Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2023
Randomized Controlled TrialRestoring tibial obliquity for kinematic alignment in total knee arthroplasty: conventional versus patient-specific instrumentation.
In total knee arthroplasty (TKA), tibial obliquity-restoration using kinematic alignment (KA) poses a major difference to conventional mechanical alignment. This study aimed at analysing the accuracy of conventional instrumentation (CI) versus patient-specific instrumentation (PSI) to restore anatomic tibial obliquity measured by the medial proximal tibial angle (MPTA) on conventional X-rays. ⋯ Both conventional and patient-specific instrumentation revealed adequate results with respect to restoring tibial obliquity in kinematically aligned TKA, with conventional instrumentation achieving superior results.
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Arch Orthop Trauma Surg · Sep 2023
Clinical TrialRadiostereometric analysis: comparison of radiation dose and precision in digital and computed radiography.
Radiostereometric Analysis (RSA) is used to measure fixation of joint prosthesis. This study compared radiation dose and image quality of a digital radiography (DR) RSA system and a computed radiography (CR) RSA system in a clinical setting. ⋯ Patients were selected from clinical studies performed on the two systems and approved by the local ethics committee [20060165, M-20100112, M-20070082, M-20110224, and 20070258] and registered with ClinicalTrials.gov [NCT00408096, NCT01289834, NCT00913679, NCT02311179, and NCT00679120].
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Arch Orthop Trauma Surg · Sep 2023
Forte ceramic-on-delta ceramic cementless total hip arthroplasty: an 8- to 15-year follow-up study.
Forte ceramic head on delta ceramic liner articulation showed satisfactory midterm results without ceramic-related complication. We aimed to investigate the clinical and radiological outcomes of cementless total hip arthroplasty (THA) with forte ceramic head on delta ceramic liner articulation. ⋯ Cementless THA with forte ceramic-on-delta ceramic articulation showed acceptable clinical and radiological results. Serial surveillance of these patients should be performed due to the possibility of cerami- related complications such as squeaking, osteolysis, and ceramic liner fracture.
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Arch Orthop Trauma Surg · Sep 2023
Development of a machine learning algorithm to identify surgical candidates for hip and knee arthroplasty without in-person evaluation.
Arthroplasty care delivery is facing a growing supply-demand mismatch. To meet future demand for joint arthroplasty, systems will need to identify potential surgical candidates prior to evaluation by orthopaedic surgeons. ⋯ III.
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Arch Orthop Trauma Surg · Sep 2023
Observational StudyPost-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.
Optimized health system approaches to improving guideline-congruent care require evaluation of multilevel factors associated with prescribing practices and outcomes after total knee and hip arthroplasty. ⋯ In the present study, several patient-, care-, and hospital-level factors were associated with an increased probability of an opioid prescription refill within 30 days after arthroplasty. Future work is needed to identify optimal approaches to reduce unwarranted and inequitable healthcare variation within a patient-centered framework.