Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2020
ReviewThe relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints.
Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromioclavicular relationship in normal, asymptomatic, and symptomatic degenerated ACJ. ⋯ In patients with degenerative ACJ, both the distal clavicle and acromion are enlarged. In asymptomatic patients, the AC relationship is the same as in normal patients, in contrast, in patients with symptomatic degenerative ACJ, the acromion is subluxated anteriorly compared to the clavicle.
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Arch Orthop Trauma Surg · Apr 2020
Fewer patients undergo surgery when adding a comprehensive geriatric assessment in older patients with a hip fracture.
Geriatricians have been increasingly involved in the pre-operative process in frail elderly patients with a hip fracture which can benefit re-hospitalization, post-operative functional performance, and mortality. The objective of this study was to compare the number of older patients with hip fractures who opted for non-surgical management after the addition of pre-operative comprehensive geriatric assessment (CGA) with shared decision making by a geriatrician to usual care. Secondary objectives were: reasons for non-surgical management, duration of life, and location of death. ⋯ The geriatrician can have an important role in decisions for non-surgical management by shared decision making in the pre-operative period in patients ≥ 70 years with a hip fracture in the emergency room.
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Arch Orthop Trauma Surg · Apr 2020
Tactile techniques are associated with a high variability of tunnel positions in lateral extra-articular tenodesis procedures.
The purpose of this study was to determine the variability of femoral tunnel positions applying two different lateral extra-articular tenodesis (LET) techniques, guiding on the tactile identification (1) of the lateral epicondyle (Lemaire procedure) and (2) of the Kaplan fibre attachments on the distal femur (MacIntosh procedure) and to analyse whether one of these procedures is more suitable for reliable femoral tunnel positioning in LET procedures. ⋯ Femoral tunnel positions in LET procedures have a high degree of variability and inaccuracy. Palpating anatomic landmarks appears to be insufficient to generate reproducible tunnel positions. Radiographic landmarks may enable more reproducible identification of isometric femoral tunnel positions and reduce malpositioning.
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Arch Orthop Trauma Surg · Apr 2020
Patients with anteromedial osteoarthritis achieve the greatest improvement in patient reported outcome after total knee arthroplasty.
The osteoarthritic (OA) disease pattern of the knee is one of the determinants for choice of arthroplasty concept when knee replacement is indicated, but whether the disease pattern has a direct effect on postoperative outcome has not previously been investigated. The aim was to investigate if different OA disease patterns have an effect on postoperative outcome after receiving total knee arthroplasty (TKA).
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Arch Orthop Trauma Surg · Apr 2020
Correction to: Fewer patients undergo surgery when adding a comprehensive geriatric assessment in older patients with a hip fracture.
The original version of this article unfortunately contained a mistake. The presentation of Figure 1 was incorrect. The correct version of Figure 1 is given in the following page.