Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2020
Does the degree of osteoarthritis influence the clinical outcome after anatomic total shoulder arthroplasty?
The degree of preoperative osteoarthritis has been shown to influence the postoperative outcome and the patients' satisfaction rate in hip and knee joint replacement surgery. However, no corresponding information is available for total shoulder arthroplasty (TSA). We therefore set out to evaluate the influence of preoperatively measured end-stage osteoarthritis on the postoperative clinical outcome of TSA. ⋯ In contrast to hip and knee joint replacement procedures, a milder grade of osteoarthritis does not adversely influence the functional result or subjective satisfaction rate after TSA. The degree of osteoarthritis on conventional X-rays has no bearing on the postoperative clinical outcome. Therefore, the decision on when to carry out anatomic total shoulder arthroplasty should depend on the patient's pain level and loss of quality of life.
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Arch Orthop Trauma Surg · Nov 2020
Correlation of tibial component size and rotation with outcomes after total knee arthroplasty.
Tibial component design and positioning contribute more to patient satisfaction than previously realized. A surgeon needs to decide on the size and rotation, bearing in mind that coverage should be as high as possible, whilst malrotation and overhang should be avoided. No study investigates the impact of each of these components on clinical outcomes in a single cohort. ⋯ This study demonstrates the individual role of three aspects of tibial component implantation properties in postoperative pain and short-term functional outcomes. Upsizing to the point of overhang with rotational tolerance of 7° internal and 3° external to Insall's axis demonstrates best patient reported outcomes. Overhang decreases the clinical outcome by the same margin as loss of 16% of coverage.
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Arch Orthop Trauma Surg · Nov 2020
Clinical outcome and failure analysis of medial meniscus bucket-handle tear repair: a series of 96 patients with a minimum 2 year follow-up.
The failure rate of meniscal repair remains significant, especially for bucket-handle tears. This study aimed to evaluate the clinical outcomes, failure rate and risk factors for failure of bucket-handle medial meniscal tear repairs performed during ACL reconstruction. ⋯ Despite the fact that failure rate remains high for medial meniscus bucket-handle tears, suture repair of bucket-handle tears should be encouraged taking into account the long-term consequences of menisectomy.
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Arch Orthop Trauma Surg · Nov 2020
Clinical and radiological mid- to long-term results after direct fixation of posterior malleolar fractures through a posterolateral approach.
Direct fixation of posterior malleolar fractures has been shown to lead to higher accuracy of fracture reduction compared to an indirect anterior to posterior fixation but lacks long-term clinical results. This study shows the mid- to long-term clinical and radiological outcome after direct fixation of the posterior malleolus through a posterolateral approach. ⋯ Therapeutic Level IV. See Instructions for authors for a complete description of levels of evidence.
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Arch Orthop Trauma Surg · Nov 2020
Multiple drilling and multiple matchstick-like bone allografts for large osteonecrotic lesions in the femoral head: an average 3-year follow-up study.
We aimed to present the clinical outcomes of multiple drilling and multiple matchstick-like bone allograft for large osteonecrotic lesions of the femoral head as a joint-preserving surgery. ⋯ Multiple drilling and multiple matchstick-like bone allograft may be a useful treatment option for alleviating the symptoms in ONFH patients with large lesions who want to preserve their hips.