Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
What is the utility of hip arthroscopy in patients with joint laxity? A contemporary systematic review of patient-reported and surgical outcomes.
The purpose of this study was to systematically review the literature to understand the contemporary outcomes for patients with joint laxity managed with hip arthroscopy. ⋯ Generalized ligamentous laxity patients managed with hip arthroscopy were predominantly young women. At short-term follow-up, mean patient-reported outcomes were positive, with improvement postoperatively in activities of daily living, sports, and quality of life.
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Arch Orthop Trauma Surg · Aug 2023
Arthrofibrosis is a common but poorly defined complication in multiligament knee injuries: a systematic review.
The purpose of this study is to systematically review multiligament knee injury (MLKI) outcome studies to determine definitions of arthrofibrosis (AF) and provide information about incidence, management as well as potential risk factors. ⋯ AF is a common but poorly defined complication particularly in high-grade MLKI. Early postoperative and intensified physiotherapy is important to reduce the risk of AF. MUA and LOA are very effective treatment options and result in good clinical outcome. Prospective studies with bigger study population are needed to optimize treatment algorithms of further patients after MLKI. The protocol of this systematic review has been prospectively registered with PROSPERO (CRD42021229187, January 4th, 2021).
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Arch Orthop Trauma Surg · Aug 2023
Combining the advantages of 3-D and 2-D templating of total hip arthroplasty using a new tin-filtered ultra-low-dose CT of the hip with comparable radiation dose to conventional radiographs.
Inaccurately scaled radiographs for total hip arthroplasty (THA) templating are a source of error not recognizable to the surgeon and may lead to inaccurate reconstruction and thus revision surgery or litigation. Planning based on computed tomography (CT) scans is more accurate but associated with higher radiation exposure. The aim of this study was (1) to retrospectively assess the scaling deviation of pelvic radiographs; (2) to prospectively assess the feasibility and the radiation dose of THA templating on radiograph-like images reconstructed from a tin-filtered ultra-low-dose CT dataset. ⋯ Retrospective and prospective comparative study, Level III.
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Arch Orthop Trauma Surg · Aug 2023
Topical vancomycin powder does not affect patella cartilage degeneration in primary total knee arthroplasty and conversion rate for secondary patella resurfacing.
Vancomycin powder (VP) is an antibiotic first introduced in pediatric spinal surgery to prevent surgical site infections (SSI). Recently its topical application was expanded to total hip and knee arthroplasty (THA, TKA) and anterior cruciate ligament reconstruction (ACLR). Toxicity to cartilage is the subject of current research. The aim of this study was to prove the hypothesis that topical application of VP in TKA does not result in a degeneration of patella cartilage. We propagate that the conversion rate for secondary patella resurfacing is not influenced by its use. ⋯ Retrospective case series, Level III.
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Arch Orthop Trauma Surg · Aug 2023
Patella resurfacing is not associated with a difference in the Oxford knee score after total knee arthroplasty but stair descent is enhanced.
The primary aim was to assess the Oxford knee scores (OKS) on patients who underwent a total knee arthroplasty (TKA) with patellar resurfacing compared to those who did not. Secondary aims were to identify: (1) factors associated with resurfacing, (2) the effect of resurfacing on specific components of the OKS related to patellofemoral function, (3) the influence on patient satisfaction, and (4) whether a subgroup of patients had an improved outcome when resurfacing was undertaken. ⋯ Patella resurfacing was not associated with a clinically important improvement in OKS. No specific indications for patella resurfacing were identified that offered an improved outcome, but when it was undertaken there was a greater improvement in the ability to descend stairs. Level of evidence Retrospective diagnostic study, Level III.