Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
An increased medial proximal tibial angle of greater than 95 degrees after opening wedge high tibial osteotomy is not associated with deterioration of minimum 10-year clinical outcomes.
The purpose of this study was to assess whether an excessively increased medial proximal tibial angle (MPTA) resulted in the deterioration of long-term clinical outcomes after opening wedge high tibial osteotomy (OWHTO) for patients with knee osteoarthritis (OA). ⋯ Increased MPTA > 95° after OWHTO is not associated with deterioration of minimum 10-year clinical outcomes.
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Arch Orthop Trauma Surg · Dec 2024
Short-term prediction of clinical and radiographic contralateral hip osteoarthritis after index total hip arthroplasty.
Patients with primary hip osteoarthritis undergoing unilateral total hip arthroplasty (THA) often face uncertainty about the future need for arthroplasty in the contralateral hip. We aimed to identify parameters that have predictive value with regard to the necessity for contralateral THA or the development of contralateral radiographic osteoarthritis (OA) phenotypes following index surgery. ⋯ Three factors - BMI, alpha angle, and osteophyte number - are key short-term predictors for contralateral THA after index THA. We also identified BMD as a surrogate for osteophyte formation. These findings provide novel and valuable insights for patients and surgeons regarding risks and counseling for contralateral OA and THA.
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Arch Orthop Trauma Surg · Dec 2024
Evaluating perioperative risks in total knee arthroplasty patients with normal preoperative cardiac stress tests.
While it is generally accepted that most patients undergoing joint replacement do not require a cardiac stress test, individuals with existing or potential cardiac conditions may be at an increased risk of perioperative complications following primary total knee arthroplasty (TKA). This study aims to analyze the immediate postoperative outcomes of patients who underwent primary TKA, comparing those who had a cardiac stress test with no abnormal results and subsequent cardiac interventions to those who did not undergo a stress test. ⋯ Level III: Case-control study or retrospective cohort study.
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Arch Orthop Trauma Surg · Dec 2024
A new classification system for distal clavicle fractures: based on fracture location and ligament integrity.
Although various classification systems have been introduced for the description of distal clavicle fractures, there is no consensus on the best classification system that is helpful in determining treatment and prognosis. The objective of this study was to establish a new classification system for distal clavicle fractures and to verify the reliability of the new classification system by evaluating the inter- and intraobserver agreement. ⋯ The new classification system which takes into account fracture location and ligament integrity brought few disputes in category division and treatment selection.
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Arch Orthop Trauma Surg · Dec 2024
Impact of the difference between preoperative planning and intraoperative femoral neck osteotomy level on stem alignment.
The combined anteversion theory is used for implant placement in total hip arthroplasty (THA). While majority of the research emphasizes the precise placement of the acetabular cup, there's less focus on stem alignment. This study aimed to investigate the impact of the discrepancy between the preoperatively planned femoral neck osteotomy level and the actual osteotomy level during surgery on stem alignment. ⋯ The study examined how differences in planned vs. actual femoral neck osteotomy affect stem alignment in THA using ACTIS stem and Taperloc stem. We found that osteotomy level influenced varus/valgus alignment; mildly affected flexion/extension; and had no effect on anteversion.