Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Clinical impact of microbiological results in two-stage revision arthroplasty with spacer exchange.
Patients who require a spacer exchange as part of a two-stage procedure for the treatment of periprosthetic hip and knee joint infections (PJI) have high failure rates. Little is known about the clinical impact of microbiological results and changes in the microbiological spectrum and resistance pattern in these patients. ⋯ Changes in microbiological spectrum and antibiotic resistance patterns between stages are common in patients who require a spacer exchange. If eradication of the microorganism at reimplantation can be accomplished, comparable re-revision rates to standard two-stage procedures can be achieved.
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Arch Orthop Trauma Surg · Aug 2023
A 10- to 12-year follow-up study of delta ceramic-on-ceramic total hip arthroplasty.
We previously reported five-to-seven-year results of total hip arthroplasty (THA) with the use of delta ceramic-on-ceramic (CoC) bearing. We conducted an extension study with a CT scan at a minimum of 10 years after surgery. ⋯ II (Prospective cohort study).
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Arch Orthop Trauma Surg · Aug 2023
Analysis of the determinant factor of the medial joint space width after medial opening wedge high tibial osteotomy.
The decrease in the medial joint space width (MJSW) in patients with osteoarthritis (OA) is proportional to the degree of arthritis. The purpose of this study was to evaluate the affecting factors of the MJSW by serial radiologic assessment after medial open wedge high tibial osteotomy (MOW-HTO). ⋯ The JLCA was the most important contributing factor for the MJSW, followed by WBLR. This contribution was more pronounced in Rosenberg view than standing AP view. Changes in cartilage status were not related to the MJSW and JLCA. The clinical outcome was not related to the MJSW, either. Level of evidence Cohort study; level III.
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Arch Orthop Trauma Surg · Aug 2023
A novel patella fracture fixation technique: finite element analysis.
Patella fractures account for approximately 1% of all bone fractures. The tension band wiring technique has been used in surgical treatment. However, there is no clear information about the location of the K-wires in sagittal plane. Thus, a transverse fracture line was created in the patella finite element model and fixed with Kirchner (k) wires and cerclage at different angles and compared with two different standard tension band models. ⋯ This study has shown that the new fixation method we propose could come to the fore as an alternative method to be used successfully in transverse patella fractures and lower complications. In transverse patellar fractures, the use of K-wires crossed at 60° may be a good alternative to the standard method.
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Arch Orthop Trauma Surg · Aug 2023
Identification of the joint line in revision total knee arthroplasty using a multiple linear regression model: a cadaveric study.
The results of revision total knee arthroplasty (rTKA) may be compromised by excessive joint line (JL) elevation. It is critical but challenging in reestablishing the JL in rTKA. Previous studies have confirmed that, biomechanically and clinically, JL elevation should not exceed 4 mm. Image-based studies described several approaches to locate the JL intraoperatively, however magnification errors could occur. In this cadaveric study, we aim to define an accurate and reliable method to determine the JL. ⋯ Compared to previous image-based measurements, the current cadaveric study most closely resembles a realistic view of intraoperative settings and could circumvents magnification errors. We recommend using Model 6, the JL can be best estimated by referencing the AT and the ATJL can be calculated as ATJL (mm) = 0.455*TEW (mm) + 1.440 (mm).