Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2021
Outcomes of hip arthroplasty with concomitant hardware removal: influence of the type of implant retrieved and impact of positive intraoperative cultures.
The impact of residual internal fixation devices on subsequent procedures about the hip has not been clearly well defined. The objective of the current study is to evaluate the outcome of hip arthroplasty after hardware retrieval as a one-stage replacement, to analyze possible differences related to the type of removed implant, and to assess the impact of unexpected intraoperative cultures during implant retrieval. ⋯ According to our results, hip arthroplasty with concomitant hardware removal is related to a high 5-year mortality rate, mainly when intramedullary nail is retrieved. Whereas a high risk of early prosthetic joint infection is associated, it seems not to be related to the elevated presence of unexpected positive cultures.
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Arch Orthop Trauma Surg · Feb 2021
Good mid-term results with the trident peripheral self-locking cup: a clinical evaluation and migration measurement with EBRA.
The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by means of Einzel-Bild-Roentgen-Analyse (EBRA) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 2 mm within 4 years after surgery. In this study, we performed a migration analysis of an uncemented peripheral self-locking (PSL) press-fit cup after 4 years follow-up. ⋯ The acetabular cup used in our study provides low migration at final follow-up. Therefore, a good long-term outcome can be expected for the PSL cup.
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Arch Orthop Trauma Surg · Feb 2021
Do we really improve life quality after total knee arthroplasty in patients with Parkinson's disease?
The knee in Parkinson's disease (PD) patients is a problematic joint due to pain, stiffness and gait instability. The aim of this study is to evaluate the functional outcome and degree of pain relief achieved after total knee arthroplasty (TKA) in PD patients. ⋯ TKA successfully provided pain relief in PD patients. However, the functional outcome is related to disease progression and, therefore, variable. Perioperative complications are difficult to avoid and manage.
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Arch Orthop Trauma Surg · Feb 2021
Higher revision rate for posterior cruciate-retaining than posterior-stabilized total knee arthroplasty for the treatment of valgus osteoarthritis.
Determining the point at which a valgus deformity requires a more invasive therapy-in this case PS TKA-is surgically challenging. Retaining the posterior cruciate ligament has both advantages and disadvantages. The aim was to evaluate the failure rate and clinical outcomes. ⋯ No difference in the clinical outcome between the CR and PS TKA patients was found. In the CR group, significantly more patients showed 'excellent' OKS than in the PS group. However, 8.0% of the patients in the CR group and none in the PS group underwent surgery due to instability. A higher rate of dissatisfied patients in the CR group is likely. In our clinic, we no longer perform CR TKA for valgus cases.
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Arch Orthop Trauma Surg · Feb 2021
Radio-luno-triquetral bone-ligament transfer as an additional stabilizer in scapholunate-instability.
Reconstruction of the scapho-lunate (SL) ligament is still challenging. Many different techniques, such as capsulodesis, tendon graft and bone-ligament-bone graft have been described to stabilize reducible SL dissociation. If primary ligament repair alone is not possible, an additional stabilizer is needed to achieve scapho-lunate stability. A new local bone-ligament transfer using half of the radio-luno-triquetral ligament is performed. The direction of traction of the transposed ligament is very similar to the original ligament. Ideal tension can be attained by fixation of the bone block at the dorsal ridge of the scaphoid. The biomechanical stability of this bone-ligament transfer shall be examined biomechanically. ⋯ Level II, therapeutic investigating experimental study.