Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 2020
Randomized Controlled Trial Comparative StudyDoes Robotic-assisted TKA Result in Better Outcome Scores or Long-Term Survivorship Than Conventional TKA? A Randomized, Controlled Trial.
Robotic-assisted TKA was introduced to enhance the precision of bone preparation and component alignment with the goal of improving the clinical results and survivorship of TKA. Although numerous reports suggest that bone preparation and knee component alignment may be improved using robotic assistance, no long-term randomized trials of robotic-assisted TKA have shown whether this results in improved clinical function or survivorship of the TKA. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2020
Preoperative Activities of Daily Living Dependency is Associated With Higher 30-Day Readmission Risk for Older Adults After Total Joint Arthroplasty.
With recent Medicare payment changes, older adults are increasingly likely to be discharged home instead of to extended care facilities after total joint arthroplasty (TJA), and may therefore be at increased risk for readmissions. Identifying risk factors for readmission could help re-align care pathways for vulnerable patients; recent research has suggested preoperative dependency in activities of daily living (ADL) may increase perioperative and postoperative surgical complications. However, the proportion of older surgical patients with ADL dependence before TJA, and the impact of ADL dependency on the frequency and timing of hospital readmissions is unknown. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jan 2020
Cemented or Uncemented Hemiarthroplasty for Femoral Neck Fracture? Data from the Norwegian Hip Fracture Register.
A displaced femoral neck fracture in patients older than 70 years is a serious injury that influences the patient's quality of life and can cause serious complications or death. Previous national guidelines and a Cochrane review have recommended cemented fixation for arthroplasty to treat hip fractures in older patients, but data suggest that these guidelines are inconsistently followed in many parts of the world; the effects of that must be better characterized. ⋯ Our study found that the fixation method was not associated with differences in pain, quality of life, or the 1-year mortality rate after hemiarthroplasty. Uncemented hemiarthroplasties should not be used when treating elderly patients with hip fractures because there is an increased reoperation risk.Level of Evidence Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jan 2020
Is Lower-limb Alignment Associated with Hindfoot Deformity in the Coronal Plane? A Weightbearing CT Analysis.
The goals of lower limb reconstruction are to restore alignment, to improve function, and to reduce pain. However, it remains unclear whether alignment of the lower limb and hindfoot are associated because an accurate assessment of hindfoot deformities has been limited by superposition on plain radiography. Consequently, surgeons often overlook hindfoot deformity when planning orthopaedic procedures of the lower limb. Therefore, we used weight-bearing CT to quantify hindfoot deformity related to lower limb alignment in the coronal plane. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Jan 2020
What Range of Motion is Achieved 5 Years After External Rotationplasty of the Shoulder in Infants with an Obstetric Brachial Plexus Injury?
Obstetric brachial plexus injuries result from traction injuries during delivery, and 30% of these children have persisting functional limitations related to an external rotation deficit of the shoulder. Little is known about the long-term effect of soft-tissue procedures of the shoulder in patients with obstetric brachial plexus injuries. ⋯ Level III, therapeutic study.