Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2024
Review Meta AnalysisThe effect of intraoperative fluoroscopy on acetabular component positioning and patient anatomy restoration during posterior or posterolateral approach total hip arthroplasty: a meta-analysis.
Positioning implant components and restoring patient anatomy during total hip arthroplasty (THA) are essential for joint stability, polyethylene liner wear, and range of motion. Previous studies comparing intraoperative fluoroscopy with no fluoroscopy during the posterior or posterolateral approach have reported conflicting results. This meta-analysis evaluated if intraoperative fluoroscopy improves component positioning and femoral component position compared to no fluoroscopy during posterior or posterolateral approach total hip arthroplasty. ⋯ Even though intraoperative fluoroscopy was not related to an improvement in cup location or dislocation incidence. Our findings demonstrate that the restoration of leg lengths and femoral offset can be significantly improved by using intraoperative fluoroscopy to supplement good surgical skills in THA. The advantages of intraoperative fluoroscopy might become more apparent for surgeons with less experience. To ascertain whether intraoperative fluoroscopy for posterior or posterolateral approach total hip arthroplasty will have clinical benefits and improve the survival of prostheses, more well-powered and well-designed long-term follow-up studies were necessary.
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Arch Orthop Trauma Surg · Apr 2024
Review Meta AnalysisEffectiveness of lumbar braces after lumbar surgery: a systematic review and meta-analysis.
To systematically analyze the effectiveness of lumbar braces in patients after lumbar spine surgery. ⋯ Whether or not the use of lumbar braces after lumbar fixation has a negligible impact on clinical outcomes was studied. Subsequent studies could further demonstrate whether the use of lumbar braces after lumbar surgery could reduce the incidence of surgical site infections.
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Arch Orthop Trauma Surg · Apr 2024
Review Meta AnalysisFunctional alignment in robotic-assisted total knee arthroplasty: a systematic review.
The present study systematically reviewed current evidence on functional alignment (FA) in robotic total knee arthroplasty (TKA), discussing advantages and limitations, possible pitfalls, and prospects. ⋯ Level IV, systematic review and meta-analysis.
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Arch Orthop Trauma Surg · Apr 2024
ReviewFactors influencing periprosthetic bone mineral density in total knee arthroplasty: a systematic review.
Following total knee arthroplasty (TKA), there is a significant decline in periprosthetic bone mineral density (BMD), potentially resulting in complications such as prosthetic loosening, periprosthetic fracture, and influencing the postoperative recovery. The objective of this study was to summarize the factors influencing periprosthetic BMD in TKA from existing studies. ⋯ Mobile-bearing prostheses, modular polyethylene design, short stems, cruciform stems, avoidance of bone cement, higher body mass index, titanium nitride coating, and a smaller medial peg distance could potentially benefit periprosthetic BMD. Comprehensive consideration of diverse factors influencing periprosthetic BMD before surgery and collaboration with post-operative drug therapy are essential.
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Arch Orthop Trauma Surg · Apr 2024
Meta AnalysisRoutine pretransfusion testing before primary total hip or knee arthroplasty are an expensive and wasteful routine. Systematic review and meta-analysis.
The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to systematically review the literature regarding the necessity of routine pretransfusion tests before total hip arthroplasty (THA) or total knee arthroplasty (TKA) and summarize their outcomes. ⋯ Our study suggests that routine pre-transfusion testing for all patients undergoing primary THA or TKA may be unnecessary. We propose limiting pretransfusion test orders to patients with preoperative hemoglobin levels below 12 g/dl in unilateral primary TKA or THA. This targeted approach can result in significant cost savings for healthcare systems and transfusion services by reducing the over-ordering of pretransfusion tests in these surgical procedures.