Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2019
Meta AnalysisHemostatic techniques to reduce blood transfusion after primary TKA: a meta-analysis and systematic review.
To investigate the efficacy of non-tranexamic acid (TXA) on reducing blood loss and requirements of allogeneic blood transfusion (ABT) in total knee arthroplasty (TKA). ⋯ The available evidence in this meta-analysis suggests that postoperative flexion position, fibrin sealant, and cell salvage can substantially decrease the rate of ABT in TKA. Further studies, including more hemostatic methods and high-quality research, are expected.
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Arch Orthop Trauma Surg · Dec 2019
Assessment of the tibial slope is highly dependent on the type and accuracy of the preceding acquisition.
Precise measurement of the tibial slope (TS) is crucial for realignment surgery, ligament reconstruction, and arthroplasty. However, there is little consensus on the ideal assessment. It was hypothesized that the tibial slope changes according to the acquisition technique and both tibial length as well as femoral rotation serve as potential confounders. ⋯ Case series (diagnosis); Level of evidence, 4.
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Arch Orthop Trauma Surg · Dec 2019
Surgical treatment of low-grade chondrosarcoma involving the appendicular skeleton: long-term functional and oncological outcomes.
The traditional treatment for chondrosarcoma is wide local excision (WLE), as these tumors are resistant to chemotherapy and radiation treatment. While achieving negative margins has traditionally been the goal of chondrosarcoma resection, multiple studies have demonstrated good short-term results after intralesional procedures for low-grade chondrosarcomas (LGCS) with curettage and adjuvant treatments (phenol application, cauterization or cryotherapy) followed by either cementation or bone grafting. Due to the rarity of this diagnosis and the recent application of this surgical treatment modality to chondrosarcoma, most of the information regarding treatment outcomes is retrospective, with short or intermediate-term follow-up. The aim of this study was to assess the long-term results of patients with LGCS of bone treated with intralesional curettage (IC) treatment versus WLE. This retrospective analysis aims to characterize the oncologic outcomes (local recurrence, metastases) and functional outcomes in these two treatment groups at a single institution. ⋯ This series of low-grade chondrosarcoma, surgically treated with an intralesional procedures, with 10-year follow-up, demonstrates excellent local control (88.9%). Complications were infrequent and minor and MSTS functional scores were excellent. Wide resection of LGCS was associated with lower MSTS score and more complications. In our series, the LR in both groups were detected within the first 3.5 years following the index procedure, and none were detected in the late surveillance period.
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Arch Orthop Trauma Surg · Dec 2019
Selective fasciotomy for acute traumatic lower leg compartment syndrome: is it feasible?
The standard treatment for an acute compartment syndrome (ACS) of the lower leg is a four compartment fasciotomy. It can be performed through either one lateral or a lateral and medial incision. Selective fasciotomy, only opening the compartments with elevated pressure, is a less invasive procedure. The aim of this study was to describe a procedure of selective fasciotomy after pressure measurement and to determine its feasibility in a retrospective cohort study. ⋯ Selective fasciotomy is feasible and seems to be safe. Future comparative studies will have to focus on possible benefits of this less invasive treatment.
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Arch Orthop Trauma Surg · Dec 2019
Radiographic analysis of lower limb alignment in professional football players.
To radiographically analyze lower limb alignment in adult asymptomatic professional football players and to correlate these values to clinical measurements. ⋯ This study was radiographically confirming increased varus of elite football players toward general population. Apex of the varus deformity was located in the proximal tibia. Clinical measurement of ICD/IMD adjusted for body height highly correlated with the radiographic values of coronal alignment; therefore, it may be used in population studies.