Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisRole of lateral soft tissue release in percutaneous hallux valgus surgery: a systematic review and meta-analysis of the literature.
It is unclear whether lateral soft tissue release (LSTR) is required as part of percutaneous hallux valgus (PHV) surgery. The primary aim of this systematic review was to assess whether LSTR reduces the risk of recurrence of hallux valgus deformity. The secondary aims were to assess if LSTR increases the risk of complications, improves the clinical outcome and leads to a greater radiographic correction. ⋯ Level IV systematic review of Level I to IV studies.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisDid the dislocation risk after primary total hip arthroplasty decrease over time? A meta-analysis across six decades.
While continuous optimization is attempted to decrease the incidence of dislocation after total hip arthroplasty (THA), dislocation remains a major complication. This meta-analysis aims to analyze the evolution of the dislocation risk after primary THA over the decades and to evaluate its potential publication bias. ⋯ The dislocation risk in THA has been decreasing over the past decades to 0.7%. Non-selective registry studies reported a higher dislocation risk compared to studies with selective cohorts and RCTs. This indicates that the actual dislocation risk is higher than often reported and 'real-world data' are reflected better in large-scale cohorts and registries.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisExtensor mechanism reconstruction with allograft following total knee arthroplasty: a systematic review and meta-analysis of achilles tendon versus extensor mechanism allografts for isolated chronic patellar tendon ruptures.
Extensor mechanism rupture is a severe complication with an incidence of 0.1-2.5% after total knee arthroplasty (TKA). Achilles tendon allograft (ATA) and extensor mechanism allograft (EMA) in TKA surgery have yielded mixed clinical results. Our systematic review aims to identify the proportion of failure in extensor mechanism reconstruction after TKA using allograft and evaluate clinical and functional outcomes and the most common complications. Furthermore, we performed a meta-analysis among studies dealing with isolated patellar tendon ruptures to assess the failure rate, surgical complications, and clinical findings (extensor lag and knee range of motion) of extensor mechanism reconstruction using either ATA or EMA grafts. ⋯ Level IV, therapeutic study.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisMonteggia fractures and Monteggia-like-lesions: a systematic review.
Monteggia injuries are rare, but severe injuries of the elbow including various injury patterns. Treatment of these injuries is still topic of debate and strategies differ widely. In this systematic review on Monteggia injuries in adults, we aimed to clarify the incidence of different injury patterns within Monteggia injuries, investigate the main reasons leading to revision surgery and explore which surgical treatments should be favored to achieve satisfactory clinical results. ⋯ Ulna non-union (28%) and limited range-of-motion (22%) are the main reasons for revision surgery. Meta-analysis shows a trend toward the use of locking plates for ulna fixation which may lead to less revision surgery and fewer ulna non-unions. Further biomechanical and clinical research is necessary to clarify the role of radial head surgery.
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Arch Orthop Trauma Surg · Jul 2023
Review Meta AnalysisImpact of concomitant upper-extremity injuries in patients with hip fractures: a systematic review and meta-analysis.
Combined hip and upper-extremity fractures raise clinical concerns because upper-extremity fractures may hinder early mobilization, thereby affecting rehabilitation and mortality. This systematic review and meta-analysis aimed to evaluate the effects of combined upper-extremity and hip fractures on rehabilitation and mortality. ⋯ III meta-analysis.