Archives of orthopaedic and trauma surgery
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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.
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Arch Orthop Trauma Surg · Aug 2024
The reliability and validity of the Lie‑To‑Sit‑To‑Stand‑To‑Walk transfer test in total knee arthroplasty.
Total knee arthroplasty (TKA) is the standard procedure for treating end-stage knee osteoarthritis. Nevertheless, some residual issues can persist, leading to various problems, including pain, compromised strength, impaired proprioception, postural instability, dynamic balance issues, and gait deficiencies. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) implements a multi-faceted methodology to evaluate basic transfer abilities. The purpose of this study is to investigate the validity, reliability, and minimal clinically important difference of the LSSWT in TKA patients. ⋯ The LSSWT displays excellent reliability and high validity in assessing fall risk, complex dynamic balance, and mobility required for daily activities in patients post-TKA. The low MCID value (3.33) indicates its sensitivity and ability to identify minor changes in a patient's status over time or in response to rehabilitation applications. Therefore, it is recommended to use the LSSWT when evaluating fall risk, dynamic balance, and mobility for community living, discharge planning, or facility admission.
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Arch Orthop Trauma Surg · Aug 2024
Primary stability of multi-hole acetabular cup combined with posterior column plating for the fixation of complex acetabular fractures in elderly patients: a biomechanical analysis.
Acute total hip arthroplasty has gained increasing popularity in the treatment of complex acetabular fractures in elderly patients, but the biomechanical evidence is lacking. Therefore, we measured the primary stability to evaluate whether acute total hip arthroplasty using a multi-hole acetabular cup and posterior column plating through a single K-L approach can safely be used for treating complexed acetabular fractures in the elderly. ⋯ Our results show, that acute total hip arthroplasty using a multi-hole cup with acetabular screws and posterior column plating through single a K-L approach offers good primary stability to allow good osseous integration for treating complex acetabular fractures in the elderly. Furthermore, it also provides good fracture gap displacement on the posterior column.
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Arch Orthop Trauma Surg · Aug 2024
Predictors of inpatient mortality following reverse shoulder arthroplasty.
The number of reverse shoulder arthroplasties (RSA) performed each year is growing rapidly, especially in elderly patients and with expanded indications including geriatric proximal humerus fractures. As the elderly population grows and the number of RSA's annually continues to rise, there will be a proportionate number of adverse events and mortality. However, the rate of early mortality has consistently shown to be less than 1%, so a large-scale analysis of possible risk factors for post-operative mortality is warranted. ⋯ Age greater than 75 years old has 4-fold higher odds and non-elective admission has 5-fold higher odds of early mortality following RSA. Appropriate pre-operative counseling should be performed with elderly patients and those undergoing non-elective indications for RSA.
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Noise-Induced Hearing Loss (NIHL) is a condition caused by repeated exposure to loud noise, with operating theatre personnel potentially at risk. The aims of this study were to establish the typical noise levels in orthopaedic theatres and to compare these to The Control of Noise at Work Regulations 2005. ⋯ We have established the baseline noise levels in various orthopaedic procedures. Measures should be taken to meet UK regulations. Further research should determine suitable measures for protection from hearing damage for theatre staff and evaluate the risks high noise levels pose to patients.