Archives of orthopaedic and trauma surgery
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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
Stem size prediction in shoulder arthroplasty with preoperative 3D planning.
Three-dimensional surgical planning software provides virtual reconstructions of the shoulder with automated joint indices for a preoperative case assessment. The aim of this single center study was to evaluate the concordance between the preoperatively selected humeral components and the final implants used in shoulder arthroplasty. ⋯ level IV, retrospective case study.
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Arch Orthop Trauma Surg · Jul 2023
A double tapered fully hydroxyapatite-coated stem has less contact area to femoral cortical bone than a tapered-wedge stem: a three-dimensional computed tomography-based density mapping analysis.
It is clinically important to analyze the initial contact state between an implant and femoral cortical bone as it affects clinical outcomes, such as stress shielding, stem subsidence, thigh pain, and patient-reported outcomes after total hip arthroplasty. Whether the initial contact state of a double-tapered fully hydroxyapatite (HA)-coated stem is achieved with the preserved cancellous or cortical bone remains to be established. This study aimed to compare the contact area with the femoral cortical bone between a double-tapered fully HA-coated stem (HA group) and a tapered wedge cementless stem (TW group) using three-dimensional computed tomography (3DCT)-based templating software. ⋯ The contact area of the double-tapered fully HA-coated stem was significantly lower than that of the tapered wedge cementless stem.
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Arch Orthop Trauma Surg · Jul 2023
Posterior wall fractures of the acetabulum: treatment using an anatomical plate through direct posterior approach.
This study was aimed to measure the application of W-shaped acetabular angular plate (WAAP) through direct posterior approach (DPA) on the reconstruction of acetabular posterior wall fractures when compared with reconstruction plates. ⋯ The application of WAAP through DPA showed satisfactory preliminary clinical outcomes, showing promise to be an alternative technique for the treatment of acetabular posterior wall fractures.