Archives of orthopaedic and trauma surgery
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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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Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients. ⋯ Beside angioembolization (AE) and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), pelvic packing PP (predominantly extraperitoneal) with direct access to the pelvic bleeding sources, are potential options. The present overview represents the present status, results and the value of pelvic packing in treating these patients. Interpretation of these results must consider the difference between the initial European concept of pelvic ring stabilization followed by PP in contrast to the North American concept with a reduced rate of pelvic ring stabilizations.
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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
Diabesity is associated with a worse joint specific functional outcome following primary total knee replacement.
The combined effect of diabetes mellitus and obesity (Diabesity) on total knee replacement (TKR) outcomes is unclear. This study aimed to assess whether diabesity influenced functional outcomes and complication rate following primary TKR. ⋯ Diabesity was independently associated with a worse knee-specific function and Eq. 5D score pre-operatively, and diminished joint specific functional improvement following TKR. Patients with diabesity also experienced reduced post-operative satisfaction due to obesity independently.
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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.