Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
C-reactive protein during the first 6 postoperative days after total hip arthroplasty cannot predict early periprosthetic infection.
Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) remains a serious complication in orthopaedic surgery. C-reactive protein (CRP) is widely used as a marker to screen for inflammatory complications. The early postoperative course is well known, but knowledge about the predictive value of CRP in the first 6 postoperative days for detecting an acute postoperative PJI is lacking. ⋯ Especially considering the decreasing length of stay after THA, the question of the usefulness of regular inpatient CRP checks arises. AUC analysis of the ROC showed a poor diagnostic accuracy in almost all cases. Only the dynamic analysis of the maximum CRP value to the lowest CRP value with a decrease of 102.7 mg/l showed a fair accuracy. This calls into question the clinical relevance of CRP in the first postoperative week for detection of acute postoperative PJI.
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Arch Orthop Trauma Surg · Jun 2023
Review Meta AnalysisPeriacetabular osteotomy to treat hip dysplasia: a systematic review of harms and benefits.
Periacetabular osteotomy (PAO) is often performed in patients with hip dysplasia. The aim of this systematic review and meta-analysis was to evaluate the harms and benefits of PAO in patients with hip dysplasia in studies reporting both adverse events and patient-reported hip pain and function. ⋯ PAO surgery has a 4% risk of major, and 14% risk of minor adverse events and a positive effect on patient-reported hip pain and function among patients with hip dysplasia.
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Arch Orthop Trauma Surg · Jun 2023
Review Meta AnalysisA meta-analysis assessing time for return to sport following hip resurfacing.
Hip resurfacing arthroplasty (HRA) is associated with excellent functional outcomes and return to pre-disease level of activity. The time for return to sport (RTS) following HRA remains unknown. The aim of this meta-analysis was to establish the time for RTS following HRA. ⋯ Pooled proportion analysis showed an increasing number of patients were able to RTS after HRA over the first one year after surgery. There remains marked inter and intra-study variations in time for RTS but the pooled analysis shows that over 80% of patients were able to RTS at 6 to 12 months after HRA. The findings of this meta-analysis will enable more informed discussions between patients and healthcare professionals about time for RTS following HRA.
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Arch Orthop Trauma Surg · Jun 2023
Review Meta AnalysisImpact of local steroid application on dysphagia after anterior cervical spine surgery: a meta-analysis.
Dysphagia is one of the most common complications of anterior cervical spine surgery. Local steroid was widely used to reduce the postoperative swallowing pain. However, the effect of local steroid application on dysphagia after anterior cervical spine surgery was still uncertain. ⋯ The use of local steroid in anterior cervical spine surgery could reduce the early postoperative dysphagia without serious steroid related complication. However, the safety of local steroid application still need further studies with larger samples.
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Arch Orthop Trauma Surg · Jun 2023
Randomized Controlled Trial Multicenter StudyThe effects of tourniquet on cement penetration in total knee arthroplasty.
Aseptic loosening is a common cause of implant failure following total knee arthroplasty (TKA). Cement penetration depth is a known factor that determines an implant's "strength" and plays an important role in preventing aseptic loosening. Tourniquet use is thought to facilitate cement penetration, but its use has mixed reviews. The aim of this study was to compare cement penetration depth between tourniquet and tourniquet-less TKA patients. ⋯ Tourniquet use does not affect average penetration depth but increases the likelihood of achieving optimal cement penetration depth. Further study is warranted to determine whether this increased likelihood of optimal cement penetration depth yields lower revision rates.