Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Hip resurfacing: case closed? A bibliometric analysis of the past 10 years.
Hip resurfacing (HR) was introduced as a potential alternative to total hip arthroplasty (THA), indicated predominantly for younger, high demand patients. The modern metal-on-metal implant was popularized in the 1990s and early 2000s and promised greater wear resistance. However, its popularity waned due to increased rates of complications related to metal toxicity including pseudo-tumors as well as the recall of many resurfacing implants. The purpose of this study was to conduct a bibliometric analysis and investigate the current trends in hip resurfacing literature. ⋯ In conclusion, our bibliometric analysis allowed novel exploration and identification of the current research trends, contributions, and the distribution of publications exploring HR. The understanding of HR and the poor long-term outcomes of some resurfacing implants has improved significantly over the past decade, with the most recent focus on failure rates and long-term complications from metal debris. However, the breadth of literature has steadily declined in the past decade, and ultimately demonstrates the decline of scientific interest and focus on novel areas in hip resurfacing and a potential reached consensus.
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Arch Orthop Trauma Surg · Feb 2024
Biomechanical analysis of different THA cementless femoral stem designs in physiological and osteoporotic bone during static loading conditions.
The influence of THA stem design on periprosthetic femoral fractures (PFFs) risk is subject of debate. This study aims to compare the effects of different cementless stem designs on stress-strain distributions in both physiological and osteoporotic femur under various loading conditions. ⋯ In physiological bone, anatomical stems demonstrated stress distribution comparable to the native model. The double-wedge stem showed uneven stress distribution, which may contribute to long-term stress shielding. In the case of osteoporotic bone, the double-wedge stem design resulted in a significant increase in average stress during both gait and sideways falling, potentially indicating a higher theoretical risk of PFF.
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Arch Orthop Trauma Surg · Feb 2024
Preventing secondary screw perforation following proximal humerus fracture after locking plate fixation: a new clinical prognostic risk stratification model.
After locking plate (LP) fixation, secondary screw perforation (SSP) is the most common complication in proximal humerus fracture (PHF). SSP is the main cause of glenoid destruction and always leads to reoperation. This study aimed to identify independent risk parameters for SSP and establish an individualized risk prognostic model to facilitate its clinical management. ⋯ We developed and validated a visual and personalized nomogram that could predict the individual risk of SSP and provide a decision basis for surgeons to create the most optional management plan. However, future prospective and externally validated design studies are warranted to verify our model's efficacy.
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Arch Orthop Trauma Surg · Feb 2024
Primary arthrodesis versus open reduction and internal fixation following intra-articular calcaneal fractures: a weight-bearing CT analysis.
To compare primary arthrodesis (PA) versus open reduction and internal fixation (ORIF) in displaced intra-articular calcaneal fractures (DIACFs), based on clinical outcome and 2D and 3D geometrical analyses obtained from weight-bearing (WB) cone-beam CT images. ⋯ Three-dimensional WB CT imaging enables functional 2D and 3D analyses under natural load in patients with complex calcaneal fractures. Based on clinical outcome, both PA and ORIF appear viable treatment options. Clinical correlation with geometrical outcomes remains to be established.
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Arch Orthop Trauma Surg · Feb 2024
Demographic characteristics influencing the stem subsidence in total hip arthroplasty: an imaging study.
The present study evaluated whether patient demographic characteristics influence the subsidence of the stem in total hip arthroplasty (THA). The following characteristics were evaluated: age, height, weight, and sex. The association between the time elapsed from the THA implantation and the amount of stem subsidence was also investigated. ⋯ Stem subsidence in THA using cementless DePuy collarless Corail implants is approximately 2.6 mm after 14.4 months. Greater patient weight, age, and longer time elapsed from THA implantation were associated with greater stem subsidence. Patient height and sex did not demonstrate any influence on the amount of stem subsidence. These results must be considered in light of the limitations of the present study.