Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Hip resurfacing: case closed? A bibliometric analysis of the past 10 years.
Hip resurfacing (HR) was introduced as a potential alternative to total hip arthroplasty (THA), indicated predominantly for younger, high demand patients. The modern metal-on-metal implant was popularized in the 1990s and early 2000s and promised greater wear resistance. However, its popularity waned due to increased rates of complications related to metal toxicity including pseudo-tumors as well as the recall of many resurfacing implants. The purpose of this study was to conduct a bibliometric analysis and investigate the current trends in hip resurfacing literature. ⋯ In conclusion, our bibliometric analysis allowed novel exploration and identification of the current research trends, contributions, and the distribution of publications exploring HR. The understanding of HR and the poor long-term outcomes of some resurfacing implants has improved significantly over the past decade, with the most recent focus on failure rates and long-term complications from metal debris. However, the breadth of literature has steadily declined in the past decade, and ultimately demonstrates the decline of scientific interest and focus on novel areas in hip resurfacing and a potential reached consensus.
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Arch Orthop Trauma Surg · Feb 2024
Biomechanical analysis of different THA cementless femoral stem designs in physiological and osteoporotic bone during static loading conditions.
The influence of THA stem design on periprosthetic femoral fractures (PFFs) risk is subject of debate. This study aims to compare the effects of different cementless stem designs on stress-strain distributions in both physiological and osteoporotic femur under various loading conditions. ⋯ In physiological bone, anatomical stems demonstrated stress distribution comparable to the native model. The double-wedge stem showed uneven stress distribution, which may contribute to long-term stress shielding. In the case of osteoporotic bone, the double-wedge stem design resulted in a significant increase in average stress during both gait and sideways falling, potentially indicating a higher theoretical risk of PFF.
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Arch Orthop Trauma Surg · Feb 2024
Staged vs concurrent hardware removal in total ankle arthroplasty.
Ankle osteoarthritis is more commonly posttraumatic. Consequently, dealing with hardware removal is quite frequent when performing a total ankle arthroplasty (TAA). The purpose of this study is to compare outcomes regarding either a staged or concurrent hardware removal when performing TAA. ⋯ III.
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Arch Orthop Trauma Surg · Feb 2024
Injections prior to hip arthroscopy are associated with increased risk of repeat hip arthroscopy at 1 and 5 years.
Previous studies have shown that intra-articular hip injections prior to hip arthroscopy (HA) can be a helpful diagnostic tool. However, local anesthetic and corticosteroid injections can be chondrotoxic and corticosteroid injections have been shown to increase the risk of infection during subsequent surgical intervention. The purpose of this study was to evaluate whether preoperative injections adversely affect outcomes of HA using a national database. ⋯ Intraarticular hip injections prior to hip arthroscopy, particularly corticosteroid injections, are associated with increased risk of repeat hip arthroscopy at 1 and 5 years. Additional studies are needed to elucidate this risk.
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Humeral shaft fractures are common fractures of the diaphysis of the humerus. The aim of this study was to evaluate factors affecting the clinical outcomes of humeral nonunions surgically treated with open reduction and single- versus double-plate fixation with grafting. ⋯ Although the double-plate fixation technique has similar clinical, radiological, and functional results to single-plate fixation, it is a more invasive and expensive technique with a longer operation time. Therefore, it should not be used as the first-line treatment option for all humeral shaft nonunion. Nevertheless, the double-plate technique may be preferred to achieve in cases requiring high stability, such as hypertrophic nonunion, osteopenia and comminuted fractures.