Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2019
Persistent postoperative step-off of the posterior malleolus leads to higher incidence of post-traumatic osteoarthritis in trimalleolar fractures.
Traditionally, size of the posterior fragment is considered the most important indicator for fixation in trimalleolar fractures. It remains unclear which factors contribute to worse functional and radiological outcome. This study was designed to determine predictors for the development of posttraumatic osteoarthritis and worse functional outcome in trimalleolar fractures. ⋯ Level IIB.
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Arch Orthop Trauma Surg · Mar 2019
Attrition of rotator cuff without progression to tears during 2-5 years of conservative treatment for impingement syndrome.
The purpose of this study was to investigate the natural history of intact rotator cuff in impingement syndrome patients with concomitant spur protruding from the undersurface of acromion. ⋯ Therapeutic case series Level IV.
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Arch Orthop Trauma Surg · Mar 2019
A new perspective on current prosthetic joint infection classifications: introducing topography as a key factor affecting treatment strategy.
Periprosthetic joint infection (PJI) is a relatively frequent and devastating complication following prosthetic joint implantation. Several classification systems have been presented by various authors and are routinely used in clinical practice to help in early diagnosis and treatment. The most widely accepted classifications of periprosthetic infections rely on the timing of clinical presentation. ⋯ The aim is to improve the understanding of the aetiology of this serious complication, lead to the appropriate treatment strategy according to the stage of the disease thus enhancing the outcomes of surgical management. Such a strategy, if widely accepted, could guide research studies on the management of PJIs. The availability of investigations like scintigraphy could aid in identifying pathogenetic processes and their exact location, which may be missed on conventional radiographs, and could enable orthopaedic surgeons to have a better understanding of PJI patterns.
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Demand for revision total hip arthroplasty (RTHA) continues to grow worldwide and is expected to more than double within the next 1-2 decades. The primary aim of this study was to examine return to function following revision THA in a UK population. ⋯ Revision THA facilitates long-term return to preoperative levels of physical activity in the majority of patients, though activity levels increase in one-third only. Overall over three-quarters are satisfied with their outcome, but revision for periprosthetic fracture or dislocation gives the worse overall outcomes and lower satisfaction levels.
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Arch Orthop Trauma Surg · Mar 2019
Adipose-to-muscle area ratio at the knee is superior to BMI in predicting post-operative outcome following arthroscopic meniscectomy.
To determine if measurement of leg adipose tissue area by MRI is a better predictor of post-operative clinical outcome compared to body mass index (BMI) following arthroscopic meniscectomy. ⋯ IV, retrospective case series.