Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2023
Observational StudyPost-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.
Optimized health system approaches to improving guideline-congruent care require evaluation of multilevel factors associated with prescribing practices and outcomes after total knee and hip arthroplasty. ⋯ In the present study, several patient-, care-, and hospital-level factors were associated with an increased probability of an opioid prescription refill within 30 days after arthroplasty. Future work is needed to identify optimal approaches to reduce unwarranted and inequitable healthcare variation within a patient-centered framework.
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Arch Orthop Trauma Surg · Sep 2023
Does high activity after total and unicompartmental knee arthroplasty increase the risk for aseptic revision?
It has been suggested that high activity might negatively impact implant survival following total and unicompartmental knee arthroplasty (TKA/UKA) and many surgeons advise their patients to only participate in moderate level sport activities. To date, it remains unclear whether such restraints are necessary to assure longevity of the implants. ⋯ The study suggests that participating in sports activity following both UKA and TKA is safe and not a risk factor for revision surgery at a mid-term follow-up. Patients should not be prevented from an active lifestyle following knee replacement.
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Arch Orthop Trauma Surg · Sep 2023
Mid-term outcomes of revision hip arthroplasty due to titanium modular neck failure.
The current strategy for modular neck failures in total hip arthroplasty (THA) is calibrated on CrCo neck failures. Stem revision is usually required, but the procedure is challenging and achieves modest outcomes (up to 20% of re-revisions at short-term). No study reports revision strategies and outcomes after Ti neck failures. Aims of the study were to evaluate: (1) demographic and implant features of the cohort to be revised, (2) intra-operative findings and surgical revision strategies and (3) clinical and radiological post-revision outcomes. ⋯ Level IV, retrospective case series.
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Arch Orthop Trauma Surg · Sep 2023
ACL reconstruction provides superior stability than ACL repair in patients with Schenck III and IV knee joint dislocations: first results of a 12 month follow-up study.
Acute knee dislocation is a rare but devastating multi-ligamentous knee injury with only limited evidence-based surgical technique recommendations. The aim of this study was a comparison of two different anterior cruciate ligament (ACL) restoration techniques as part of an early total surgical care concept: (1) repair of ACL with additional internal bracing (ACLIB) compared to; (2) ACL reconstruction with autograft (ACLR). ⋯ Retrospective cohort study, III.
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Arch Orthop Trauma Surg · Sep 2023
Short- to mid-term results of minimally invasive lateral unicompartmental knee replacement: 133 cases in a non-designer series.
The aim of the current study was to demonstrate short- to mid-term survivorship as well as clinical outcome of lateral unicompartmental knee replacement (UKR) with a fixed-bearing (FB) design from a non-designer center using the Oxford Fixed Lateral prosthesis. ⋯ Retrospective cohort study, level IV.