Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2024
Assessment of fatty infiltration of the hamstring muscles in chronic proximal hamstring ruptures and effect on clinical outcomes after surgical repair: a novel application of the Goutallier classification.
Increased time to surgery has been previously associated with poorer clinical outcomes after surgical treatment of proximal hamstring ruptures, though the etiology remains unclear. The purpose of this study was to evaluate whether degree of muscle atrophy, as assessed using the Goutallier classification system, is associated with worse outcomes following surgical treatment of chronic proximal hamstring ruptures. ⋯ The degree of atrophy was not found to be an independent predictor of clinical outcomes following repair of chronic proximal hamstring ruptures. Increasing age was significantly predictive of increased atrophy and poorer patient-reported outcomes.
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Arch Orthop Trauma Surg · Mar 2024
Comparative study of retrograde intramedullary nailing versus locking extramedullary plating in complete articular fractures with metaphyseal comminution of the distal femur.
Fractures of the distal femur with metaphyseal comminution and complete intra-articular involvement (AO/OTA classifications 33C2 and 33C3) present challenges for reduction and fixation. However, an optimal fixation method remains unknown. This study aimed to compare the clinical and radiographic outcomes of locking extramedullary plating (LEP) and retrograde intramedullary nailing (RIN) for complete distal femoral intra-articular fractures with metaphyseal comminution. ⋯ The surgical fixation methods, RIN and LEP, for complete distal femoral intra-articular fractures with metaphyseal comminution showed similar clinical and radiological outcomes. However, regardless of the type of fixation device used, there was a reduced rate of bone union owing to high energy and a less favorable prognosis.
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Arch Orthop Trauma Surg · Mar 2024
Impact of intra- and extramedullary alignment on blood loss in total knee arthroplasty: a retrospective study.
There is a scarcity of scientific data regarding the correlation between alignment techniques during total knee arthroplasty (TKA) and blood loss as well as transfusion rates. This study's hypothesis posited that intramedullary-aligned (IM) TKA exhibits higher blood loss and transfusion rates when contrasted with extramedullary-aligned (EM) TKA. ⋯ We observed no statistically significant variance in blood loss between the IM and EM groups. Likewise, there was no substantial disparity in transfusion rates between these groups. It can be concluded that the selection of a knee arthroplasty system incorporating either intramedullary tibial alignment or extramedullary alignment does not significantly impact blood loss.
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Systematic review and meta-analysis. ⋯ There is no evidence that CT has a benefit in patients with LSS, either alone or in combination with other treatments, or depending on the route of administration, according to the systematic review and meta-analysis of relevant RCTs.
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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.