Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
ReviewPerioperative management of leg-length discrepancy in total hip arthroplasty: a review.
Leg-length discrepancy (LLD) presents a significant management challenge to orthopedic surgeons and remains a leading cause of patient dissatisfaction and litigation after total hip arthroplasty (THA). Over or under-lengthening of the operative extremity has been shown to have inferior outcomes, such as dislocation, exacerbation of back pain and sciatica, and general dissatisfaction postoperatively. The management of LLD in the setting of THA is multifactorial, and must be taken into consideration in the pre-operative, intra-operative, and post-operative settings. ⋯ Pre-operatively, we provide an overview of the appropriate radiographic studies to be obtained and their interpretation, as well as considerations to be made when templating. Intra-operatively, we discuss several techniques for the assessment of limb length in real time, and post-operatively, we discuss both operative and non-operative management of LLD. By providing a summary of the best available practices and strategies for mitigating the impact of a perceived LLD in the setting of THA, we hope to maximize the potential for an excellent surgical and clinical outcome.
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Arch Orthop Trauma Surg · Aug 2023
Multicenter StudyA predictive score of high tibial osteotomy survivorship to help in surgical decision-making: the SKOOP score.
The high tibial osteotomy (HTO) survival rate is strongly correlated with surgical indications and predictive factors. This study aims to assess HTO survival in the long term, to determine the main predictive factors of this survival, to propose a predictive score for HTO based on those factors. ⋯ Retrospective cohort study.
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Arch Orthop Trauma Surg · Aug 2023
Randomized Controlled TrialClinical and radiological comparison between partial and complete resection of the anterior cruciate ligament in patients with mucoid degeneration of the anterior cruciate ligament: a controlled clinical trial.
The pathology of a mucoid degeneration of the anterior cruciate ligament (MDACL) has been mentioned in several publications but due to its rare incidence it is not a well-known pathology. Partial or complete resection of the ACL is the option of choice after failed non-surgical treatment. However, the success rate of both surgical techniques and the subsequent risk of an ACL instability is not known. The purpose of this study was to compare the clinical and radiological outcome between partial resection and complete resection of the ACL in patients with MDACL. ⋯ Both arthroscopic debridement and complete resection of the ACL lead to improvement of clinical and radiological findings in isolated MDACL. However, complete resection of the ACL will result in higher instability. Therefore, partial resection might be the better treatment option, especially in young patients with MDACL.
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Arch Orthop Trauma Surg · Aug 2023
Randomized Controlled TrialThe use of an individualized intraoperative video shows no impact on the early postoperative clinical outcome after total knee arthroplasty: a prospective, randomized, controlled trial.
The purpose of the study was to evaluate the potential of an intraoperatively recorded video shown to patients immediately postoperatively on early outcome after total knee arthroplasty (TKA). The hypothesis was that there is a beneficial outcome concerning range of motion (ROM) and patient-reported outcome due to enhanced trust into the artificial joint. ⋯ I.
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Current femoral implants are manufactured based on Western anatomical structures and may be too large for smaller physiques, such as those of Asian females. This study reviewed the femoral stem size distribution used in a high-volume total hip arthroplasty (THA) practice and evaluated malalignment in patients receiving a size one implant. ⋯ The high proportion of size one stems required in Asian females and the higher incidence of LLD > 6 mm and varus malalignment suggest a distinct need for smaller femoral implants, especially for Asian females.