Archives of orthopaedic and trauma surgery
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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.
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Arch Orthop Trauma Surg · Jul 2023
High-risk ankle fractures in high-risk older patients: to fix or nail?
Optimal treatment of high-risk ankle fractures in older, comorbid patients is unknown. Results of open reduction internal fixation (ORIF) versus tibiotalocalcaneal (TTC) fusion nailing for the treatment of high-risk geriatric ankle fractures were investigated. ⋯ ORIF and TTC fusion nailing result in comparable and acceptable reoperation, infection, and union rates in treating high-risk ankle fractures in patients over 50 with at least 1 major comorbidity for increased complications; further study is warranted.
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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 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
Coronal tibiofemoral subluxation under valgus stress force radiography is useful for evaluating postoperative coronal tibiofemoral subluxation in mobile-bearing UKA.
Coronal tibiofemoral subluxation (CTFS) is considered a controversial and potential contraindication to unicompartmental knee arthroplasty (UKA) but is less discussed. The study aims to observe the CTFS in a cohort of patients before and after mobile-bearing UKA and to investigate the relationship between preoperative variables (preoperative CTFS and preoperative CTFS under valgus stress) and postoperative CTFS after mobile-bearing UKA. ⋯ Level III.