promising biomechanical results. The aim of this study is to evaluate clinical results of the FNS and compare it to the DHS. ⋯ FNS proved to be as reliable as DHS in all patients with hip fractures. Not the type of implant but blade positioning is still key to prevent implant failure. Still due to minimal invasive approach implant related infections and postoperative hematomas might have been prevented using the FNS.