Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2023
Cervical alignment and clinical outcome of open-door laminoplasty vs. laminectomy and instrumentation in kyphotic multilevel cervical degenerative myelopathy.
The aim of this study was to determine whether the sagittal lordotic alignment, clinical outcomes and axial symptoms (AS) could be improved by kyphotic correction through the posterior approach for the treatment of multilevel cervical degenerative myelopathy (CDM) and to further analyze the changes of cervical spinal alignment parameters after correction of kyphosis. The hypothesis was that correction of kyphosis can improve the severity of AS and neurological recovery. ⋯ Satisfied neurological improvement was achieved by LP and LI for multilevel CDM combined with kyphosis. Cervical kyphotic correction produced significant improvement of AS and increase of T1 slope and C2-7 SVA. However, the kyphotic correction may not be associated with better neurological recovery in the short-term postoperative period.
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Arch Orthop Trauma Surg · Mar 2023
Gender related results in total knee arthroplasty: a 15-year evaluation of the Italian population.
This study aimed to estimate separately in women and men the number of Total knee arthroplasty (TKA) procedures performed in Italy from 2001 to 2016, exploring specific gender-related characteristics and trends. ⋯ This study showed that TKA is growing and heavily affecting the female population (70.6% of all TKAs) between 2001 and 2016. However, under 50 years old there was a higher percentage of surgeries performed in males (57.1%). The average number of days of hospitalization in females was higher than in males.
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Arch Orthop Trauma Surg · Mar 2023
Analyzing risk factors for treatment failure in fracture-related infection.
Fracture-related infection (FRI) represents a challenging clinical scenario. Limited evidence exists regarding treatment failure after initial management of FRI. The objective of our investigation was to determine incidence and risk factors for treatment failure in FRI. ⋯ Retrospective cohort study; Level III.
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Arch Orthop Trauma Surg · Mar 2023
Long-term cost-effectiveness of matrix-associated chondrocyte implantation in the German health care system: a discrete event simulation.
Cartilage defects in the knee can be caused by injury, various types of arthritis, or degeneration. As a long-term consequence of cartilage defects, osteoarthritis can develop over time, often leading to the need for a total knee replacement (TKR). The treatment alternatives of chondral defects include, among others, microfracture, and matrix-associated autologous chondrocyte implantation (M-ACI). The purpose of this study was to determine cost-effectiveness of M-ACI in Germany with available mid- and long-term outcome data, with special focus on the avoidance of TKR. ⋯ M-ACI is projected to be a highly cost-effective treatment for chondral defects of the knee in the German healthcare setting.
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Arch Orthop Trauma Surg · Mar 2023
Novel metaphyseal porous titanium cones allow favorable outcomes in revision total knee arthroplasty.
Loosening and migration are common modes of aseptic failure following complex revision total knee arthroplasty (rTKA). Metaphyseal cones allow surgeons to negotiate the loss of femoral and tibial bone stock while obtaining stable bony fixation. This study examines the mid-term functional and radiographic outcomes in patients undergoing rTKA utilizing a novel metaphyseal cone system with stems of variable length and fixation methods. ⋯ IV, case series.