Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2023
ReviewDual-mobility total hip arthroplasty in patients younger than 55 years old: a systematic review.
Total hip arthroplasty (THA) is regarded as one of the most successful and cost-effective orthopedic procedures. However, THA is a surgical procedure with potential intraoperative and postoperative risks. Dislocation is one of the common postoperative complications and remains one of the main indications for THA revision. ⋯ The mean revision rate at twelve years was 11%. The mean value of Harris Hip Score increased from 50.9 pre-operatively to 91.6 after surgery. Dual mobility is a valid option for young patients with extended survivorship and low rates of instability and dislocation after primary THA.
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Arch Orthop Trauma Surg · Nov 2023
ReviewPatellar tendinopathy: an overview of prevalence, risk factors, screening, diagnosis, treatment and prevention.
Patellar tendinopathy (PT), or jumper's knee, is an overuse injury that occurs in professional, as well as recreational, athletes. This condition is a noncontact injury, typically characterized by gradually increasing pain in the patellar tendon. It is prevalent in participants of several sports, but it occurs mostly in jumping sports. ⋯ If conservative treatment fails, surgery is the next most preferable step. Even though there are many surgical treatment methods, there is no clear evidence on what is the most effective approach to address PT. Taking this into consideration, as well as the extent of this clinical entity, novel therapeutic techniques, as well as screening and prevention methods, are expected to emerge in the near future.
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Bone marrow edema (BME) of the hip is a radiological-clinical condition with symptoms ranging from asymptomatic to severe, and it is characterized by increased interstitial fluid within the bone marrow, usually at the femur. Depending on the etiology it can be classified as primary or secondary. The primary cause of BME is unknown, while the secondary forms include traumatic, degenerative, inflammatory, vascular, infectious, metabolic, iatrogenic, and neoplastic etiologies. ⋯ MRI is the gold standard, and it shows an area of intermediate signal on T1-weighted MRI scans and a high signal on T2-weighted scans, usually lacking sharps margins. In the reversible form, BME is typically self-limiting, and it can be managed conservatively by means of pharmacological and physical therapy. Surgery is generally required for progressive forms in patients who failed non-operative treatment, and it ranges from femoral head and neck core decompression to total hip arthroplasty.
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Arch Orthop Trauma Surg · Nov 2023
Randomized Controlled TrialHigher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty.
This was a prospective single-blinded study comparing the peri-operative opioid consumption and motor weakness for patients undergoing total hip arthroplasty (THA) with either a Quadratus Lumborum Type 3 Nerve Block (QLB) or a Paravertebral Nerve Block (PVB). ⋯ III, Non-randomized controlled cohort/follow-up study.
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Arch Orthop Trauma Surg · Nov 2023
Multicenter StudyMulticenter consensus statements on the use of low-intensity pulsed ultrasound (LIPUS) in Hand Surgery.
The purpose of this agreement was to establish consensus statements on the use of low-intensity pulsed ultrasound (LIPUS) in hand surgery. ⋯ There is a consensus among German hand surgeons, when and how LIPUS can be applied for improving fracture healing of the hand. Randomized controlled trials with direct comparison of fracture treatment with and without LIPUS are needed to support these statements with objective data.