Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2023
Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection.
Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI. ⋯ TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single-stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.
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Arch Orthop Trauma Surg · Sep 2023
Navigation in reverse shoulder arthroplasty: how the lateralization of glenosphere can affect the clinical outcome.
One of the main causes of RSA failure is attributable to the malpositioning of the glenoid component. Initial experiences with computer-assisted surgery have shown promising results in increasing the accuracy and repeatability of placement of the glenoid component and screws. The aim of this study was to evaluate the functional clinical results, in terms of joint mobility and pain, by correlating them with intraoperative data regarding the positioning of the glenoid component. The hypothesis was that the lateralization more than 25 mm of the glenosphere can led to better stability of the prosthesis but should pay in term of a reduced range of movement and increased pain. ⋯ Level IV; Case Series; Treatment Study.
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Arch Orthop Trauma Surg · Sep 2023
Total hip arthroplasty through the direct anterior approach for sequelae of Legg-Calvé-Perthes disease.
Due to multiplanar deformities of the hip, total hip arthroplasty (THA) for sequelae of Legg-Calvé-Perthes disease (LCPD) is often technically demanding. This study aimed to compare the clinical and radiographic outcomes of patients with sequelae of LCPD undergoing THA through the direct anterior approach (DAA) and non-anterior approaches to the hip. ⋯ THA through the DAA might be a credible option for the treatment of sequelae of LCPD with comparable complication rates and functional outcomes to non-anterior approaches.
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Arch Orthop Trauma Surg · Sep 2023
Postoperative recommendations for single-level lumbar disc herniation: a cross-section survey.
Lumbar degenerative disc disease is one of the leading causes of low back and leg pain. Conservative treatment is the mainstay treatment, but for some patients surgical approach is required. The literature concerning postoperative recommendations on patients' return to work is sparse. The aim of this study is to assess spine surgeons' consensus regarding postoperative recommendations, including return to work, restart of daily-living activities, analgesic medication usage and rehabilitation referral. ⋯ Despite not having clear guidelines in postoperative management of surgically treated patients, Portuguese practice is in line with international experience and literature.
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Arch Orthop Trauma Surg · Sep 2023
Randomized Controlled TrialA prospective randomised controlled trial of cemented and uncemented tibial baseplates: functional and radiological outcomes.
With the success of uncemented fixation in younger patients undergoing total hip arthroplasty and the growing demand for total knee arthroplasty (TKA) in a younger cohort of patients, there has been an increasing interest in cementless tibial baseplate fixation. We sought to determine whether there was a clear advantage to the use of three different forms of tibial baseplate fixation. The primary outcome of this study was survivorship and secondary outcomes were functional and radiological outcomes, up until 10 years. ⋯ Irrespective of tibial fixation method, functional and radiological outcomes remain similar at follow-up at 10 years, with no clear difference in outcome between each group. Each method of fixation also had excellent survivorship over this period and should reassure surgeons that whichever method of fixation they choose, long-term outcomes are likely to be satisfactory.