Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2024
The medullary cavity morphology of the proximal femur influences the fixation pattern of the rectangular tapered short stem in total hip arthroplasty.
This study aimed to evaluate differences in the pattern of fixation with a rectangular tapered short stem (Fitmore stem) due to proximal femoral medullary cavity morphology based on periprosthetic bone mineral density (BMD) and radiological findings. ⋯ In Dorr type C, BMD significantly decreased in the proximal femur with a rectangular tapered short stem, suggesting that the stem was fixed at the distal part. Careful observation of this prosthesis over time is needed in patients with Dorr type C.
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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.
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Arch Orthop Trauma Surg · Aug 2024
Cementless short stem total hip arthroplasty in patients older than 75 years: is it feasible?
In recent years, the indication for cementless short stem total hip arthroplasty (THA) has been widened to elderly patients as they might profit by the advantages of the short-curved implant design as well. Therefore, this study was conducted to evaluate the clinical and radiological outcome of a cementless short stem in elderly patients (≥ 75 years) compared to a young control group (≤ 60 years). ⋯ III Case-controlled study.
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Arch Orthop Trauma Surg · Aug 2024
Protective effect of modified lange "second position" for developing avascular necrosis following closed reduction for developmental dysplasia of the hip.
Developmental Dysplasia of the Hip (DDH) is a condition affecting hip joint development in children, presenting multiple manifestations. Immobilization methods to ensure hip concentricity, such as the human position and modified Lange position, vary in effectiveness and risks, especially avascular necrosis. The purpose of this study was to identify whether closed reduction (CR), with two different immobilization techniques, is effective in avoiding complications such as residual hip dysplasia (RHD), re-dislocation, and Avascular Necrosis (AVN). ⋯ After the initial Human Position immobilization, the second cast with the modified Lange "second position" demonstrated a protective effect compared with maintaining the Human Position immobilization throughout the immobilization period, reducing the likelihood of AVN development in patients undergoing closed reduction for developmental dysplasia of the hip.
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Arch Orthop Trauma Surg · Aug 2024
The resisted torsional stress test in diagnosis of femoral stem loosening in uncemented total hip arthroplasty - first description and retrospective study.
Aseptic femoral stem loosening is among the most common causes for revision in total hip arthroplasty (THA). We describe a simple clinical test that triggers pain in the proximal femur in patients with a loose stem. A previously described passive rotation test was associated with a poor sensitivity. The resisted torsional stress test (RTST) was used for several years in our hospital, and this is the first description of its reliability. ⋯ The RTST provides a helpful tool in the clinical assessment of femoral stem fixation in THA with good accuracy and should be included in standard follow-up examinations and in the assessment of painful THAs.