Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Functional outcome after bicompartmental knee replacement for medial and patellofemoral osteoarthritis.
Total knee arthroplasty (TKA) is used for tricompartmental knee osteoarthritis, while unicompartmental knee arthroplasty (UKA) is preferred for unicompartmental knee osteoarthritis. Bicompartmental knee arthroplasty (BKA) aims to address 2 knee compartments by combining 2 UKA's or 1 UKA with a patellofemoral replacement. This study examines the clinical outcomes of BKA, focusing on pain alleviation and knee function. The aim of this study is to report the functional outcome of BKA and see if this aligns with BKA outcomes from literature in terms of patient reported outcome measurements (PROMs) and range of motion (ROM) after a 2-year follow-up. Additionally, radiographic alignment, implant survivorship, adverse events and length of stay are secondary outcomes. ⋯ BKA shows promise in alleviating pain and improving knee function in patients with medial and patellofemoral osteoarthritis. Challenges include the risk of revision and technical difficulties during surgery. Comparative studies suggest similar outcomes between BKA and TKA, with potential advantages for younger, more active patients. Further research, particularly randomized trials with larger cohorts, is necessary to elucidate the long-term benefits and drawbacks of BKA compared to other knee arthroplasty options.
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Arch Orthop Trauma Surg · Sep 2024
Specific tibial landmarks to improve to accuracy of the tibial cut during total knee arthroplasty. A case control study.
More personalized alignment techniques in total knee arthroplasty (TKA) have recently been described particularly for the young and active patients. Performing the ideal tibial cut might be challenging with a conventional ancillary. Therefore the aims of this study were: (1) to describe specific tibial landmarks to optimize the tibial cut in TKA; (2) to compare the accuracy of the tibial cut with these landmarks compared to a conventional technique. ⋯ IV.
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Arch Orthop Trauma Surg · Sep 2024
The unintentional effect of unicompartmental knee arthroplasty on extraarticular deformity and of high tibial osteotomy on intraarticular deformity for the treatment of anteromedial osteoarthritis.
Unicompartmental Knee Arthroplasty (UKA) and High Tibial Osteotomy (HTO) are two valid options in the treatment of Anteromedial Osteoarthritis (AMOA) of the knee with UKA being mainly performed in cases of Intraarticular deformity (IA) and HTO in cases of Extraarticular deformity (EA). The exact unintentional effect of UKA on EA deformity and HTO on IA deformity is still not well understood. The aim of this study was to assess this unintentional effect of UKA on EA and HTO on IA deformities respectively. ⋯ In addition to intraarticular varus correction, UKA can partly correct the extraarticular varus deformity in AMOA even when resurfacing is exclusively attempted. Additionally, intraarticular deformity can be also partially managed by HTO along with the extraarticular varus correction even without performing overcorrection.
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Arch Orthop Trauma Surg · Sep 2024
Lateral unicompartmental knee arthroplasty: is really a good option?
Lateral unicompartmental knee arthroplasties (LUKA) account for only < 1% of all knee arthroplasties and for only 5-10% of all unicompartmental knee replacements. This means that there is less published literature on these procedures and that the surgeon's experience with them is smaller than with medial UKA. The aim of this study was to analyze the survival and the clinical-functional outcomes of LUKA according to the type of bearing surface (all-polyethylene versus metal-backed) used. ⋯ LUKA is a valid and definitive option for patients with lateral tibiofemoral osteoarthritis, with a survival rate of > 95% at 5-years follow-up. Clinical-functional outcomes are the same, irrespective of the tibial component used.
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Arch Orthop Trauma Surg · Sep 2024
Case ReportsBilateral ST-coalition with thumb hypoplasia and scaphoid synchondrosis.
Carpal coalitions are rare wrist anomalies and are most often diagnosed incidentally. Due to their infrequent occurrence, there is a lack of treatment guidelines in the literature. We present a case study of a 13-year-old boy who presented with symptomatic synchondrosis in both scaphoids along with a bilateral osseous coalition between the scaphoid and trapezium bones in combination with bilateral thumb hypoplasia. We initiated a 10-week immobilization of the wrist, followed by gradual increasing weight-bearing. ⋯ For young patients, we suggest initiating conservative treatment as the first option. A precise analysis of the pathology and wrist kinematics is mandatory to recommend further therapy especially if operative interventions might be considered.