Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2021
The direct anterior approach provokes varus stem alignment when using a collarless straight tapered stem.
Inaccurate stem implantation can cause unsatisfactory offset reconstruction and may result in insufficient gluteal muscle function or aseptic loosening. In this study, stem alignment of a collarless straight tapered HA-coated stem was retrospectively analyzed during the learning phase of the direct anterior approach (DAA) for primary total hip arthroplasty (THA). ⋯ In the learning curve, the DAA can be associated with a high incidence of varus stem alignment when using a straight tapered stem, especially in men with coxa vara deformity: low CCD, high femoral offset and long thigh neck. An insufficient capsule release makes femur exposure more difficult and might be an additional factor for this finding. We recommend intraoperative X-ray in the learning phase of the DAA to verify correct implant positioning and to adjust offset options.
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Arch Orthop Trauma Surg · Jun 2021
Meta AnalysisEarly complications and reoperation rates are similar amongst open reduction internal fixation, intramedullary nail, and distal femoral replacement for periprosthetic distal femur fractures: a systematic review and meta-analysis.
Our purpose was to perform a systematic review and meta-analysis to evaluate complication and revision rates for periprosthetic distal femur fractures (PPDFF) treated with: (1) ORIF using periarticular locking plates (ORIF), (2) retrograde intramedullary nail (IMN), and (3) distal femoral replacement (DFR). ⋯ There was no difference in major complications or reoperations between the three treatment groups. Deep infection rates were higher in DFR relative to internal fixation, malunion rates were higher in IMN versus ORIF, and periprosthetic fracture rates were higher in DFR and IMN versus ORIF.
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Arch Orthop Trauma Surg · Jun 2021
End-stage renal disease increases risk of postoperative complications after lower extremity fracture.
End-stage renal disease (ESRD) leads to multiple systemic effects and patients suffer from multiple comorbidities including fractures. While previous studies have examined complications following hip fracture surgery in ESRD patients, there are no studies evaluating other lower extremity fractures. This study aimed to identify postoperative complication risk in patients with ESRD who had lower extremity fractures. ⋯ ESRD was associated with higher rates of complications, especially mechanical failure, after lower extremity fracture surgeries.
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Arch Orthop Trauma Surg · Jun 2021
Comparative StudyComparison of mid-term clinical results between cementless and cemented femoral stems in total hip arthroplasty with femoral shortening osteotomy for Crowe type IV hips.
This report is the first study to compare the clinical outcomes between cementless and cemented femoral prostheses in total hip arthroplasty (THA) with subtrochanteric femoral shortening osteotomy for Crowe type IV hips. ⋯ The cemented femoral prosthesis is superior to the cementless femoral prosthesis for early clinical recovery, while the duration required to achieve bone union at the osteotomy site is longer in the cemented femoral prostheses. It is possible for surgeons to perform successful hip reconstructions, regardless of the fixation method used for THA with shortening femoral osteotomy.
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Arch Orthop Trauma Surg · Jun 2021
Comparative StudyArthroscopic ankle lateral ligament repair alone versus arthroscopic ankle lateral ligament repair with reinforcement by inferior extensor retinaculum.
This study aimed to compare the clinical outcomes and postoperative activities of arthroscopic ankle lateral ligament (ALL) repair alone with arthroscopic ALL repair and reinforcement by the inferior extensor retinaculum (IER) for chronic ankle instability (CAI). ⋯ Retrospective comparative study, level III.