Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
All-polyethylene unicompartmental knee arthroplasty is associated with increased risks of poorer knee society knee score and lower satisfaction in obese patients.
Although metal-backed tibial component (MB) is biomechanically superior to all-polyethylene (AP) implants in fixed-bearing unicompartmental knee arthroplasty (UKA), recent studies have shown comparable functional outcomes between the two. However, no study has examined this comparison in obese patients (BMI ≥ 30 kg/m2). We investigated whether functional outcomes between the two implants differ among obese patients, and whether the extent of obesity influences these outcomes. ⋯ We found no differences in functional and quality-of-life outcomes between fixed-bearing AP and MB tibial components among obese patients who underwent UKA. However, among higher obesity patients (BMI ≥ 35 kg/m2), patients with AP tibial component were associated with lower KSKS score and a lower proportion of attaining satisfaction fulfillment 2 years postoperatively.
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Arch Orthop Trauma Surg · Dec 2022
Fully hydroxyapatite-coated compaction broached and triple-tapered stem may reduce the risk of stress shielding after primary total hip arthroplasty.
Changes in bone mineral density (BMD) around the fully hydroxyapatite (HA)-coated compaction broached and triple-tapered stem, namely, Polarstem, after total hip arthroplasty (THA) are currently unknown. Therefore, the aims of this study were to investigate clinical outcomes of Polarstem, mainly postoperative temporal changes in BMD around the stem for 2 years, and to compare them with those of HA-coated and non-HA-coated tapered-wedge stems. ⋯ Polarstem, a fully HA-coated compaction broached and triple-tapered stem, maintained BMD around the femoral calcar until 2 years postoperatively and could reduce the risk of stress shielding compared with tapered-wedge stems.
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Arch Orthop Trauma Surg · Dec 2022
Slight cartilage damage in weight-bearing area of lateral femoral condyle do not compromise short-term outcomes of medial unicompartmental knee arthroplasty.
Medial unicompartmental knee arthroplasty (mUKA) requires full-thickness cartilage in the lateral compartment, but slight damage of the cartilage surface can be ignored. However, as this statement lacks literature support, we investigated whether slight cartilage damages in the weight-bearing area of the lateral femoral condyle would affect the outcome of mUKAs. ⋯ Cartilage damage of Outerbridge grade 1 and grade 2 in the weight-bearing area of the lateral femoral condyle will not compromise the short-term outcome of medial mobile-bearing UKA.
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Arch Orthop Trauma Surg · Dec 2022
Comparison between single anterior and single posterior approaches of debridement interbody fusion and fixation for the treatment of mono-segment lumbar spine tuberculosis.
To compare the efficacy of single anterior and single posterior approach of debridement, interbody fusion, and fixation for the treatment of mono-segment lumbar spine tuberculosis (TB) patients. ⋯ Both single anterior and single posterior approaches of debridement, interbody fusion and fixation are effective for mono-segment lumbar TB patients, although the single posterior approach is of a shorter duration and results in less blood loss.
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Arch Orthop Trauma Surg · Dec 2022
What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review.
In orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes. ⋯ The fast-track pathway avoided unnecessary delays in emergency departments due to faster X-rays, direct admission to orthopaedic wards, and reduced delirium rates. However, results were unable to show the impact of fast-track on length of stay, time to surgery, and mortality.