Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Multicenter StudyModified notching classification in inverted-bearing and conventional-bearing reverse total shoulder arthroplasty.
Scapular notching is a common complication of reverse total shoulder arthroplasty (RTSA). Although the notching rate has reduced significantly thanks to modifications to the surgical technique and humeral and glenoid components, uncontrollable polyethylene (PE)-induced osteolysis can still occur. In contrast to conventional-bearing (CB-RTSA), inverted-bearing RTSA (IB-RTSA) systems, with PE glenospheres and metal or ceramic humeral liners, avoid PE abrasion through scapulohumeral contact. If present, the resulting notch has a different size and configuration than with CB-RTSA. Thus, a modified notching classification seems reasonable. Even in CB-RTSA, the early stages of notching show a different configuration than implied by the established Nerot-Sirveaux classification; therefore, a modification of the classification system is recommended. ⋯ Level 4, Case Series, Treatment Study.
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Cartilage restoration or repair, also known as orthobiologic therapy, is indicated after the failure of conservative or supportive treatment. However, there is paucity in evidence supporting the efficacy of orthobiologic therapy. The blood-derived products, such as platelet-rich plasma (PRP), is one of the commonly used orthobiologic therapy for knee osteoarthritis. ⋯ However, ethical concerns and high costs remain major challenges associated with MSC therapy. Gene therapy, another promising orthobiologic therapy, is currently in phase II clinical trial and has shown promising results. The key factors for successful orthobiologic therapy include patient selection, appropriate dosing, treatment of underlying mechanical problems, age, severity, and cost-effectiveness.
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Arch Orthop Trauma Surg · Sep 2024
Randomized Controlled TrialAnimated video reduces pain and anxiety during pin removal in children with supracondylar humerus fractures: a randomized controlled trial.
The aim of this study; is to determine the level of pain and anxiety experienced by pediatric patients with operated humeral supracondylar fractures during pin removal, and to investigate the effectiveness of animated video impressions. ⋯ Watching an introductory animated video before pin removal is an effective method to relieve the anxiety and pain felt in children with supracondylar fractures.
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Arch Orthop Trauma Surg · Sep 2024
Increased rate of injuries to the anterior cruciate ligament in amateur soccer players after the COVID-19 pandemic lockdown.
The COVID-19 pandemic led to the discontinuation of soccer activities at all levels of play. Injuries to the anterior cruciate ligament (ACL) are still one of the most severe injuries in soccer. The aim of this investigation was to analyze the changes in the incidence and mechanism of ACL injuries in professional and amateur soccer before and after the lockdown period. ⋯ The absence from training and match practice in German soccer during the COVID-19 lockdown led to a significantly increased ACL injury rate in amateur leagues, while in professional and semi-professional soccer no differences were reported. The mechanism of ACL injuries did not change after the lockdown period. Level of evidence: II.
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Arch Orthop Trauma Surg · Sep 2024
Clinical and radiological outcome of acute quadriceps tendon repair at 2 - year follow-up.
Though previous studies on surgical quadriceps tendon repair reported good to satisfactory results its impact on knee extensor strength and patellofemoral joint is unknown. The purpose of the study was to assess the clinical and functional outcome by quantifying subjective knee related outcome, isokinetic extensor strength complemented by magnetic resonance imaging (MRI). ⋯ Distal quadriceps tendon repair leads to satisfactory subjective outcome in patients with low to moderate activity levels. Tendon integrity was reliably restored. However, extensor strength deficits remain in more than 40% of patients. Atrophy signs of advanced fatty infiltration were recorded in 15% and patellofemoral cartilage defects in 20% of all patients, indicating that previous assessment tools do not display functional outcome adequately.