Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Operative room time comparison between general and spinal anesthesia in total hip arthroplasty: an institutional study.
A relatively high expense with any procedure is total operative time; two components being the time spent anesthetizing the patient and time spent transferring the patient out of the operating room (OR). Both times can be affected by the anesthetic method used. This study compares different operative time intervals for both spinal anesthesia (SA) and general anesthesia (GA), in patients undergoing a primary total hip arthroplasty (THA), to identify the most appropriate and cost-effective anesthetic method. ⋯ III.
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Arch Orthop Trauma Surg · Aug 2023
Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations.
In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kinematic factors influencing the risk of dislocation in order to give recommendations for optimal placement of the cup. We hypothesized that the lack of pelvic adaptation would influence the risk of prosthetic instability and motivate adapted. ⋯ Level III (matched case-control study).
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Hip abductor tear (HAT) is an increasingly diagnosed cause of refractory lateral hip pain and dysfunction, affecting 10-25% of the general population. ⋯ All patients who underwent an oHATr were able to return at least to one type of sport. This cohort was highly satisfied with their sports involvement and recreational activity achievement. In addition, 88% of patients reported that oHATr improved sports activity. There was a shift from higher to lower impact sports. Furthermore, just 3 hips present a retear after surgery.
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Arch Orthop Trauma Surg · Aug 2023
Intraoperative 3D imaging in plate osteosynthesis of proximal humerus fractures.
Proximal humerus fractures are common and often associated with osteoporosis in the elderly. Unfortunately, the complication and revision rate for joint-preserving surgical treatment using locking plate osteosynthesis is still high. Problems include insufficient fracture reduction and implant misplacement. Using conventional intraoperative two dimensional (2D) X-ray imaging control in only two planes, a completely error-free assessment is not possible. ⋯ This study shows that insufficient fracture reduction and implant misplacement can be easily and reliably detected by intraoperative DVT scan with an isocentric mobile C-arm set up in the usual parasagittal position to the patient.
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Arch Orthop Trauma Surg · Aug 2023
Preoperatively elevated HbA1c levels can meaningfully improve following total joint arthroplasty.
Prior literature has demonstrated that diabetic (DM) patients undergoing total joint arthroplasty (TJA) with elevated preoperative HbA1c scores have poorer clinical outcomes. However, no literature has reported the effect of undergoing TJA on laboratory markers of glycemic control. This study sought to evaluate effect of undergoing TJA on postoperative glycemic control and outcomes. ⋯ Patients with higher preoperative HbA1c were more likely to have clinically meaningful decreases in HbA1c postoperatively. A combination of preoperative medical optimization and improvements in mobility after TJA may play a role in these changes. Those with elevated HbA1c can have meaningful improvement in HbA1c after TJA.