Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2023
Recurrence of glenohumeral instability in patients with isolated rotator cuff repair after a traumatic shoulder dislocation.
The primary objective of this study was to assess the incidence of recurrent glenohumeral instability in patients over 40 years with isolated rotator cuff (RC) repair for traumatic shoulder dislocation. The secondary objectives were to identify risk factors for glenohumeral recurrence after RC repair and to describe the causes and incidences of re-intervention. ⋯ Recurrent glenohumeral instability in active patients over 40 years with isolated RC repair after traumatic shoulder dislocation was infrequent, despite the incidence of significant Hill-Sachs defects, anterior glenoid defects, bipolar bone defects, size of the RC injury, and tendon re-tears. The incidence of re-interventions was 11.9%, with symptomatic RC retear as the main cause.
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Arch Orthop Trauma Surg · Jul 2023
Observational StudyMusculoskeletal tuberculosis revisited: bone and joint tuberculosis in Austria.
To prevent further spread of the disease and secondary deformity, musculoskeletal tuberculosis (TB) remains a challenge in terms of early diagnosis and treatment. This study gives an overview on TB trends in Austria (pulmonary and extrapulmonary TB) (A) and analyses a retrospective series of musculoskeletal TB cases diagnosed and treated at an Austrian tertiary centre (B). ⋯ Musculoskeletal TB should be considered if untypical joint infections or nonspecific bone lesions occur in younger patients with a migration background or in patients with specific risk factors.
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Arch Orthop Trauma Surg · Jul 2023
Revision surgery after failed surgical treatment of midshaft clavicle fractures is often associated with positive detection of bacteria.
Midshaft clavicle fractures are common, and the proportion of patients treated surgically has increased in recent years. With this increase in surgical treatments, the complication rate, for instance of infection, non-union, or implant failure, has also risen. This study evaluates the frequency of pathogen detection during revision surgeries occurring after a prior failed osteosynthesis of midshaft clavicle fractures. ⋯ Revision surgery frequently shows pathogen detection without signs of infection. Cutibacterium acnes is the most common pathogen. Despite pathogen detection, bone healing can be achieved with revision surgery, although the rate of repeat revision surgeries is high.
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Arch Orthop Trauma Surg · Jul 2023
Changes in microbiological spectrum and antibiotic susceptibility in two-stage exchange for periprosthetic shoulder infections.
Periprosthetic joint infections (PJI) are a major concern in shoulder arthroplasty, which in some cases require two-stage exchange. While it was shown that low-virulence bacteria are the most isolated pathogens in shoulder PJI, little is known about changes in microbiological spectrum and resistance patterns during two-stage revision. ⋯ There is a high rate of changes in microbiological spectrum and resistance patterns between culture positive first- and second-stage procedures as well as subsequent re-revisions. Intraoperative samples during reimplantation should be taken and resistance reconsidered in case of re-revision.
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Arch Orthop Trauma Surg · Jul 2023
Elevated hip adduction angles and abduction moments in the gait of adolescents with recurrent patellar dislocation.
Impaired hip kinematics and kinetics may incite patellar instability. This study tested the hypothesis that hip adduction and internal rotation angles during gait are higher in adolescents with recurrent patellar dislocations compared to healthy controls. ⋯ Elevated hip adduction angles and higher hip abduction moments in gait of adolescents with recurrent patellar dislocation may indicate an impaired function of hip abductors that contributes to patellar instability.