Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2023
Combined distal femoral osteotomy and tibial tuberosity distalization is effective in patients presenting with patellar instability and patellofemoral pain due to patella alta and femoral malalignment.
Patellar malalignment has been considered one of the major pathomechanical causes of patellofemoral instability and pain. The results have been reported after femoral varization/torsional osteotomy and tibial tuberosity distalization osteotomy (TTD-O). However, the combination of a femoral deformity (genu valgum/increased femur antetorsion) and patella alta remains underreported. Therefore, the aim of this study was to investigate the clinical outcomes of patients simultaneously treated by distal femoral osteotomy and TTD-O. The hypothesis was that restoration of patellofemoral (PF) alignment via the abovementioned osteotomies would achieve good patient-reported outcome measures. ⋯ The findings of this study indicate that the combination of a distal femoral osteotomy and a tibial tuberosity distalization osteotomy is effective in patients presenting with patellar instability and patellofemoral pain due to patella alta and femoral malalignment.
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Arch Orthop Trauma Surg · May 2023
Posterior shoulder dislocation with associated reverse Hill-Sachs lesion: clinical outcome 10 years after joint-preserving surgery.
Posterior shoulder dislocation in association with reverse Hill-Sachs lesion is a rather rare injury. Few studies reporting results after joint-preserving surgery in these cases are available. This current study presents the clinical outcomes 10 years postoperatively. ⋯ Joint-preserving surgical therapy of posterior shoulder dislocation provides excellent results when the morphology of the reverse Hill-Sachs lesion is respected in surgical decision-making.
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Arch Orthop Trauma Surg · May 2023
"One millimetre equals one degree": a simple way to achieve in 92% of cases the desired correction after opening proximal tibial osteotomy for genu varum.
When performing a high tibial osteotomy (HTO) for genu varum deformity, it is not always easy to obtain the correct amount of overcorrection. The aims of this study were to review the results of a simple and reproducible method of correction that we have called "1 mm equals 1°". We have applied this technique to the medial opening wedge osteotomy. Our hypothesis was that one degree of correction corresponded with one degree of opening. ⋯ The method of "1 mm equals 1°" is a simple, reliable, and reproducible method to achieve in 92% of cases the desired overcorrection (i.e., 184 ± 2°) with valgising proximal medial opening wedge osteotomy in genu varum.
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Arch Orthop Trauma Surg · May 2023
Dissociation of liner from cup in THA: does liner damage affect the risk of dissociation?
A rare catastrophic failure of modular component Total Hip Arthroplasty is dissociation between liner and cup, which has been associated with component malposition and/or impingement and seems to be more frequently associated with the Pinnacle system. The goal of this study was to evaluate the resistance of a polyethylene liner to lever-out-forces of the Pinnacle locking mechanism and the locking mechanisms of two other current cup/liner systems using a standardized testing method (ASTM). ⋯ The intact Pinnacle system appeared the most stable in lever-out tests when compared to the other systems. However, after removal of the ARTs, the Pinnacle system required the least force for dissociation, consistent with locking mechanism failure, and suggesting that the ARTs are a critical component of the locking mechanism. Our findings are consistent with the clinical experience of dissociated Pinnacle constructs displaying damaged or missing ARTs, and that damage to these may increase risk of liner dissociation.
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Arch Orthop Trauma Surg · May 2023
A new robotically assisted technique can improve outcomes of total knee arthroplasty comparing to an imageless navigation system.
Robotic assisted total knee arthroplasty (RTKA) has shown improved knee alignment and reduced radiographic outliers. However, there remains debate on functional outcomes and patient-reported outcomes (PROMs). This study compares the 1-year clinical outcomes of a new imageless robotically assisted technique (ROSA Knee System, Zimmer Biomet, Warsaw, IN) with an imageless navigated procedure (NTKA, iAssist Knee, Zimmer, Warsaw, IN). ⋯ III.