Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2024
Establishing minimal clinically important differences and patient acceptable symptom state thresholds following birmingham hip resurfacing.
Birmingham Hip Resurfacing (BHR) has emerged as a compelling and innovative alternative to total hip arthroplasty (THA), especially among young, active patients. However, the Minimal Clinically Important Difference (MCID) and the Patient Acceptable Symptom State (PASS) thresholds have not yet been determined for patients undergoing BHR. Therefore, the current study aimed to (1) determine the MCID and PASS thresholds for both the Hip disability and Osteoarthritis Outcome Score (HOOS)-Pain and HOOS physical function shortform (PS), for patients who underwent BHR; and (2) identify factors influencing the achievement of MCID and PASS for HOOS-Pain and HOOS-PS. ⋯ MCID and PASS thresholds were established for HOOS-Pain and PS domains following BHR with most patients achieving these clinically meaningful benchmarks. Additionally, several factors affecting achievement of MCID and PASS were identified, including modifiable risk factors that may allow clinicians to implement optimization strategies and further improve outcomes.
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Arch Orthop Trauma Surg · Aug 2024
The lateralization and distalization index is more reliable than angular radiographic measurements in reverse shoulder arthroplasty.
The lateralization shoulder angle (LSA) and distalization shoulder angle (DSA) are used to reproducibly measure lateralization and distalization after reverse shoulder arthroplasty (RSA). However, LSA and DSA may not offer a precise measurement of humeral lateralization and distalization and this relationship has not been explored. The aim of this study was to evaluate the validity of these measurements and to propose new measurement methods to estimate implant lateralization and distalization. ⋯ LI and DI are more reliable methods to estimate implant lateralization and distalization compared to angular radiographic measurements. However, the prognostic significance in predicting clinical outcomes after RSA remains unknown.
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Arch Orthop Trauma Surg · Aug 2024
Characteristics of pelvic obliquity in dysplastic hip osteoarthritis.
Factors affecting direction of pelvic obliquity (PO) in dysplastic hip osteoarthritis (DHOA) remains unclear. This retrospective cohort study evaluates morphological characteristics, spinal alignment, and hip function in patients with unilateral DHOA. ⋯ Hip adduction angle influenced A-PO, while age, subluxation percentage, and hip adduction angle influenced U-PO; lumbar scoliosis angle was associated with PO direction. U-PO patients had poorer functional scores, indicating the impact of hip contracture and subluxation on PO direction in DHOA.
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Arch Orthop Trauma Surg · Aug 2024
Survivorship of total knee arthroplasty in poliomyelitis patients: long-term results from the R.I.P.O. registry and single-institution retrospective study.
The survival of total knee arthroplasty (TKA) in patients with poliomyelitis remains a debated topic due to the high recurrence of postoperative genu recurvatum. This study aims to report the long-term survival of TKA in patients with poliomyelitis, using data from the Italian Register of Prosthetic Implantology. ⋯ TKA is a viable alternative to knee arthrodesis and, in properly selected patients, might represent the first-choice treatment for articular degeneration due to its high survivorship. Despite the complexity of these cases, TKA can effectively alleviate articular pain, instability, and angular deviation, thereby preserving knee functionality.
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Arch Orthop Trauma Surg · Aug 2024
Reconstruction of mechanical leg axis using non-modular cemented hinged prosthesis in complex primary total knee arthroplasty.
Modular cementless knee arthroplasty systems are capable of precise reconstruction of the mechanical axis. However, they are considered more susceptible to complications. In contrast, non-modular cemented systems are said to be more forgiving and show good long-term results. The aim of this study was to investigate the resulting leg axis after implantation of a non-modular cemented rotating hinged knee prosthesis. Furthermore, potential risk factors for the occurrence of malalignment and complications should be identified. ⋯ Level III: Retrospective cohort study.