Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2023
ReviewIndications and techniques for non-articulating spacers in massive bone loss following prosthetic knee joint infection: a scoping review.
Prosthetic joint infection (PJI) is a destructive complication of knee replacement surgery (KR). In two-stage revision a spacer is required to maintain limb length and alignment and provide a stable limb on which to mobilise. Spacers may be articulating or static with the gold standard spacer yet to be defined. The aims of this scoping review were to summarise the types of static spacer used to treat PJI after KR, their indications for use and early complication rates. ⋯ This study has summarised the large variety in static spacer constructs used for staged revision KR for PJI. Static spacers were associated with a high risk of complications and further work in this area is required to improve the quality of care in this vulnerable group.
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Arch Orthop Trauma Surg · Sep 2023
ReviewNonunion of the so-called acromion: a systematic review with consideration of the terminology.
There is no widely accepted standard for the classification and treatment of traumatic acromion/scapular spine fracture nonunion due to the scarcity of this condition and the confusion of terminology. ⋯ V.
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Arch Orthop Trauma Surg · Sep 2023
Observational StudyPost-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.
Optimized health system approaches to improving guideline-congruent care require evaluation of multilevel factors associated with prescribing practices and outcomes after total knee and hip arthroplasty. ⋯ In the present study, several patient-, care-, and hospital-level factors were associated with an increased probability of an opioid prescription refill within 30 days after arthroplasty. Future work is needed to identify optimal approaches to reduce unwarranted and inequitable healthcare variation within a patient-centered framework.
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Arch Orthop Trauma Surg · Sep 2023
Comparison of segmental lordosis gain of prone transpsoas (PTP) vs. lateral lumbar interbody fusion.
Lumbar interbody fusion is a standard method to treat certain degenerative conditions that are refractory to conservative treatments. LLIF reduces posterior muscle damage, can relieve neurological symptoms through indirect decompression, provides increased stability with its wider cages, and promotes more significant segmental lordosis than standard posterior techniques. However, the technique possesses its issues, such as unusual positioning, possible plexus-related symptoms, and median segmental lordosis correction. Trying to ease those issues, the idea of a prone transpsoas technique occurred. ⋯ The prone transpsoas approach can significantly enhance the correction of segmental lordosis proportionated to the traditional LLIF approach.
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Arch Orthop Trauma Surg · Sep 2023
Review Meta AnalysisModern implants in total knee arthroplasty are more patellofemoral joint friendly compared to their traditional design: a systematic review and meta-analysis.
Implant designs for total knee arthroplasties (TKA) are continuously evolving to improve outcomes and satisfaction rates after TKA. The present systematic review and meta-analysis aimed to explore the evidence in the literature regarding the outcomes of the Attune knee system over the PFC Sigma knee design and investigate the advantage of one over the other. ⋯ The present systematic review highlights better KSS and lesser chances of PF complications favouring a modern implant design over its traditional counterpart. Other patient-reported outcome analyses at a short-term follow-up period were comparable among patients undergoing total knee replacements with two different implant designs. Radiological outcomes for component positioning also suggested similar results among the two groups.