Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2023
Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem.
Fully hydroxyapatite-coated titanium alloy double-tapered stems have been successful implant designs for THA. The Novation Element Stem (Exactech, Gainesville, FL) is one of several of these implants following a modified Corail design philosophy. Although a great deal is known about the results of the Corail stem, little is known about the more recent Corail-inspired implants. The authors evaluated the clinical outcomes, radiographic findings and survival statistics of the collarless version of the Element Stem when used routinely in a diverse patient population. ⋯ Clinical outcomes using the collarless Novation Element Stem are good, but early proximal medial fracture is still a factor in patients with poor-quality bone. Proximal radiolucencies progressing to aseptic loosening post-operatively are also a concern. The 11.5% rate of subsidence is comparable to other fully HA-coated collarless stems. This study provides a thorough critical analysis of outcomes and midterm survival data of this dual tapered-wedge fully HA-coated collarless stem used routinely in a diverse patient population.
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Arch Orthop Trauma Surg · Mar 2023
Randomized Controlled TrialProgressive lateralization and constant hip geometry in children with DDH, NDH, and LCPD following hip reconstructive surgery: a cohort study of 73 patients with a mean follow-up of 4.9 years.
Pelvic and femoral osteotomies have been effective methods to treat developmental dysplasia of the hip (DDH), neurogenic dislocation of the hip (NDH), and Legg-Calvé-Perthes disease (LCPD). The aim of this study was to evaluate the mid-term results after hip reconstruction in children with DDH, NDH, and LCPD. ⋯ Evidence level: Level IV, case series.
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Arch Orthop Trauma Surg · Mar 2023
Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study.
To our knowledge, no papers have reported the results of robotic-assisted surgery for sequential bilateral Total Knee Arthroplasty (TKA). Indeed, sequential bilateral TKA present several benefits, as one single anesthesia, surgical episode, hospitalization, and rehabilitation. The purpose of our study was to evaluate peri-operative outcomes and compare the complication rates, clinical outcomes, and implant positioning of sequential bilateral TKA performed with a robotic-assisted system versus a conventional technique. ⋯ Despite a longer operative time, the peri-operative parameters of sequential bilateral TKA were similar between robotic and conventional techniques. Further, sequential bilateral raTKA was at least as safe as a conventional technique, without additional risk of medical complications.
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Arch Orthop Trauma Surg · Mar 2023
Effect of coronavirus (COVID-19) pandemic on orthopedic trauma patients presenting in the emergency department of a maximum care hospital and level 1 trauma center.
While overcrowding of emergency departments was often reported in the recent years, during the early phase of the pandemic, a reduction in patient numbers was seen. The aim of the current study was to describe the orthopedic trauma patient cohort presenting to the emergency department (ED) during the early pandemic period as compared to the cohort from the analogue time period 2019. ⋯ The present study shows a significant decline in the number of patients treated in the ED during the pandemic period but at the same time almost identical numbers of patients with fractures or diagnoses requiring surgical treatment. In the context of an overall decline in patient numbers, a stronger concentration on level 1 trauma centers seems to be evident during the pandemic.
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Arch Orthop Trauma Surg · Mar 2023
Do cobalt and chromium blood metal ion levels normalize after revision of failed metal-on-metal total hip replacements?
Increased cobalt (Co) and chromium (Cr) serum levels are one reason for revision surgery in metal on metal (MoM) total hip arthroplasty (THA) patients. Dual mobility liners are a simple revision option; however, they preserve the metal shell and stem and it is therefore not clear if metal ion levels will fully normalize after revision surgery. ⋯ The off-label use of a dual-mobility liner in the current study resulted in normalization of the metal ion levels suggesting that preserving the cobalt-chromium acetabular component has little impact on ion levels. In addition, dual mobility liners have a low complication and revision rate.