Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2024
Treatment of femoral neck fractures using actis stem: complication rate in 188 uncemented hemiarthroplasties.
Cemented hemiarthroplasty (HA) is preferred in treating dislocated femoral neck fractures in elderly, osteoporotic patients, since uncemented HA was associated with mechanical complications more frequently. Cementation can conversely cause cardiopulmonary complications, leading to demand on safe, uncemented implants addressing osteoporosis. This study is set up as a retrospective feasibility study on the use of an uncemented, collared wedge implant (Actis®, DePuy Synthes, Warsaw, IN), for HA in elderly patients, focusing on complication rate. ⋯ Our data provide proof of concept, that Actis® Stem allows an alternative, uncemented treatment option for displaced femoral neck fractures with HA. In case of preoperative or intraoperative medial cortical bone defects, stability of this implant is deteriorated.
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Arch Orthop Trauma Surg · Jun 2024
Long-term outcomes of the mayo conservative hip system in patients aged 30 years or less with osteonecrosis of the femoral head: mean follow-up of more than 10 years.
Historically, total hip arthroplasty (THA) in very young patients has been associated with lower survivorship. However, the long-term outcomes of THA using short stems for osteonecrosis of the femoral head (ONFH) in very young patients remain unclear. Therefore, this study aimed to investigate the long-term outcomes of the Mayo conservative hip system, a short metaphyseal stabilised stem, in patients with ONFH aged ≦30 years. ⋯ The use of short stems in patients aged ≤ 30 years with ONFH showed favourable long-term outcomes.
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Arch Orthop Trauma Surg · Jun 2024
Quality of cementing in hemiarthroplasty for elderly neck of femur fractures does not affect short term functional outcomes.
Cemented hip hemiarthroplasty is a routine surgical option for elderly neck of femur (NOF) fractures. It is uncertain if quality of cementing has any effect on functional outcomes. The aim of this study was to determine if the quality of cementing would affect short term functional outcomes in elderly neck of femur fractures. ⋯ Quality of cementing in cemented hip hemiarthroplasty for elderly NOF fractures does not affect the short-term functional outcomes. In low demand patients and patients at risk of BCIS, optimal cementing may not be necessary to achieve similar short-term functional outcomes. Further studies should be conducted to determine the effect of sub-optimal cementing on long-term functional outcomes.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyBiomechanical analysis of push-pull principle versus traditional approach in locking plates for proximal humeral fracture treatment.
Proximal humerus fractures are usually treated with locking plates, which could present recurrence, screw penetration, joint varization. The push-pull principle was introduced to prevent these risks and showed promising results; a dedicated design was then developed and this feasibility study aims to compare the biomechanical performances of such dedicated push-pull plate with the traditional locking plate using finite elements. ⋯ More homogeneous stress distribution is found with the push-pull plate in all three testing set-ups, showing lower unloaded areas (and thus lower stress-shielding) compared to the traditional plate; the screws implemented returned to be all loaded in at least one of the set-ups, thus showing that they all contribute to plate stability.
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Arch Orthop Trauma Surg · Jun 2024
The burden of knee osteoarthritis worldwide, regionally, and nationally from 1990 to 2019, along with an analysis of cross-national inequalities.
To describe the disease burden of knee osteoarthritis (KOA) globally, regionally, and in 204 countries by age, sex, and sociodemographic index (SDI) from 1990 to 2019, and to explore cross-national inequalities across SDI. ⋯ The global KOA burden has risen steadily between 1990 and 2019, and cross-national inequality gaps remain large. Targeted measures must therefore be taken to address this inequality and the increasing global KOA disease burden.