Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2021
Changes in joint space width over time and risk factors for deterioration of joint space width after medial opening-wedge high tibial osteotomy.
The purpose of this study was to evaluate the changes in joint space width (JSW) over time after medial opening-wedge high tibial osteotomy (MOWHTO) and identify risk factors for deterioration of JSW using anteroposterior (AP) and Rosenberg views. ⋯ Level III, case control study.
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Arch Orthop Trauma Surg · Mar 2021
The effect of gastrocnemius resection on knee flexion in a total knee arthroplasty model.
Flexion contracture in knee arthritis and total knee arthroplasty (TKA) is a common and significant problem. An improvement in knee extension in patients with TKA and mild flexion contractures has been observed clinically when a gastrocnemius recession was performed for other concomitant conditions. The goal of this study was to quantify the effect of gastrocnemius recession on knee flexion in TKA cadaver model. ⋯ Performing a gastrocnemius recession improves the knee extension in TKA knees with flexion contractures. Gastrocnemius recession may be a useful technique to improve terminal extension in TKA.
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Arch Orthop Trauma Surg · Mar 2021
Usefulness of histology for predicting infection at the time of hip and knee revision in patients with rheumatoid arthritis.
It remains unclear whether rheumatoid arthritis might be a cause of false positive of the histology for the diagnosis of prosthetic joint infection. Our aim was to evaluate the usefulness of the histology for the diagnosis of infection during hip and knee prosthesis revision in patients with rheumatoid arthritis. ⋯ Our results suggest that, in the context of RA, negative histological results have a very high negative predictive value. RA poses false positive histology results for the diagnosis of infection during hip and knee revision when conventional cultures are used for diagnosis of infection.
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Arch Orthop Trauma Surg · Mar 2021
Treatment of acquired patella baja by proximalization tibial tubercle osteotomy significantly improved knee joint function but overall patient-reported outcome measures remain diminished after two to four years of follow-up.
Acquired patella baja is often characterized by painful limitation of knee joint range of motion and anterior knee pain (AKP). Only few studies have evaluated the effectiveness of surgical treatment in terms of patient-reported outcome measures (PROM's) and sports activity. Thus, the goal of this study was to assess PROM's and sports activity after proximalization tibial tubercle osteotomy (P-TTO) in patients with symptomatic patella baja. ⋯ P-TTO yielded significant improvements in terms of AKP, subjective knee joint function and sports activity. However, the overall Kujala score results remained reduced, indicating that surgical correction of patellar height is not sufficient to relieve all patients' complaints. In addition, the incidence of postoperative complications was high.
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Arch Orthop Trauma Surg · Mar 2021
Management of septic and aseptic prepatellar bursitis: a systematic review.
Despite contributing to significant morbidity in working-age adults, there is no consensus on the optimal treatment for prepatellar bursitis. Much of the existing literature combines prepatellar and olecranon bursitis. This systematic review aims to determine the optimal management of prepatellar bursitis. ⋯ Our study represents the largest cohort of patients evaluating management strategies for prepatellar bursitis, and includes data not previously published. Endoscopic bursectomy is non-inferior to open bursectomy, enabling a shorter hospital stay. It also offers a relatively low risk of post-operative pain. Endoscopic bursectomy is a viable option to treat both septic and aseptic prepatellar bursitis. Our small cohort suggests recurrence and hospital stay are not improved with antibiotic treatment exceeding 7 days for septic prepatellar bursitis.