Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2021
Review Meta AnalysisCemented versus uncemented hemiarthroplasty for the management of femoral neck fractures in the elderly: a meta-analysis and systematic review.
Hemiarthroplasty is commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty. Therefore, we performed a systematic review to focus on the outcomes of cemented and uncemented hemiarthroplasty for the treatment of femoral neck fractures in older patients. ⋯ This meta-analysis showed cemented hemiarthroplasty might be an optimum choice for treating unstable femoral neck fractures in older patients. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.
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Arch Orthop Trauma Surg · Jun 2021
Meta AnalysisPrevalence and risk factors for prolonged opioid use after total joint arthroplasty: a systematic review, meta-analysis, and meta-regression.
Opioids are a mainstay for pain management after total joint arthroplasty (TJA). The prevalence and risk factors for prolonged opioid use after TJA are important to understand to help slow the opioid epidemic. We aim to summarize and evaluate the prevalence and time trend of prolonged opioid use after TJA and pool its risk factors. ⋯ To our knowledge, this is the first meta-analysis determining the risk factors of prolonged opioid use and characterizing its rate and time trend in TJA. Understanding risk factors for patients with higher potential for prolonged opioids use can be used to implement appropriate management strategies, reduce unsafe opioid prescriptions, and decrease the risk of prolonged opioid use after TJA.
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Arch Orthop Trauma Surg · Jun 2021
Review Meta AnalysisImpact of tourniquet during knee arthroplasty: a bayesian network meta-analysis of peri-operative outcomes.
The role of tourniquet during knee arthroplasty is controversial. The present study compares various tourniquet protocols using a Bayesian network meta-analysis of peri-operative data. ⋯ For knee arthroplasty, longer tourniquet use is associated with the shorter duration of surgery, lower intra-operative blood lost, lower drops in haemoglobin and fewer transfusion units. The shortest average hospitalisation was associated with no tourniquet use.
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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.