Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2024
Periprosthetic joint infections in patients with rheumatoid arthritis are associated with higher complication and mortality rates.
Periprosthetic joint infection (PJI) remains the most devasting complication after total joint arthroplasty (TJA). There has been a significant focus on this topic in recently-published medical literature. However, relatively little has been published about PJI in patients with rheumatoid arthritis (RA), which are often physiologically frail and immunocompromised. A better understanding of PJI in this patient population is therefore crucial. The main aims of this paper are to (1) report complication and mortality rates in a cohort of PJI-RA patients; and (2) clinically characterize them. ⋯ A cohort level III retrospective study.
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Arch Orthop Trauma Surg · Mar 2024
Epiphyseal fixation in revision total knee arthroplasty: a comparison between trabecular metal and titanium augments.
The purpose of this retrospective study was to compare the medium-term clinical and radiographic outcomes of two series of patients treated for revision TKA: one implanted with trabecular metal (TM) augments and one implanted with classic titanium augments. ⋯ The use of TM augments directly screwed to the epiphysis of the femur and the tibia reduced the incidence of RLL compared to standard titanium augments during revision TKA with promising medium-term results.
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Arch Orthop Trauma Surg · Mar 2024
Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes.
Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs. ⋯ III.
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Arch Orthop Trauma Surg · Mar 2024
Favorable early outcomes of medial unicompartimental knee arthroplasty in active patients presenting a degenerative medial meniscus root tear with meniscal extrusion and mild radiographic osteoarthritis.
There is only limited literature available evaluating the preferable treatment for active mid-age or elderly patients presenting with a degenerative medial meniscus root tear (d-MMRT) with medial meniscal extrusion (MME) and early-phase radiographic osteoarthritis (OA), failing to provide solid evidence. The aim of this study was to evaluate early outcomes of medial unicompartimental arthroplasty (mUKA) in active patients presenting a d-MMRT with meniscal extrusion and mild radiographic OA of the knee. To prove this claim we hypothesized that (1) patients with a d-MMRT with initial grade 1-3 KL OA of the medial compartment of the knee present the same pre-operative symptoms as patients with an end-stage grade 4 K-L OA, and that (2) those patients with d-MMRT and low-grade OA achieve the same early clinical and functional outcomes when treated with mUKA compared to patients with end-stage medial OA. ⋯ Favorable early clinical outcomes were obtained after mUKA in active mid-age and elderly patients presenting with degenerative medial meniscus root tear and mild isolated medial OA. Patients with mild no bone-on-bone OA but with degenerative medial meniscus root tear and medial meniscal extrusion presented the same or worse pre-operative symptoms as patients with end-stage medial OA and benefit the same from mUKA.
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Arch Orthop Trauma Surg · Mar 2024
ReviewTotal knee arthroplasty survivorship and outcomes in young patients: a review of the literature and 40-year update to a longitudinal study.
Growing numbers of younger patients are electing to undergo total knee arthroplasty (TKA) for end-stage osteoarthritis. The purpose of this study was to compare established literature regarding TKA outcomes in patients under age 55, to data from an ongoing longitudinal young patient cohort curated by our study group. Further, we aimed to provide a novel update on survivorship at 40 years post-TKA from our longitudinal cohort. ⋯ Young TKA patients demonstrated improved functionality at each follow-up time point assessed. Survivorship decreased with increasing lengths of follow-up, ultimately ranging from 52.1-65.3% at 40 years post-TKA. The paucity of literature on long-term TKA outcomes in this patient population reinforces the necessity of further research on this topic.