Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Comparison of traditional PS versus kinematically designs in primary total knee arthroplasty.
Kinematically designed total knee arthroplasty (TKA) aims to restore normal kinematics by replicating the function of both cruciate ligaments. Traditional posterior-stabilized (PS) TKA designs, on the other hand, simplify knee kinematics and may improve TKA cost-effectiveness. The purpose of this study was to compare outcomes of patients who underwent primary TKA using either a traditional PS or kinematically designed TKA. ⋯ Retrospective study-III.
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Arch Orthop Trauma Surg · Aug 2023
A propensity score-matched analysis on the impact of patient and surgical factors on early periprosthetic joint infection in minimally invasive anterolateral and transgluteal total hip arthroplasty.
Increased risk of periprosthetic joint infection (PJI) in minimally invasive (MIS) total hip arthroplasty (THA) is still debated. This study aimed to identify differences in surgical and patient-related risk factors for PJI between an MIS anterolateral approach and transgluteal-modified Hardinge approach. ⋯ Minimally invasive anterolateral and transgluteal THA show a comparable rate of early PJI within the first year of index surgery. A BMI of ≥ 35 kg/m2 was detected as a clear risk factor for infection in the anterolateral approach. Prolonged operation time ≥ 121 min increases the risk of PJI regardless of approach.
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Arch Orthop Trauma Surg · Aug 2023
Identification of the joint line in revision total knee arthroplasty using a multiple linear regression model: a cadaveric study.
The results of revision total knee arthroplasty (rTKA) may be compromised by excessive joint line (JL) elevation. It is critical but challenging in reestablishing the JL in rTKA. Previous studies have confirmed that, biomechanically and clinically, JL elevation should not exceed 4 mm. Image-based studies described several approaches to locate the JL intraoperatively, however magnification errors could occur. In this cadaveric study, we aim to define an accurate and reliable method to determine the JL. ⋯ Compared to previous image-based measurements, the current cadaveric study most closely resembles a realistic view of intraoperative settings and could circumvents magnification errors. We recommend using Model 6, the JL can be best estimated by referencing the AT and the ATJL can be calculated as ATJL (mm) = 0.455*TEW (mm) + 1.440 (mm).
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Arch Orthop Trauma Surg · Aug 2023
A novel classification based on magnetic resonance imaging for individualized surgical strategies of lumbar disc herniation.
Although the anatomy and pathology of lumbar disc herniation (LDH) have been clearly defined and classified in many studies, its imaging definition and classification still needs further clarification. This study intends to propose a novel classification and individualized surgical strategy for LDH based on preoperative magnetic resonance imaging (MRI). ⋯ We proposed a novel classification system and an individualized surgical strategy for LDH based on preoperative MRI. Further, the surgical suitable interventions guided by this system achieved good clinical outcomes and mild recurrence rates.
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Arch Orthop Trauma Surg · Aug 2023
Impact of aberrant beam paths on antero-posterior shoulder radiographs in proximal humeral fractures.
Accurate radiographic assessment of proximal humeral fractures (PHF) is important as it influences clinical decision-making and predicts clinical outcome. Since aberrant radiographic views might influence the assessment of fracture displacement, it was the goal of this study to investigate the impact of aberrant beam paths on radiographic assessment of PHF. ⋯ Humeral angulation and offset measurements on AP radiographs are more susceptible to aberrant beam paths in fractured humeri. Altered radiographic beam paths around the vertical axis showed the most substantial influence on the assessment of PHF, with angular measurements demonstrating larger differences then offset measurements. Beam path alterations of 30° can influence the Neer classification, and might influence fracture displacement-based decisions.