Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
Fully hydroxyapatite-coated compaction broached and triple-tapered stem may reduce the risk of stress shielding after primary total hip arthroplasty.
Changes in bone mineral density (BMD) around the fully hydroxyapatite (HA)-coated compaction broached and triple-tapered stem, namely, Polarstem, after total hip arthroplasty (THA) are currently unknown. Therefore, the aims of this study were to investigate clinical outcomes of Polarstem, mainly postoperative temporal changes in BMD around the stem for 2 years, and to compare them with those of HA-coated and non-HA-coated tapered-wedge stems. ⋯ Polarstem, a fully HA-coated compaction broached and triple-tapered stem, maintained BMD around the femoral calcar until 2 years postoperatively and could reduce the risk of stress shielding compared with tapered-wedge stems.
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Arch Orthop Trauma Surg · Dec 2022
What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review.
In orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes. ⋯ The fast-track pathway avoided unnecessary delays in emergency departments due to faster X-rays, direct admission to orthopaedic wards, and reduced delirium rates. However, results were unable to show the impact of fast-track on length of stay, time to surgery, and mortality.
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Arch Orthop Trauma Surg · Dec 2022
Surgical outcomes of dual-plate fixation for periprosthetic femur fractures around a stable hip arthroplasty stem.
The incidence of periprosthetic femur fractures is increasing. Multiple treatment methods exist to treat fractures surrounding stable hip arthroplasty implants including locking plate fixation, cable fixation, allograft augmentation, and revision arthroplasty. No consensus regarding optimal treatment has been reached, and significant complications remain. Recently, biomechanical studies have demonstrated the benefits of orthogonal dual-plate fixation, but little clinical data exist. The purpose of the current study was to investigate the clinical and radiographic outcomes of dual-plated periprosthetic femur fractures around stable hip stems. ⋯ Dual-plating achieved high union rates with an acceptable complication profile for the treatment of periprosthetic femur fractures surrounding a stable hip arthroplasty stem. Our preferred fixation construct involves a lateral plate spanning the entire femur secured with non-locking bicortical screws supplemented with an anteriorly based reconstruction plate. Additional prospective research is required to confirm the results of this study.
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Arch Orthop Trauma Surg · Dec 2022
Comparison between single anterior and single posterior approaches of debridement interbody fusion and fixation for the treatment of mono-segment lumbar spine tuberculosis.
To compare the efficacy of single anterior and single posterior approach of debridement, interbody fusion, and fixation for the treatment of mono-segment lumbar spine tuberculosis (TB) patients. ⋯ Both single anterior and single posterior approaches of debridement, interbody fusion and fixation are effective for mono-segment lumbar TB patients, although the single posterior approach is of a shorter duration and results in less blood loss.
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Arch Orthop Trauma Surg · Dec 2022
Comparative study of Vancouver type B2 periprosthetic fractures treated by internal fixation versus stem revision.
Currently, accepted treatment for periprosthetic femoral fractures with loose femoral stem indicates its revision; however, recent studies have proposed treating Vancouver type B2 fractures via internal fixation without stem revision, particularly in the elderly or multi-morbid patients. Despite indications for stem revision, some surgeons tend to perform internal fixation. The main goal of this study was therefore to identify the parameters that were significantly different comparing internal fixation to stem revision for Vancouver type B2 fractures. ⋯ Revision did not exhibit better radiological results; moreover, internal fixation resulted in significantly less perioperative blood loss and a shorter operating time, concluding that ORIF is a viable alternative to revision arthroplasty, particularly in older patients.