Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2023
An evaluation of the inlet obturator oblique view for sacroiliac and transsacral screw placement.
Between 2005 and 2017, the number of closed reduction and internal fixation of pelvic ring injuries increased by 1116%. Percutaneous fixation is currently the only minimally invasive technique that can stabilize the posterior elements of the pelvis. The purpose of this study was to investigate the utility of the inlet obturator oblique view (IOO) with the hypothesis that the IOO view will improve the accuracy of sacroiliac and transsacral screw placement in the S1 or S2 body and improve the accuracy of assessing whether the implant is fully seated against the outer cortex of the ilium. ⋯ Our findings demonstrate that misinterpretation of sacroiliac and transsacral screw placement can occur with the standard fluoroscopic imaging. We suggest the addition of the IOO view increases the overall accuracy of screw placement and whether the screw head is fully seated against the outer table of the ilium. This in turn can improve fixation and potentially improve patient outcomes and decrease adverse events.
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Arch Orthop Trauma Surg · Apr 2023
Clinical TrialCure rate of infections is not an argument for spacer in two-stage revision arthroplasty of the hip.
A devastating complication after total hip arthroplasty (THA) is chronic periprosthetic joint infection (PJI). Most frequently spacers (Sp) with or without antibiotics are implanted in a two-stage procedure even though not always indicated due to unknown pathogen, femoral and acetabular defects or muscular insufficiency. ⋯ III, Retrospective trial.
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Arch Orthop Trauma Surg · Apr 2023
Randomized Controlled TrialGap balanced adjusted mechanical alignment versus measured resection mechanical alignment: a randomised controlled trial.
Alignment goals in total knee replacement (TKR) is a topical subject. This study compares the short-term functional outcomes and patient reported outcome measures (PROMs) of two philosophies for knee arthroplasty alignment: measured resection (MR) and an individualised alignment philosophy, with the tibia mechanically aligned and an instrumented gap balancer (GB) to align the femur in both flexion and extension. ⋯ Individualised alignment philosophy utilising a GB technique did not demonstrate an improvement in the primary outcome measure quadriceps peak torque. Improvement was seen in the GB group in PROM pain scores that was significant, both statistically and clinically, out to at least 1 year. Gains that were seen in functional assessment with GB, although significant at some time points, were no longer significant at 1 year and no difference was seen in quads strength. Compared to a MR technique, the individualised GB technique appears to confer some improvement in pain, ROM and some functional tests following TKR in the short-term.
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Arch Orthop Trauma Surg · Apr 2023
Midterm outcomes of 18 patients with primary intra-articular diffuse tenosynovial giant cell tumor (TGCT) of the knee treated with complete arthroscopic synovectomy and postoperative low-dose radiotherapy at a mean follow-up of 68 months.
To evaluate the long-term clinical outcome of the treatment of complete arthroscopic synovectomy combined with low-dose external radiotherapy in the knee affected by primary intra-articular diffuse tenosynovial giant cell tumor (TGCT). ⋯ The outcome of this study proved that complete arthroscopic synovectomy combined with low-dose external radiotherapy was appropriate for treating primary intra-articular diffuse TGCT of the knee joint. It could be safely and reliably used with minimal complications, fast postoperative recovery and satisfactory control of recurrence rates.
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Arch Orthop Trauma Surg · Apr 2023
Evaluation of the knee joint morphology associated with a complete discoid lateral meniscus, as a function of skeletal maturity, using magnetic resonance imaging.
A discoid lateral meniscus (DLM) is associated with increased risk for meniscal tears and progression of knee joint osteoarthritis. Our aim was to differentiate knee joint morphology between patients with and without a DLM, as a function of skeletal maturity, using magnetic (MR) imaging. ⋯ Case-control study, III.