Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2023
Case ReportsRevision of inlay resurfacing prosthesis with patellar realignment surgery and a new inlay prosthesis for persistent patellofemoral pain und patella subluxation.
We present the case of a 35-year-old patient who underwent inlay patellofemoral arthroplasty (I-PFA) followed by secondary patellar realignment surgery and inlay-to-inlay revision. Revision was performed because of ongoing pain, crepitation, and lateral subluxation of the patella. The original patella component (30-mm button) was replaced with a 35-mm dome, while the Hemi-Cap Wave® (7 × 5 mm) I-PFA was replaced with the Hemi-Cap Kahuna® (10 × 5 mm). ⋯ Radiography revealed an aligned patellofemoral compartment with no signs of loosening. Inlay-to-inlay PFA revision appears to be a reasonable alternative to total knee arthroplasty and conversion to onlay-PFA (O-PFA) for symptomatic patients with primary I-PFA failure. Thorough patellofemoral evaluation and appropriate patient and implant selection are key for successful I-PFA, while additional procedures for patellar realignment may also be required for satisfactory long-term outcomes.
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Arch Orthop Trauma Surg · Dec 2023
Association of osteoporosis and high serum homocysteine levels with intraoperative periprosthetic fracture during total hip arthroplasty: a propensity-score matching analysis.
Intraoperative periprosthetic fracture, one of the most frequent complications of total hip arthroplasty, is a very important factor that affects rehabilitation, hospitalization time, and cost of treatment. Osteoporosis is common in total hip arthroplasty patients and likely contributes to the increasing incidence of periprosthetic fracture. Despite this awareness, preoperative and postoperative osteoporosis evaluations remain insufficient. The purpose of this study was to evaluate the relationships between the occurrence of intraoperative periprosthetic fractures and both bone mineral density (BMD) and osteoporosis-related biomarkers. ⋯ III, A single-center retrospective study.
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Arch Orthop Trauma Surg · Dec 2023
Can machine learning models predict prolonged length of hospital stay following primary total knee arthroplasty based on a national patient cohort data?
The total length of stay (LOS) is one of the biggest determinators of overall care costs associated with total knee arthroplasty (TKA). An accurate prediction of LOS could aid in optimizing discharge strategy for patients in need and diminishing healthcare expenditure. The aim of this study was to predict LOS following TKA using machine learning models developed on a national-scale patient cohort. ⋯ ANN demonstrated modest discrimination capacity and excellent performance in calibration and clinical utility for the prediction of prolonged LOS following TKA. Clinical application of the machine learning models has the potential to improve care coordination and discharge planning for patients at high risk of extended hospitalization after surgery. Incorporating more relevant patient factors may further increase the models' prediction strength.
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Arch Orthop Trauma Surg · Dec 2023
Accuracy comparison of cup positioning during total hip arthroplasty using Hip Align and AR-Hip in the supine position.
The aim of this study is to compare the accuracy of acetabular cup positioning between the accelerometer-based navigation system and the augmented reality-based navigation system during THA in the supine position. ⋯ The accuracy of the acetabular cup positioning between the Hip Align and AR-Hip showed no difference during THA in the spine position. The high BMI could have negative influence on the accuracy of cup positioning in THA using Hip Align, thus AR-Hip could be designable for obesity patients.
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Arch Orthop Trauma Surg · Dec 2023
Multicenter StudyAnatomic repair and ligament bracing as an alternative treatment option for acute combined PCL injuries involving the posteromedial or posterolateral corner-results of a multicentre study.
Combined PCL injuries involving the posteromedial/-lateral corner (PMC/PLC) usually require surgical management. Literature shows controversy regarding the standards of treatment. Suture-augmented repair leads to excellent results in acute knee dislocations but has not been investigated clinically in combined PCL injuries. The purpose of this multicentre study was to evaluate the clinical outcome of this technique in acute combined PCL injuries. ⋯ Level II.