Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2024
Ilizarov fixator as salvage procedure after frustrating arthrodesis using intramedullary nailing - is there a chance of consolidation?
Arthrodesis of the tibiotalar and subtalar joints is a salvage procedure that has been used successfully for years. Treatment options include internal procedures and external procedures. Retrograde intramedullary nailing is considered a safe procedure with a high degree of stability and comfort. Nevertheless, there are cases in which this internal arthrodesis fails and another procedure must be considered. Ilizarov fixator treatment could be a solution for those patients in whom intramedullary nailing has failed. Even if it means another surgical revision - is it possible to finally achieve consolidation with this method? ⋯ If patients have undergone fusion of the tibiotalar and subtalar joints with a retrograde nail and this fails, it is difficult to achieve complete consolidation in the further course. A further attempt at arthrodesis using an Ilizarov fixator is possible, but the overall results are also poor. This procedure must therefore be seen as a last resort before amputation.
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Arch Orthop Trauma Surg · Nov 2024
Evaluation of a radiological grading system for the early detection of total knee arthroplasties at risk for revision surgery.
X-rays are regularly performed after primary total knee arthroplasty (TKA). While soft tissue management and ligament tension cannot be evaluated, important information, such as inadequate component positioning and loose cement location, as well as subsequent loosening, can be detected. The aim of this study was to correlate radiological findings, referring to the radiological grading system (previously published by the same study group, henceforth abbreviated as "RGS"), with long-term outcomes and implant survival. ⋯ Level IV - retrospective cohort study.
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Arch Orthop Trauma Surg · Nov 2024
A radiographic artificial intelligence tool to identify candidates suitable for partial knee arthroplasty.
Knee osteoarthritis is a prevalent condition frequently necessitating knee replacement surgery, with demand projected to rise substantially. Partial knee arthroplasty (PKA) offers advantages over total knee arthroplasty (TKA), yet its utilisation remains low despite guidance recommending consideration alongside TKA in shared decision making. Radiographic decision aids exist but are underutilised due to clinician time constraints. ⋯ The AI decision tool shows promise in identifying PKA candidates, potentially addressing underutilisation of this procedure. Its integration into clinical practice could enhance shared decision making and improve patient outcomes. Further validation and implementation studies are warranted to assess real-world utility and impact.
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Arch Orthop Trauma Surg · Nov 2024
Work productivity after periacetabular osteotomy was affected by preoperative progression of osteoarthritis and heavy workload.
Many patients who have undergone a periacetabular osteotomy (PAO) for developmental dysplasia of the hip (DDH) have had jobs preoperatively. Postoperative return to work and work productivity are important for livelihood security and the social economy. However, there is a lack of evidence on work productivity after PAOs. Therefore, this study investigated the return to work rates and influence of workload, clinical, and radiographic parameters on work productivity after a curved PAO. ⋯ Curved PAOs can improve postoperative work productivity and return to work rates. Preoperative progression of osteoarthritis and heavy workload affect postoperative work productivity.
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Arch Orthop Trauma Surg · Nov 2024
Accelerometer-based portable navigation system shows no superior accuracy over pelvic alignment guide for acetabular cup placement in total hip arthroplasty in lateral decubitus position.
Total hip arthroplasty (THA) using a portable navigation system (PNS) incurs costs per procedure. However, it does not require a large console. This study aimed to compare the accuracy of acetabular cup placement using a pelvic alignment guide (PAG) attached to the pelvis and an accelerometer-based PNS in THA performed in the lateral decubitus position. ⋯ The accelerometer-based PNS did not demonstrate superior cup alignment accuracy compared to the PAG in THA performed in the lateral decubitus position. This finding informs surgeons that computer-assisted surgery is not necessarily superior to conventional THA using a PAG.