Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2025
ReviewPrecision medicine in diagnosis, prognosis, and disease monitoring of bone and soft tissue sarcomas using liquid biopsy: a systematic review.
Liquid biopsy as a non-invasive method to investigate cancer biology and monitor residual disease has gained significance in clinical practice over the years. Whilst its applicability in carcinomas is well established, the low incidence and heterogeneity of bone and soft tissue sarcomas explains the less well-established knowledge considering liquid biopsy in these highly malignant mesenchymal neoplasms. ⋯ This systematic literature review provides an extensive up-to-date overview about the current and potential future uses of different liquid biopsy modalities as diagnostic, prognostic, and disease monitoring markers in sarcoma.
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Arch Orthop Trauma Surg · Jan 2025
ReviewIndications for the addition of a patellofemoral joint arthroplasty following a previous unicondylar knee arthroplasty- a literature review and Delphi consensus.
The aim of this study was to establish an international consensus statement on the indications for the addition of a patellofemoral joint arthroplasty (PFJA) in patients with a unicondylar knee arthroplasty (UKA) and symptomatic progression of patellofemoral compartment osteoarthritis. ⋯ The simple addition of a PFJA to patients with an existing UKA and progression of patellofemoral compartment osteoarthritis is an attractive option. This EKS Delphi-derived consensus statement, which reached a strong consensus, can be used by clinicians to identify patients suitable for this procedure.
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Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. ⋯ Particular attention must be given to the preoperative evaluation of both the iliosacral and transsacral corridors, as anatomical variations may restrict the available space for screw insertion. This review aims to highlight the essential aspects of sacroiliac osteosynthesis, with a focus on the critical role of thorough preoperative planning and its impact on achieving successful surgical outcomes.
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Arch Orthop Trauma Surg · Jan 2025
Comparative StudyDifferential effects of tibia varus deformity on clinical outcomes following high tibial osteotomy and unicompartmental knee arthroplasty for moderate medial compartment osteoarthritis with moderate varus alignment.
There is a lack of clinical evidence supporting the decision-making process between high tibial osteotomy (HTO) and unicomparmental knee arthroplasty (UKA) in gray zone indication, such as moderate medial osteoarthritis with moderate varus alignment. This study compared the outcomes between HTO and UKA in such cases and assessed the risk factor for not maintaining clinical improvements. ⋯ Tibial varus deformity differentially affects clinical outcomes after HTO and UKA in moderate medial compartment osteoarthritis with moderate varus alignment. Clinicians should consider the deformity's origin when selecting treatment for this patient, as certain combinations (HTO without tibia vara and UKA with tibia vara) are associated with increased risk of not maintaining mid-term clinical improvements.
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Arch Orthop Trauma Surg · Jan 2025
Percutaneous hallux fusion with calcaneus bone autograft: a retrospective cohort study of clinical and radiographic outcomes.
In the case of end-stage hallux rigidus, first metatarsophalangeal (MTP) joint arthrodesis is the gold-standard and is traditionally performed via an open approach. However, complications such as nonunion have been reported to be as high as 30%. Recently, there have been reports demonstrating a percutaneous approach to be effective and safe. ⋯ Observed union rate is comparable to the average fusion rate previously reported for open and minimally invasive procedure union rates. Mean time to union was observed to be comparable to open procedures union time. Observed overall complication rate is similar to those reported for open techniques as well. Patient reported outcomes demonstrated a significant reduction in postoperative VAS and FFI for the percutaneous metatarsophalangeal arthrodesis with calcaneus bone autograft. Patient satisfaction rates compared favorably to those reported following open surgery.