Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Muscle fatigue response of rotator cuff muscles in different postures.
Muscle fatigue is a leading cause of rotator cuff (RC) pathologies. Scapular orientation affected by changes in the thoracic spine account for differences in body postures leading to altered RC muscle activation. This posture-related alteration in RC muscle activation and its fatigue response needs to be analyzed. ⋯ The findings indicate that alterations in the body postures and different elevation angles affect the RC muscles' fatigue response.
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Arch Orthop Trauma Surg · Jun 2023
The utilization of artificial neural networks for the prediction of 90-day unplanned readmissions following total knee arthroplasty.
A reliable predictive tool to predict unplanned readmissions has the potential to lower readmission rates through targeted pre-operative counseling and intervention with respect to modifiable risk factors. This study aimed to develop and internally validate machine learning models for the prediction of 90-day unplanned readmissions following total knee arthroplasty. ⋯ Level III, case-control retrospective analysis.
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Arch Orthop Trauma Surg · Jun 2023
Subscapularis tendon tears hidden by the medial biceps sling can be missed on arthroscopic examination.
To investigate (1) the prevalence of "hidden lesions" and "non-hidden lesions" of subscapularis tendon tears requiring repair during arthroscopic examination that would be missed by a 30° arthroscope, but could be identified by a 70° arthroscope, from the standard posterior portal and (2) the correlation of preoperative internal rotation weakness and findings of magnetic resonance imaging (MRI) indicating hidden lesions. ⋯ Among the subscapularis tears requiring repair, 19.1% could be identified by a 70° arthroscope, but not by a 30° arthroscope, through the posterior portal. The hidden lesions showed a significantly lower detection rate on preoperative MRI than the non-hidden lesions. Thus, for subscapularis tears suspected on preoperative physical examination, the 70° arthroscope would be helpful to avoid a misdiagnosis.
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Arch Orthop Trauma Surg · Jun 2023
Reducing transfusion in hip arthroplasty: tranexemic acid diminishes influence of anesthesia administered.
The risk of transfusion following total hip arthroplasty (THA) continues to be problematic. The best choice of anesthesia (spinal vs general) and impact of tranexamic acid (TXA) use in reducing transfusions following surgery remain unclear. Therefore, the purpose of this study was to compare rates of blood transfusion following THA via the anterior approach using three different anesthesia protocols with and without TXA. ⋯ The use of TXA during THA via the anterior approach removed the influence of anesthesia type regarding risk of transfusion. The use of TXA may reverse presumed disadvantages of GA alone, potentially facilitating rapid discharge following 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.