Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Sep 2024
Intraoperative fluoroscopic confirmation of the knee improves the accuracy of stem anteversion in total hip arthroplasty with direct anterior approach using traction table.
Stem anteversion (SA) in total hip arthroplasty (THA) is crucial for postoperative outcomes, affecting dislocation risk and hip function. Accurate SA placement is challenged by intraoperative estimation methods, with discrepancies reported between predicted and true SA. This study investigates the effect of conventional methods and intraoperative fluoroscopic confirmation on SA accuracy in THA performed with a direct anterior approach using a traction table. ⋯ Intraoperative fluoroscopic confirmation of knee external rotation angle markedly decreases the proportion of excessive SA and enhances the precision of stem placement in THA with a direct anterior approach. This technique represents a significant advancement in surgical practice, offering a simple and effective method to achieve optimal postoperative results.
-
Arch Orthop Trauma Surg · Sep 2024
Validation of a computerized model for a new biomechanical concept- the fossa-foveolar mismatch- the answer to lesions of the ligamentous fossa-foveolar complex in the hip?
Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the "fossa-foveolar mismatch" (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies. ⋯ The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.
-
Arch Orthop Trauma Surg · Sep 2024
Adverse events related to robotic-assisted knee arthroplasty: a cross-sectional study from the MAUDE database.
Robotic-assisted surgical technique has been clinically available for decades, yet real-world adverse events (AEs) and complications associated with primary knee arthroplasty remain unclear. ⋯ Our analysis shows that while reported AEs might be increasing for RAKAs, the overall rate remains relatively low. Reassuringly, device malfunction was the most commonly AEs observed, with a minor impact on postoperative outcomes. Furthermore, our data provide a benchmark for patients, surgeons, and manufacturers to evaluate RAKA performance, though continued improvement in reducing serious AEs incidence is warranted.
-
Arch Orthop Trauma Surg · Sep 2024
Treatment of anterior knee pain due to chondromalacia patellae with platelet-rich plasma and hyaluronic acid in young and middle-aged adults, a cohort study.
Anterior knee pain commonly affects young women resulting in the declination of the quality of life. One of the possible pathologies causing this symptom is chondromalacia patellae (CMP). Although CMP is used to describe the softening of patellar articular cartilage, it remains a general descriptive term as it cannot be associated with a specific pathophysiologic mechanism. The objective of this study is to investigate the effect of injectable PRP on patients with anterior knee pain in absence of altered patellofemoral joint anatomy. ⋯ The main results of this study affirm the positive effects of PRP and HA for the treatment of anterior knee pain described by previous research and the subsequent improvement of the quality of life. Relatively little information was found in the literature search regarding the therapeutic effects of PRP on anterior knee pain and chondropathies. While a previous radiologic study found no evidence regarding the effect of PRP, this study found a benefit when comparing PROMs between patient groups.
-
Arch Orthop Trauma Surg · Sep 2024
Influence of cartilage defects and a collagen gel on integrity of corresponding intact cartilage: a biomechanical in-vitro study.
Numerous cartilage repair procedures have been developed for focal lesions to minimize suffering and possibly prevent the development of osteoarthritis with a focus on so-called one-step procedures. The aim of this work was to investigate the effects of both focal cartilage defects and a biomaterial (ChondroFiller) on the corresponding articular cartilage. ⋯ Even focal grade IV cartilage lesions can lead to significant damage to the corresponding cartilage in vitro. The damage could not be reduced by the use of ChondroFiller, likely because of the initial instability of this biomaterial. Therefore, a biomaterial must be stable in the beginning with regard to full weight-bearing, or joint loading should be delayed until stable filling of the defect is achieved.