Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty.
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples. ⋯ This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended.
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Arch Orthop Trauma Surg · Dec 2024
Percutaneous calcaneal sliding osteotomy with the rising sun technique.
Calcaneal slide osteotomies represent a well-established component in the surgical treatment of joint-preserving hind foot corrections. The percutaneous technique aims to minimize the surgical morbidity and maximize surgical efficiency. There is a consensus that percutaneous calcaneal sliding osteotomy (PCSO), using a low-speed and hightorque burr, is generally performed in four steps corresponding to the four quadrants of the cross-section of the calcaneal tuber. We present a technique that allows a more efficient osteotomy by cutting the far cortex in one step using standard percutaneous equipment. The aim of this study is to present preliminary results and the surgical technique of a modification for percutaneous calcaneal sliding osteotomy. ⋯ Compared to traditional open calcaneal slide osteotomies, PCSO helps to reduce softtissue morbidity and may result in fewer surgery-related complications. The Rising Sun procedure of PCSO represents a safe and easy-to-perform alternative to the traditional 4-quadrants technique in the percutaneous correction of hindfoot malalignment. Our prospective case series showed a low rate of complications and reproducible surgery time and use of fluoroscopy.
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Arch Orthop Trauma Surg · Dec 2024
Management of osteochondritis dissecans lesions of the elbow including return to sport remains variable among orthopaedic surgeons.
Management of osteochondritis dissecans (OCD) lesions of the capitellum is challenging. Historically, variability exists between surgeons in the evaluation, treatment, and return to sport criteria. The purpose of this study was to define the current trends regarding evaluation, nonoperative and surgical management, and return to sport criteria for capitellar OCD lesions among surgeons. ⋯ There is significant variability in the management of capitellar OCD in athletes. Small, centralized lesions are likely to be treated with debridement and microfracture with faster return to sport. Treatment of large, lateral lesions remains variable. Regarding OAT procedures, perceived morbidity, reimbursement, and limited evidence dissuade use. There is no consensus on return to sport, though lack of pain and time were most important; overhead athletes and gymnasts are restricted longer from returning to sport. Level of Evidence Level 5, diagnostic, cross-sectional survey.
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Arch Orthop Trauma Surg · Dec 2024
Enhancing treatment outcomes for Acute Periprosthetic Hip Joint infection: optimizing debridement, antibiotics, and Implant Retention through vacuum sealing drainage in the deep tissue.
Debridement, antibiotics, and implant retention (DAIR) for acute periprosthetic joint infection (PJI) is under debated since the reported success rate is inconsistent. This study aimed to explore the efficacy of vacuum sealing drainage (VSD) used as an adjunct to irrigation and debridement for acute PJI. ⋯ The incorporation of VSD in the deeper region enhances the outcomes of DAIR, achieving an 86.67% success rate in managing acute PJI. This approach offers a potentially safe and effective treatment, though patients with higher Charlson comorbidity index and elevated preoperative CRP levels face increased risks of failure.
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Arch Orthop Trauma Surg · Dec 2024
Stem subsidence in total hip arthroplasty: retrospective investigation of a short stem using a simple measurement approach.
Uncemented total hip arthroplasty (THA) is a successful treatment for advanced hip joint diseases. More recently, short stems became increasingly popular, but stem subsidence remains a concern. This study investigates early short stem subsidence in a large patient cohort using a simple measurement approach for everyday practice. ⋯ Early subsidence is relatively frequent with this uncemented short stem, however revisions are rare. Patients with risk factors should be counseled regarding FWB and radiographic controls should be performed. The SID provides an easy, non-invasive and inexpensive tool for early subsidence assessment; however, its simplicity limits its accuracy. Further research is needed in comparison to more elaborate methods.