Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2024
Comparative StudyLeg length discrepancy risk differs between fit-and-fill and taper wedge stems across Dorr types.
The comparison between the cementless taper wedge stem and fit-and-fill stem in total hip arthroplasty (THA) for various proximal femoral morphological types has not been thoroughly assessed. This study aimed to compare the risk of leg length discrepancy (LLD) ≥ 10 mm between these two stem types in Dorr type A, B, and C femurs. ⋯ The taper wedge stem demonstrated an elevated risk of LLD ≥ 10 mm in Dorr type A femurs compared with the fit-and-fill stem, necessitating meticulous preoperative templating and intraoperative femoral canal preparation.
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Arch Orthop Trauma Surg · Nov 2024
Comparative StudyIntraoperative cartilage analysis of the first carpometacarpal joint - comparison with conventional staging according to Eaton and Littler.
Osteoarthritis of the first carpometacarpal joint is a common pathology of the hand, which may show an increasing prevalence in Germany due to the demographic development. In recent years, not only the current gold standard - the resection arthroplasty of the thumb saddle joint - has been used, but also therapeutic thumb saddle joint arthroscopy. In addition to the patient's clinical complaints, radiographic diagnostics have been used to decide on treatment, although it has not been proven whether there is a correlation between imaging and clinical complaints. ⋯ III.
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Arch Orthop Trauma Surg · Nov 2024
Accelerometer-based portable navigation system shows no superior accuracy over pelvic alignment guide for acetabular cup placement in total hip arthroplasty in lateral decubitus position.
Total hip arthroplasty (THA) using a portable navigation system (PNS) incurs costs per procedure. However, it does not require a large console. This study aimed to compare the accuracy of acetabular cup placement using a pelvic alignment guide (PAG) attached to the pelvis and an accelerometer-based PNS in THA performed in the lateral decubitus position. ⋯ The accelerometer-based PNS did not demonstrate superior cup alignment accuracy compared to the PAG in THA performed in the lateral decubitus position. This finding informs surgeons that computer-assisted surgery is not necessarily superior to conventional THA using a PAG.
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Arch Orthop Trauma Surg · Nov 2024
Acetabular retroversion and cam morphology are contributing risk factors for posterior hip dislocation independent of the trauma mechanism.
A high-energy trauma impact is generally considered the crucial factor causing native hip dislocation. However, femoroacetabular variations are assumed to contribute to low-energy posterior hip dislocations, especially in adolescent athletes. The study aimed to analyze the femoroacetabular morphology of adults who sustained traumatic posterior hip dislocations, comparing high-energy, sports-related, and low-energy trauma mechanisms. ⋯ Acetabular retroversion contributes to posterior hip dislocation in high-energy and sports-related trauma mechanisms and decreases the likelihood of sustaining concomitant fractures. Acetabular morphology was subordinate to causing hip dislocation following a low-energy impact. Increased alpha angles were identified as a risk factor contributing to posterior hip dislocations, regardless of the trauma mechanism.