Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
The development of long-term osteoarthritis following anterior cruciate ligament injury: reconstruction vs no reconstruction.
The high incidence of osteoarthritis (OA) in relatively young sportspeople following anterior cruciate ligament (ACL) reconstruction is concerning. Surgery is considered to reduce the development of OA compared to conservative management. This long-term study aimed to compare the incidence and severity of tibiofemoral OA (TFOA) and patellofemoral OA (PFOA) between reconstructed and non-reconstructed treatment groups and to determine which factors influence the development of OA. ⋯ There were no significant differences in OA incidence between reconstructed and non-reconstructed groups but fewer patients developed TFOA following HT grafting compared to B-PT-B grafting and to non-surgical treatment. Quadriceps weakness and meniscal injuries/meniscectomy, both potentially modifiable, were strongly associated with the development of TF and PFOA.
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Arch Orthop Trauma Surg · Jun 2023
Effect of anterior tibial bowing on measurement of posterior tibial slope on conventional X-rays.
The posterior tibial slope (PTS) has different biomechanical effects on the knee. Especially in revision ACL reconstruction, a precise analysis is essential. Therefore, we investigate the influence of the anterior tibial bowing angle on the posterior slope measurement. Our hypothesis of the present study is that the short tibial X-rays underestimate the PTS in cases with increased anterior bowing of the tibia. ⋯ With increasing anterior tibial bowing, the posterior tibial slope on the short knee radiograph is underestimated compared to the slope measurement on the lateral mechanic axis.
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Arch Orthop Trauma Surg · Jun 2023
Lateral unicompartmental knee arthroplasty (UKA) showed a lower risk of failure compared to medial unicompartmental knee arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO).
The present study aimed to investigate differences in survivorship between medial and lateral unicompartmental knee arthroplasty (UKA) by analyzing the data of an Italian regional registry. The hypothesis was that, according to recent literature, lateral implants have comparable survivorship with regard to the medial implants. ⋯ Level 3, therapeutic study.
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Arch Orthop Trauma Surg · Jun 2023
Sagittal alignment in patients with flexion contracture of the hip before and after total hip arthroplasty.
In hip osteoarthritis, hip flexion contracture can severely alter the patient's alignment, and, therefore, affect the patient's quality of life (QOL). Hip contracture is not well-studied, partly because of the difficulties of its diagnosis. The aim of this study was to propose a quantitative definition of hip flexion contracture, and to analyse sagittal alignment in these patients compared to non-contracture ones, before and 12 months after total hip arthroplasty (THA). ⋯ The proposed method to diagnose hip contracture group allowed to define a group of patients who showed a specific pattern of sagittal spinopelvic alignment. These patients improved their alignment and quality of life postoperatively, but their hip mobility was not always restored. Diagnosing these patients is a first step toward the development of more specific surgical approaches, aiming to improve their surgical outcome.
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Arch Orthop Trauma Surg · Jun 2023
Reducing transfusion in hip arthroplasty: tranexemic acid diminishes influence of anesthesia administered.
The risk of transfusion following total hip arthroplasty (THA) continues to be problematic. The best choice of anesthesia (spinal vs general) and impact of tranexamic acid (TXA) use in reducing transfusions following surgery remain unclear. Therefore, the purpose of this study was to compare rates of blood transfusion following THA via the anterior approach using three different anesthesia protocols with and without TXA. ⋯ The use of TXA during THA via the anterior approach removed the influence of anesthesia type regarding risk of transfusion. The use of TXA may reverse presumed disadvantages of GA alone, potentially facilitating rapid discharge following surgery.