Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2024
Long-term patient reported outcome measures and kneeling function in patients with tibial intramedullary nails.
Anterior knee pain (AKP) is a common complaint following intramedullary nail (IMN) insertion for tibial shaft fractures. There is a lack of long-term patient reported outcome data following tibial IMN, with conflicting evidence of the role of nail protrusion on AKP. In this study, we assess the long-term patient reported outcome measures and kneeling function in patients with tibial IMNs and compare the results with IMN protrusion, measured radiologically. ⋯ AKP affects a subset of patients more than five years post-tibial IMN, limiting their ability to kneel and other functions of daily living. Tibial IMN prominence does not seem to be associated with AKP.
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Arch Orthop Trauma Surg · Aug 2024
Clinical outcomes and survival rates of a uncemented modular revision stem system in hip arthroplasty: a 10-year single-institution study on a frail population.
The increasing prevalence of primary hip arthroplasty has led to a parallel rise in revision cases. Femoral revision often entails compromised bone integrity, requiring consideration of various solutions for optimal reconstructive options. Despite technological advancements, there is limited evidence on the clinical outcomes of the latest modular revision stems. This study aimed to evaluate the clinical outcomes and survival rates of next generation uncemented modular revision stem in patients undergoing hip revision surgery. ⋯ This study on this uncemented modular revision stem demonstrated favorable outcomes in an elder fragile population with moderate to severe femoral bone loss. The implant's modularity provides versatility in addressing various defects, without any implant breakage observed during the study period. Literature comparison highlighted similar outcomes despite sample size differences. The promising results warrant continued investigation into the long-term survivorship of this modular stem system.
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Arch Orthop Trauma Surg · Aug 2024
The reliability and validity of the Lie‑To‑Sit‑To‑Stand‑To‑Walk transfer test in total knee arthroplasty.
Total knee arthroplasty (TKA) is the standard procedure for treating end-stage knee osteoarthritis. Nevertheless, some residual issues can persist, leading to various problems, including pain, compromised strength, impaired proprioception, postural instability, dynamic balance issues, and gait deficiencies. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) implements a multi-faceted methodology to evaluate basic transfer abilities. The purpose of this study is to investigate the validity, reliability, and minimal clinically important difference of the LSSWT in TKA patients. ⋯ The LSSWT displays excellent reliability and high validity in assessing fall risk, complex dynamic balance, and mobility required for daily activities in patients post-TKA. The low MCID value (3.33) indicates its sensitivity and ability to identify minor changes in a patient's status over time or in response to rehabilitation applications. Therefore, it is recommended to use the LSSWT when evaluating fall risk, dynamic balance, and mobility for community living, discharge planning, or facility admission.
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Arch Orthop Trauma Surg · Aug 2024
Intramedullary nailing of proximal humerus fractures does not achieve superior functional results to non-operative treatment in the long term.
Non-operative treatment (NOT) of proximal humerus fractures (PHF) has regained significance due to recent evidence. Additionally, positive outcomes of plate osteosynthesis and fracture arthroplasty prompt a reassessment of the role of intramedullary nailing (IMN). While favorable short and medium-term results have been documented following IMN, little is known regarding functional outcomes and quality of life in the long-term. ⋯ In the long-term, functional and quality of life-related outcomes of IMN did not diverge significantly from those of NOT, while causing a higher incidence of follow-up interventions.
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Arch Orthop Trauma Surg · Aug 2024
What features of stem increase the risk of intraoperative femoral fracture during cementless primary hip arthroplasty?
Cementless fixation has become increasingly popular in hip arthroplasty due to its shorter operation time, easier technique, biologic fixation, and avoidance of bone cement implantation syndrome compared to cemented fixation. However, intraoperative periprosthetic femoral fracture (IOPFx) is a disconcerting complication during cementless hip arthroplasty. Our purpose was to identify the features of cementless stem that increase the risk of IOPFx during primary hip arthroplasty. ⋯ In conclusion, a stem with a standard length is significantly associated with risk of IOPFx compared to a shortened stem. These findings highlight the importance of careful consideration in terms of the risk of IOPFx when standard length cementless stem is chosen.