Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Dec 2024
Review Meta AnalysisEffect of systemic steroids administration in the clinical outcome of total hip arthroplasty: a systematic review and meta-analysis of prospective randomized controlled trials.
Perioperative steroids administration in total joint arthroplasty gained popularity for pain relief, reduction of postoperative nausea and vomiting (PONV) and enhanced recovery. The purpose of this study is to systematically review and meta-analyze comparative results of prospective randomized trials focused on the effect of systemic steroid administration at different dosages in THA for hip osteoarthritis. The hypothesis is that perioperative systemic steroid administration has a positive impact on postoperative outcomes. ⋯ The use of steroids in total hip arthroplasty (THA) has positive effects in terms of reducing length of stay (LOS), post operative pain, opioid use, postoperative nausea and vomiting (PONV) and systemic inflammatory response.
-
Arch Orthop Trauma Surg · Dec 2024
Multicenter StudyStepping up recovery: integrating patient reported outcome measures and wearable technology for 90-day rehabilitation following total hip arthroplasty.
There is conflicting data in the literature regarding the clinical utility of wearable devices. This study examined the association between patient reported outcome measures (PROMs) and step and stair flight counts obtained from wearable devices in postoperative total hip arthroplasty (THA) patients. ⋯ The utilization of wearable technology can enhance the evaluation of patient outcomes after THA, primarily due to the observed correlation between data collected from wearables and PROMs. Our study highlights the importance of the use of objective data, in addition to subjective patient reported data, when analyzing postoperative patient progress, which propels forward the field of postoperative THA patient care.
-
Arch Orthop Trauma Surg · Dec 2024
ReviewChronic pelvic insufficiency fractures and their treatment.
Fragility and insufficiency fractures of the pelvis (FFP) and sacrum (SIF) are increasingly prevalent, particularly among the elderly, due to weakened bone structure and low-energy trauma. Chronic instability from these fractures causes persistent pain, limited mobility, and significant reductions in quality of life. Hospitalization is often required, with substantial risks of loss of independence (64-89%) and high mortality rates (13-27%). ⋯ Sacroplasty provides significant pain relief but has limited stabilizing capacity, while screw augmentation with polymethylmethacrylate improves fixation in osteoporotic bones. Anterior ring fractures may be treated with retrograde transpubic screws or symphyseal plating, with biomechanical stability and long-term outcomes depending on fixation techniques. FFP and SIF management requires a multidisciplinary approach to ensure stability, pain relief, and functional recovery, emphasizing early diagnosis, tailored surgical strategies, and secondary prevention of osteoporotic fractures.
-
Arch Orthop Trauma Surg · Dec 2024
ReviewTechniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.
Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur. ⋯ Adjunctive therapeutics such as tantalum rods, bone-grafting, orthobiologic (e,g, bone marrow aspirate concentrate, mesenchymal stem cells, platelet-rich plasma, and human umbilical cord mesenchymal stem cell extracts) as well as electric stimulation have all been studied. No consensus regarding the ideal treatment has been reached. This review analyzes the advantages and disadvantages of current core decompression techniques to provide orthopaedic surgeons with direction in managing patients with avascular necrosis of the femoral head.
-
Arch Orthop Trauma Surg · Dec 2024
Comparative StudyLocal anaesthesia vs. brachial plexus block in trapeziometacarpal joint arthroplasty.
An established anaesthetic procedure used during total trapeziometacarpal joint (TMCJ) arthroplasty is the brachial plexus block (BPB). It was hypothesized that local anaesthesia (LA) provides advantages in overall cost, enables intraoperative assessment of the prosthesis, and minimises the anaesthetic risk. In this study, LA to BPB was compared and outcomes, safety, and overall patient satisfaction were analyzed. ⋯ The use of LA in total TMCJ arthroplasty is a practical and reliable alternative to the well-established BPB. LA reduces the cost of the procedure, necessity of an anaesthesiology team and the duration of the patients´ hospital stay. Patients should be actively involved in selecting the anaesthetic method to optimize the operative procedure and overall outcome.