Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2025
Presurgical anxiety and acute postsurgical pain predict worse chronic pain profiles after total knee/hip arthroplasty.
Total joint arthroplasties generally achieve good outcomes, but chronic pain and disability are a significant burden after these interventions. Acknowledging relevant risk factors can inform preventive strategies. This study aimed to identify chronic pain profiles 6 months after arthroplasty using the ICD-11 (International Classification of Diseases) classification and to find pre and postsurgical predictors of these profiles. ⋯ Most patients had low chronic pain severity at 6 months, but a relevant percentage exhibited poor outcomes. Membership to different outcome profiles was predicted by presurgical anxiety and acute postsurgical pain. These seem promising targets to prevent pain chronification that should be optimized for better surgical outcomes.
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Arch Orthop Trauma Surg · Jan 2025
Functional outcomes after ankle fracture-dislocation: a systematic review.
Ankle fractures represent a significant portion of orthopedic injuries, with fracture dislocations tending to have worse outcomes. Logsplitter fractures represent a subset of fracture dislocations in which the talus is axially wedged in the tibiofibular joint. We aim to comprehensively investigate and report on the complications and functional outcomes associated with ankle fracture-dislocations. ⋯ Ankle fracture-dislocations are high-energy injuries that affect a younger population compared to non-dislocated ankle fractures. Their functional outcomes resemble those of pilon fractures more than common ankle fractures. Logsplitter injuries are a subset of fracture dislocations that occur in even younger patients, with worse functional outcomes. This information can guide perioperative discussion and expectations for functional recovery. Additional studies are needed to evaluate the impact of these injuries on return to employment.
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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.
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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
Randomized Controlled Trial Comparative StudyA modified suture technique using polydioxanone (PDS II) for capsule closure in total knee arthroplasty: a prospective randomized study compared with traditional suture technique.
To describe and evaluate the modified suture technique using PDS II for capsule closure in Total knee arthroplasty. ⋯ The modified suture technique using PDS II appears to be a promising option for the capsule closure in TKA because it was associated with shorter surgical time, better water tightness, fewer wound see-page, shorter of hospitalization and relatively fewer complications.