Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Oct 2023
Observational StudyGastrointestinal complications after fast-track total hip and knee replacement: an observational study in a consecutive 36,932 patient cohort.
Gastrointestinal complications after total hip (THA) and knee arthroplasty (TKA) have been reported to be between 0.3 and 2.6% with bleeding and C. difficile infection in 0-1%, and 0.1-1.7%, respectively. The use of enhanced recovery or "fast-track" protocols have focused on optimizing all aspects of perioperative care resulting in reduced length of hospital stay (LOS) and potentially also gastrointestinal complications. This study is a detailed analysis on the occurrence of postoperative gastrointestinal complications resulting in increased hospital stay or readmissions in a large consecutive cohort of fast-track THA and TKA with complete 90 days follow-up. ⋯ The risk of GI-complications within the first 90 postoperative days after fast-track THA and TKA was low (0.75%).
-
Arch Orthop Trauma Surg · Oct 2023
Distal femoral osteotomy for the valgus knee: indications, complications, clinical and radiological outcome.
The aim of this study was to describe the indications and technical aspects of medial closing and lateral opening distal femoral osteotomy (MCDFO and LODFO) for patients with a valgus knee and to report clinical and radiological outcomes and complications. ⋯ DFO is a reasonable treatment for lateral osteoarthritis in younger patients to avoid disease progression and the need for an UKA/TKA. However, there is a long rehabilitation time, a considerable risk for complications, and a high need for hardware removal. While many patients experienced symptoms at the long-term follow-up, most were satisfied with the outcome. Appropriate patient information is essential. Level of evidence Level IV, Case Series. Trial registration number NCT04382118, clinicaltrials.gov, May 11, 2020.
-
Arch Orthop Trauma Surg · Oct 2023
The modification of bone cut angle and joint line obliquity did not change the tibiofemoral kinematics and stability of knee joint after total knee arthroplasty.
Previous reports using cadaveric knees and musculoskeletal computer simulation have shown that kinematically aligned (KA) total knee arthroplasty (TKA) provides more natural and physiological tibiofemoral kinematic patterns than mechanically aligned (MA) TKA. These reports suggested that the modification of joint line obliquity improve the knee kinematics. This study aimed to determine whether joint line obliquity change the intraoperative tibiofemoral kinematics in TKA candidates with knee osteoarthritis. ⋯ Although the degree of joint line obliquity varies widely in various KA TKA methods, this study, which mimicked the method of Dossett et al. showed that the modification of joint line obliquity did not change the tibiofemoral kinematics and stability of the knee joint in TKA candidates with knee osteoarthritis.
-
Arch Orthop Trauma Surg · Oct 2023
Larger operating rooms have better air quality than smaller rooms in primary total knee arthroplasty.
Operating room air quality can be affected by several factors including temperature, humidity, and airborne particle burden. Our study examines the role of operating room (OR) size on air quality and airborne particle (ABP) count in primary total knee arthroplasty (TKA). ⋯ Although total time spent in the room did not differ between the large and small OR, there were significant differences in humidity and ABP rates for particles measuring 2.5 μm and 5.0 μm, suggesting the filtration system encounters less particle burden in larger rooms. Larger studies are required to determine the impact this may have on OR sterility and infection rates.
-
Arch Orthop Trauma Surg · Oct 2023
Two-staged management of ankle fracture-dislocations with a posterior fragment: computer-tomography-based classification, treatment and its outcome.
Trimalleolar fractures are difficult to treat and malreduction can lead to functional impairment. Involvement of the posterior malleolus has a poor predictive value. Current computed-tomography (CT)-based fracture classifications led to an increase in fixation of the posterior malleolus. The aim of this study was to describe the functional outcome after a two-stage stabilisation with direct fixation of the posterior fragment in trimalleolar dislocation fractures. ⋯ A two-stage procedure of trimalleolar dislocation fractures with in-direct reduction and fixation of the posterior tibial fragment through a posterior approach leads to good functional outcome scores with a low rate of complications.