Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Autologous microfragmented adipose tissue treatment of knee osteoarthritis demonstrates effectiveness in 68% of patients at 4-year follow-up.
Adipose tissue-derived stem cells are an interesting therapeutic option for early knee osteoarthritis (OA) treatment due to their high plasticity, easiness of harvesting and rapidity of administration. The aim of this study was to evaluate the medium-term effectiveness and safety of Microfragmented Autologous Fat Tissue (MFAT) injection treatment at 4-year follow-up and to investigate potential correlations among patients' pre-treatment clinical condition and clinical outcomes to identify possible predicting factors for procedure success or failure. ⋯ MFAT intra-articular injection is a safe procedure with positive improvements up to 4-year follow-up in patients with early knee OA. These findings suggest MFAT could be a minimally invasive treatment of early knee OA with durable benefits at mid-term evaluation.
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Arch Orthop Trauma Surg · Sep 2024
The need for state-of-the-art orthopedic surgical technology in low- to middle income countries : The case of distraction epiphyseolysis for limb lengthening in children with fibular hemimelia in Uzbekistan.
Amongst low- to middle income countries (LMIC), outdated and poorly documented orthopedic interventions may pose patients at risk for complications, serious adverse events (SAE) and unsatisfactory results, contradicting the World Health Organization's (WHO) Safe Surgery mandates. Use cases of conditions managed inadequately in LMIC environments are necessary to increase awareness of stakeholders and overcome deficiencies in collaboration with high-income countries (HIC). ⋯ Limb lengthening for hereditary fibular hemimelia in Uzbekistan revealed rather obsolete surgical algorithms, inadequate documentation, and unreliable outcome assessment. Resource limitations notwithstanding, knowledge transfer, implementation of current procedures and hardware, and international collaboration is vital to improve quality of care in this scenario and for the benefit of LMIC in general.
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Guideline-based surgical cartilage therapy for focal cartilage damage offers highly effective possibilities to sustainably reduce patients' complaints and to prevent or at least delay the development of early osteoarthritis. In the knee joint, it has the potential to reduce almost a quarter of the arthroses requiring joint replacement caused by cartilage damage. Biologically effective injection therapies could further improve these results. ⋯ The role of a combination therapy with use of intra-articular corticosteroids is lacking in the absence of adequate study data and cannot be defined yet. With regard to adipose tissue-based cell therapy, the current scientific data do not yet justify any recommendation for its use. Further studies also regarding application intervals, timing and differences in different joints are required.
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Arch Orthop Trauma Surg · Sep 2024
Randomized Controlled TrialDurability of transosseous repair of posterior soft tissues after primary total hip arthroplasty: a prospective randomized controlled trial.
Posterior soft tissue repair is one of the methods for preventing dislocation after total hip arthroplasty (THA). This study aimed to evaluate durability of two separate suture materials in THA patients who underwent posterior soft tissue repair. ⋯ We conclude that for transosseous posterior soft tissue repair in THA, both absorbable and nonabsorbable sutures are similarly durable and can be routinely performed.
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Arch Orthop Trauma Surg · Sep 2024
Clinical and radiological outcome of acute quadriceps tendon repair at 2 - year follow-up.
Though previous studies on surgical quadriceps tendon repair reported good to satisfactory results its impact on knee extensor strength and patellofemoral joint is unknown. The purpose of the study was to assess the clinical and functional outcome by quantifying subjective knee related outcome, isokinetic extensor strength complemented by magnetic resonance imaging (MRI). ⋯ Distal quadriceps tendon repair leads to satisfactory subjective outcome in patients with low to moderate activity levels. Tendon integrity was reliably restored. However, extensor strength deficits remain in more than 40% of patients. Atrophy signs of advanced fatty infiltration were recorded in 15% and patellofemoral cartilage defects in 20% of all patients, indicating that previous assessment tools do not display functional outcome adequately.