Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2024
Coxa valga and antetorta configuration leads to underestimation of the femoral component size: a matched case-control study of patients undergoing cementless total hip arthroplasty.
Total hip arthroplasty (THA) is the gold standard procedure for patients with end-stage osteoarthritis after failed conservative therapy. Digital templating is commonly employed in preoperative preparation for THA and contributes positively to its outcome. However, the impact of coxa valga and antetorta (CVA) configurations on stem size prediction accuracy remains not reported. Previous studies demonstrated that the size of the lesser trochanter (LT) can be used to determine femoral anteversion on pelvis radiographs. This study investigates the accuracy of preoperative digital templating in predicting stem size in patients with CVA undergoing cementless THA. ⋯ Stem size in patients with a CVA configuration are at high risk of being underestimated when using digital templating. These findings can be valuable for guiding in intraoperative decisions and lowering the risk of complications associated with an undersized femoral component.
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Arch Orthop Trauma Surg · Jun 2024
Long-term results of arthroscopic capsulolabral revision repair for failed anterior shoulder instability repair using suture anchors at a minimum of 10 years follow-up.
Arthroscopic revision anterior shoulder instability repair has been proposed, and early clinical results have been promising. However, long-term results after this procedure and the probable risk factors for failure have not been sufficiently discussed in the literature. ⋯ Long-term follow-up after ACRR shows predictable results, with a high degree of patient satisfaction, good to excellent patient-reported outcome scores and minimal radiological degenerative changes. However, with an average recurrence rate of 19.3% after 11.86 years, the redislocation rate appears high. With careful patient selection, recurrence rates can be significantly reduced.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyNew dynamic suture material for tendon transfer surgeries in the upper extremity - a biomechanical comparative analysis.
Early mobilization after tendon surgery is crucial to avoid commonly observed postoperative soft tissue adhesions. Recently, a new suture was introduced (DYNACORD; DC) with a salt-infused silicone core designed to minimize laxity and preserve consistent tissue approximation in order to avoid gap formation and allow early mobilization. ⋯ From a biomechanical perspective, DC preserved tissue approximation and might be considered as a valid alternative to conventional high-strength sutures in tendon transfer surgery. DC might allow for a shorter interweaving zone and a more aggressive early postoperative rehabilitation program, possibly avoiding commonly observed postoperative soft tissue adhesions and stiffness.
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Arch Orthop Trauma Surg · Jun 2024
The effect of a collar on primary stability of standard and undersized cementless hip stems: a biomechanical study.
Aseptic loosening and periprosthetic fractures are main reasons for revision after THA. Quite different from most other stem systems, Corail cementless hip stems show better survival rates than their cemented counterpart, which can possibly be explained by the use of a collar. The study aimed to investigate primary stability with standard and undersized hip stems both collared and collarless. ⋯ The key finding is that the collarless and collared Corail hip stems, within one stem size, showed no significant differences in primary stability. Undersized stems showed significantly higher micromotion in the distal area both with and without collar.
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Arch Orthop Trauma Surg · Jun 2024
Managing an epidemic within a pandemic: orthopedic opioid prescribing trends during COVID-19.
In response to the opioid epidemic, a multitude of policy and clinical-guideline based interventions were launched to combat physician overprescribing. However, the sudden rise of the Covid-19 pandemic disrupted all aspects of healthcare delivery. The purpose of this study was to evaluate how opioid prescribing patterns changed during the Covid-19 pandemic within a large multispecialty orthopedic practice. ⋯ During the Covid-19 pandemic opioid prescribing levels remained below historical averages. While continued efforts are needed to minimize opioid overprescribing, it appears that the significant progress made toward this goal was not lost during the pandemic era.