Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Convertible glenoid replacement in the anatomical total shoulder arthroplasty: medium-term results.
The older generation of high thickness metal-backed glenoid prostheses had a high failure rate. The goal of our study was to analyze the medium-term clinical and radiological results of a technically modified generation of metal backed glenoids with 35% decrease in thickness. ⋯ Favorable clinical results can be achieved, especially in patients with an eccentric glenoid type. Severe preoperative glenoid erosion (Walch A2, B2, B3) does not appear to have any influence on postoperative functional results. The complication and revision rates are significantly better than in previous studies with conventional metal-backed glenoid components. Conversion of the anatomical glenoid component to a reverse system was always possible and good clinical results were achieved.
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Arch Orthop Trauma Surg · Sep 2024
Case ReportsBilateral ST-coalition with thumb hypoplasia and scaphoid synchondrosis.
Carpal coalitions are rare wrist anomalies and are most often diagnosed incidentally. Due to their infrequent occurrence, there is a lack of treatment guidelines in the literature. We present a case study of a 13-year-old boy who presented with symptomatic synchondrosis in both scaphoids along with a bilateral osseous coalition between the scaphoid and trapezium bones in combination with bilateral thumb hypoplasia. We initiated a 10-week immobilization of the wrist, followed by gradual increasing weight-bearing. ⋯ For young patients, we suggest initiating conservative treatment as the first option. A precise analysis of the pathology and wrist kinematics is mandatory to recommend further therapy especially if operative interventions might be considered.
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Arch Orthop Trauma Surg · Sep 2024
Trends and outcomes in the surgical management of young adults with knee osteoarthritis using high tibial osteotomy and unicompartmental knee arthroplasty.
A significant portion of knee osteoarthritis is diagnosed in patients under the age of 55, where greater activity demands make total knee arthroplasty less desirable. High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are useful alternatives, but there is little understanding of which procedure is advantageous. Hence, this study examines the utilization, complication, and reoperation rates among the HTO vs. UKA in young patients with primary osteoarthritis. ⋯ Although healthier patients were selected for HTOs, UKAs were found to have a lower risk of complications and immediate reoperation. Additionally, UKAs had the advantage of lower operative burden, shorter length of stay, and a higher efficacy in outpatient settings.
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Arch Orthop Trauma Surg · Sep 2024
Functional outcome after bicompartmental knee replacement for medial and patellofemoral osteoarthritis.
Total knee arthroplasty (TKA) is used for tricompartmental knee osteoarthritis, while unicompartmental knee arthroplasty (UKA) is preferred for unicompartmental knee osteoarthritis. Bicompartmental knee arthroplasty (BKA) aims to address 2 knee compartments by combining 2 UKA's or 1 UKA with a patellofemoral replacement. This study examines the clinical outcomes of BKA, focusing on pain alleviation and knee function. The aim of this study is to report the functional outcome of BKA and see if this aligns with BKA outcomes from literature in terms of patient reported outcome measurements (PROMs) and range of motion (ROM) after a 2-year follow-up. Additionally, radiographic alignment, implant survivorship, adverse events and length of stay are secondary outcomes. ⋯ BKA shows promise in alleviating pain and improving knee function in patients with medial and patellofemoral osteoarthritis. Challenges include the risk of revision and technical difficulties during surgery. Comparative studies suggest similar outcomes between BKA and TKA, with potential advantages for younger, more active patients. Further research, particularly randomized trials with larger cohorts, is necessary to elucidate the long-term benefits and drawbacks of BKA compared to other knee arthroplasty options.
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Arch Orthop Trauma Surg · Sep 2024
Return to athletics after total knee arthroplasty: a survey study of 784 recreational athletes across 12 sports.
Postoperative return to recreational activity is a common concern among the increasingly active total knee arthroplasty (TKA) patient population, though there is a paucity of research characterizing sport-specific return and function. This study aimed to assess participation level, postoperative return to activity, sport function, and limitations for recreational athletes undergoing TKA. ⋯ Return to sport is feasible following TKA with high satisfaction. Swimming and cycling represent manageable postoperative activities with high return-rates, while runners and joggers face increased difficulty returning to equal or better activity levels. Patients should receive individualized, sports-specific counseling regarding their expected postoperative course based on their goals of treatment.