Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2023
Selective THA-approach use amongst junior surgeons improves safety of introducing the anterior approach: a prospective, multi-surgeon, comparative, study.
Learning curves associated with independent practice and anterior approach total hip arthroplasty (AA-THA) has been associated with inferior outcome. This study compared outcome of junior, fellowship-trained, surgeons who perform THA through both anterior and posterior (PA) approach, with senior surgeons who perform either AA or PA, to determine whether: 1. Fellowship training and selective practice allows for safe introduction of AA into practice; and 2. Whether selective approach-use influences outcome. ⋯ Contemporary training and selective approach-use minimizes the learning curve, allowing junior staff to have equivalent outcome to established, senior surgeons in both AA and PA. We would advocate for selective approach use amongst junior arthroplasty surgeons when introducing the AA into independent practice.
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Arch Orthop Trauma Surg · Nov 2023
Multicenter StudyFactors that affect external rotation following reverse shoulder arthroplasty: a retrospective multi-centre study on 501 shoulders.
The purpose of this multi-centre study was to assess external rotation in a large cohort following reverse shoulder arthroplasty (RSA) at a minimum follow-up of 2 years, and identify factors that influence postoperative and/or net-improvement of external rotation. ⋯ IV.
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Arch Orthop Trauma Surg · Nov 2023
Long-term outcomes of total hip arthroplasty in patients with developmental dysplasia of the hip: a minimum 21-year follow-up.
Early osteoarthritis (OA) due to developmental dysplasia of the hip (DDH) is a known indication for total hip arthroplasty (THA). Though screening tools and joint-preserving procedures have been established successfully, there still is a relevant number of patients suffering DDH. Due to the lack of long-term outcome studies, we like to close this gap and present the results of a highly specialized center. ⋯ Though implants and surgical techniques have improved over time, our results suggest THA in patients suffering DDH to be seriously challenging with relatively high overall complications in long-term observation and fair clinical outcome after 21 years postoperatively. There is evidence that prior osteotomy might be associated with a higher revision rate.
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Arch Orthop Trauma Surg · Nov 2023
Early complications of percutaneous K-wire fixation in pediatric distal radius fractures-a prospective cohort study.
Distal radius fractures (DRF) are the most common pediatric fractures, but the current evidence for management remains inconclusive. Closed reduction and percutaneous pinning (CRPP) provide excellent stability but are not complications-free. Therefore, a thorough evaluation of their adverse events is necessary to provide reliable information on risks and benefits in different clinical scenarios. The current literature lacks studies conducted with rigorous grading systems and uniform follow-up protocols on this topic. This prospective cohort study used a validated grading scheme to analyze complications associated with CRPP in an unselected pediatric population with displaced, unstable distal third radius fractures. ⋯ The CRPP is a safe treatment method for DRF in pediatric patients, with a low major complication rate. However, minor adverse events are frequent and can significantly burden the patient's postoperative well-being. The application of rigorous definitions and grading systems should not only lead to the obtainment of high-quality data but also to higher awareness of possible pin tract infections and therefore allow for better therapeutic decisions.
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Arch Orthop Trauma Surg · Nov 2023
Validation of the subjective spine value: a new single item score for the assessment of spine-specific function.
Spinal function can be assessed through different patient reported outcome measures (PROMs). ⋯ I, prospective cohort study.