Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2020
Can Machine-learning Algorithms Predict Early Revision TKA in the Danish Knee Arthroplasty Registry?
Revision TKA is a serious adverse event with substantial consequences for the patient. As the demand for TKA rises, reducing the risk of revision TKA is becoming increasingly important. Predictive tools based on machine-learning algorithms could reform clinical practice. Few attempts have been made to combine machine-learning algorithms with data from nationwide arthroplasty registries and, to the authors' knowledge, none have tried to predict the likelihood of early revision TKA. ⋯ The inability to predict early TKA revision highlights that predicting revision based on preoperative information alone is difficult. Future models might benefit from including medical comorbidities and an anonymous surgeon identifier variable or may attempt to build a postoperative predictive model including intra- and postoperative factors as these may have a stronger association with early TKA revisions.
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Clin. Orthop. Relat. Res. · Sep 2020
Meta AnalysisAre There Differences in Accuracy or Outcomes Scores Among Navigated, Robotic, Patient-specific Instruments or Standard Cutting Guides in TKA? A Network Meta-analysis.
Several kinds of cutting guides, including patient-specific instrumentation, navigation, standard cutting guides, accelerometer-based navigation, and robotic guidance, are available to restore a planned alignment during TKA. No previous study has simultaneously compared all of these devices; a network meta-analysis is an especially appealing method because it allows comparisons across approaches that were not compared head-to-head in individual randomized controlled trials. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Sep 2020
Multicenter StudyA High Proportion of Patients Have Unfulfilled Sexual Expectations After TKA: A Prospective Study.
Most patients have high expectations about restoration of the knee function after TKA, expecting a more active life after retirement. However, 20% to 30% of patients report that their expectations are not met postoperatively. Among those unmet expectations may be the anticipation to engage in sexual activity after surgery, but few studies have evaluated sexual activity after arthroplasty. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Sep 2020
Comparative StudyDoes Computer-assisted Surgery Improve Lag Screw Placement During Cephalomedullary Nailing of Intertrochanteric Hip Fractures?
Computer-assisted surgery (CAS) techniques have been shown to improve implant placement and reduce the radiation time during cephalomedullary nailing in cadaveric and pilot clinical studies of intertrochanteric hip fractures. However, clinical comparisons of CAS and conventional techniques are lacking. It is unclear whether CAS offers clear advantages in terms of radiation time, operative time, and accuracy of lag-screw placement in patients undergoing surgery for intertrochanteric hip fractures and whether any potential difference in accuracy is associated with a change in the risk of lag-screw cut-out postoperatively. ⋯ Level III, therapeutic study.