Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2025
What does the patients' perception of alignment tell us about alignment targets in total knee arthroplasty?
Knee alignment significantly impacts the outcome of total knee arthroplasty (TKA). Understanding patient perceptions of their knee alignment in relation to objective measurements is essential to ensure optimal surgical outcomes and to meet patients' expectations. This study reports patients' perception of pre- and postoperative knee alignment in relation to radiographic alignment measurements. ⋯ Patients predominantly desire a straight knee postoperatively, however, most patients tend to perceive some varus alignment as straight. This is most common in patients with up to 5 degrees of varus deformity and suggests that a restricted or inverse kinematic alignment with up to 5 degrees of varus can meet the expectations of most patients. In contrast, patients with valgus deformity are sensitive to any remaining valgus deformity and leaving the knees in more than 2 deg. of valgus will unlikely satisfy the patients' overall desire for a straight knee after surgery.
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Arch Orthop Trauma Surg · Jan 2025
Multicenter StudyPredictors of functional recovery following surgical repair of quadriceps tendon rupture: insights from a German multicentre study.
More extensive and cohesive studies on quadriceps tendon rupture (QTR) repair surgery are required to guide effective treatment strategies. Therefore, in this study, we aimed to identify predictors of subjective functional recovery following QTR repair surgery. ⋯ IV-Retrospective cohort study without a comparison group.
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Arch Orthop Trauma Surg · Jan 2025
Blood management protocol for baseline anemic patients undergoing hip arthroplasty.
Patients undergoing total hip arthroplasty (THA) with preoperative anemia are at higher risk for transfusion. Blood-conserving interventions can reduce perioperative transfusions. This retrospective study evaluates the efficacy and safety of a patient blood management (PBM) protocol in elective primary THA patients with preoperative anemia. ⋯ THA patients with baseline Hb < 12 g/dL had a zero-transfusion rate and significantly lower blood loss than those with Hb ≥ 12 g/dL. Optimizing preoperative Hb levels above 12 g/dL is not necessary for patients undergoing standard THA. Optimizing preoperative Hb may not be necessary for patients with baseline anemia due to their low blood loss. The PBM protocol was effective in conserving blood, time, and resources, offering a viable alternative for blood conservation in elective hip arthroplasty.
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Arch Orthop Trauma Surg · Jan 2025
Increased stiffness with medial column screw supplementation of lateral locking plate for distal femur fractures: a biomechanical study.
We propose and assess the biomechanical stability of medial column screw supplementation in a synthetic distal femur fracture model. ⋯ This is the first study to evaluate the contribution of a medial column screw in a distal femur fracture model. PWS had superior stiffness and few failures compared to PA. Applied clinically, a medial column screw can increase construct stability in the setting of complex distal femur fractures with minimal increase in operative time, patient morbidity and cost.
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Arch Orthop Trauma Surg · Jan 2025
Randomized Controlled Trial Comparative StudyContinuous local infiltration analgesia is equal to femoral and sciatic nerve block for total knee arthroplasty.
Total knee arthroplasty (TKA) is associated with moderate to severe postoperative pain. Pain control is crucial for rapid mobilisation and reduces side effects as well as the length of hospital stay. In this context, a variety of multimodal pain control regimes show good pain relief, including several nerve blocks, iPACK and local infiltration analgesia (LIA). To compare the analgesic potency of LIA and the combination of continuous femoral nerve block + sciatic single-shot nerve block under general anaesthesia, we conducted a prospective, randomized, controlled, non-blinded single-centre study. ⋯ Both techniques are well established, provide equal pain relief for TKA and support early postoperative mobilisation.