Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Socioeconomic deprivation is predictive of incomplete postoperative follow-up in patients with tibial shaft fractures.
Patients who sustain tibial shaft fractures are at risk for delayed recognition of complications with inadequate postoperative follow-up. Area Deprivation Index (ADI) is a surrogate which may be used to analyze the effects of socioeconomic deprivation on postoperative follow-up rates. The purpose of this study was to determine if ADI is associated with incomplete postoperative follow-up after intramedullary (IM) nailing for fractures of the tibial diaphysis. ⋯ III.
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Arch Orthop Trauma Surg · Dec 2024
Thrombotic events in patients underwent simultaneous bilateral total knee arthroplasty with modern perioperative blood management strategy.
Thrombotic events, the leading cause of death after total knee arthroplasty (TKA), occurred more frequently in simultaneous bilateral TKA than unilateral TKA under conventional perioperative management. The aim of the study was to determine whether the simultaneous bilateral TKA using contemporary blood management strategies would be associated with higher risk of thrombotic events than unilateral TKA. ⋯ The rate of thrombotic events after simultaneous bilateral TKA with contemporary perioperative blood management strategies did not significantly differ from that after unilateral TKA.
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Arch Orthop Trauma Surg · Dec 2024
Relationship between soft tissue envelope thickness of the lower extremity and acute periprosthetic joint infection of the knee.
The prevalence of obesity is increasing worldwide and it is known to be associated with many postoperative complications, including infection. Patients' body fat distribution may vary and body mass index (BMI) does not provide sufficient information about adipose tissue thickness of the lower extremities. The aim of this study is to investigate the relationship between thigh diameters and early postoperative prosthesis-related joint infections (PJI) in patients who underwent arthroplasty. ⋯ The incidence of acute PJI was found to be significantly higher in patients with larger thigh diameters, whereas no such relationship was observed for BMI. The incorporation of preoperative soft tissue envelope measurements into routine clinical examination may prove beneficial in reducing the risk of PJI.
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Arch Orthop Trauma Surg · Dec 2024
Prevalence of unexpected intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) and risk of periprosthetic joint infection (PJI).
Prevalence of unexpected positive intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) is reported to be 8.32% with largely varying findings in individual studies (5.92-62.07%) due to a heterogeneity in preoperative diagnostic work-up and diagnostic criteria for periprosthetic joint infection (PJI). When diagnosed as unsuspected PJI, re-revision rate is reported to be as high as 18.45% compared to 2.94% in patients with UPIC classified as contamination (p = 0.0237). We performed a monocentric retrospective analysis of revision TKA surgery to determine prevalence of UPIC, risk of developing a subsequent PJI and re-revision rate after 24 months compared to those without UPIC. ⋯ Presence of UPIC in presumed aseptic revision TKA does not correlate with a lower survival rate, but a higher incidence of subsequent PJI was observed in cases interpreted as unsuspected PJI.
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Arch Orthop Trauma Surg · Dec 2024
Review Meta AnalysisSynovial calprotectin in prosthetic joint infection. A systematic review and meta-analysis of the literature.
Calprotectin is a protein endowed with antimicrobial properties, rendering it a distinctive marker for infection. Two methods are currently available for the assay of calprotectin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test (LFT). We aimed to assess the diagnostic accuracy of synovial fluid calprotectin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection. ⋯ Detection of synovial calprotectin is an accurate test for diagnosis of hip and knee prosthetic infections. The diagnostic accuracy of the two calprotectin assessment methods is almost comparable. The LFT is a valid, rapid, and more available diagnostic tool, particularly to rule out PJI.