Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2024
The influence of body mass index on patient-reported outcome measures following total hip arthroplasty: a retrospective study of 3,903 Cases.
The influence of obesity on patient-reported outcome measures (PROMs) following total hip arthroplasty (THA) is currently controversial. This study aimed to compare PROM scores for pain, functional status, and global physical/mental health based on body mass index (BMI) classification. ⋯ Obese patients undergoing THA achieve lower absolute scores for pain, function, and self-perceived health, despite achieving comparable relative improvements in pain and function with surgery. Denying THA based on BMI restricts patients from clinically beneficial improvements comparable to those of non-obese patients, though morbidly obese patients may benefit from additional weight loss to achieve maximal functional improvement.
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Arch Orthop Trauma Surg · Jun 2024
The peak force to push a trial tibial insert into position cannot be used to select the correct thickness in total knee arthroplasty.
An objective of a total knee arthroplasty (TKA) is to restore native (i.e. healthy) function, and a crucial step is determining the correct insert thickness for each patient. If the insert is too thick, then stiffness results, and if too thin, then instability results. Two methods to determine the insert thickness are by manually assessing the joint laxity and by using a trial insert with goniometric markings that measures the internal-external rotation of the trial with respect to a mark on the femoral component. ⋯ The peak push forces going from an insert 1 mm thinner than the correct thickness as determined by an insert goniometer and from the correct thickness to 1 mm thicker were measured. Mean peak forces for the different insert thicknesses were 127 ± 104 N, 127 ± 95 N, and 144 ± 96 N for 1 mm thinner, correct, and 1 mm thicker, respectively, and did not differ (p = 0.3210). As a result, measurement of peak force during trial positioning of a tibial insert cannot be used to identify the correct thickness for all insert designs.
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Arch Orthop Trauma Surg · Jun 2024
Meta Analysis Comparative StudySystematic review and meta-analysis of studies comparing cyst wall preservation against cyst wall resection during arthroscopic popliteal cyst decompression.
The optimal arthroscopic management for popliteal cyst decompression remains uncertain, with ongoing debate between preserving the cyst wall or completely removing it. The purpose of this study is to compare the outcomes and complications of arthroscopic popliteal cyst decompression with cyst wall preservation and cyst wall resection. ⋯ During arthroscopic popliteal cyst decompression, cyst wall resection led to longer operative times and higher complication rates but lower recurrence rates and better MRI outcomes. The functional outcomes after surgery were found to be similar.
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Arch Orthop Trauma Surg · Jun 2024
Randomized Controlled TrialEffect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial.
Patients are often instructed to avoid weight bearing on the proximal tibia for 6 - 12 weeks post-surgery to avoid fracture fixation failure. However, delayed weight bearing leads to delayed mobility, causing difficulties in daily activities; problems such as pain, limited knee ROM, reduced quadriceps muscle strength, and impaired functional outcomes are reported in long-term follow-up. This study primarily aimed to evaluate the feasibility and explore the effect size. The secondary aim was to determine the effectiveness of early weight bearing along with conventional physiotherapy on functional outcomes. ⋯ A full-scale RCT for early weight bearing along with conventional physiotherapy for patients operated for Type I, II, and III proximal tibia fracture is feasible. Early weight bearing along with conventional physiotherapy could have a positive effect on reducing patient's pain perception and increasing knee joint mobility, quadriceps isometric muscle strength, knee function, and quality of life without any adverse effects.
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Arch Orthop Trauma Surg · Jun 2024
Randomized Controlled Trial Comparative StudyComparison of virtual reality and computed tomography in the preoperative planning of complex tibial plateau fractures.
Preoperative planning is a critical step in the success of any complex surgery. The pur-pose of this study is to evaluate the advantage of VR glasses in surgical planning of complex tibial plateau fractures compared to CT planning. ⋯ The use of virtual reality for surgical planning of complex tibial plateau fractures resulted in significantly shorter planned operative time, while planning time was longer compared to CT planning. After VR planning, more surgeons felt (very) well prepared for surgery.