Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Sep 2024
A novel radiological index uses the inner canal diameter and the Citak classification index to predict risk factor for aseptic loosening following hinged total knee arthroplasty.
It remains unclear if distal femoral morphology should be a key consideration when selecting the implant or fixation strategy. A novel radiological index has been proposed to classify patients' distal femoral morphology. This study aims to evaluate the validity of this classification system in a cohort of patients undergoing hinged Total Knee Arthroplasty (TKA), and to determine if distal femoral morphology is a risk factor for aseptic loosening or all cause revision following hinged TKA. ⋯ Distal femoral morphology plays an important role in the risk of aseptic loosening following hinged knee replacement, and should be considered when deciding implant type and fixation in these patients.
-
Arch Orthop Trauma Surg · Sep 2024
International consensus-based ranking of definitions for poor response to primary total knee arthroplasty: a Delphi study.
This study aimed to rank definitions for measuring poor response one year after TKA, after assessing the face validity and feasibility of existing or newly proposed definitions. ⋯ This study identified seventeen potential definitions of poor response to TKA, offering valuable options for integration into quality assessment investigations. Remarkably, all identified definitions were patient-centered and none were clinician-centered. Single-item questions, capturing change from the patient's viewpoint, appear to be the most practicable format to assess response.
-
Arch Orthop Trauma Surg · Sep 2024
The impact of crohn's disease on patients undergoing total knee arthroplasty.
The knee joint remains the most affected joint in extra-intestinal manifestations of Crohn's disease (CD). Given the increasing prevalence of CD and overall demand for total knee arthroplasty (TKA), it is likely that an increasing number of patients with CD will require TKA. The purpose of this study was to assess the inpatient postoperative complication in patients with CD undergoing TKA. ⋯ CD patients undergoing TKA experienced increased LOS and postoperative complications. However, these complications were minor and did not affect total hospital cost. Further prospective cohort studies could build upon the findings described to continue to maximize outcomes in CD patients undergoing TKA, which might extend to other cohorts.
-
Arch Orthop Trauma Surg · Sep 2024
Better restoration of joint line obliquity in tibia first restricted kinematic alignment versus mechanical alignment TKA.
In total knee arthroplasty (TKA), suboptimal restoration of joint line obliquity (JLO) and joint line height (JLH) may lead to diminished implant longevity, increased risk of complications, and reduced patient reported outcomes. The primary objective of this study is to determine whether restricted kinematic alignment (rKA) leads to improved restoration of JLO and JLH compared to mechanical alignment (MA) in TKA. ⋯ rKA-TKA results in high restoration accuracy of JLO and JLH, and demonstrates less pre- and post-operative JLO alteration compared to MA-TKA. With risen interest in joint line restoration accuracy with kinematic alignment, these findings suggest potential advantages compared to MA. Future investigation is needed to correlate between joint line restoration accuracy achieved by rKA and enhanced implant longevity, reduced risk of post-operative complications, and heightened patient satisfaction.
-
Arch Orthop Trauma Surg · Sep 2024
Cannulated compression screws with cable technique leads to a dramatic reduction in patella fracture fixation complications compared to tension band wiring.
The aim of this study was to compare the clinical, radiological and functional outcomes between cannulated compression screw with cable construct (CS) and tension band wiring (TBW) in transverse patella fractures. ⋯ The CS technique demonstrated lower complications, in particular, no CS patient had implant removals, wire migration or fracture displacement. Additionally, CS technique showed a faster return to ambulation and time to achieving full weight bearing status.