Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2020
Maximal flexion and patient outcomes after TKA, using a bicruciate-stabilizing design.
Physiological motion after total knee arthroplasty (TKA) should result in a large range of motion, which would lead to good clinical outcomes. An adjusted design of a bicruciate-stabilizing TKA was developed to reproduce physiological motion. The aim of this study was to (1) investigate the maximal knee flexion of this knee system, 1 year post-operatively; (2) determine the clinical and functional improvement and compare the outcomes between patients with and without high maximal flexion; and (3) evaluate the adverse events. ⋯ Prospective cohort study, Level II.
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Arch Orthop Trauma Surg · Oct 2020
Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study.
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA). ⋯ GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.
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Arch Orthop Trauma Surg · Oct 2020
Decision making for concomitant high tibial osteotomy (HTO) in cartilage repair patients based on a nationwide cohort study of 4968 patients.
High tibial osteotomy (HTO) for varus deformities is a common concomitant treatment in cartilage surgery. Aim of the present study was to analyze factors influencing the decision towards accompanying HTO in patients with cartilage defects of the medial femoral condyle, such as the amount of varus deformity. ⋯ Based upon data from a nationwide cohort, additional HTO in context with cartilage repair procedures of the medial femoral condyle is frequently performed even in mild varus deformities less than 5°. Other factors also seem to influence decision for HTO.
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Arch Orthop Trauma Surg · Oct 2020
Meta AnalysisRobotic-assisted total knee arthroplasty is comparable to conventional total knee arthroplasty: a meta-analysis and systematic review.
Total knee arthroplasty (TKA) is a successful procedure in managing end-stage arthritis when non-operative treatments fail. New technologies such as robotic TKA (rTKA) have been developed to improve the accuracy of prosthesis implantation. While short-term cohort studies on rTKA have shown excellent results, the evidence comparing between rTKA and conventional TKA (cTKA) is not yet well established. This meta-analysis aims to compare the efficacy and safety of rTKA versus cTKA in terms of clinical outcomes, radiographic results, complications, peri-operative parameters and costs. ⋯ Level II, Meta-analysis of non-homogeneous studies.
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Arch Orthop Trauma Surg · Oct 2020
ReviewClinical outcome of bi-unicompartmental knee arthroplasty for both medial and lateral femorotibial arthritis: a systematic review-is there proof of concept?
Unicompartmental knee arthroplasty (UKA) is a well-accepted treatment for isolated unicompartmental osteoarthritis (OA) of the knee. In previous literature, it has been suggested that bi-unicompartmental knee arthroplasty (bi-UKA) which uses two UKA implants in both the medial and lateral compartments of the same knee is a feasible and viable option for the treatment of knee OA. Given the advantages of UKA treatment, it is warranted to review the literature of bi-UKA and discuss the evidence in terms of implant selection, indications, surgical techniques, and outcomes, respectively. ⋯ Both simultaneous and staged bi-UKA has demonstrated good functional outcomes. However, the volume and level of evidence in general is low for studies captured in this review, and the data on long-term outcomes remain limited. The present review indicates that bi-UKA is a feasible and viable surgical option for bicompartmental femorotibial OA in carefully selected patients.