Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2023
Can machine learning models predict prolonged length of hospital stay following primary total knee arthroplasty based on a national patient cohort data?
The total length of stay (LOS) is one of the biggest determinators of overall care costs associated with total knee arthroplasty (TKA). An accurate prediction of LOS could aid in optimizing discharge strategy for patients in need and diminishing healthcare expenditure. The aim of this study was to predict LOS following TKA using machine learning models developed on a national-scale patient cohort. ⋯ ANN demonstrated modest discrimination capacity and excellent performance in calibration and clinical utility for the prediction of prolonged LOS following TKA. Clinical application of the machine learning models has the potential to improve care coordination and discharge planning for patients at high risk of extended hospitalization after surgery. Incorporating more relevant patient factors may further increase the models' prediction strength.
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Arch Orthop Trauma Surg · Dec 2023
Accuracy comparison of cup positioning during total hip arthroplasty using Hip Align and AR-Hip in the supine position.
The aim of this study is to compare the accuracy of acetabular cup positioning between the accelerometer-based navigation system and the augmented reality-based navigation system during THA in the supine position. ⋯ The accuracy of the acetabular cup positioning between the Hip Align and AR-Hip showed no difference during THA in the spine position. The high BMI could have negative influence on the accuracy of cup positioning in THA using Hip Align, thus AR-Hip could be designable for obesity patients.
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Arch Orthop Trauma Surg · Dec 2023
Mechanisms, interventions at risk and clinical presentation of iatrogenic nerve lesions in trauma patients.
Iatrogenic nerve lesions during surgical interventions are avoidable complications that may cause severe functional impairment. Hereby, awareness of physicians and knowledge of structures and interventions at risk is of utmost importance for prevention. As current literature is scarce, we evaluated all patients treated surgically due to peripheral nerve injuries in our specialized nerve center for the presence of iatrogenic nerve lesions. ⋯ Awareness of major surgical complications such as iatrogenic nerve injuries is important for surgeons. An often-seen trivialization or "watch and wait" strategy results in a huge delay for starting an adequate therapy. The high number of in-continuity lesions mainly in close proximity to osteosyntheses makes diagnosis and treatment planning a delicate challenge, especially due to the varying clinical presentations we found. Diagnostics and therapy should therefore be performed as early as possible in specialized centers capable of performing nerve repair as well as salvage therapies.
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The objective of this study was to evaluate the outcome of THA done in patients with sickle cell disease at a single center, and compare with rest of the world before we could recommend routine THA in SCD patients. ⋯ Our analysis shows that THA in sickle cell disease is safe with average 12 years of follow-up, indicating that surgery in these young patients (≤ 25 years) is safe and should not be delayed.