Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Analysis of systemic serum vancomycin levels following intraarticular application in primary total joint arthroplasty.
Periprosthetic joint infection (PJI) is a serious complication following primary total joint arthroplasty (TJA). PJI accounts for 15-25% of revision surgeries, therefore it is associated with PJI is associated with substantial patient morbidity and mortality as well as increased healthcare expenditures due to complex treatment strategies. Recently, intraoperative local application of vancomycin powder is increasingly being used in primary total hip and knee arthroplasty (THA, TKA) as an additive strategy for PJI prevention. Whereas local vancomycin concentrations have already been investigated in prior studies, evidence on systemic vancomycin levels and potential adverse drug reactions (ADR) is limited. Purpose of this study was to investigate systemic vancomycin levels following intraarticular application in primary TJA. ⋯ Following intraarticular administration of vancomycin powder, no systemic vancomycin levels within the therapeutic range were detected, thus it may serve as a safe and cost-effective adjunct to strategies for prevention of PJI.
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Arch Orthop Trauma Surg · Dec 2024
Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up.
The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs. ⋯ Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA.
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Arch Orthop Trauma Surg · Dec 2024
More intraoperative complications but similar revision rate in primary total hip arthroplasties using direct anterior approach in supervised trainees-a retrospective cohort study.
There are conflicting data regarding the safety of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) during the learning process. The aim of this study was to evaluate the intra- and postoperative complication rates of DAA THA performed by supervised trainees compared with senior surgeons. ⋯ Although the operating time and intraoperative complication rates are higher for supervised trainees, there is no significantly higher rate of postoperative septic or aseptic revisions. These findings highlight the importance of structured training programs in ensuring patient safety and surgical competence among trainees.
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Arch Orthop Trauma Surg · Dec 2024
Total knee arthroplasty in patient with poliomyelitis sequelae: maintaining a recurvatum is associated with better mid-term functional results.
Total knee arthroplasty (TKA) in patients with sequelae of poliomyelitis is a surgical challenge due to muscle weakness, bone deformities or post-polio syndrome (PPS). Few data exist to determine the factors contributing to poor functional results. This study aimed: (1) to describe a cohort of patients with poliomyelitis sequelae who underwent TKA; (2) to examine risk factors for poor functional outcome. ⋯ IV.
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Arch Orthop Trauma Surg · Dec 2024
Is it time to Reassess The Role of Preoperative HypoalbuminemiaAmong Geriatric Distal Femur Fracture Patients?
Hypoalbuminemia, blanketly defined as Albumin < 3.5 g/dL, is often utilized as a threshold associated with postoperative complications and mortality among orthopedic and non-orthopedic surgical procedures. Albumin level is influenced by a myriad of factors including liver function, malnutrition, and inflammation. This study evaluates the role preoperative albumin as an independent risk factor for mortality and increased length of stay (LOS) among distal femur fracture (DFF) patients. ⋯ Prognostic Level III.