Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Robotic-assisted TKA reduces surgery duration, length of stay and 90-day complication rate of complex TKA to the level of noncomplex TKA.
Complex primary total knee arthroplasties (TKA) are reported to be associated with excessive episode of care (EOC) costs as compared to noncomplex procedures. The impact of robotic assistance (rTKA) on economic outcome parameters in greater case complexity has not been described yet. The purpose of this study was to investigate economic outcome parameters in the 90-days postoperative EOC in robotic-assisted complex versus noncomplex procedures. ⋯ Robotic-assisted primary TKA reduces the surgical time, inpatient length of stay as well as 90-days complication and readmission rates of complex TKA to the level of noncomplex TKA. Greater case complexity does not seem to have a negative impact on economic outcome parameters when surgery is performed with robotic assistance.
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Arch Orthop Trauma Surg · Jun 2023
Finite element analysis of malposition in bi-unicompartmental knee arthroplasty.
Bi-unicompartmental knee arthroplasty is a less invasive treatment than a total one, great advantage for the patient but more difficult for the surgeon because of the lower visibility during surgery; this can therefore lead to eventual small errors in cutting angles during the procedure. The aim of this study is to investigate the effects of these slight angle variations in terms of anterior-posterior slope for the lateral tibial tray. ⋯ Slight errors can happen during the surgery: performing the cut aiming to slightly posterior slopes during the surgery helps to minimize the chances of obtaining positive slopes that could lead to an unstable implant.
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Arch Orthop Trauma Surg · Jun 2023
Comparing modern uncemented, hybrid and cemented implant combinations in older patients undergoing primary total hip arthroplasty, a New Zealand Joint Registry study.
Multiple joint registries have reported better implant survival for patients aged > 75 years undergoing total hip arthroplasty (THA) with cemented implant combinations when compared to hybrid or uncemented implant combinations. However, there is considerable variation within these broad implant categories, and it has therefore been suggested that specific implant combinations should be compared. We analysed the most common contemporary uncemented (Corail/Pinnacle), hybrid (Exeter V40/Trident) and cemented (Exeter V40/Exeter X3) implant combinations in the New Zealand Joint Registry (NZJR) for patients aged > 75 years. ⋯ The cemented implant and hybrid implant combinations provide equivalent survival and functional outcomes in patients aged over 75 years. Caution is advised if considering use of the uncemented implant combination in this age group, predominantly due to a higher risk of femoral-sided revisions. The authors recommend comparison of individual implants rather than broad categories of implants.