Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Aug 2024
Clinical outcomes and survival rates of a uncemented modular revision stem system in hip arthroplasty: a 10-year single-institution study on a frail population.
The increasing prevalence of primary hip arthroplasty has led to a parallel rise in revision cases. Femoral revision often entails compromised bone integrity, requiring consideration of various solutions for optimal reconstructive options. Despite technological advancements, there is limited evidence on the clinical outcomes of the latest modular revision stems. This study aimed to evaluate the clinical outcomes and survival rates of next generation uncemented modular revision stem in patients undergoing hip revision surgery. ⋯ This study on this uncemented modular revision stem demonstrated favorable outcomes in an elder fragile population with moderate to severe femoral bone loss. The implant's modularity provides versatility in addressing various defects, without any implant breakage observed during the study period. Literature comparison highlighted similar outcomes despite sample size differences. The promising results warrant continued investigation into the long-term survivorship of this modular stem system.
-
Arch Orthop Trauma Surg · Aug 2024
Clinical outcomes of total joint arthroplasty in patients with bowel ostomies.
The influence of prior colostomy or ileostomy on patients undergoing joint arthroplasty remains poorly understood. Our study aimed to assess whether patients with an ostomy undergoing hip and knee arthroplasties have worse postoperative outcomes and increased rates of revisions. ⋯ Patients undergoing hip arthroplasties with an open stoma are at an increased risk of hospital encounters and revisions, whereas TKA patients with stomas are not at increased risk of complications. These findings emphasize the importance of recognizing and addressing the unique challenges associated with this patient population.
-
Arch Orthop Trauma Surg · Aug 2024
Reconstruction of mechanical leg axis using non-modular cemented hinged prosthesis in complex primary total knee arthroplasty.
Modular cementless knee arthroplasty systems are capable of precise reconstruction of the mechanical axis. However, they are considered more susceptible to complications. In contrast, non-modular cemented systems are said to be more forgiving and show good long-term results. The aim of this study was to investigate the resulting leg axis after implantation of a non-modular cemented rotating hinged knee prosthesis. Furthermore, potential risk factors for the occurrence of malalignment and complications should be identified. ⋯ Level III: Retrospective cohort study.
-
Arch Orthop Trauma Surg · Aug 2024
Mid-term outcomes of total hip arthroplasty in patients younger than 30 years.
Total hip arthroplasty (THA) has predominantly been utilized to treat older patients with primary osteoarthritis. However, recent improvements in surgical technique and implant materials have increased implant longevity, making THA a viable option for younger patients (< 30 years old). While trend analyses indicate an expanding utilization of THA in younger patients with non-OA diagnoses, current data on mid- and long-term THA outcomes in this population are limited. This study aims to describe the demographics, perioperative data, and implant survivorship of patients younger than 30 years undergoing THA. ⋯ With a 10-year aseptic implant survivorship rate of 97.4%, THA is a reliable surgical intervention for patients younger than 30 years of age who have severe hip pathology. Further studies are warranted for a more comprehensive understanding of mid- and long-term survivorship risk factors in this demanding population, facilitating improved risk assessment and informed surgical decisions.
-
Arch Orthop Trauma Surg · Aug 2024
Age-adjusted Charlson Comorbidity Index as an effective tool for the choice between simultaneous or staged bilateral total knee arthroplasty.
The choice between simultaneous and staged bilateral total knee arthroplasty (BTKA) remains controversial. Age-adjusted Charlson Comorbidity Index(CCI) is a promising tool for risk-stratification. We aimed to compare the outcomes between patients who underwent simultaneous and staged BTKA, stratified by age-adjusted CCI scores. ⋯ Simultaneous BTKA was associated with an increased risk of short-term readmissions in patients with age-adjusted CCI ≥ 4 points but not in those with age-adjusted CCI ≤ 3 points. Age-adjusted CCI can be an effective index for the choice between simultaneous and staged BTKA procedures.