Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Finite element analysis of malposition in bi-unicompartmental knee arthroplasty.
Bi-unicompartmental knee arthroplasty is a less invasive treatment than a total one, great advantage for the patient but more difficult for the surgeon because of the lower visibility during surgery; this can therefore lead to eventual small errors in cutting angles during the procedure. The aim of this study is to investigate the effects of these slight angle variations in terms of anterior-posterior slope for the lateral tibial tray. ⋯ Slight errors can happen during the surgery: performing the cut aiming to slightly posterior slopes during the surgery helps to minimize the chances of obtaining positive slopes that could lead to an unstable implant.
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Arch Orthop Trauma Surg · Jun 2023
Comparative Study Clinical TrialClinical outcomes in TKA are enhanced by both robotic assistance and patient specific alignment: a comparative trial in 120 patients.
Robotically assisted surgery was introduced in total knee arthroplasty (TKA) to increase the precision of implant positioning and optimize clinical outcomes. However, the target implant position or alignment is debated. The aim of this study was twofold: to compare clinical outcomes of conventional TKA vs. robotically assisted TKA in an adjusted mechanically aligned (MA) TKA series, and to analyze the clinical effects of introducing patient-specific alignment (inverse kinematic alignment, iKA) in a robotically assisted TKA cohort. ⋯ The results of this study suggest that the introduction of both patient-specific alignment and robotically assisted surgery improve clinical outcomes in TKA surgery. When access to robotic assistance is available, performing patient-specific alignment should be the objective.
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Arch Orthop Trauma Surg · Jun 2023
Randomized Controlled TrialEffects of neuromuscular electrical muscle stimulation on the deltoid for shoulder function restoration after reverse total shoulder arthroplasty in the early recovery period: a prospective randomized study.
Neuromuscular electrical stimulation (NMES) is a treatment modality that has been used to accelerate the rehabilitation of patients with neurological damage. However, it is unclear whether NMES of the deltoid can lead to the early restoration of shoulder function after reverse total shoulder arthroplasty (RSA). ⋯ Postoperative NMES of the deltoid after RSA contributed to significantly faster ROM restoration and considerable improvement in the power of external rotation. Therefore, NMES following RSA could lead to the early restoration of external rotation and recovery of deltoid function.
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Arch Orthop Trauma Surg · Jun 2023
Meta AnalysisA comparison of distal femoral replacement versus fixation in treating periprosthetic supracondylar femur fractures: a systematic review and meta-analysis.
The treatment of periprosthetic femur fractures around a total knee replacement remains a technical challenge for the orthopedic surgeon. Management options include non-operative treatment, plate fixation, intramedullary nailing and distal femur replacement (DFR), with few studies comparing fixation with DFR. This is an up-to-date meta-analysis in the literature to directly compare clinical outcomes between fixation and distal femoral replacement in the treatment of supracondylar periprosthetic femur fractures. ⋯ The results of this meta-analysis suggest no proven statistically significant difference between DFR and fixation in terms of length of hospital stay, mortality rate, revision rate and complication rate for the treatment of periprosthetic supracondylar femur fractures. Further prospective randomized research may help to define the specific indications for each treatment option which must include fracture configuration. Early functional outcome and cost-effectiveness have yet to be evaluated in the available literature.
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Arch Orthop Trauma Surg · Jun 2023
ReviewBiologic principles of minced cartilage implantation: a narrative review.
Cartilage tissue has a very limited ability to regenerate. Symptomatic cartilage lesions are currently treated by various cartilage repair techniques. Multiple treatment techniques have been proposed in the last 30 years. ⋯ Minced cartilage implantation is a newer technique that has garnered increasing attention. This procedure is attractive because it is autologous, can be performed in a single surgery, and is therefore given it is cost-effective. This narrative review provides an overview of the biological potential of current cartilage regenerative repair techniques with a focus on the translational evidence of minced cartilage implantation.