Archives of orthopaedic and trauma surgery
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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.
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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.
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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.
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Arch Orthop Trauma Surg · Nov 2024
The role of femoral head size in metal-on-metal hip arthroplasty: analysis of a cohort of 3813 patients with long term follow-up.
Metal-on-metal (MoM) large headed arthroplasties were suggested to decrease failure rates by means of reduced volumetric wear and enhanced implant stability. However, they caused high rates of revisions due to adverse reaction to metal debris, osteolysis, pseudotumor growth, and other issues. The study aims to present the long-term outcomes of MoM arthroplasties on a large cohort of patients, evaluating the impact of head sizes on survival rate. ⋯ Gender, patient's age and the use of modular neck were not correlated with higher failure rates. MoM implants implants do not have the same reliability as other couplings, considering the significantly greater failure/complication rates. However, the knowledge of risks linked to head size is fundamental for establishing the right type of follow-up to the patient and recognize any complications early.
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Arch Orthop Trauma Surg · Nov 2024
The role of MRI in the diagnosis of aseptic loosening following total hip arthroplasty.
The role of advanced imaging in diagnosing aseptic implant loosening following total hip arthroplasty (THA) remains unclear. This study aimed to assess the diagnostic value of magnetic resonance imaging (MRI) in detecting aseptic loosening. ⋯ III.