Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2023
More than a feeling?-Overruling the preoperatively templated offset option leads to a minor offset increase in short stem total hip arthroplasty.
Short stems are increasingly used in total hip arthroplasty (THA) because of advantages in bone and soft tissue preservation and reconstruction of hip geometry. Digital templating is essential in determining the correct offset option and stem size in THA. However, the preoperative template sizes might be intraoperatively overruled. ⋯ Intraoperative overruling of the preoperative digital template in cementless short stem total hip arthroplasty results in an increase of hip offset compared to a contralateral healthy hip. However, the increase is marginal and clearly under 5 mm compared to the contralateral healthy hip.
-
Arch Orthop Trauma Surg · Jan 2023
Does the surgical treatment of concomitant upper limb fractures affect the outcomes of hip fractures in the elderly population?
Elderly patients with concomitant upper limb and hip fractures present a management dilemma because upper limb fractures potentially affect rehabilitation outcomes for the hip fracture. This study aims to evaluate whether the site of upper limb fractures and the decision to surgically treat such fractures affect the functional outcome of surgically treated hip fracture patients. ⋯ Surgical treatment of concomitant upper limb fractures does not appear to change the outcomes of the hip fractures. Hip fracture patients with surgically treated wrist fractures had better functional outcomes at 6 months compared to those treated non-surgically; however, there was no difference at 12 months. Hip fracture patients with concomitant wrist fractures had better functional outcomes compared to hip fracture patients with proximal humerus fractures.
-
Arch Orthop Trauma Surg · Jan 2023
High-grade preoperative osteoarthritis of the index compartment is a major predictor of meniscal allograft failure.
Preoperatively available predictors of meniscal allograft failure would help in patient counseling and surgical indication for meniscal allograft transplantation (MAT). It was hypothesized that young patient age, high posterior tibial slope (PTS), and high-grade osteoarthritis (OA) are predictors of meniscal allograft failure. ⋯ High-grade preoperative OA of the index compartment was found to be a significant and clinically relevant predictor of meniscal allograft failure. Surgeons should be aware of the impact of OA on meniscal allograft survival, which needs to be considered in patient counseling and surgical indication for MAT in patients.
-
Arch Orthop Trauma Surg · Jan 2023
The 'critical trochanter angle' does not show superiority over the CCD angle in predicting varus stem alignment in cementless short-stem total hip arthroplasty.
Varus positioning of the femoral stem can affect the hip offset (HO). The critical trochanter angle (CTA) was introduced in 2019 as a novel geometric angle, to predict varus stem alignment in cementless straight stem THA. The aim of this study was to evaluate the applicability of the CTA as a predictor for stem alignment in THA with a cementless neck resecting short stem. ⋯ IV.