Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2020
ReviewImproved outcomes after mesenchymal stem cells injections for knee osteoarthritis: results at 12-months follow-up: a systematic review of the literature.
According to the World Health organization (WHO), more than 10% in people older than 60 years suffer from osteoarthritis (OA). Over the last years, there has been an increased interest around regenerative medicine, especially regarding stem cell treatments and related applications. We hypothesize that stem cell therapies can represent a feasible option for idiopathic knee OA, delaying or even avoiding the joint replacement. To emphasize the potential of percutaneous injections of mesenchymal stem cells for knee OA, a comprehensive systematic review of the literature was conducted. ⋯ According to the current evidences and the main findings of this systematic review, we reported that MSC infiltrations for knee OA can represent a feasible option, leading to an overall remarkable improvement of all clinical and functional considered outcomes, regardless of the cell source. Patients treated at earlier-degeneration stages reported statistically significant greater outcomes. The pain and function scores were improved considerably, thus, leading to a significant improvement of patient participation in recreational activities and quality of life.
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Arch Orthop Trauma Surg · Jul 2020
ReviewComparative clinical outcomes of anterolateral ligament reconstruction versus lateral extra-articular tenodesis in combination with anterior cruciate ligament reconstruction: systematic review and meta-analysis.
Anterolateral augmentation procedures can be divided into traditional lateral extra-articular tenodesis (LET) and modern anterolateral ligament (ALL) reconstruction. Nevertheless, no studies have compared the clinical results between LET and ALL reconstruction, when combined with intra-articular ACL reconstruction. This study was therefore designed to compare the clinical results, including the anterior translation, rotational laxity, and patient-reported outcomes, in a group of patients who underwent ACL reconstruction combined with LET or ALL reconstruction. ⋯ LET could lead to worse anterior instability than with ALL reconstruction when these two approaches were combined with single-bundle ACL reconstruction. However, rotational stability and patient-reported outcomes were similar between the techniques.
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Arch Orthop Trauma Surg · Jul 2020
Return to sports after hip resurfacing versus total hip arthroplasty: a mid-term case control study.
Hip resurfacing (HR) is an alternative to conventional total hip arthroplasty (THA) for the treatment of osteoarthritis (OA) in very active, young male patients. However, there is no study in the literature that has proven its benefits for high-impact sport over standard primary THA. The aim of the current study was to investigate the return to sport and function level of male patients after THA vs. HR. ⋯ HR patients showed a significantly higher High-activity arthroplasty score (HAAS) (14.9 vs. 12.9, p < 0.001) and Lower extremity activity scale (LEAS) (15.9 vs. 14.1, p < 0.001) and reached significantly higher values in the Hip cycle score (HCS) (44.7 vs. 35.7 p = 0.037) and Impact score (IS) (40.9 vs. 29.6, p < 0.002) than THA patients. No significant differences were found in the HOOS function section (91.4 vs. 90.3, p = 0.803) and the Pain numeric rating scale (NRS)-11 (0.6 vs. 0.9 p = 0.169). Patients with HR had a slightly higher Harris hip score (HHS) (97.8 vs. 95.6, p = 0.015) CONCLUSION: The current study suggests that young male patients are able to engage in higher activity levels after HR compared to standard THA.
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Arch Orthop Trauma Surg · Jul 2020
Evaluation of radiological instability signs in the distal radioulnar joint in children and adolescents with arthroscopically-verified TFCC tears.
Recent reports in the adult literature reported the use of standardized radiographic measurement techniques to determine distal radioulnar joint (DRUJ) instability. The aim of this study was to evaluate the efficacy and accuracy of (1) the MRI-based modified radioulnar ratio technique and (2) the pisoscaphoid (PiSca) and radioulnar (RaUl) distances in true lateral radiographs in children and adolescents with arthroscopically-verified TFCC tears. ⋯ Level III; Diagnostic.
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Arch Orthop Trauma Surg · Jul 2020
Acetabular retroversion in dysplastic hips is associated with decreased 3D femoral head coverage independently from lateral center-edge angle.
The clinical significance of acetabular retroversion in non-dysplastic hips can be explained as pincer-type femoroacetabular impingement (FAI), whereas that in dysplastic hips is not clarified because FAI normally poses little problems for dysplastic hips. We aimed to evaluate three-dimensional (3D) femoral head coverage in dysplastic hips with and without acetabular retroversion and to elucidate the role of acetabular retroversion on the 3D femoral head coverage. ⋯ Acetabular retroversion in dysplastic hips was associated with decreased 3D femoral head coverage independently from lateral center-edge angle. The age at surgery in the retroversion group was significantly younger, suggesting a relationship between decreased 3D coverage and potentially earlier symptom onset.