Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Evaluating perioperative risks in total knee arthroplasty patients with normal preoperative cardiac stress tests.
While it is generally accepted that most patients undergoing joint replacement do not require a cardiac stress test, individuals with existing or potential cardiac conditions may be at an increased risk of perioperative complications following primary total knee arthroplasty (TKA). This study aims to analyze the immediate postoperative outcomes of patients who underwent primary TKA, comparing those who had a cardiac stress test with no abnormal results and subsequent cardiac interventions to those who did not undergo a stress test. ⋯ Level III: Case-control study or retrospective cohort study.
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Arch Orthop Trauma Surg · Dec 2024
Optimizing total hip arthroplasty: the gripper table mounted system for enhanced soft tissue preservation and postoperative outcomes.
In total hip arthroplasty (THA), soft tissue retraction is crucial, but traditional methods may cause damage. This study addresses the issue by introducing the Gripper Table Mounted System, a pulley-based retraction system. The research compares THA outcomes with and without the Gripper system, whether reducing soft tissue damage and postoperative pain. The Gripper, with its unique design, aims to minimize tissue damage during surgery. ⋯ Therapeutic Level III.
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Arch Orthop Trauma Surg · Dec 2024
Medial degenerative disease of the knee without radiographic osteoarthritis is a good indication for medial open wedge high tibial osteotomy.
Medial open wedge high tibial osteotomy (MOWHTO) is a well-established surgical procedure for osteoarthritis (OA) of the knee with varus malalignment. However, it is uncertain whether MOWHTO is an effective surgical procedure for early OA. This study aimed to evaluate the clinical results of MOWHTO for early OA of the knee with varus malalignment. ⋯ III, retrospective study.
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Arch Orthop Trauma Surg · Dec 2024
Observational StudyIdentification of preoperative predictive markers of periprosthetic joint infection in presumed aseptic revisions of total hip arthroplasty: a retrospective observational study.
Periprosthetic joint infections (PJIs) occur at a rate of 1-2% in primary arthroplasties and 4% in revisions, posing a significant healthcare challenge. PJI diagnosis is hindered by absence of a universally accepted diagnostic standard. The primary outcome was to develop a predictive model to identify patients at risk of developing unforeseen PJI subsequent to presumed aseptic revision of total hip arthroplasty (THA). The secondary aim was to determine the reintervention-free survival rate among aseptic patients and those presenting unexpected positive cultures. ⋯ Erythrocyte sedimentation rate, leukocyte count, and increased prothrombin time were risk factors for PJI, whereas comorbidities were associated with a lower risk. Further research is needed to understand this association fully. Larger datasets are recommended to explore the complex interplay between risk factors and PJI development.
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Arch Orthop Trauma Surg · Dec 2024
Short-term prediction of clinical and radiographic contralateral hip osteoarthritis after index total hip arthroplasty.
Patients with primary hip osteoarthritis undergoing unilateral total hip arthroplasty (THA) often face uncertainty about the future need for arthroplasty in the contralateral hip. We aimed to identify parameters that have predictive value with regard to the necessity for contralateral THA or the development of contralateral radiographic osteoarthritis (OA) phenotypes following index surgery. ⋯ Three factors - BMI, alpha angle, and osteophyte number - are key short-term predictors for contralateral THA after index THA. We also identified BMD as a surrogate for osteophyte formation. These findings provide novel and valuable insights for patients and surgeons regarding risks and counseling for contralateral OA and THA.