Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2025
Meta AnalysisUnilateral versus bilateral pedicle screw fixation in minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis of randomized controlled trials.
The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) that adopts paramedian incisions and tubular retractors to perform the decompression and interbody fusion has been widely used in the surgery for lumber degenerative disease (LDD). Bilateral pedicle screw fixation (BPSF) and unilateral pedicle screw fixation (UPSF) are the primary fixing techniques in MIS-TLIF. We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the efficacy and safety between UPSF and BPSF in patients undergoing MIS-TLIF surgery for LDD. ⋯ UPSF is better than BPSF when operation time and estimated blood loss are considered. BPSF may be considered for patients with single-level LDD without high-grade spondylolisthesis.
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Arch Orthop Trauma Surg · Feb 2025
Comparative StudyComparison of clinical outcomes among patients treated with high tibial osteotomy and meniscal repair of degenerative medial meniscal tear with mild varus deformity.
The clinical benefits of high tibial osteotomy (HTO) in patients with mild varus deformity with degenerative medial meniscal tear (DMMT) remain unclear. This study aimed to compare clinical outcomes among middle-aged patients with mild varus deformity who underwent arthroscopic meniscal repair and HTO for DMMT. ⋯ Retrospective comparative study, Level III.
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Arch Orthop Trauma Surg · Feb 2025
Reliability and utility of the new Belt et al. classification for revision of infected total knee arthroplasty.
The frequency of revisions in total knee arthroplasty (TKA) is rising. Various classifications of bone defects exist, each with its own limitations. Recently, Belt et al. have proposed a new classification for TKA revisions based on X-ray imaging. We evaluated the Belt et al. classification and verified if this new classification is reliable, and if it correlates with the implant used during revision surgery for periprosthetic joint infection. ⋯ The Belt at al. classification is reliable, but a classification which can predict the implant neded have to be developed.
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Arch Orthop Trauma Surg · Feb 2025
No influence of patient age on operative treatment outcome of osteochondral lesions of the talus: data from the German Cartilage Registry (GCR, KnorpelRegister DGOU).
The influence of patient age on the clinical outcome of surgically treated osteochondral lesions of the talus (OCT) is controversial. Aim of this study was to evaluate the 24 months follow-up data of the German Cartilage Registry (KnorpelRegister DGOU, GCR) regarding the influence of patient age on clinical outcomes after surgical OCT treatment. ⋯ Results of surgical therapy of OCTs are independent from patient age. There is no superiority of a specific surgical technique depending on patient age.
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Arch Orthop Trauma Surg · Feb 2025
ReviewTraumatic lumbosacral instability: part 2-indications and techniques for surgical management.
Traumatic lumbosacral instability (TLSI) refers to a traumatic disruption of the axial skeleton at the level of the lumbosacral motion segment and/or sacrum, resulting in mechanical separation of the caudal spinal column from the posterior pelvic ring. Managing TLSI and its four underlying conditions poses unique challenges among spinal and pelvic injuries. This second part of a two-part series focuses on treatment strategies and decision making in TLSI, with an emphasis on surgical stabilization techniques. The primary objectives of this article are to: (1) elucidate factors influencing clinical decision-making, (2) synthesize current treatment options for the injury patterns underlying TLSI, and (3) briefly outline expected outcomes and complications.