Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Osteoscopic versus open surgery for the treatment of enchondroma in the foot.
The conventional treatment of enchondromas is the open surgery with curettage of lesions. Osteoscopic surgery is a minimally invasive endoscopic approach for lesions inside bone. The aim of this study was to evaluate the feasibility of the osteoscopic surgery in comparison with the conventional open surgery for patients with foot enchondromas. ⋯ The osteoscopic surgery is feasible to provide earlier functional recovery and fewer complications than the open surgery.
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Arch Orthop Trauma Surg · Aug 2023
Topical vancomycin powder does not affect patella cartilage degeneration in primary total knee arthroplasty and conversion rate for secondary patella resurfacing.
Vancomycin powder (VP) is an antibiotic first introduced in pediatric spinal surgery to prevent surgical site infections (SSI). Recently its topical application was expanded to total hip and knee arthroplasty (THA, TKA) and anterior cruciate ligament reconstruction (ACLR). Toxicity to cartilage is the subject of current research. The aim of this study was to prove the hypothesis that topical application of VP in TKA does not result in a degeneration of patella cartilage. We propagate that the conversion rate for secondary patella resurfacing is not influenced by its use. ⋯ Retrospective case series, Level III.
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Arch Orthop Trauma Surg · Aug 2023
The effects of hypoalbuminemia in obese patients undergoing total joint arthroplasty.
Total joint arthroplasty (TJA) is a highly effective surgery. However, poor nutritional status has been associated with worse outcomes. In orthopedics, nutrition status is commonly evaluated using serum albumin. When albumin levels fall below 3.0 g/dL, wound healing ability becomes impaired. Typically, malnutrition is associated with low BMI, but malnourished patients can also be obese. The goals of this study were to investigate the relationship between malnourishment represented through albumin levels of obese patients and likelihood of postoperative complications. ⋯ Our results demonstrated the prevalence of malnutrition increases as a patient's BMI increases. Further, hypoalbuminemia was associated with increased resource utilization and increased complication rates in all obese patients. We suggest screening albumin levels in obese patients preoperatively to give surgeons the best opportunity to optimize patient nutrition before undergoing surgery.
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Arch Orthop Trauma Surg · Aug 2023
Clinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties.
In septic two-stage revision surgery, success depends on numerous factors. Key steps are the procedure of ex- and reimplantation and the choice of spacer in the interim phase. The latter is still a matter of debate. Recently, we showed the microbial non-inferiority of a spacer technique using prosthetic cemented implants with an individualized antibiotic mixture in the cement applying a mechanically inferior cementation method. The aim of the present study was to evaluate the clinical results of these spacers in view of either an endofemoral or a transfemoral procedure. ⋯ In this study, we were able to show good clinical results for the presented spacer technique. With no relevant difference in outcome, the decision for an endofemoral or transfemoral technique can be based on technical deliberations. Further prospective comparative studies are necessary to show the clinical benefit of this procedure.
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Arch Orthop Trauma Surg · Aug 2023
Two fingerbreadths, one finger's width: on the proximity of the radial nerve to the deltoid tuberosity.
The aim of this study was to find a convenient technique to evaluate the location of the radial nerve (RN) with reference to the deltoid tuberosity (DT). ⋯ This study provides an easily applicable technique to localize the RN with reference to the DT.