Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2021
Medium-term outcomes in single anaesthetic bilateral total knee replacement surgery: a single surgeon series.
The lifetime risk of developing symptomatic knee osteoarthritis (OA) is estimated to be 45%, with up to two thirds of patients presenting with bilateral knee symptoms. Patients presenting with end stage bilateral knee OA may benefit from single anaesthetic bilateral total knee replacement (SABTKR). Our study aim was to compare the outcomes of SABTKR with unilateral total knee arthroplasty (TKA) in a single surgeon series over a 20 year period. ⋯ This NZJR study demonstrates excellent medium term survival outcomes for selected patients having simultaneous bilateral total knee replacements.
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Arch Orthop Trauma Surg · Sep 2021
Preoperative uncorrectable tibiofemoral subluxation can worsen clinical outcomes after fixed-bearing unicompartmental knee arthroplasty: a retrospective analysis.
The presence of tibiofemoral subluxation (TFS) in patients with unicompartmental arthritis, a potential contraindication to unicompartmental knee arthroplasty (UKA), remains controversial and is not commonly discussed. This study aimed to determine the predictability of postoperative TFS before surgery and the effect of TFS on clinical outcomes after fixed-bearing UKA. ⋯ Preoperative assessment of TFS under valgus stress could be a predictor of postoperative TFS. Furthermore, preoperative uncorrectable TFS could increase pain and decrease patient satisfaction 2 years after undergoing fixed-bearing UKA.
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Arch Orthop Trauma Surg · Sep 2021
Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery.
Gap balance of the knee at 0° and 90° of flexion has been pursued in total knee arthroplasty (TKA) with the trans-epicondyle axis (TEA) as a reference. This study investigated the height changes of the tibiofemoral articulation and compared the data with the femoral condyle height changes measured using different flexion axes. ⋯ The TEA and GCA measured varying femoral condyle heights, but the IHA resulted in minimal condyle height changes and could better represent the articulation characteristics of the knee. The data suggested that the IHA could be used as an alternative reference to guide surgical preparation of gap balance along the knee flexion path during TKA surgeries.
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Arch Orthop Trauma Surg · Sep 2021
Arthroscopic and open partial arthroplasty for the treatment of focal grade IV cartilage defects of the humeral head.
Focal Outerbridge grade IV cartilage defects of the proximal humerus may lead to pain and an impaired shoulder function. In cases of failed operative or conservative treatment options such as intraarticular injections or arthroscopic microfracturing of the subchondral bone, partial arthroplasty of the humeral may restore the articular surface of the humeral head without altering the anatomy. This study evaluates mid-term results of open and arthroscopic partial resurfacing of the humeral head in the context of focal grade IV cartilage defects. ⋯ Level IV (retrospective study).
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Arch Orthop Trauma Surg · Sep 2021
Randomized Controlled TrialTranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study.
The purpose of this study was to investigate whether TXA can effectively reduce blood loss after HTO and related complications and to evaluate its safety. ⋯ Intravenous TXA can effectively and safely reduce blood loss and bleeding-related complications after HTO and was beneficial for the blood management of HTO.