Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Nov 2024
Comparative StudyComparison of early outcomes of primary total knee arthroplasties performed using subvastus and medial parapatellar approaches and evaluation of quadriceps muscle elastography.
In primary total knee arthroplasty (TKA) surgeries, the medial parapatellar (MP) and subvastus (SV) approaches are frequently employed. The SV approach involves preserving the vastus medialis muscle, leading to debates about the possibility of earlier healing of the extensor mechanism. Shear wave elastography (SWE) is known for monitoring tissue healing. In this study, our research question revolves around whether there exist differences in tissue healing following MP and SV approaches. Unlike previous studies, we aim to investigate this difference using solely SWE, which provides a quantitative measurement specifically targeting the vastus medialis muscle. ⋯ Both MP and SV approaches demonstrate similar and favorable early outcomes in TKA surgery. The preservation of the vastus medialis in the SV approach does not lead to significant differences in clinical scores or muscle recovery compared to the MP approach.
-
Arch Orthop Trauma Surg · Nov 2024
Observational StudyEvolution and characteristics of nocturnal knee pain after knee arthroplasty.
Nocturnal knee pain and sleep disorders are two common but poorly studied issues contributing to dissatisfaction following knee arthroplasty. This study aims to evaluate the prevalence and associated factors of nocturnal pain and sleep disturbance in a population undergoing knee arthroplasty. ⋯ Bad sleeping quality is present in 54% of knee arthroplasty patients before and after surgery. Nocturnal pain is present in 39% of knee arthroplasty patients before surgery and this drops to 3% after one year. Nocturnal pain is associated with higher pain intensity, neuropathic symptoms, increased medication consumption and poor sleeping quality. Night pain disappeared faster after UKA than TKA, with a tipping point around 6 weeks postoperatively.
-
Arch Orthop Trauma Surg · Nov 2024
Three-dimensional acetabular reorientation during periacetabular osteotomy: an intraoperative navigation method using an external fixator for periacetabular osteotomy.
Bernese periacetabular osteotomy (PAO) is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection or changes in acetabular version resulting in residual dysplasia or femoroacetabular impingement. Thus, we wanted to develop a simple and straightforward navigation method that provides information about acetabular correction in all three planes during surgery. ⋯ Three-dimensional control of the acetabular orientation during periacetabular osteotomy is important to avoid over- and undercorrection. Using a fixateur externe as an analog navigation method this three-dimensional control can be implemented intraoperatively for PAOs.
-
Arch Orthop Trauma Surg · Nov 2024
Validation of the hip disability osteoarthritis outcome Score-12 shortform in a German cohort.
To consider the inherent respondent burden of PROMs, the HOOS-12 as a shortform of the well-established HOOS questionnaire has been published. While the HOOS-12 has been validated in an initial study, further evaluation in other, non-English speaking cohorts is necessary. We therefore aimed to evaluate responsiveness, convergent construct validity, internal consistency, and floor and ceiling effects of the HOOS-12 in a cross-sectoral german cohort. ⋯ The HOOS-12 showed good convergent construct validity and is responsive to changes in pain, function, QoL and hip impact between preoperatively and 1 year postoperatively. A substantial ceiling effect for all subscales at 1 year postoperatively limits the ability to capture variance across particularly well performing patients.
-
Arch Orthop Trauma Surg · Nov 2024
Diagnosis of periprosthetic loosening of total hip and knee arthroplasty using 68Gallium-Zoledronate PET/CT.
Periprosthetic loosening is a major complication after total hip and knee arthroplasty. Early and accurate diagnosis is essential to choose the right therapeutic path and to avoid further complications. The aim of the study was to evaluate the diagnostic performance of 68Gallium-Zoledronate ([68Ga]Ga-DOTAZol) PET/CT in detecting periprosthetic loosening in total hip (THA) and total knee arthroplasty (TKA). ⋯ The use of [68Ga]Ga-DOTAZol PET/CT in periprosthetic loosening is a remarkable diagnostic tool and a promising approach. In comparison to established radionuclide tracers, 68Gallium-Zoledronate offers notable advantages due to its availability via 68Ge/68Ga-generators, improving its potential for clinical application.