Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Aug 2023
Multicenter StudyTechnical challenges and surgical outcomes of percutaneous transforaminal endoscopic discectomy in patients with upper lumbar disc herniation: a prospective clinical study.
Upper lumbar disc herniation (ULDH) constitutes a considerably complex and rare anatomic entity. As such, there are only a handful of studies investigating the application of percutaneous transforaminal endoscopic discectomy (PTED) in the management of this cause of low back pain. ⋯ Level III.
-
Arch Orthop Trauma Surg · Aug 2023
Re-initiation of elective total knee arthroplasty with an adapted pathway during the 2020 COVID-19 pandemic was safe and effective.
In June 2020 when elective total knee arthroplasty (TKA) resumed after the initial COVID-19 surge, we adapted our TKA pathway focusing on a shorter hospitalization, increased home discharge, and use of post-discharge telemedicine and telerehabilitation. The purpose of this study was to evaluate if changes in postoperative care affected early TKA outcomes. ⋯ A protocol implemented during the COVID-19 pandemic that leveraged a shortened hospitalization, higher rates of home discharge, and increased use of telemedicine and telerehabilitation was safe and effective.
-
Arch Orthop Trauma Surg · Aug 2023
The distal metatarsal screw is not always necessary in third-generation MICA: a case-control study.
To evaluate the clinical and radiological results after fixation of the first metatarsal head (MTH) with one or two screws as part of the third-generation minimally invasive Chevron-Akin osteotomy (MICA) for hallux valgus deformities. ⋯ Fixation of the first MTH with a single bicortical screw in MICA with moderate lateralization of MTH shows stable anchoring and good clinical results. The routine use of a second metatarsal screw can be omitted.
-
Arch Orthop Trauma Surg · Aug 2023
A propensity score-matched analysis on the impact of patient and surgical factors on early periprosthetic joint infection in minimally invasive anterolateral and transgluteal total hip arthroplasty.
Increased risk of periprosthetic joint infection (PJI) in minimally invasive (MIS) total hip arthroplasty (THA) is still debated. This study aimed to identify differences in surgical and patient-related risk factors for PJI between an MIS anterolateral approach and transgluteal-modified Hardinge approach. ⋯ Minimally invasive anterolateral and transgluteal THA show a comparable rate of early PJI within the first year of index surgery. A BMI of ≥ 35 kg/m2 was detected as a clear risk factor for infection in the anterolateral approach. Prolonged operation time ≥ 121 min increases the risk of PJI regardless of approach.
-
Arch Orthop Trauma Surg · Aug 2023
Latissimus dorsi and teres major tendon transfer for irreparable anterosuperior rotator cuff tear improves kinematics and internal rotation compared to latissimus dorsi tendon transfer.
Latissimus dorsi and teres major (LDTM) tendon transfer has demonstrated better clinical outcomes compared to Latissimus dorsi (LD) transfer for irreparable anterosuperior cuff (subscapularis/supraspinatus) tears; however, the biomechanical effects of these procedures are unknown. Therefore, the objective of this study was to compare kinematics and internal rotation of LDTM transfer to LD transfer for anterosuperior cuff tear. ⋯ Although both LDTM and LD tendon transfer improved the abnormal humeral head apex position and internal rotation compared with the tear condition, the LDTM transfer was biomechanically superior to the LD transfer in a cadaveric model.