Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2024
Impact of intra- and extramedullary alignment on blood loss in total knee arthroplasty: a retrospective study.
There is a scarcity of scientific data regarding the correlation between alignment techniques during total knee arthroplasty (TKA) and blood loss as well as transfusion rates. This study's hypothesis posited that intramedullary-aligned (IM) TKA exhibits higher blood loss and transfusion rates when contrasted with extramedullary-aligned (EM) TKA. ⋯ We observed no statistically significant variance in blood loss between the IM and EM groups. Likewise, there was no substantial disparity in transfusion rates between these groups. It can be concluded that the selection of a knee arthroplasty system incorporating either intramedullary tibial alignment or extramedullary alignment does not significantly impact blood loss.
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Arch Orthop Trauma Surg · May 2024
ReviewFactors influencing periprosthetic bone mineral density in total knee arthroplasty: a systematic review.
Following total knee arthroplasty (TKA), there is a significant decline in periprosthetic bone mineral density (BMD), potentially resulting in complications such as prosthetic loosening, periprosthetic fracture, and influencing the postoperative recovery. The objective of this study was to summarize the factors influencing periprosthetic BMD in TKA from existing studies. ⋯ Mobile-bearing prostheses, modular polyethylene design, short stems, cruciform stems, avoidance of bone cement, higher body mass index, titanium nitride coating, and a smaller medial peg distance could potentially benefit periprosthetic BMD. Comprehensive consideration of diverse factors influencing periprosthetic BMD before surgery and collaboration with post-operative drug therapy are essential.
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Arch Orthop Trauma Surg · May 2024
Long-terms outcomes of radial head arthroplasty using a bipolar prosthesis.
In acute treatment of radial head fractures, a radial head prosthesis can be considered if open reduction and internal fixation are not technically feasible. ⋯ Bipolar radial head prostheses are an option for acute treatment of isolated unreconstructable radial head fractures. During follow-up, three patients required implant revision and removal; the capitellum surface presented severe degenerative changes and the prosthesis was not replaced. Another complication was the risk of implant dislocation, in relation to implant design, incorrect positioning of the radial head stem or else to inadequate reconstruction of the lateral collateral ligament. Further work is needed to establish the long-term follow-up results of Judet implants in complex elbow fractures.
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Arch Orthop Trauma Surg · May 2024
Comparative StudyImproved patient reported outcomes with the direct anterior approach versus the posterior approach for total hip arthroplasty in the early post-operative period.
Patients undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA) may experience faster recovery but may also have better baseline health than those who undergo THA with the posterior approach (PA). This study aimed to compare patient-reported outcome measures (PROMs) between the DAA and PA while controlling for baseline factors. ⋯ THA patients undergoing DAA demonstrate earlier improvements in HOOS JR and EQ-5D-5L. However, these differences may not be clinically significant and are not evident at 1-year post-operative. Patient selection and surgeon training may continue to affect outcomes by surgical approach.