Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2022
Changes in the femoral osteotomy level coefficient and neck shaft angle during limb lengthening with an intramedullary magnetic nail.
The intramedullary magnetic IM nail enables bone graduated distraction. Proximal femur osteotomies for ante grade IM lengthening nails have a tendency towards varus-procurvatum malalignment. We examined the effect of the level of the osteotomy and of trochanteric versus piriformis entry points on the neck shaft angle (NSA) during lengthening with the PRECICE IM magnetic nail. ⋯ Proximal femur lengthening with the PRECICE IM nail significantly reduced the NSA and might cause Varus deformity. The level of osteotomy by OLC did not influence the amount of NSA reduction. The trochanteric entry points have a greater tendency to reduce the NSA compared to the piriformis entry points.
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Arch Orthop Trauma Surg · Aug 2022
Bone impaction grafting and anti-protrusio cages in high-grade acetabular defects: a 22-year single centre experience.
Report clinical and radiological long-term follow-up (FU) outcome of bone impaction grafting (BIG) and anti-protrusio cage (APC) technique in hip revision surgery. ⋯ Impaction grafting with femoral head and APC is an effective technique for treating high-grade acetabular defects. APC reconstructs the hip centre of rotation, avoiding loading forces on the underlying bone graft that can be correctly integrated. At long-term FU, satisfactory clinical results, not strictly correlated to radiological signs of integration, were observed; Paprosky type III B reported worse results in terms of graft resorption and a greater migration of the APC.
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Arch Orthop Trauma Surg · Aug 2022
Precision of the Wilson corrective osteotomy of the first metacarpal base using specific planning and instruments for treatment of basal thumb arthritis.
Arthritis of the basal thumb is a relatively common condition also affecting younger patients. Wilson et al. described a 20°-30° closing wedge osteotomy of the first metacarpal bone to unload the trapeziometacarpal joint. It was the purpose of this study to analyze the clinical and radiographic outcome of patients who underwent proximal extension osteotomy of the first metacarpal bone using patient-specific planning and instruments (PSI). ⋯ Type IV-retrospective, therapeutic study.
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Arch Orthop Trauma Surg · Aug 2022
Unicompartmental vs. total knee replacement in patients with failed high tibial osteotomy.
The influence of a previous high tibial osteotomy (HTO) on the outcome and survival of a knee arthroplasty is a debated issue. The purpose of this study is to compare subjective, radiographic, and functional outcomes of unicompartmental knee replacement (UKR) and total knee replacement (TKR) after failed open wedge HTO. ⋯ Performing UKR after previous failed HTO is a safe and effective procedure which leads to clinical, radiological and functional outcomes comparable to TKR after HTO.
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Arch Orthop Trauma Surg · Aug 2022
Perioperative blood transfusions in hip and knee arthroplasty: a retrospective assessment of combined risk factors.
Accurate identification of patients at risk of blood transfusion can reduce complications and improve institutional resource allocation. Probabilistic models are used to detect risk factors and formulate patient blood management strategies. Whether these predictors vary among institutions is unclear. We aimed to identify risk factors among our patients who underwent total hip (THA) or knee (TKA) arthroplasty, and combine these predictors to improve our model. ⋯ Level 3, retrospective cohort study.