Journal of orthopaedic surgery and research
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Recently, many authors have reported the effects of platelet-rich plasma (PRP) on rotator cuff repair. Whether PRP treatment during arthroscopic rotator cuff repair improves tendon healing rates or restores full function remains unknown. The purpose of this meta-analysis was to evaluate the clinical improvement and radiological outcomes of PRP treatment in patients undergoing arthroscopic rotator cuff repair. ⋯ PROSPERO CRD42016048416.
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Metal sensitivity as a cause for painful joint replacement has become increasingly prevalent; however, there is a lack of reported clinical outcome data from total knee arthroplasty patients with metal allergies. The purpose of this study was to determine whether patients presenting with a painful total knee arthroplasty with a positive metal sensitivity have improved outcomes following revision to a hypoallergenic implant. ⋯ Patients presenting with a painful knee arthroplasty and positive metal LTT have improved pain scores, walking function, and range of motion following revision to a hypoallergenic component. This study also provides a treatment algorithm for patients presenting with a painful knee replacement, in order to provide effective and timely diagnosis and management.
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To evaluate the short-term in vivo dynamic motion characteristics of the lower lumbar spine (L3-S1) after unilateral pedicle screw fixation (UPSF) or bilateral pedicle screw fixation (BPSF) combined with TLIF for treatment of L4-5 lumbar degenerative disc diseases (DDD). ⋯ The ROM in left-right twisting of UPSF group was significantly larger compared with BPSF group at the index level in the short term. The UPSF has less impact on the cranial adjacent level (L3-4) in left-right twisting and bending activities compared to the BPSF. The data implied that the UPSE and BPSF combined with TLIF would result in different biomechanics in the index and cranial adjacent segment biomechanics. Long-term follow-up studies are necessary to compare the clinical outcomes of the two surgeries.
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Observational Study
The impact of warfarin on operative delay and 1-year mortality in elderly patients with hip fracture: a retrospective observational study.
Guidelines underline the importance of early surgery in elderly patients with proximal femoral fractures. However, most of these patients present a high number of comorbidities, some of which require the use of warfarin. Waiting for INR decrease is a cause of surgical delay, and this influences negatively their outcome. ⋯ Warfarin therapy at the time of proximal femoral fractures is associated with increased time to surgery, blood loss, and mortality.
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Stem malalignment can affect offset reconstruction and may result in gluteal muscle insufficiency. In this retrospective study, a novel geometric angle named 'critical trochanter angle' (CTA) is described and investigated towards the risk of malposition of a collarless straight tapered hydroxyapatite-coated stem in primary total hip arthroplasty (THA). ⋯ Varus stem alignment in THA is associated with coxa vara deformity and a radiological low CTA. In preoperative planning, the critical trochanter angle can help to evaluate the risk for intraoperative stem malpositioning. If navigation or robotic assistance is not available when using this stem design, we recommend an intraoperative x-ray to verify correct implant positioning in patients with a CTA under 20° or above 30°.