Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2023
The learning curve associated with imageless navigation in total knee arthroplasty.
Computer-assisted navigation systems (CAS) are increasingly being integrated into total knee arthroplasty (TKA) procedures, but perceptions of associated learning curve and increased operative time continue to curtail uptake. Newer-generation navigational systems aim to streamline integration into surgical workflow to mitigate increases in operative time. Here, we assess the impact of a novel imageless CAS on operative time for TKA. ⋯ The learning curve for TKA navigation may be as few as 10 cases, and any associated increases in operative time may be transient and non-significant. Moreover, navigation may ultimately speed operative time, perhaps as the result of enhanced intraoperative assessment of alignment.
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Arch Orthop Trauma Surg · Feb 2023
Long-term preservation of metacarpophalangeal joint function in traumatic defects by metatarsophalangeal osteochondral transplantation.
The integrity of the metacarpophalangeal (MCP) joints is essential for finger and hand function. Preservation of range-of-motion is one of the aims in reconstruction of complex injuries to these joints. Osteochondral transplants have shown to be reliable in reconstruction of various joint defects. This series presents three patients with traumatic injuries to four MCP joints, which were reconstructed by seven avascular osteochondral transplants of metatarsophalangeal (MTP) joints. The joints were examined for radiographic signs of resorption or joint space narrowing, and if this would affect the joints' function in the long term. ⋯ Osteochondral transplants for reconstruction of MCP defects are able to preserve function in severely injured joints even in the long term. Joint space narrowing may occur, which is not accompanied by pain, however. Since localized osteolysis can cause screw head prominence, mid-term radiographic follow-up is necessary to prevent damage to the joint. In the long term, remaining bone stock may be adequate for total joint replacement.
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Arch Orthop Trauma Surg · Feb 2023
Comparisons between treatment of isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies: arthroscopic treatment of posterosuperior paralabral cysts.
The purpose of this study is to report the radiologic and clinical outcomes of arthroscopic intervention for isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies. ⋯ Level III, Retrospective Comparative Trial, Treatment Study.
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Arch Orthop Trauma Surg · Feb 2023
Repeat revision TKR for failed management of peri-prosthetic infection has long-term success but often require multiple operations: a case control study.
Prosthetic joint infection (PJI) is associated with poor outcomes and catastrophic complications. The aim of this study was to present the outcomes of re-revision surgery for PJI of the knee following previous failed two-stage exchange arthroplasty. ⋯ Outcomes for re-revision knee arthroplasty for PJI have higher re-operation and failure rates, but no worse mortality than in revisions of primary knee replacements. Failures can successfully be managed by further operation.
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Arch Orthop Trauma Surg · Feb 2023
Ultrasonographic evaluation of contact configuration between flexor pollicis longus tendon and the volar prominence of volar plate in patients with distal radius fracture.
We classified the contact configuration between the volar prominence of volar locking plate (VLP) and flexor pollicis longus (FPL) tendon using ultrasound (US) into indentation contact and smooth contact, and investigated whether the contact configuration is associated with the flexor tendon attrition. ⋯ This study demonstrated that FPL tendon attrition was significantly associated with indentation contact on US with high sensitivity. Therefore, we recommend selective implant removal in patients with indentation contact configuration.