Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2019
Cannulated Screw Prominence in Tension Band Wiring of Patella Fractures Increases Fracture Gapping: A Cadaver Study.
Transverse patella fractures are often treated with cannulated screws and a figure-of-eight anterior tension band. A common teaching regarding this construct is to recess the screws so that their distal ends do not protrude beyond the patella because doing so may improve biomechanical performance. However, there is a lack of biomechanical or clinical data to support this recommendation. ⋯ This biomechanical cadaver study found that the use of prominent cannulated screws for the fixation of transverse patella fractures increases the likelihood of interfragmentary gap formation, which may potentially increase the risk of fracture nonunion and implant failure. These findings suggest that proximally and distally recessed screws may increase construct stability, which may increase the potential for bony healing. The findings support further laboratory and clinical investigations comparing recessed screws supplemented by anterior tension banding with other repair methods that are in common use, such as transosseous suture repair.
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Clin. Orthop. Relat. Res. · May 2019
Meta AnalysisIs the Risk of Infection Lower with Sutures than with Staples for Skin Closure After Orthopaedic Surgery? A Meta-analysis of Randomized Trials.
Two previous meta-analyses comparing staples versus sutures have led to conflicting relative risks for surgical site infection between skin closure methods after orthopaedic surgery. Consequently, the choice of sutures or staples for skin closure continues to be a subject of conversation. Recently, additional randomized trials have been published, and an updated meta-analysis is needed to inform this debate. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2019
Are Complications After the Bernese Periacetabular Osteotomy Associated With Subsequent Outcomes Scores?
The Bernese periacetabular osteotomy (PAO) continues to be a commonly performed nonarthroplasty option to treat acetabular dysplasia, but only a few short-term studies have evaluated complications rigorously after PAO. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2019
What Is the Association Between Hospital Volume and Complications After Revision Total Joint Arthroplasty: A Large-database Study.
Studies of primary total joint arthroplasty (TJA) show a correlation between hospital volume and outcomes; however, the relationship of volume to outcomes in revision TJA is not well studied. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2019
What Is the Prevalence of Cam Deformity After Prophylactic Pinning of the Contralateral Asymptomatic Hip in Unilateral Slipped Capital Femoral Epiphysis? A 10-year Minimum Followup Study.
Prophylactic pinning of the asymptomatic and normal-appearing contralateral hip in patients with unilateral slipped capital femoral epiphysis (SCFE) remains controversial. Understanding the minimal 10-year clinical, functional, and radiographic outcomes of the contralateral asymptomatic hip in unilateral SCFE may be helpful in the decision regarding whether the benefits associated with potentially preventing a SCFE are outweighed by the risk of additional surgery. ⋯ Level IV, therapeutic study.