International Orthopaedics最新文献

{"title":"Step-cut osteotomy for cubitus varus deformity with application of patient-specific instrument in children: a preliminary report.","authors":"An Yan, Xiaoqian Tan, Qian Tan, Weihua Ye, Jiangyan Wu, Haibo Mei, Guanghui Zhu, Han Xiao","doi":"10.1007/s00264-024-06268-4","DOIUrl":"10.1007/s00264-024-06268-4","url":null,"abstract":"<p><strong>Purpose: </strong>The step-cut osteotomy has been recognized as a valuable approach for addressing cubitus varus deformity, albeit one that necessitates technical proficiency. This study aims to evaluate the efficacy of the modified step-cut osteotomy technique in conjunction with patient-specific instruments by clinical and radiological assessment.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients who underwent modified step-cut osteotomy with the use of patient-specific instruments in conjunction with Kirschner wires fixation for the correction of cubitus varus deformity between April 2016 and April 2022. Follow-up was performed for a minimum of two years, during which pre-operative and post-operative clinical and radiological parameters were compared.</p><p><strong>Results: </strong>Fifteen patients were enrolled in this study. The mean pre-operative humeral-elbow-wrist (HEW) of the affected side was -21.7° (ranging from -14° to -34°), while the normal side was 9.4° (ranging from 5° to 15°). The post-operation HEW of affected side was 9° (ranging from 4° to 16°). There was no significant difference between the normal side and affected side after operation (p = 0.74). Pre-operative range of motion in the affected side was 130°, while the post-operative range of motion was 132°. Fourteen patients (93.3%) were pleased with the overall appearance of their elbow. None lazy-S deformity was observed in these cases. There were no major complications.</p><p><strong>Conclusion: </strong>The modified step-cut osteotomy technique, utilizing patient-specific instrument in conjunction with Kirschner wires fixation was found to be a safe, reliable, and technically easy procedure for correcting cubitus varus deformity.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status affects amputation and mortality rates in necrotizing fasciitis patients.","authors":"David Momtaz, David Heath, Abdullah Ghali, Hari N Krishnakumar, Rebecca J Schultz, Rishi K Gonuguntla, Christina Brady","doi":"10.1007/s00264-024-06266-6","DOIUrl":"10.1007/s00264-024-06266-6","url":null,"abstract":"<p><strong>Purpose: </strong>Necrotizing fasciitis (NF) is a rare, but rapidly progressing bacterial infection of the subcutaneous tissues and muscular fascia with high rates of morbidity and mortality. Our study aims to determine if socioeconomic status (SES) is a predictor of outcomes in NF.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients diagnosed with NF at our institution. Demographic information, insurance status, medical and surgical history, vitals, ASA score, blood laboratory values, surgical procedure information, and outcomes prior to patient discharge were collected. Patient zip codes were utilized to obtain median household incomes at the time of the patient's surgical procedure to determine SES. Patients without complete data in their medical record were excluded. Initial descriptive statistics and logistic regression models were performed.</p><p><strong>Results: </strong>We identified 196 patients (mean age 50.13 ± 13.03 years, 31.6% female) for inclusion. Mortality rate was 15.3% (n = 30) and 33.7% (n = 66) underwent amputation. Mortality rate was not significantly different across income brackets. Lower income brackets had higher rates of amputation than higher income brackets (p < 0.05). A logistic regression models showed the rate of amputation decreases by 29% for every $10,000 increment in median household income and ASA score decreased by 0.15 units for every $10,000 increase in median household income.</p><p><strong>Conclusions: </strong>Amputation rates in cases of NF are significantly higher in lower SES groups than higher SES groups. Patients with perivascular disease in lower SES groups were more likely to experience serious complications of NF than their counterparts in higher SES groups.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological profiles in periprosthetic joint infections after total knee arthroplasty: a comparative analysis of diabetic and non-diabetic patients.","authors":"Musa Ergin, Maximilian Budin, Sebati Başer Canbaz, Osman Ciloglu, Thorsten Gehrke, Mustafa Citak","doi":"10.1007/s00264-024-06275-5","DOIUrl":"10.1007/s00264-024-06275-5","url":null,"abstract":"<p><strong>Aim of the study: </strong>The purpose of this study is to conduct a comparative analysis of the microbiological profiles in periprosthetic joint infections (PJIs) after total knee arthroplasty (TKA) between diabetic and non-diabetic patients. The study aims to address what are the variations in microbial colonization and infection patterns between diabetic and non-diabetic patients undergoing total knee arthroplasty.</p><p><strong>Methods: </strong>A retrospective analysis of 2,569 culture-positive cases of PJIs post-TKA was conducted, comparing outcomes between diabetic (n = 321) and non-diabetic (n = 2,248) patients. Demographic, clinical, and microbiological data were collected and analyzed using descriptive statistics, chi-squared tests, logistic regression, and other statistical tests.</p><p><strong>Results: </strong>Diabetic patients exhibited distinct microbial colonization patterns, with a higher prevalence of pathogens such as Staphylococcus aureus (p = 0.033), Pseudomonas aeruginosa (p < 0.001), Streptococcus spp. (Streptococcus agalactiae and Streptococcus dysgalactiae; p = 0.010, 0.016 respectively), Candida spp. (p = 0.010), and Corynebacterium spp. (p = 0.024). Additionally, diabetic patients were at increased risk of polymicrobial infections. Comorbidities associated with diabetes, including chronic pulmonary disease, renal insufficiency, and peripheral artery disease, were significantly more prevalent in diabetic patients and further complicated PJI outcomes.</p><p><strong>Conclusion: </strong>This study underscores the importance of tailored perioperative antimicrobial strategies and vigilant infection control measures in diabetic patients undergoing TKA. Understanding the differential microbial profiles and associated comorbidities can inform targeted interventions to mitigate the risk of PJIs and improve outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and optimize management strategies for diabetic patients undergoing TKA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of radiological parameters with functional outcomes post fixation with proximal humerus locking plates.","authors":"Bhavya Mathur, Sundar Suriyakumar, Karthikeyan Manickam, Mohamed Sameer, J K Giriraj Harshvardhan","doi":"10.1007/s00264-024-06324-z","DOIUrl":"https://doi.org/10.1007/s00264-024-06324-z","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal humerus fractures account for 4-5% of all fractures in adults and affect females more than males. With the advent of special locking plates, the treatment trend has shifted more towards a surgical approach. These methods have produced good results but very high complications rates have been reported in the literature. This study was undertaken to analyse the radiological parameters which reflect towards a favourable long term functional outcome in order to advance the surgical fixation skills for managing fractures of the proximal part of the humerus.</p><p><strong>Materials and methods: </strong>83 study participants with proximal humerus fracture fixed using proximal humerus locking plates were retrospectively analysed. The radiological parameters studied were neck shaft angle, head shaft angle, head diameter, head height, greater tuberosity to articular surface distance and reduction of the medial hinge with or without placement of calcar screw. The functional parameters assessed were the Constant Murley Score and range of movements of the shoulder joint. The patients were not followed further for the purpose of the study.</p><p><strong>Results: </strong>The mean Constant Murley Score for the participants was 80.75 ± 8.09 (range 60-90). The participants with good to excellent CM Score had a significantly higher neck shaft angle (107.47 ± 9.74 v/s 124.16 ± 10.68) and (-0.28 ± 0.85 v/s 2.37 ± 2.28), head shaft angle (23.09 ± 4.82 v/s 31.76 ± 7.76), head diameter (40.08 ± 8.63 v/s 45.15 ± 4.73), head height (18.77 ± 1.96 v/s 20.69 ± 2.76) and greater tuberosity to articular surface distance (-0.28±0.85 v/s 2.37±2.28) as compared to the patients with satisfactory and worse CM Score. The patients with a higher neck shaft angle and a maintained subacromial space had a better range of shoulder abduction. A higher rate of valgus collapse was seen with an inadequate medial hinge reduction.</p><p><strong>Conclusion: </strong>The radiological parameters which can predict towards a good functional outcome are a higher neck shaft angle and head shaft angle, a larger head diameter and head height, a superior position of the greater tuberosity in relation to the articular surface and a good medial hinge reduction.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of Botulinum Toxin in Tennis Elbow: a meta-analysis of randomized clinical trials.","authors":"Eduardo Silva Reis Barreto, César Romero Antunes Júnior, Vinícius Borges Alencar, Márcio Passos Leandro, Luiz Marcelo Bastos Leite, Liliane Elze Falcão Lins-Kusterer, Durval Campos Kraychete","doi":"10.1007/s00264-024-06339-6","DOIUrl":"https://doi.org/10.1007/s00264-024-06339-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the efficacy of botulinum toxin type A (BT-A) in treating tennis elbow.</p><p><strong>Methods: </strong>We systematically reviewed the literature and included full-text randomized clinical trials (RCTs) published until June 2024, available in PubMed, Scopus, Embase, and Cochrane CENTRAL databases. Eligible studies involved patients with tennis elbow and compared BT-A with placebo or other injectable treatments. Primary outcomes included pain relief, while secondary outcomes assessed quality of life, adverse effects, and grip strength. The risk of bias was evaluated using the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>Seven RCTs with a total of 381 patients were included. The participants were predominantly middle-aged (mean age 46.64 ± 7.72 years) and diagnosed with chronic tennis elbow. BT-A doses ranged from 20U to 60U. Compared to placebo, BT-A effectively reduced pain at two to four weeks (MD = -1.37; 95% CI = -2.18 to -0.57) and at eight to 12 weeks (MD = -1.13; 95% CI = -1.62 to -0.65). Grip strength was comparable between the BT-A and placebo groups at both time points (2 to 4 weeks: SMD = -0.86; 95% CI -1.78 to 0.05; 8 to 12 weeks: SMD = 0.00; 95% CI = -0.95 to 0.95).</p><p><strong>Conclusion: </strong>This meta-analysis suggests that BT-A reduces pain in tennis elbow within two to 12 weeks compared to placebo. Findings are limited by study size, and further research is needed to confirm its efficacy and safety.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer modeling and validation testing for glenoid component rotation and optimal glenoid screw angles for reverse shoulder arthroplasty in an Asian population.","authors":"Shun Sing Martin Cheng, Colin Shing-Yat Yung, Samuel De Hoi Wong, Christopher Chun Hei Yip, Issac Jun Ren Khoo, Tsoi Wan Karen Wong, Christian Fang","doi":"10.1007/s00264-024-06340-z","DOIUrl":"https://doi.org/10.1007/s00264-024-06340-z","url":null,"abstract":"<p><strong>Purpose: </strong>Good initial fixation of glenoid component for reverse total shoulder arthroplasty (RTSA) relies on component placement and screw purchase in the scapula bone. This is especially difficult in an Asian population with small glenoid geometry. Optimal glenoid component roll angle and screw angulation to achieve the longest screws for best fixation has not been defined in the current literature.</p><p><strong>Methods: </strong>Computer 3D modelling of 133 scapulas with RTSA performed were analyzed to determine patient specific optimal glenoid roll angle (GRA) for the longest bi-cortical screws attainable. The cranial-caudal angle (CCA), anterior-posterior angle (APA) and lengths for the superior and inferior screws were measured. Validation testing using calculated average (CA) angles and rounded average (RA) angles to the nearest 5 degree were recomputed for each case to determine the bi-cortical screw lengths achievable. The CA and RA screw lengths were compared against patient specific modelling using paired-sample t-tests.</p><p><strong>Results: </strong>Average GRA was - 1.6°, almost perpendicular to the long axis of the glenoid and achieves an average bi-cortical screw length of 51.3 mm and 45.5 mm for the superior and inferior screws respectively. The CCA and APA were 9.1° cranial and 6.5° posterior for the superior screw and screw angulation of 11.2° caudal and 0.7° anterior for the inferior screw. Validation testing shows statistically shorter screw lengths in the CA and RA models compared to patient specific modelling (p < 0.01).</p><p><strong>Conclusion: </strong>Validation testing with average angles for GRA, CCA and APA demonstrates strong patient heterogeneity and anatomical variation. Despite this, screw lengths attainable in the RA group were > 38 mm with good safety profile. Surgeons may consider the additional use of navigation-assisted, or 3D printed patient specific instrumentation to optimize baseplate and screw configuration for RTSA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of patellar morphology on clinical outcomes after unicompartmental knee arthroplasty.","authors":"Ying-Jin Sun, Ning Liu, Long Huang, Xiang-Yang Chen, Cheng Li, Shuo Feng","doi":"10.1007/s00264-024-06336-9","DOIUrl":"https://doi.org/10.1007/s00264-024-06336-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the influence of patellar morphology on functional outcomes and patellofemoral joint alignment after unicompartmental knee arthroplasty (UKA).</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical and imaging data of 207 patients with osteoarthritis of the unicompartment of the knee who underwent UKA between September 2020 and April 2023. Patients were divided into three groups according to the Wiberg classification: group W1 (I, n = 47), group W2 (II, n = 117), and group W3 (III, n = 43). Knee function was assessed using the Hospital for Specialty Surgery (HSS) knee score and Feller patellar score, and the incidence of anterior knee pain after surgery was recorded and compared. Imaging parameters such as patellar tilt angle (PTA), lateral patellofemoral angle (LPA) and Insall-Salvati ratio (ISR) were measured to assess patellofemoral joint alignment.</p><p><strong>Results: </strong>The HSS scores of the three groups were not statistically different; the postoperative Feller scores of the group W3 differed significantly from those of the other two groups. The incidence of early postoperative anterior knee pain was higher in the group W3 than in the other two groups. The difference between preoperative PTA, postoperative PTA and preoperative LPA in the group W3 and the other two groups was statistically significant.</p><p><strong>Conclusion: </strong>Patients with Wiberg III patellae exhibited worse patellar scores, as well as more anterior knee pain and patellar tilt postoperatively. This finding highlights the need for individualized treatment to the Wiberg III patella during UKA to enhance surgical outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study on anterior pelvic plating and pubic ramus screw fixation for straddle fracture: a matched-pair outcome analysis.","authors":"Yong-Cheol Yoon, Joshua A Parry, Cyril Mauffrey","doi":"10.1007/s00264-024-06338-7","DOIUrl":"https://doi.org/10.1007/s00264-024-06338-7","url":null,"abstract":"<p><strong>Purpose: </strong>Straddle fractures involving both the superior and inferior rami often require surgical fixation due to instability. This study compared the clinical and radiological outcomes of pubic ramus screw fixation (PRSF) and anterior pelvic plating (APP) for the treatment of these fractures to identify the superior method.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 70 patients (37 males, 33 females; average age 47.6 years) treated surgically for straddle fractures at two Level 1 trauma centres between May 2017 and August 2022. The patients were divided into two groups, where 26 underwent PRSF and 44 underwent APP. The groups were matched based on preoperative characteristics such as age, sex, body mass index, injury mechanism, and severity. The key variables analysed included operation time, blood transfusion volume, early weight-bearing capability, and complication and reoperation rates.</p><p><strong>Results: </strong>After matching, PRSF was associated with a shorter operative time (71.0 min vs. 118.3 min for APP, p < 0.0009) and lower blood transfusion requirements (0 units vs. 1 unit, p < 0.0001). Postoperatively, 61.5% of PRSF patients tolerated early weight-bearing, compared to none in the APP group. However, in two cases, PRSF could not be performed due to severe comminution or anatomical limitations, necessitating conversion to APP. Complication rates were similar between the groups (30.8% for PRSF vs. 27.3% for APP, p = 0.93).</p><p><strong>Conclusion: </strong>PRSF demonstrated advantages, such as shorter operative time, reduced blood transfusions, and earlier weight-bearing. However, APP remains valuable for complex fracture patterns. Treatment should be individualized based on fracture complexity and patient-specific factors to optimize outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age, activity, and native femoral offset are associated with articular noise in ceramic on ceramic total hip arthroplasty (THA) with custom stems.","authors":"Idriss Tourabaly, Cyril Courtin, Elodie Baraduc, Alexis Nogier","doi":"10.1007/s00264-024-06299-x","DOIUrl":"https://doi.org/10.1007/s00264-024-06299-x","url":null,"abstract":"<p><strong>Purpose: </strong>To report the prevalence of articular noise following total hip arthroplasty (THA) with custom stems and ceramic-on-ceramic (CoC) bearings, to determine the risk factors for articular noise, and the effect of articular noise on quality of life (QoL).</p><p><strong>Methods: </strong>A consecutive series of uncemented primary THAs using custom stems implanted between 01/02/ 2014-01/04/2017 were evaluated. The cohort comprised 479 patients (529 hips, 301 males and 228 females), aged 55.9 ± 11.6 with a BMI of 25.8 ± 4.3 kg/m². Postoperative assessment included Oxford hip score (OHS), forgotten joint score (FJS), and a dedicated questionnaire on articular noise. Descriptive statistics were used to summarise the data. Regression analyses were performed to study factors associated with presence of noise.</p><p><strong>Results: </strong>At a minimum follow-up of five years, 431 patients (476 hips) were available for postoperative assessment. OHS was 45.3 ± 6.1, FJS was 83.6 ± 24.7, and 69 patients (71 hips, 15%) reported articular noise. The impact of noise on QoL was 1.4 ± 2.1. Multivariable analyses confirmed that the presence of articular noise was associated with younger age (OR,0.95; 95%CI,0.93-0.97; p < 0.001), smaller native femoral offset (OR, 0.95; 95%CI,0.90-1.00;p = 0.034), as well as intense (OR, 3.15; 95%CI, 1.15-9.79; p = 0.033) and very intense physical activity (OR, 4.71; 95%CI, 1.52-16.15; p = 0.009).</p><p><strong>Conclusion: </strong>The prevalence of articular noise following primary THA with custom stems and CoC bearings was 15%, but the impact of noise on QoL was minimal for most patients. Younger, highly active patients should be advised of an increased likelihood of noise from CoC THA, particularly if they have low native femoral offset on preoperative imaging.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-vascularized coracoid process autograft for glenoid reconstruction in revision shoulder arthroplasty.","authors":"Jean-Gabriel Delvaque, Mohamad K Moussa, Efi Kazum, Carlos Murillo, Philippe Valenti","doi":"10.1007/s00264-024-06296-0","DOIUrl":"https://doi.org/10.1007/s00264-024-06296-0","url":null,"abstract":"<p><strong>Purpose: </strong>To report the radiological and clinical outcomes of non-vascularized coracoid process autografts used for glenoid reconstruction during revision shoulder arthroplasty.</p><p><strong>Material and method: </strong>This is a retrospective, monocentric study from January 2016 to October 2022 targeting patients treated with a coracoid bone graft for glenoid reconstruction during revision of shoulder arthroplasty. The primary outcome measures were coracoid graft union rate and graft-implant osseointegration. Secondary outcome measures included clinical and CT-scan identified radiological complications and functional outcomes as measured by the Visual Analog Scale (VAS), Range of Motion (ROM), Subjective Shoulder Value (SSV), Constant score (absolute and ponderate), and ASES score.</p><p><strong>Results: </strong>Fifteen patients (9 males, 6 females; mean age 66.9 years, range 38-85) were included. At a mean follow-up of 20.9 months (range 12-56 months), 93.3% achieved complete graft integration. One case of partial lysis without baseplate loosening was noted. Regarding range of motion, the mean forward elevation was 130° (range 90°-170°), external rotation at the side 25° (range 10°-40°), external rotation in 90° of abduction 45° (range 10°-80°), and internal rotation 52° (range 10-80°). The mean VAS for pain was 1.1 (range 0-8), mean SSV 67.3% (range 40-90%), mean ASES score 85.5 (range 65-98.3), mean Absolute Constant score 58.6 (range 21-83), and mean Ponderate Constant score 77.5% (range 28.8-110.7%). No neurological injuries were reported.</p><p><strong>Conclusion: </strong>Utilizing a non-vascularized coracoid graft during shoulder arthroplasty revision is a safe, reproducible, and time-efficient technique that demonstrated satisfactory osseointegration, implant stability, good functional results, and a low complication rate.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}