Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2022
Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty.
Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique. ⋯ Although no difference was found between the Grid and the Overlay cohorts for LLD, GHO or abduction angle, the Overlay resulted in greater accuracy for acetabular component anteversion angle, with only a slight decrease in surgical efficiency.
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Arch Orthop Trauma Surg · Jun 2022
Standard radiographic assessments of distal radius fractures miss involvement of the distal radioulnar joint: a diagnostic study.
Distal radius fractures account for one-fifth of all fractures in the emergency department. Their classification based on standard radiographs is common practice although low inter-observer reliabilities and superiority of computer tomography (CT) scanning in evaluation of joint congruency have been reported. ⋯ This study demonstrates that involvement of the sigmoid notch is frequently missed in standard radiographs. The presented data support the frequent use of CT imaging to allow the holistic illustration of a fracture's complexion and to ensure optimal pre-operative planning.
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Arch Orthop Trauma Surg · Jun 2022
Specific knowledge and resilience affect short-term outcome in patients following primary total hip arthroplasty.
The aim of the present study was to investigate the potential associations between specific knowledge, resilience and patient-reported outcome measures (PROMS) following primary total hip arthroplasty (THA). ⋯ The present study demonstrated that patients with a feeling of uncertainty had an inferior short-term functional outcome following primary THA. Moreover, it could be shown that higher specific knowledge and resilience are associated with a better functional outcome according to validated PROMS. While these findings need to be prospectively validated in future studies, specific patient knowledge and resilience may have a direct impact on the outcome of primary THA.
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Arch Orthop Trauma Surg · Jun 2022
Functional stability: an experimental knee joint cadaveric study on collateral ligaments tension.
Applying proper tension to collateral ligaments during total knee arthroplasty surgery is fundamental to achieve optimal implant performance: low tension could lead to joint instability, over-tensioning leads to pain and stiffness. A "functional stability" must be defined and achieved during surgery to guarantee optimal results. In this study, an experimental cadaveric activity was performed to measure the minimum tension required to achieve knee functional stability. ⋯ Results agree with other experimental studies, showing that the tensions required to stabilize a knee joint are lower than the ones applied nowadays via surgical tensioners. To reach functional stability, surgeons should consider such results intraoperatively and avoid ligament laxity or over-tension.
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Arch Orthop Trauma Surg · Jun 2022
Autogenous iliac crest bone grafting for tibial nonunions revisited: does approach matter?
Tibial nonunion remains a considerable burden for patients and the surgeons who treat them. In recent years, alternatives to autogenous grafts for the treatment of tibial nonunions have been sought. The purpose of this study was to evaluate the efficacy of autogenous iliac crest bone graft (ICBG) in the treatment of tibial shaft nonunions. ⋯ Level III.