Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
AI-based hip prosthesis failure prediction through evolutional radiological indices.
This study aimed to develop artificial intelligence models for predicting hip implant failure from radiological features. Analyzing the evolution of the periprosthetic bone and implant's position throughout the entire follow-up period has shown the potential to be more relevant in outcome prediction than simply considering the latest radiographic images. Thus, we investigated an AI-based model employing a small set of evolutional parameters derived from conventional radiological features to predict hip prosthesis failure. ⋯ The proposed predictor may represent a highly sensitive screening tool for clinicians, capable to predict THA failure with an advance between a few months and more than a year through only four radiological parameters, considering either their value at the latest visit or their evolution through time.
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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
Are Cutibacterium acnes delivered from skin to deep tissues in primary reverse shoulder arthroplasty? A prospective study.
The objective of this study is to determine whether the deep tissues are inoculated during surgery with the Cutibacterium acnes still present in the skin after the surgical preparation in reverse shoulder arthroplasties. ⋯ The C. acnes present in the skin at the beginning of the surgery are the same as those found in the deep tissues at the end of the surgery. This result strengthens the possibility that the C. acnes is delivered from the skin to the deep tissues.
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Arch Orthop Trauma Surg · Feb 2024
Radiographic evaluation of radial flexion osteotomy effect on static scapholunate instability: a preliminary cadaveric study.
The optimal treatment of chronic scapholunate instability has yet to be established. Scapholunate ligament grafts are still far from being the ideal solution. We conducted an experimental study to evaluate whether flexion-opening wedge osteotomy of the distal radius improves misalignment and avoids rotatory subluxation of the scaphoid in a cadaveric model of static scapholunate dissociative instability. ⋯ Flexion-addition osteotomy of the distal radius appears to improve carpal alignment parameters in a cadaveric model of static scapholunate instability, achieving similar values to those obtained before instability.
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Surgical treatment options for acromioclavicular joint separations are varied. Frequently, suspension devices (SD) are inserted for stabilization under arthroscopic view. This study investigates the feasibility and accuracy of three-dimensional (3D) digital-volume-tomography (DVT) C-arm navigated implantation with regard to the general trend toward increasingly minimally invasive procedures. ⋯ Intraoperative 3D DVT imaging of the shoulder joint using a mobile isocentric C-arm in the usual parasagittal position to the patient is possible. Likewise, DVT navigated SD implantation at the AC joint in CC and AC direction on a synthetic shoulder model. By combining both methods, the application in vivo could be possible. Further clinical studies on feasibility and comparison with established methods should be performed.