Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2018
Meta AnalysisArthroscopic meniscal surgery versus conservative management in patients aged 40 years and older: a meta-analysis.
The efficacy of arthroscopic meniscus surgery in old aged patients remains controversial. The purpose of the present study was to review published studies comparing arthroscopic meniscal surgery with conservative management to treat meniscal injuries in patients 40 years of age and older. ⋯ The efficacy of arthroscopic surgery was not superior to conservative management in this type of patients. Therefore, arthroscopic meniscal surgery should not be recommended as a first choice of treatment for degenerative meniscal tears. In patients over 40 years of age, arthroscopic surgery should be cautiously considered for degenerative meniscal tears and only when there has not been a satisfactory response to conservative management.
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Arch Orthop Trauma Surg · Dec 2018
ReviewThe value of radiography in the follow-up of extremity fractures: a systematic review.
The added value of routine radiography in the follow-up of extremity fractures is unclear. The aim of this systematic review was to create an overview of radiography use in extremity fracture care and the consequences of these radiographs for the treatment of patients with these fractures. ⋯ Based on current literature, the added value of routine radiography in the follow-up of extremity fractures seems limited. Results, however, should be interpreted with care, considering that available evidence is of a low level.
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Arch Orthop Trauma Surg · Dec 2018
Clinical TrialCourse of pain after total hip arthroplasty within a standardized pain management concept: a prospective study examining influence, correlation, and outcome of postoperative pain on 103 consecutive patients.
Postoperative pain management options are of great importance for patients undergoing total hip arthroplasty, as joint replacement surgery is reported to be one of the most painful surgical procedures. This study demonstrates pain outcome until 4 weeks postoperatively and evaluates factors influencing pain in the postoperative course after total hip arthroplasty. ⋯ Increasing pain levels after the first week postoperatively, for 3 days, are most likely to be caused by the change to more extensive mobilization and physiotherapy in the rehabilitation unit. No significant influence or correlation on the intensity of postoperative pain could be found while evaluating potential predictors except preoperative pain levels. Pain management has to take these findings into account in the future to further increase patients' satisfaction in the postoperative course after total hip arthroplasty and to adapt pain management programs.
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Arch Orthop Trauma Surg · Dec 2018
Risk of neurological injury in posterior bone block surgery for recurrent glenohumeral instability: a cadaveric study.
Recurrent posterior glenohumeral instability poses a challenge for treatment. Bone block procedures have been advocated in cases where a bony defect is present. However, these techniques are not free of complications due to the proximity of neurovascular structures. The aim of this study is to measure the distance to the axillary and suprascapular nerves at the different steps of the procedure. ⋯ Not applicable (cadaveric study).
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Arch Orthop Trauma Surg · Dec 2018
Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty.
Management of the young patient with end-stage osteoarthritis of the knee is difficult, with surgical options of osteotomy, partial or total knee arthroplasty (TKA). The primary aim of this study was to assess whether age of less than 55 years was an independent predictor of functional outcome and satisfaction after total knee arthroplasty (TKA). The secondary aims were to identify pre-operative differences in patient demographics, comorbidity and function between patients less than 55 years old compared to those 55 years old and over. ⋯ Age of less than 55 years is not an independent predictor of functional outcome or rate of patient satisfaction after TKA. However, depression and poor mental health are significantly more prevalent in patients less than 55 years old and were independently associated with a lower satisfaction rate.