Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
The quality of immediate postoperative radiographs, performed after total hip replacement in the operating room versus in the post-anesthesia care unit: is there a difference?
Currently, there are no clear guidelines regarding the optimal settings for immediate postoperative imaging following total hip arthroplasty (THA). Authors' primary aim was to determine the preferred setting for postoperative radiographs by comparing a technical quality of imaging performed in postanesthesia care unit (PACU) versus operating room (OR). ⋯ Postoperative X-rays performed in the PACU were characterized by better technical quality compared to postoperative radiographs performed in OR. We, therefore, suggest to perform immediate postoperative evaluation in PACU to provide baseline radiographs of higher quality for future follow-up.
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Arch Orthop Trauma Surg · Aug 2023
Good clinical scores, no evidence of excessive anterior tibial translation, a high return to sport rate and a low re-injury rate is observed following anterior cruciate ligament reconstruction using autologous hamstrings augmented with suture tape.
Augmented anterior cruciate ligament reconstruction (ACLR) techniques have been proposed to reduce the high reported re-injury rates and low rates of return to sport (RTS). This study reports clinical outcomes, RTS and re-injury rates in patients undergoing ACLR using autologous hamstrings augmented with suture tape. ⋯ ACLR with suture tape augmentation demonstrated no evidence of excessive anterior tibial translation, high-scoring PROMs, sound performance scores, a high rate of RTS and low re-injury rate.
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Arch Orthop Trauma Surg · Aug 2023
Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile discoid lateral meniscus with peripheral tear.
We compared subtotal meniscectomy and saucerization with stabilization for osteocartilaginous damage based on injured location and further examined the factors related to osteocartilaginous damage in juvenile discoid lateral meniscus (DLM) with peripheral tear after a follow-up period of at least 5 years. ⋯ Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile DLM with peripheral tear over a minimum follow-up period of 5 years.
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Arch Orthop Trauma Surg · Aug 2023
Review Meta AnalysisExtramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis.
This systematic review and meta-analysis compared extramedullary fixation and intramedullary fixation for stable two-part trochanteric femoral fractures (AO type 31-A1) with regards to functional outcomes, complications, and surgical outcomes. ⋯ Current literature shows no meaningful differences in complications, surgical, or functional outcomes between extramedullary and intramedullary fixation of stable two-part trochanteric femoral fractures. Both treatment options result in good outcomes. This study implicates that, costs should be taken into account when considering implants or comparing fixation methods in future research.
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Arch Orthop Trauma Surg · Aug 2023
ReviewPerioperative management of leg-length discrepancy in total hip arthroplasty: a review.
Leg-length discrepancy (LLD) presents a significant management challenge to orthopedic surgeons and remains a leading cause of patient dissatisfaction and litigation after total hip arthroplasty (THA). Over or under-lengthening of the operative extremity has been shown to have inferior outcomes, such as dislocation, exacerbation of back pain and sciatica, and general dissatisfaction postoperatively. The management of LLD in the setting of THA is multifactorial, and must be taken into consideration in the pre-operative, intra-operative, and post-operative settings. ⋯ Pre-operatively, we provide an overview of the appropriate radiographic studies to be obtained and their interpretation, as well as considerations to be made when templating. Intra-operatively, we discuss several techniques for the assessment of limb length in real time, and post-operatively, we discuss both operative and non-operative management of LLD. By providing a summary of the best available practices and strategies for mitigating the impact of a perceived LLD in the setting of THA, we hope to maximize the potential for an excellent surgical and clinical outcome.