Archives of orthopaedic and trauma surgery
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Guideline-based surgical cartilage therapy for focal cartilage damage offers highly effective possibilities to sustainably reduce patients' complaints and to prevent or at least delay the development of early osteoarthritis. In the knee joint, it has the potential to reduce almost a quarter of the arthroses requiring joint replacement caused by cartilage damage. Biologically effective injection therapies could further improve these results. ⋯ The role of a combination therapy with use of intra-articular corticosteroids is lacking in the absence of adequate study data and cannot be defined yet. With regard to adipose tissue-based cell therapy, the current scientific data do not yet justify any recommendation for its use. Further studies also regarding application intervals, timing and differences in different joints are required.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisAre leukocyte-poor or multiple injections of platelet-rich plasma more effective than hyaluronic acid for knee osteoarthritis? A systematic review and meta-analysis of randomized controlled trials.
Platelet-rich plasma (PRP) has gained popularity as a treatment option for knee osteoarthritis; however, its efficacy remains controversial. The optimal leukocyte concentration and number of injections have not been well investigated. This study was, therefore, designed to provide clinical evidence on the leukocyte concentration and number of intra-articular injections of PRP via a meta-analysis of randomized controlled trials (RCTs). ⋯ Meta-analysis of level I studies.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisComplications associated using the reamer-irrigator -aspirator (RIA) system: a systematic review and meta-analysis.
Complications associated with the application of the Reamer-irrigator-Aspirator (RIA) system are described in the literature. However, to date a systematic review and meta-analysis to assess prevalence of complications associated with the use of the RIA system have not been conducted. ⋯ The systematic review and meta-analysis demonstrate a low overall prevalence rate of complications associated with the RIA system. However, especially the risk of cortical perforation and the frequently reported relevant intraoperative blood loss are complications that should be anticipated in perioperative management and ultimately considered when using the RIA system.
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Arch Orthop Trauma Surg · Jul 2023
Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament.
Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a mucoid-like substance. This study is to determine the anatomical associated factors for MD-ACL using radiographic and magnetic resonance imaging (MRI). ⋯ Level IIIb.
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Arch Orthop Trauma Surg · Jul 2023
Acetabular deficiency in borderline hip dysplasia is underestimated by lateral center edge angle alone.
In hip preservation surgery, the term "borderline hip dysplasia" was used when the lateral center edge angle (LCEA), historically described by Wiberg, measured 18-25°. In recent years, several radiographic parameters have been described to assess the antero posterior coverage of the femoral head, for example, the anterior and posterior wall index (AWI and PWI). This allowed an increasingly comprehensive understanding of acetabular morphology and a questioning of the borderline definition. ⋯ The rather high proportion of symptomatic hips labelled borderline dysplastic suggested, that there might be substantial acetabular deficiency not recognizable by LCEA. Comprehensive deformity analysis using LCEA, AI, AWI and PWI showed, that 40% of these hips were deficient either antero-laterally or postero-laterally. Male acetabula were more deficient postero-laterally than female.