Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
ReviewLearning curve of total ankle arthroplasty: a systematic review.
Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evaluate the effect of a learning curve in total ankle arthroplasty outcomes. ⋯ This review finds a largely non-significant trend towards improvements in PROMs, complication, and revision rates with improved surgeon experience. The lack of statistical significance in a number of studies may be partially explained by methodological flaws, with more suitably designed studies reporting significant improvements. Future research into the effect of advancements in implant design and insertion guides is required to further characterise the magnitude of the learning curve and guide both mitigation and learning strategies.
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Arch Orthop Trauma Surg · Feb 2024
Observational StudyPostoperative cognitive dysfunction after beach chair positioning compared to supine position in orthopaedic surgery in the elderly.
Postoperative cognitive dysfunction (POCD) occurs in up to 26% of patients older than 60 years 1 week after non-cardiac surgery. Intraoperative beach chair positioning (BCP) is advantageous for some types of shoulder surgery. However, this kind of positioning leads to a downward bound redistribution of blood volume, with possible hypoperfusion of the brain. We hypothesized that patients > 60 years undergoing orthopaedic shoulder surgery in a BCP might experience more POCD than patients operated in the supine position (SP). ⋯ POCD at 1 week after surgery tended to occur more often in patients operated in beach chair position compared to patients in supine position without being statistically significant.
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Arch Orthop Trauma Surg · Feb 2024
Simplifying radiologic reports with natural language processing: a novel approach using ChatGPT in enhancing patient understanding of MRI results.
The aim of this prospective cohort study was to assess the factual accuracy, completeness of medical information, and potential harmfulness of incorrect conclusions by medical professionals in automatically generated texts of varying complexity (1) using ChatGPT, Furthermore, patients without a medical background were asked to evaluate comprehensibility, information density, and conclusion possibilities (2). ⋯ By using ChatGPT, MRI reports can be simplified automatically with consistent quality so that the relevant information is understandable to patients. However, a report generated in this way does not replace a thorough discussion between specialist and patient.
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Arch Orthop Trauma Surg · Feb 2024
Long-term clinical and radiological outcome of a cementless titanium-coated total knee arthroplasty system.
To ensure a high-quality standard, it is important to frequently evaluate different prostheses models to avoid prostheses with high failure rates. Thus, the aim of the study was to evaluate the long-term outcome of the uncemented titanium-coated total knee arthroplasty (TKA) system (Advanced Coated System (ACS) III, Implantcast, GERMANY). We hypothesized that the ACS III would have a similar performance as other cemented TKA systems. ⋯ Level III-Retrospective cohort study.
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Arch Orthop Trauma Surg · Feb 2024
Clinical outcomes following tibiotalocalcaneal arthrodesis with intramedullary nailing combined with partial fibulectomy and onlay bone graft.
Although intramedullary nailing is a popular method for tibiotalocalcaneal arthrodesis, nonunion is one of the most commonly reported complications. This study aimed to evaluate the fusion rate, improvement in functional outcomes, and occurrence of complications in tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing with partial fibulectomy and onlay bone graft technique. ⋯ Our technique of tibiotalocalcaneal arthrodesis with partial fibulectomy and onlay bone grafting could be a good option where both the tibiotalar and subtalar joints need to be fused.