Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2019
A new perspective on current prosthetic joint infection classifications: introducing topography as a key factor affecting treatment strategy.
Periprosthetic joint infection (PJI) is a relatively frequent and devastating complication following prosthetic joint implantation. Several classification systems have been presented by various authors and are routinely used in clinical practice to help in early diagnosis and treatment. The most widely accepted classifications of periprosthetic infections rely on the timing of clinical presentation. ⋯ The aim is to improve the understanding of the aetiology of this serious complication, lead to the appropriate treatment strategy according to the stage of the disease thus enhancing the outcomes of surgical management. Such a strategy, if widely accepted, could guide research studies on the management of PJIs. The availability of investigations like scintigraphy could aid in identifying pathogenetic processes and their exact location, which may be missed on conventional radiographs, and could enable orthopaedic surgeons to have a better understanding of PJI patterns.
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Arch Orthop Trauma Surg · Mar 2019
Attrition of rotator cuff without progression to tears during 2-5 years of conservative treatment for impingement syndrome.
The purpose of this study was to investigate the natural history of intact rotator cuff in impingement syndrome patients with concomitant spur protruding from the undersurface of acromion. ⋯ Therapeutic case series Level IV.
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Demand for revision total hip arthroplasty (RTHA) continues to grow worldwide and is expected to more than double within the next 1-2 decades. The primary aim of this study was to examine return to function following revision THA in a UK population. ⋯ Revision THA facilitates long-term return to preoperative levels of physical activity in the majority of patients, though activity levels increase in one-third only. Overall over three-quarters are satisfied with their outcome, but revision for periprosthetic fracture or dislocation gives the worse overall outcomes and lower satisfaction levels.
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Arch Orthop Trauma Surg · Mar 2019
Functional outcomes and repair integrity after arthroscopic repair of partial articular supraspinatus tendon avulsion.
Partial-thickness rotator cuff tears are a common cause of shoulder pain and disability. Arthroscopic repair is an effective treatment for partial articular supraspinatus tendon avulsion (PASTA) lesions, and transtendon repair and completion of the tear and repair are the surgical techniques commonly used to treat such lesions. Our aim was to retrospectively evaluate the minimum 24-month clinical and radiological results of PASTA. ⋯ Arthroscopic repair of PASTA lesion achieves high rates of repair integrity regardless of repair type and high levels of functional recovery and patient satisfaction 6 years after surgery.
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Arch Orthop Trauma Surg · Mar 2019
Articular cartilage regeneration and tissue engineering models: a systematic review.
Cartilage regeneration and restoration is a major topic in orthopedic research as cartilaginous degeneration and damage is associated with osteoarthritis and joint destruction. This systematic review aims to summarize current research strategies in cartilage regeneration research. ⋯ In the past three decades, knowledge about articular cartilage and its defects has multiplied in clinical and experimental settings and the respective body of research literature has grown significantly. However, current strategies for articular cartilage repair have not yet succeeded to replicate the structure and function of innate articular cartilage, which makes it even more important to understand the current strategies and their impact. Therefore, the purpose of this review was to globally summarize experimental strategies investigating cartilage regeneration in vitro as well as in vivo. This will allow for better referencing when designing new models or strategies and potentially improve research translation from bench to bedside.