Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Is there an optimal perioperative risk assessment tool for older adult ankle fractures?
To measure the predictive value of three perioperative risk assessment tools (National Surgical Quality Improvement Program-NSQIP, Modified 5-factor Frailty Index-mFI-5, and Score for Trauma Triage in Geriatric and Middle Aged-STTGMA) in predicting postoperative complications in older adult ankle fractures. ⋯ NSQIP performed better than mFI-5, STTGMA, and CCI for postoperative complications and mortality, but none of the perioperative risk assessment tools performed exceptionally well in the context of isolated older adult ankle fractures.
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Arch Orthop Trauma Surg · Dec 2024
What are the risk factors and microorganism profiles of periprosthetic hip joint infections with a concomitant sinus tract?
A sinus tract, an abnormal channel between the skin and joint, is a major criterion that proves the presence of an underlying periprosthetic joint infection. Its presence not only increases failure rates but also leads to poor outcomes. Despite its clinical relevance, little is known about risk factors and underlying microorganism profiles. The aim of this study was to investigate PJIs of the hip with a sinus tract, identifying risk factors and microorganism profiles. ⋯ Microorganism profiles and risk factors differ significantly in patients with PJI of a THA with a sinus tract. These insights can help surgeons in planning and selecting appropriate antibiotics for cement loading and empiric antibiotic treatment, as well as in risk stratification of patients, who may develop a sinus tract following THA.
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Arch Orthop Trauma Surg · Dec 2024
Impact of femoral stem alignment on periprosthetic bone density in THA: a study of the Avenir Complete stem.
Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD. ⋯ The findings underscore the importance of accurate stem positioning in THA, particularly in avoiding varus malalignment and anteversion errors, as misalignment can adversely affect proximal femoral BMD and potentially lead to early stem loosening. This study enhances the understanding of the influence of the Avenir Complete stem on postoperative BMD, highlighting the need for precise alignment to optimize outcomes.
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Arch Orthop Trauma Surg · Dec 2024
A systematic review on revision total hip arthroplasty employing the direct anterior approach.
The increased use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has extended to revision THA. This systematic review evaluated studies reporting both the utility and clinical outcomes of revision THA using DAA, focusing on studies comparing revision approaches. ⋯ Current data on revision DAA THA are limited due to their retrospective nature. They demonstrate the ability to safely perform acetabular and head-liner revisions in carefully selected patients. Comparative studies lack femoral revisions, show a propensity for femoral fractures, and exhibit selection bias. Higher-quality, comparative prospective studies are needed.