Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2022
Total knee arthroplasty after a prior knee arthroscopy has higher complication rates: a systematic review.
This article aimed to study in a systematic manner outcomes and complication rates after total knee arthroplasty (TKA) in patients who have undergone a prior knee arthroscopy for osteoarthritis. Our hypothesis was that a prior knee arthroscopy may be detrimental to the outcomes of knee arthroplasty in the future. ⋯ III.
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Arch Orthop Trauma Surg · Nov 2022
The significance of synovial biopsy in the diagnostic workup of the low-grade periprosthetic joint infection of shoulder arthroplasty.
A common reason for painful shoulder arthroplasties and revision surgery is a low-grade periprosthetic joint infection (PJI). Diagnosing a low-grade infection is, however, a major diagnostic challenge. This applies even more to the shoulder, which differs from other large joints in terms of clinical features and microbiological spectrum. Aim of this study was to evaluate the diagnostic value of the synovial biopsy in the diagnostic workup of low-grade PJI of the shoulder. ⋯ The sensitivity of only 67% of our standard workup emphasizes the difficulty to adequately diagnose low-grade infections after shoulder arthroplasty. The excellent specificity of 95% ensures, however, that non-infected prostheses are not incorrectly explanted. This study highlights that synovial biopsy has a high diagnostic value and should be done prior to complex revision surgeries to raise sensitivity in diagnosing a PJI.
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Arch Orthop Trauma Surg · Nov 2022
The histopathological synovitis score is influenced by biopsy location in patients with knee osteoarthritis.
Osteoarthritis (OA) and rheumatoid arthritis (RA) represent the most common forms of arthritis, which are mainly caused by mechanical and inflammatory components, respectively. Determination of synovial inflammation in synovial biopsies via the histopathological Krenn score may be crucial for correct diagnosis and treatment. Specifically, it remains unclear whether synovitis scores differ among multiple biopsy locations within a single joint. ⋯ While we confirmed the synovitis score as a reliable and reproducible parameter to assess the histopathological synovitis grade in the knee, the considerable variability within the joint indicates that multiple synovial biopsies from different regions should be obtained to enable reliable results of the synovitis score.
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Arch Orthop Trauma Surg · Nov 2022
ReviewFailure rates of common grafts used in ACL reconstructions: a systematic review of studies published in the last decade.
In this review paper, graft failure rates of different graft types (hamstring tendon autografts, bone-patellar tendon-bone autografts, quadriceps tendon autografts and diverse allografts) that are used for surgical reconstruction of the anterior cruciate ligament are compared and statistically analysed. ⋯ The findings of this meta-data study indicate that reconstructing the anterior cruciate ligament using quadriceps tendon autografts, hamstring tendon autografts, patellar tendon autografts or allografts does not show significant differences in terms of graft failure rates.