Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2022
Arthroscopic management of unexplained pain following total knee arthroplasty.
Arthrofibrosis develops in 3-10% of knees after total knee arthroplasty (TKA), which may result in pain and restricted range-of-motion. Treatment options include manipulation under anaesthesia, arthroscopic debridement, and quadricepsplasty, but there is little consensus on their efficacy for treatment of unexplained pain after TKA. The purpose of this study was to report the prevalence and characteristics of unexplained pain after TKA as revealed by arthroscopic exploration, and assess the efficacy of arthroscopic procedures to relieve pain. ⋯ Arthroscopic exploration revealed that all 11 knees with unexplained pain had fibrotic tissues, the removal of which alleviated pain in only 67%, while moderate to severe pain persisted in 33% which merits further scrutiny.
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Arch Orthop Trauma Surg · Jun 2022
The distal femur trochlear groove appears to compensate for tibial deformity but not femoral deformity in an investigation of five-hundred and seventy-nine cadaveric skeletons.
The etiology of patellofemoral disorders is multifactorial. Preoperative patellofemoral anatomy evaluation is of great importance in patients undergoing surgery for patellofemoral disorders. Although anatomical risk factors of patellofemoral disorders have been thoroughly investigated in clinical and radiological studies, there are sparse data regarding the association between trochlear dysplasia with other anatomical parameters. This study sought to explore those associations using a large osteological collection. ⋯ To maintain the equilibrium necessary for effective patellar tracking, the depth of trochlear groove appears to effectively compensate for some of the anatomical parameters of the proximal tibia associated with patellofemoral disorders, and appears to be less influenced by femoral alignment. The clinical relevance of these findings warrants further investigation, and emphasizes the importance of carefully assessing the lower limb alignment in the management of patellofemoral disorders.
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Arch Orthop Trauma Surg · Jun 2022
Changes in acute and trauma hand surgery in the first Covid-19 lockdown in a German trauma center: a retrospective analysis of 338 cases.
Although Covid-19 and especially lockdown periods have affected our everyday live, its impact on hand traumatology is under investigated. ⋯ IV (therapeutic).
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Arch Orthop Trauma Surg · Jun 2022
Autogenous iliac crest bone grafting for tibial nonunions revisited: does approach matter?
Tibial nonunion remains a considerable burden for patients and the surgeons who treat them. In recent years, alternatives to autogenous grafts for the treatment of tibial nonunions have been sought. The purpose of this study was to evaluate the efficacy of autogenous iliac crest bone graft (ICBG) in the treatment of tibial shaft nonunions. ⋯ Level III.
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Arch Orthop Trauma Surg · Jun 2022
Patients' perceived walking abilities, daily-life gait behavior and gait quality before and 3 months after total knee arthroplasty.
Functional outcome and patients' daily-life activities after total knee arthroplasty are becoming more important with a younger and more active patient population. In addition to patient-reported outcome measures (PROMs), trunk-based accelerometry has shown to be a promising method for evaluating gait function after total knee arthroplasty. The aim of this study was to evaluate daily-life perceived walking abilities, gait behavior and gait quality before and 3 months after total knee arthroplasty, using PROMs and trunk-based accelerometry. ⋯ In contrast to the significant improvements in patients' perception of their walking abilities and PROMs, patients did not show improvements in gait behavior and gait quality. This implies that after 3 months patients' perceived functional abilities after total knee arthroplasty do not necessarily represent their actual daily-life quantity and quality of gait, and that more focus is needed on postoperative rehabilitation to improve gait and functional behavior.