Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2024
Multicenter StudyThe incidence and risk factors for extensive epidural cement leakage in cement-augmented pedicle screw fixation: a multicenter retrospective study.
In cement-augmented pedicle screw fixation (CAPSF), epidural cement leakage (CL) is a frequently reported complication with the potential for neural injury, especially when it is extensive. To date, there has been no reports discussing basivertebral foramen morphology and pedicle screw placement, which is critical in the analysis of the risk of extensive epidural CL. Thus, this study aimed to identify the incidence and risk factors for extensive epidural CL in osteoporotic patients with CAPSF. ⋯ Extensive epidural CL risk was significant in CAPSF when a magistral basivertebral foramen was present; solid screws and more volume of cement were used; and screw tip was implanted shallower or closer to the midline.
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Arch Orthop Trauma Surg · Mar 2024
Femoral revision in total hip arthroplasty using a cementless modular stem: clinical and radiological results with a 8-year follow-up.
Modular femoral components allow for patient-specific restoration of hip joint geometry and the reconstruction of extensive bone defects in revision total hip arthroplasty (THA); however, potential problems of modular implants such as taper corrosion and the risk of implant fracture continue to be of concern. The aim of the present study was to evaluate the clinical and radiological results of a cementless modular revision stem following revision surgery due to aseptic loosening and periprosthetic fracture and to assess patient-reported outcome measures (PROMs) in these patients at mid-term follow-up. ⋯ Revision THA using a modular cementless titanium revision stem demonstrated adequate clinical and radiological results at mid- to long-term follow-up in this cohort. Cementless revision stems are a useful treatment option to restore the anatomy, especially in deformed hips and in complex revision hip arthroplasty. However, there are some significant disadvantages related to an increased risk of mechanical failure such as corrosion/fretting damage and implant fracture. Future high-quality prospective studies with longer follow-up are necessary to confirm the supposed advantages.
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Arch Orthop Trauma Surg · Mar 2024
Prognostic nutritional index (PNI) is an independent risk factor for the postoperative mortality in geriatric patients undergoing hip arthroplasty for femoral neck fracture? A prospective controlled study.
Hip fracture is very common in advanced ages, and it is very likely that this condition is accompanied by nutritional deficiencies. The aim of this study was to investigate the effect of prognostic nutritional index (PNI) on postoperative mortality in geriatric patients who underwent hip arthroplasty for femoral neck fracture. ⋯ PNI seems to be an independent risk factor on mortality after hip fracture surgery in geriatric patients. PNI is a preventable and correctable risk factor that affects patient survival.
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Arch Orthop Trauma Surg · Mar 2024
Functional results of Circumferential Capsular Release in adhesive shoulder capsulitis. Comparative study of patients over and under fifty years of age.
The aim of our study is to evaluate the functional and mobility outcomes in patients who have undergone arthroscopic circumferential arthrolysis of the shoulder and to find out if there are differences in the results in relation to the patient's age. ⋯ Patient age did not affect outcomes significantly, with patients older than 50 years showing similar results to younger patients.
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Despite being the most used exam today, few studies have evaluated the accuracy of findings on non-contrast magnetic resonance imaging (MRI). The primary objective of the study was to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of non-contrast MRI findings in frozen shoulder, isolated and in combination. The secondary objectives were to define the interobserver and intraobserver agreement of the assessments and the odds ratio for frozen shoulder because of the various findings of MRI. ⋯ Level III, study of diagnostic test.