Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2013
Review Meta Analysis Comparative StudyTotal knee replacement following high tibial osteotomy versus total knee replacement without high tibial osteotomy: a systematic review and meta analysis.
Currently, there is no consensus as to whether total knee replacement(TKR) following high tibial osteotomy(HTO) provides similar postoperative outcomes as compared to TKR without previous HTO. Previous studies have provided limited evidence to small sample sizes and methodological inappropriateness. ⋯ Systematic review and meta analysis suggested that TKR following HTO provides similar outcomes as compared to TKR without previous HTO. Therefore, a previous HTO does not negatively influence a future TKR, though the conversion process of HTO to TKR is technically challenging. Systematic review also identified paucity in prospective and long term studies.
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Arch Orthop Trauma Surg · Sep 2013
Review Meta AnalysisMalposition and revision rates of different imaging modalities for percutaneous iliosacral screw fixation following pelvic fractures: a systematic review and meta-analysis.
Percutaneous iliosacral screw placement following pelvic trauma is associated with high rates of revisions, screw malpositioning, the risk of neurological damage and inefficient stability. The correct entry point and the small target corridor may be difficult to visualize using only an image intensifier. Therefore, 2D and 3D image-based navigation and reconstruction techniques could be helpful tools. The aim of this systematic review and meta-analysis was to evaluate the best available evidence regarding the rate of malpositioning and revisions using different techniques for screw implantation, i.e., conventional, 2D and 3D image-based navigation and reconstruction techniques, CT navigation. ⋯ CT navigation has the lowest rate of screw malposition, but on the other hand it could not be used for all type of fractures where surgical procedures (reduction maneuvers, additional osteosynthetic procedures) are necessary. The 2D and 3D image-based navigation and reconstruction techniques provide encouraging results with slightly lower rate of complications compared to the conventional technique and are additional tools to enhance the precision and decrease the rate of revision.
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Arch Orthop Trauma Surg · Jul 2013
Meta AnalysisDo we really need tranexamic acid in total hip arthroplasty? A meta-analysis of nineteen randomized controlled trials.
Studies have shown that tranexamic acid reduces blood loss and transfusion need in patients undergoing total hip arthroplasty. However, no to date, no study has been large enough to determine definitively whether the drug is safe and effective. We examined whether intravenous tranexamic acid, when compared with placebo, was safe and effective in total hip arthroplasty. ⋯ The data from this meta-analysis indicate that intravenous tranexamic acid may reduce blood loss and transfusion need in patients undergoing total hip arthroplasty without increasing the risk of complications. However, high-quality randomized controlled trials are required to validate the results.
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Arch Orthop Trauma Surg · May 2013
Meta AnalysisRisk factors for deep infection after total knee arthroplasty: a meta-analysis.
Estimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence. ⋯ There were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.
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Arch Orthop Trauma Surg · Jan 2013
Review Meta AnalysisVascularized fibular grafts in patients with avascular necrosis of femoral head: a systematic review and meta-analysis.
Vascularized fibular grafting (VFG) has been initiated to treat avascular necrosis of the femoral head (ANFH) since the late 1970s. There are a number of review articles updating the use of VFG to treat the ANFH. None of them applied statistical analysis for combining results from different studies to obtain a quantitative estimate of the overall effect and potential harm of VFG in comparison to other treatment. ⋯ VFG is a justified method that can prevent the ANFH from progressing to collapse, and that can retard or avoid hip replacement, especially in the hips of Steinberg stage I, II, and III.