Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
Proximal humeral bone loss in stemless shoulder arthroplasty: potential factors influencing bone loss and a new classification system.
Proximal humeral bone loss in total shoulder arthroplasty (TSA) is more frequent than in hemiarthroplasty. Factors such as age, gender, inclination angle, and radiolucent lines may also contribute. Additionally, current bone loss grading systems are often not sensitive enough to detect slight bone changes, especially at the medial calcar where bone loss is commonly observed. This study uses a new, more detailed bone loss grading system to evaluate factors that could influence bone loss at the proximal humerus. ⋯ Results showed gender had the greatest influence on bone loss after stemless shoulder arthroplasty. Furthermore, both patients with or without bone loss can expect similar clinical outcomes with the stemless prosthesis used in this study. Lastly, the new grading system is simple and straightforward to use.
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Arch Orthop Trauma Surg · Jun 2023
Total hip arthroplasty with femoral shortening osteotomy using polished cemented stem vs. modular cementless stem in patients with Crowe type IV developmental dysplasia of the hip.
There is still little information regarding the advantages of a using a polished tapered stem for Crowe Type IV developmental dysplasia of the hip (DDH). This study aimed to investigate the mid-term clinical and radiological outcomes of primary total hip arthroplasty (THA) with femoral shortening osteotomy using modular and polished tapered stems and to compare the results between the modular and polished tapered stems. ⋯ The findings of this study suggest that THA with femoral shortening osteotomy using both cemented and modular stems can provide satisfactory results. However, considering the occurrence of intraoperative fracture and radiographic analysis in the current study, the cement stem may have an advantage for patients with bone fragility and deterioration in bone quality.
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Arch Orthop Trauma Surg · Jun 2023
Should the early surgery threshold be moved to 72 h in over-85 patients with hip fracture? A single-center retrospective evaluation on 941 patients.
Aim of the study was to assess whether early surgery and other clinical and orthogeriatric parameters could affect mortality rate in hip fracture patients aged > 85. ⋯ In over-85 hip fracture patients, the threshold for early surgery might be moved to 72 h to allow patients pre-operative stabilization and medical optimization as intra-hospital and 30-day mortality rates remain significantly lower. Advanced age, male sex, number of comorbidities, pre-operative dependency in ADL, general anesthesia, length of hospitalization and transfer to other departments were significantly related to mortality rate.
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Arch Orthop Trauma Surg · Jun 2023
Is new always better: comparison of the femoral neck system and the dynamic hip screw in the treatment of femoral neck fractures.
Hip fractures in the elderly population are common and the number of patients is rising. For young and geriatric patients with undisplaced fractures osteosynthesis is the primary type of treatment. The dynamic hip screw (DHS) is around for many years and proved its value especially in displaced fractures. Since 2018 the femoral neck system (FNS) is available as an alternative showing promising biomechanical results. The aim of this study is to evaluate clinical results of the FNS and compare it to the DHS. ⋯ FNS proved to be as reliable as DHS in all patients with hip fractures. Not the type of implant but blade positioning is still key to prevent implant failure. Still due to minimal invasive approach implant related infections and postoperative hematomas might have been prevented using the FNS.
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Arch Orthop Trauma Surg · Jun 2023
Lateral unicompartmental knee arthroplasty (UKA) showed a lower risk of failure compared to medial unicompartmental knee arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO).
The present study aimed to investigate differences in survivorship between medial and lateral unicompartmental knee arthroplasty (UKA) by analyzing the data of an Italian regional registry. The hypothesis was that, according to recent literature, lateral implants have comparable survivorship with regard to the medial implants. ⋯ Level 3, therapeutic study.