Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Comparative Study
The pelvic radius technique in the assessment of spinopelvic sagittal alignment of degenerative spondylolisthesis and lumbar spinal stenosis.
Degenerative spondylolisthesis (DS) and lumbar spinal stenosis (LSS) are the most common degenerative spinal diseases. The evaluating of spinopelvic sagittal alignment of the two diseases using pelvic radius (PR) technique have not been reported. The purpose of this study was to use PR measurement technique to compare the differences in spinopelvic sagittal alignment between DS and LSS. ⋯ PR-L4 and PR-L5 may be the predisposing factors for DS development. Spinopelvic morphology differed in patients with DS and LSS compared to NP. The compensatory mechanisms to maintain spinopelvic sagittal alignment in DS and LSS patients may be different.
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It remains unclear whether early surgical intervention can reduce mortality after surgery in hip fracture patients. The aim of this study was to investigate the association between time from injury to surgery and mortality rate within 90 days after hip fracture surgery. ⋯ Our results demonstrated that time from injury to surgery was not associated with mortality within 90 days after surgery after adjusting for age, sex, operative procedure, and ASA score.
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Cage subsidence or pedicle screw loosening following lumbar fusion surgery is frequently reported in osteoporotic patients. However, few studies have analyzed clinical as well as radiological outcomes after such surgeries as a function of bone mineral density. We aimed to evaluate the impact of osteoporosis on the clinical and radiological outcomes of patients who underwent one-level posterior lumbar interbody fusion (PLIF). ⋯ Higher cage subsidence and pedicle screw loosening rates in osteoporotic patients did not significantly affect the clinical outcomes, but screw loosening, which occurred more frequently in older patients, significantly reduced the fusion success rate. Thus, PLIF procedure may be a good surgical treatment option to achieve good clinical outcomes, even in osteoporotic patients despite higher rates of cage subsidence and pedicle screw loosening. However, surgeons should monitor screw loosening because of its significant association with non-union.
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The use of direct anterior approach (DAA) for hemiarthroplasty in femoral neck fracture patients has recently increased worldwide. However, no previous studies have elucidated or validated risk factors for prolonged operative time in hemiarthroplasty through DAA. Accurately predicting operative time would contribute to and the selection of the most appropriate surgical approach for each patient and the effective use of operating room. ⋯ We demonstrated that increased approach depth and surgeons' DAA experience (<20 cases) are novel risk factors for prolonged operative time in femoral neck fracture patients undergoing hemiarthroplasty through DAA. Surgeons should consider these factors when estimating the operative time of surgery and selecting the most appropriate and safe surgical approach for a patient undergoing hemiarthroplasty.
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Meta Analysis
A meta-analysis evaluates the efficacy of intravenous acetaminophen for pain management in knee or hip arthroplasty.
The objective of this study was to assess whether intravenous acetaminophen for patients undergoing knee or hip arthroplasty could reduce the opioid consumption and improve pain management. ⋯ Perioperative intravenous acetaminophen use in multimodal analgesia could significantly reduce of total opioid consumption, but it did not contribute to decrease the average pain scores and shorten the length of hospital stays in total hip or knee arthroplasty.