Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jul 2023
Anatomical risk factors for aseptic loosening of full hinge knee prosthesis in primary and revision TKAs.
Risk factors (RF) associated with aseptic loosening (AL) in total knee arthroplasty (TKA) are poorly understood. Therefore, the aim of this study was to investigate the anatomical shape variations in relation to the inner-diameter of the femur and the tibia as prognostic RF for AL of full hinge prosthesis (FHP) in primary and revision TKA. ⋯ This is the first study to calculate the tibial measurements and the tibial index according to Citak et al. and to identify them as prognostic RF for AL of the full hinge knee prosthesis in TKA and confirm the femoral index as a RF for AL also in revision full hinge knee prosthesis. Therefore, the preoperative radiological evaluation should include the analysis of the anatomical shape variants in order to select the appropriate prosthesis design with a possibly enhanced prognosis.
-
Arch Orthop Trauma Surg · Jul 2023
High-risk ankle fractures in high-risk older patients: to fix or nail?
Optimal treatment of high-risk ankle fractures in older, comorbid patients is unknown. Results of open reduction internal fixation (ORIF) versus tibiotalocalcaneal (TTC) fusion nailing for the treatment of high-risk geriatric ankle fractures were investigated. ⋯ ORIF and TTC fusion nailing result in comparable and acceptable reoperation, infection, and union rates in treating high-risk ankle fractures in patients over 50 with at least 1 major comorbidity for increased complications; further study is warranted.
-
Arch Orthop Trauma Surg · Jul 2023
Observational StudyDevelopment of acetabular retroversion in LCPD hips-an observational radiographic study from early stage to healing.
Acetabular retroversion is observed frequently in healed Legg-Calvé-Perthes disease (LCPD). Currently, it is unknown at which stage and with what prevalence retroversion occurs because in non-ossified hips, retroversion cannot be measured with standard radiographic parameters. ⋯ Level III, retrospective observational study.
-
Arch Orthop Trauma Surg · Jul 2023
Coronal tibiofemoral subluxation under valgus stress force radiography is useful for evaluating postoperative coronal tibiofemoral subluxation in mobile-bearing UKA.
Coronal tibiofemoral subluxation (CTFS) is considered a controversial and potential contraindication to unicompartmental knee arthroplasty (UKA) but is less discussed. The study aims to observe the CTFS in a cohort of patients before and after mobile-bearing UKA and to investigate the relationship between preoperative variables (preoperative CTFS and preoperative CTFS under valgus stress) and postoperative CTFS after mobile-bearing UKA. ⋯ Level III.
-
Arch Orthop Trauma Surg · Jul 2023
Acetabular deficiency in borderline hip dysplasia is underestimated by lateral center edge angle alone.
In hip preservation surgery, the term "borderline hip dysplasia" was used when the lateral center edge angle (LCEA), historically described by Wiberg, measured 18-25°. In recent years, several radiographic parameters have been described to assess the antero posterior coverage of the femoral head, for example, the anterior and posterior wall index (AWI and PWI). This allowed an increasingly comprehensive understanding of acetabular morphology and a questioning of the borderline definition. ⋯ The rather high proportion of symptomatic hips labelled borderline dysplastic suggested, that there might be substantial acetabular deficiency not recognizable by LCEA. Comprehensive deformity analysis using LCEA, AI, AWI and PWI showed, that 40% of these hips were deficient either antero-laterally or postero-laterally. Male acetabula were more deficient postero-laterally than female.