Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudySimilar outcomes in collision athletes with subcritical glenoid bone loss and on-Track Hill Sachs lesion versus off-track Hill Sachs lesion managed with open Bankart repair plus inferior capsular shift.
Open Bankart repair plus inferior capsular shift has not yet been tested under the concept of glenoid track as a predictor of failure. The aim of this study was to compare the subjective and objective outcomes in collision athletes with subcritical glenoid bone loss and on-track Hill Sachs lesions versus those with off-track Hill Sachs lesions, all treated with open Bankart repair. ⋯ We found no differences between the outcomes of the two groups. According to the surgeon's preference, we recommend performing open Bankart repair plus inferior capsular shift as a treatment alternative in collision athletes with SGBL ≤ 10% independently of the type of Hill Sachs lesion.
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudyComparison of anatomic axes with a navigated functional rotation axis determined by ligament tension for rotational femoral component alignment in cadaver knee arthroplasty.
The malimplantation of the total knee arthroplasty (TKA) components is one of the main reasons for revision surgery. For determining the correct intraoperative femoral rotation several anatomic rotational axes were described in order to achieve a parallel, balanced flexion gap. In this cadaveric study prevalent used rotational femoral axes and a navigated functional rotational axis were compared to the flexion-extension axis defined as the gold standard in rotation for femoral TKA component rotation. ⋯ All axes showed a significant angular deviation from the FEA. We conclude that the presented technique achieves comparable results in terms of FEA reconstruction when compared with the use of the known surrogate axes, with certain deviations in terms of outliers in the internal or external rotation.
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Arch Orthop Trauma Surg · Jul 2024
The role of different acetabular morphologies on patient-reported outcomes following periacetabular osteotomy in borderline hip dysplasia.
The treatment option for borderline hip dysplasia (BHD) includes hip arthroscopy and periacetabular osteotomy (PAO). To the present day the controversial discussion remains, which intervention to prefer. Literature reports supporting an educated choice are scare, based on small patient cohorts and do not address the variability of acetabular morphology. Consequently, we intended to report PAO outcomes, from patients diagnosed with BHD, dependent on acetabular morphology, in a large patient cohort and aimed to define risk factors for poor clinical results and patient satisfaction. ⋯ This study demonstrates that PAO is an effective means to treat symptomatic BHD with variable acetabular morphologies, achieving a clinical success in 91.5% of all patients. To maintain a high level of safety and patient satisfaction technical accuracy appears crucial.
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Arch Orthop Trauma Surg · Jul 2024
Intrafocal injection of tranexamic acid decreases early return to hospital after high tibial osteotomy.
High tibial osteotomy (HTO) is a surgery performed to treat the symptoms and prevent the progression of medial osteoarthritis. Post-operative bleeding has led to early returns to hospital following surgery. Intrafocal injection of tranexamic acid (TXA) could reduce this bleeding complication. The objective of the study was to evaluate the effect of TXA during HTO on the incidence of post-operative complications and early returns to hospital. ⋯ The intrafocal injection of TXA during HTO decreases early returns to hospital.
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Arch Orthop Trauma Surg · Jul 2024
Clinical and radiological outcome following trauma-related reverse shoulder arthroplasty.
Reverse shoulder arthroplasty (RSA) is a frequently used therapy for complex proximal humeral fractures and posttraumatic disorders. The present study's purpose was to assess the clinical and radiological outcome of primary and secondary RSA, and to analyze the impact of refixation of the greater tuberosity (GT). ⋯ Superior range of motion and clinical outcome scores were present for anatomically healed GT. Therefore, refixation of the tuberosities is recommended. Secondary RSA can result in inferior results compared to primary RSA, so patients need to be adequately informed.