Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2024
Equivalent revision rates and patient reported outcomes with routine use of a short (125mm) cemented stem for total hip arthroplasty compared to a standard length (150mm) cemented stem. A two surgeon series of 1335 patients.
Routine total hip arthroplasty (THA) using a short cemented stem as compared with a standard length cemented stem may have benefits in terms of stress distribution, bone preservation, stem subsidence and ease of revision surgery. Two senior arthroplasty surgeons transitioned their routine femoral implant from a standard 150 mm Exeter V40 cemented stem to a short 125 mm Exeter V40 cemented stem for all patients over the course of several years. We analysed revision rates, adjusted survival, and PROMS scores for patients who received a standard stem and a short stem in routine THA. ⋯ Routine use of a short 125 mm stem had no statistically significant impact on revision rate or PROMS scores when compared to a standard 150 mm stem. There may be benefits to routine use of a short cemented femoral implant.
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Arch Orthop Trauma Surg · Apr 2024
Diagnostic power of ChatGPT 4 in distal radius fracture detection through wrist radiographs.
Distal radius fractures rank among the most prevalent fractures in humans, necessitating accurate radiological imaging and interpretation for optimal diagnosis and treatment. In addition to human radiologists, artificial intelligence systems are increasingly employed for radiological assessments. Since 2023, ChatGPT 4 has offered image analysis capabilities, which can also be used for the analysis of wrist radiographs. ⋯ Results demonstrate ChatGPT 4's good diagnostic accuracy (sensitivity 0.88, specificity 0.98, diagnostic power (AUC) 0.93), surpassing the medical student (sensitivity 0.98, specificity 0.72, diagnostic power (AUC) 0.85; p = 0.04) significantly. Nevertheless, the diagnostic power of ChatGPT 4 lags behind the hand surgery resident (sensitivity 0.99, specificity 0.98, diagnostic power (AUC) 0.985; p = 0.014) and Gleamer BoneView™(sensitivity 1.00, specificity 0.98, diagnostic power (AUC) 0.99; p = 0.006). This study highlights the utility and potential applications of artificial intelligence in modern medicine, emphasizing ChatGPT 4 as a valuable tool for enhancing diagnostic capabilities in the field of medical imaging.
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Arch Orthop Trauma Surg · Apr 2024
Factors affecting operating room scheduling accuracy for primary and revision total hip arthroplasty: a retrospective study.
Optimizing operating room (OR) scheduling accuracy is important for OR efficiency, meeting patient expectations, and maximizing value for health systems. However, limited data exist on factors influencing the precision of Total Hip Arthroplasty (THA) OR scheduling. This study aims to identify the factors influencing the accuracy of OR scheduling for THA. ⋯ This study highlights several critical patient, surgeon, and intraoperative factors influencing OR scheduling accuracy for THA. OR scheduling models should consider these factors to enhance OR efficiency.
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Arch Orthop Trauma Surg · Apr 2024
Study on impact of robotic-assisted orthopaedic industrial noise (SIREN).
The aim of this study was to evaluate noise exposure to the operating room staff consisting of the surgeon, assistant, anaesthetist and Mako Product Specialist (MPS) during Mako robotic-arm assisted total knee arthroplasty (TKA) and total hip arthroplasty (THA). We aimed to determine whether employees were exposed to noise at or above a lower exposure action value (LEAV) set out by the Noise at Work Regulations 2005, Health and Safety Executive (HSE), UK. ⋯ Operating room staff, particularly the primary surgeon and assistant are exposed to significant levels of noise during Mako robotic-arm assisted TKA and THA. Formal assessments should be performed to further assess the risk of noise induced hearing loss in robotic-arm assisted arthroplasty.
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Arch Orthop Trauma Surg · Apr 2024
Long-terms outcomes of radial head arthroplasty using a bipolar prosthesis.
In acute treatment of radial head fractures, a radial head prosthesis can be considered if open reduction and internal fixation are not technically feasible. ⋯ Bipolar radial head prostheses are an option for acute treatment of isolated unreconstructable radial head fractures. During follow-up, three patients required implant revision and removal; the capitellum surface presented severe degenerative changes and the prosthesis was not replaced. Another complication was the risk of implant dislocation, in relation to implant design, incorrect positioning of the radial head stem or else to inadequate reconstruction of the lateral collateral ligament. Further work is needed to establish the long-term follow-up results of Judet implants in complex elbow fractures.