Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2024
Influence of cartilage defects and a collagen gel on integrity of corresponding intact cartilage: a biomechanical in-vitro study.
Numerous cartilage repair procedures have been developed for focal lesions to minimize suffering and possibly prevent the development of osteoarthritis with a focus on so-called one-step procedures. The aim of this work was to investigate the effects of both focal cartilage defects and a biomaterial (ChondroFiller) on the corresponding articular cartilage. ⋯ Even focal grade IV cartilage lesions can lead to significant damage to the corresponding cartilage in vitro. The damage could not be reduced by the use of ChondroFiller, likely because of the initial instability of this biomaterial. Therefore, a biomaterial must be stable in the beginning with regard to full weight-bearing, or joint loading should be delayed until stable filling of the defect is achieved.
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Arch Orthop Trauma Surg · Oct 2024
Relationship between soft tissue envelope thickness of the lower extremity and acute periprosthetic joint infection of the knee.
The prevalence of obesity is increasing worldwide and it is known to be associated with many postoperative complications, including infection. Patients' body fat distribution may vary and body mass index (BMI) does not provide sufficient information about adipose tissue thickness of the lower extremities. The aim of this study is to investigate the relationship between thigh diameters and early postoperative prosthesis-related joint infections (PJI) in patients who underwent arthroplasty. ⋯ The incidence of acute PJI was found to be significantly higher in patients with larger thigh diameters, whereas no such relationship was observed for BMI. The incorporation of preoperative soft tissue envelope measurements into routine clinical examination may prove beneficial in reducing the risk of PJI.
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Arch Orthop Trauma Surg · Oct 2024
Prevalence of unexpected intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) and risk of periprosthetic joint infection (PJI).
Prevalence of unexpected positive intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) is reported to be 8.32% with largely varying findings in individual studies (5.92-62.07%) due to a heterogeneity in preoperative diagnostic work-up and diagnostic criteria for periprosthetic joint infection (PJI). When diagnosed as unsuspected PJI, re-revision rate is reported to be as high as 18.45% compared to 2.94% in patients with UPIC classified as contamination (p = 0.0237). We performed a monocentric retrospective analysis of revision TKA surgery to determine prevalence of UPIC, risk of developing a subsequent PJI and re-revision rate after 24 months compared to those without UPIC. ⋯ Presence of UPIC in presumed aseptic revision TKA does not correlate with a lower survival rate, but a higher incidence of subsequent PJI was observed in cases interpreted as unsuspected PJI.
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Arch Orthop Trauma Surg · Oct 2024
Comparison of the AO/OTA 1996/2007 and 2018 pelvic ring fracture classifications.
Pelvic ring fractures may present with relevant mechanical and haemodynamic instability. Classifications of the bony or ligamentous injuries of the pelvic ring are well established. The most common classifications used analyse the injury mechanisms and the resulting instability of the pelvic ring structure. ⋯ Overall, several problems were identified regarding the type-B pelvic ring injury classification. These changes may result in difficulties in classifying pelvic ring injuries and thereby prevent relevant comparisons between former and future clinical studies on pelvic injuries. Level of Evidence: V.
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Arch Orthop Trauma Surg · Oct 2024
ReviewDifferent peripheral nerve blocks for patients undergoing total knee arthroplasty: a network meta-analysis of randomized controlled trials.
To comprehensively compare the effect of different peripheral nerve blocks for patients undergoing total knee arthroplasty (TKA). ⋯ cACB combined with IPACK/GNB may be the most favorable block after TKA, continuous blocks may be better than single-shot blocks, and combined blocks may be better than separate blocks.