Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2022
Risk factors for failure after cementless femoral revision THA: a consecutive series of 105 cases.
Cementless femoral revision total hip arthroplasty (RTHA) after periprosthetic fracture, aseptic loosening or infection is a challenging surgical procedure. The aim of this study was to evaluate the incidence and reasons for failure after two-stage septic revision, periprosthetic fracture or aseptic loosening that may reveal a rationale for cementless RTHA in two-stage revisions. ⋯ Cementless revision using a modular tapered device is reliable with respect to reinfection risk in two-stage procedures.
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Arch Orthop Trauma Surg · May 2022
Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up.
Lumbar spinal fusion surgery is a widely accepted surgical treatment in degenerative causes of lumbar spondylolisthesis. The benefit of reduction of anterior displacement and restoration of sagittal parameters is still controversially debated. Purpose of the underlying publication was to analyze the influence of radiographic sagittal parameters of the spine in aspects of changes in postoperative clinical outcome. ⋯ In low-grade spondylolisthesis, spinal fusion surgery is a well-established surgical procedure; however, the impact of sagittal parameters and reduction of anterior displacement remains controversial. Within our findings, restoration of sagittal parameters showed significant correlation to improvement in clinical outcome in our mid-term follow-up data.
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Arch Orthop Trauma Surg · May 2022
Perioperative complications in osteotomies around the knee: a study in 858 cases.
Eight hundred and fifty-eight consecutive osteotomies around the knee joint were analyzed retrospectively to detect intra- and early postoperative complications in a period of 4 weeks postoperative. Indications for osteotomy were unilateral gonarthritis or torsional deformities resulting in femoropatellar instability or anterior knee pain. ⋯ Osteotomy around the knee is a safe procedure in the treatment of unicompartmental gonarthritis in terms of intra- and postoperative complications. Major complications are rare. Pit falls for compartment syndromes (LCW and torsional corrections) have to kept in mind. There is no difference in frequency of complications between HTO and supracondylar osteotomies. Risk for superficial wound infection is higher in posttraumatic osteotomies and with continuous corrections. Osteoclasia contains a higher risk for vascular lesion compared to oscillating saw.
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Arch Orthop Trauma Surg · May 2022
Rotation osteotomy of the distal femur influences coronal femoral alignment and the ischiofemoral space.
Despite the fact that osteotomies around the knee represent well-established treatment options for the redistribution of loads and forces within and around the knee joint, unforeseen effects of these osteotomies on the remaining planes and adjacent joints are still to be defined. It was, therefore, the aim of this study to determine the influence of a distal femoral rotation osteotomy on the coronal limb alignment and on the ischiofemoral space of the hip joint. ⋯ Supracondylar external rotation osteotomy of the femur leads to valgisation of the coronal limb alignment and increases the ischiofemoral space. This is resultant to the reorientation of the femoral antecurvature and the femoral neck. When planning a rotational osteotomy of the lower limb, this should be appreciated and may also aid in the decision regarding osteotomy site.
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Arch Orthop Trauma Surg · May 2022
No implant, no solution, lost cases to surgery: orthopedic trauma triage for surgery in an NGO hospital in Sierra Leone.
In low-income countries (LIC), international surgeons face the fact that there are patients they cannot treat. The goal of this study was to identify and analyze patients lost to treatment. ⋯ One quarter of the patients did not receive the surgical treatment needed. Besides acquisition of implants, surgical skills and expertise could be a solution for this issue. Nevertheless, these skills must be passed to local surgeons.