Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2024
Assessing the impact of distal femoral morphology using Citak's ratio: an independent risk factor for aseptic loosening in rotating hinge knee prosthesis.
Aseptic loosening (AL) is a frequent complication after rotating hinge knee (RHK) prosthesis. Citak's ratio has recently been developed to describe and classify distal femoral morphology into 3 groups (A, B, C). It consists in a ratio between the diameters of the femoral canal at 20 cm from the knee joint line and at 2 cm from the adductor tubercle. The objective of the study was to identify whether the femoral distal anatomical shape described with this ratio represents a risk factor for AL in RHK prosthesis. ⋯ The inner femoral diameter at 20 cm proximal to the knee joint line and Citak's ratio help indentify patients at risk of AL after RHK prosthesis, and thus a better planning of the surgery.
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Arch Orthop Trauma Surg · Aug 2024
Age-adjusted Charlson Comorbidity Index as an effective tool for the choice between simultaneous or staged bilateral total knee arthroplasty.
The choice between simultaneous and staged bilateral total knee arthroplasty (BTKA) remains controversial. Age-adjusted Charlson Comorbidity Index(CCI) is a promising tool for risk-stratification. We aimed to compare the outcomes between patients who underwent simultaneous and staged BTKA, stratified by age-adjusted CCI scores. ⋯ Simultaneous BTKA was associated with an increased risk of short-term readmissions in patients with age-adjusted CCI ≥ 4 points but not in those with age-adjusted CCI ≤ 3 points. Age-adjusted CCI can be an effective index for the choice between simultaneous and staged BTKA procedures.
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Arch Orthop Trauma Surg · Aug 2024
The resisted torsional stress test in diagnosis of femoral stem loosening in uncemented total hip arthroplasty - first description and retrospective study.
Aseptic femoral stem loosening is among the most common causes for revision in total hip arthroplasty (THA). We describe a simple clinical test that triggers pain in the proximal femur in patients with a loose stem. A previously described passive rotation test was associated with a poor sensitivity. The resisted torsional stress test (RTST) was used for several years in our hospital, and this is the first description of its reliability. ⋯ The RTST provides a helpful tool in the clinical assessment of femoral stem fixation in THA with good accuracy and should be included in standard follow-up examinations and in the assessment of painful THAs.
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Arch Orthop Trauma Surg · Aug 2024
Primary stability of multi-hole acetabular cup combined with posterior column plating for the fixation of complex acetabular fractures in elderly patients: a biomechanical analysis.
Acute total hip arthroplasty has gained increasing popularity in the treatment of complex acetabular fractures in elderly patients, but the biomechanical evidence is lacking. Therefore, we measured the primary stability to evaluate whether acute total hip arthroplasty using a multi-hole acetabular cup and posterior column plating through a single K-L approach can safely be used for treating complexed acetabular fractures in the elderly. ⋯ Our results show, that acute total hip arthroplasty using a multi-hole cup with acetabular screws and posterior column plating through single a K-L approach offers good primary stability to allow good osseous integration for treating complex acetabular fractures in the elderly. Furthermore, it also provides good fracture gap displacement on the posterior column.
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Arch Orthop Trauma Surg · Aug 2024
The temperature profile in elbow arthroscopy using radiofrequency ablation.
Over the last decades, arthroscopic surgery has become increasingly relevant as its minimally invasive approach offers many benefits. To investigate the risks of orthoscopic surgery at the elbow, this study aimed to investigate the development of temperatures in elbow joints while performing radiofrequency ablation in arthroscopic surgery. ⋯ Radiofrequency ablation (RFA) can be safely used in elbow arthroscopy with irrigation. The continuous use without irrigation should be limited to 3 s. Despite the anatomical proximity of the ulnar nerve and capsule, we were able to show that a possible rise in temperature most likely does not affect the ulnar nerve.