Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2024
Knotless suture in revision total joint arthroplasty: a prospective randomized controlled trial.
The use of barbed sutures for wound closure in primary total joint arthroplasty (TJA) has been shown to be effective and safe. However, their effectiveness and safety in revision TJA procedures has not been thoroughly studied. This study aims to evaluate the efficacy and safety of using barbed suture closure in revision TJA setting. ⋯ I.
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A significant proportion of patients remain dissatisfied following total knee arthroplasty (TKA) surgery. Reasons for this are unclear. Contemporary implants seek to mirror innate anatomy. Such innovations are necessarily subject to scrutiny to validate their use. The Zimmer-Biomet Persona® Personalized Knee system is such an anatomic TKA. This work seeks to establish medium term survival data and patient reported outcomes for this implant. ⋯ We demonstrate excellent medium term survival of the Persona TKA in this large cohort, coupled with improvements in patient reported outcomes, range of motion and patient satisfaction at one year which compare favourably to other implants.
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Arch Orthop Trauma Surg · Mar 2024
Extended offset stems are infrequently required in anterior approach total hip arthroplasty and low usage does not compromise stability.
Extended offset (EO) stems are commonly used in posterior approach (PA) total hip arthroplasty (THA), but usage rates and complications are not well studied with anterior approach (AA) THA. This study evaluated usage rates, radiographic outcomes and complications following AA THA between patients receiving EO stems and a matched cohort receiving standard offset (SO) stems. ⋯ Prioritizing hip symmetry over stability results in a high proportion of patients achieving hip symmetry without high usage of EO stems in AA THA. Furthermore, low use of EO stems did not result in increased dislocations. Due to racial anatomical differences, Caucasian patients required EO stems to achieve hip symmetry more frequently than Asian and NHPI patients.
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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.