Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2023
Meta AnalysisComparison of clinical outcomes of VISIONAIRE patient-specific instrumentation with conventional instrumentation in total knee arthroplasty: a systematic literature review and meta-analysis.
Malalignment and resulting complications are major challenges in total knee arthroplasty (TKA) which patient-specific instrumentation (PSI) is proposed to alleviate. Previous PSI meta-analyses of TKA outcomes typically do not differentiate between PSI systems and assess relatively few outcomes, so the value of their findings is limited. VISIONAIRE™ cutting guides (Smith + Nephew Inc., Memphis, TN, USA) is a PSI system based on preoperative magnetic resonance and X-ray imaging. A systematic literature review (SLR) and meta-analysis, focussed specifically on VISIONAIRE, were conducted to assess TKA accuracy, intraoperative outcomes, and postoperative outcomes, compared with conventional instrumentation (CI). ⋯ Options for PSI in TKA differ substantially, and it is important to assess the outcomes of individual systems. The current findings suggest that VISIONAIRE guides can lead to improved alignment accuracy and surgical efficiency compared with CI, without compromising postoperative safety and return-to-function outcomes.
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Arch Orthop Trauma Surg · Jul 2023
Medial oblique malleolar osteotomy for approach of medial osteochondral lesion of the talus.
The medial malleolar osteotomy is commonly performed to gain access to the medial talar dome for treatment of osteochondral lesions of the talus. The primary aim of this study was to assess osseous healing based on postoperative radiographs to determine consolidation, non-union and malreduction rates. ⋯ Level III, retrospective cohort study.
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Arch Orthop Trauma Surg · Jul 2023
The clinical outcome of total knee arthroplasty is compromised by a previously implanted medial unicondylar knee arthroplasty.
To investigate the clinical outcome of patients that underwent conversion of a medial unicondylar knee arthroplasty (UKA) to a total knee arthroplasty (TKA) and to compare that outcome to patients that underwent primary TKA. It was hypothesized that those groups would significantly differ in terms of knee score outcome and implant survival. ⋯ Based on our findings it is concluded that patients who received a TKA after UKA have inferior results than those that directly receive a TKA. This is true for both patient-reported knee outcome and prosthesis survival. Converting UKA to TKA should not be seen as an easy operation, but should rather be done by surgeons with considerable experience in both primary and revision knee arthroplasty.
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Arch Orthop Trauma Surg · Jul 2023
Revision lateralization osteotomy of the tibial tubercle has excellent outcomes in patients suffering from previous medial tibial tubercle overcorrection.
Tibial tubercle osteotomy (TTO) is a common procedure used to treat patients with patellofemoral instability (PFI) and osteoarthritis (PFOA). Medial patellar maltracking due to previous excessive medialization of the tibial tubercle has rarely been reported. Therefore, the goal of this study was to assess patient-reported outcome measures (PROMs) after revision osteotomy with lateralization of the tibial tubercle (RL-TTO) to correct medial patellofemoral maltracking. ⋯ RL-TTO significantly improved subjective knee function and AKP in patients suffering from medial patellar maltracking due to previous excessive tibial tubercle medialization osteotomy at short-term follow-up.
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Arch Orthop Trauma Surg · Jul 2023
The effect of topical tranexamic acid on functional outcomes and quality of life in patients undergoing unicompartmental knee arthroplasty.
Tranexamic acid (TXA) is being increasingly utilized to reduce blood loss after knee joint arthroplasty. However, there is a lack of studies on the effect of topical TXA on the functional outcomes and quality of life after Unicompartmental Knee Arthroplasty (UKA). The aim of this study was to determine the effect of topical TXA on functional outcomes and quality of life scores in patients undergoing UKA. ⋯ In patients undergoing UKA, functional outcomes and quality of life scores were comparable between those who received topical TXA and those who did not. There was no significant improvement or impairment in knee function associated with topical TXA administration in UKA up to 2 years follow-up.