Journal of orthopaedics最新文献

{"title":"Difficulty in bone union after arthrodesis to treat Charcot arthropathy of the foot and ankle","authors":"Mitsuru Hanada,&nbsp;Kensuke Hotta,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jor.2024.10.018","DOIUrl":"10.1016/j.jor.2024.10.018","url":null,"abstract":"<div><h3>Introduction</h3><div>A major complication of arthrodesis is non-union in patients with Charcot arthropathy. This study examined the bone union in joints affected arthrodesis for Charcot arthropathy of the foot and ankle.</div></div><div><h3>Methods</h3><div>The current retrospective study enrolled 15 patients (20 feet) who underwent arthrodesis (performed in 47 joints) for Charcot arthropathy from 2014 to 2020. Post-operative radiographs were classified based on the Brodsky anatomical classification system at 6 months, 1 year, and 2 years post-operatively. The association with pre-operative and intra-operative data was determined.</div></div><div><h3>Results</h3><div>Bone union was achieved in 28 % of patients at 6 months, 57 % at 1 year, and 66 % at 2 years post-operatively. The bone union rates according to the Brodsky anatomic classification at 6 months, 1 year, and 2 years were 50 %, 67 %, and 67 % for type 1; 20 %, 44 %, and 56 % for type 2; and 36 %, 86 %, and 86 % for type 3A, respectively. At 1 year after arthrodesis surgery, the odds ratio for non-union in Brodsky type 2 compared to that in type 3A joints was 8.727 (95 % CI: 1.623–46.935, <em>p</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>Arthrodesis procedures in joints affected by Charcot arthropathy, especially in Brodsky type 2 joints, should ensure perfect bone-to-bone fitting, good adaptation, sufficient bone grafting, and strong fixation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite element analysis of the Fibula's contribution to lower extremity torsional stiffness","authors":"Angelo Alito ,&nbsp;Andrea Vitali ,&nbsp;Antongiulio Bruschetta ,&nbsp;Elvira Maria Mantineo ,&nbsp;Vincenzo Filardi","doi":"10.1016/j.jor.2024.10.007","DOIUrl":"10.1016/j.jor.2024.10.007","url":null,"abstract":"<div><h3>Aims</h3><div>The purpose of this article is to investigate the effects of the fibula on the torsional stiffness of the lower limb. A comprehensive model of the lower limb was constructed, including the resected femur, patella, tibia, fibula, and foot, with tendons and ligaments. Two configurations were developed, with and without the presence of the fibula, to evaluate the resulting stress state and consequently determine the contribution of the fibula to the torsional stiffness of the lower limb.</div></div><div><h3>Methods</h3><div>The finite element method was used to analyse how the fibula affects the stress distribution in the lower extremity under body weight loading and torsional forces. A detailed three-dimensional solid model of the lower extremity with and without the fibula was constructed. Loading conditions were imposed simulating an axial compressive load of 700 N applied to the upper extremity of the resected femur and a torsional load of 6000 Nmm applied to the proximal femur, and a fixed constraint was imposed on the foot.</div></div><div><h3>Results</h3><div>Removing the fibula results in an increase in stress on all the tendons and ligaments tested. The increases ranged from 4 % (patellar tendon) to 21 % (lateral retinaculum). This suggests that the fibula plays a significant role in the distribution of mechanical stress in the lower extremity. The most affected structures are the lateral retinaculum and the posterior cruciate ligament, both with a 21 % increase in stress, suggesting that these structures may compensate more for the absence of the fibula.</div></div><div><h3>Conclusion</h3><div>The fibula plays a critical role in maintaining the structural integrity and biomechanical function of the lower extremity. It acts as a lateral strut, contributing to the stability of the ankle and knee by providing an attachment point for several muscles and ligaments that are essential for coordinating complex movements and providing stability during dynamic activities.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The performance of cruciate-retaining implants for primary total knee arthroplasty in valgus deformed knees: A systematic review","authors":"Peter A. Falgiano ,&nbsp;John J. Heifner ,&nbsp;Thomas O. Yergler ,&nbsp;Christopher Guerra ,&nbsp;Arturo Corces","doi":"10.1016/j.jor.2024.10.002","DOIUrl":"10.1016/j.jor.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Valgus deformity of the knee comprises upwards of 15 % of the deformities in primary total knee arthroplasty (TKA) patients. 1,2 The two implants most commonly used in valgus deformed knees are posterior stabilizing (PS) and cruciate-retaining (CR) implants. CR implants may offer a more advantageous construct due to the retention of the PCL for proprioception and less bony resection compared to PS implants. The purpose of this systematic review is to aggregate findings for cruciate-retaining implants used in primary TKA with valgus deformed knees.</div></div><div><h3>Methods</h3><div>In compliance with PRISMA guidelines, databases were queried for CR TKA studies which met the inclusion criteria. Cochrane ROBINS-I and the GRADE framework assessed bias and quality respectively.</div></div><div><h3>Results</h3><div>There was a statistically significant (p &lt; 0.001) difference between preoperative and postoperative valgus deformity as measured by tibiofemoral angle. The all-cause revision rate was 8.3 % in our sample of 710 total knee arthroplasties.</div></div><div><h3>Conclusion</h3><div>This review of the literature demonstrates that, although scarcely reported, cruciate-retaining implants used in primary total knee arthroplasties in valgus deformed knees provide satisfactory outcomes such as arc of motion and knee score. Our results demonstrate a significant increase in all-cause revision when using CR implants for valgus deformed knee. For this reason, further investigations should be conducted to evaluate modes of failure in this specific patient population.</div></div><div><h3>Level of evidence</h3><div>IV systematic review.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral column midfoot injury: Do they all need fixation?","authors":"Thomas R.W. Ward ,&nbsp;Khalis Boksh ,&nbsp;Grace Airey ,&nbsp;Darren Myatt ,&nbsp;Junaid Aamir ,&nbsp;James Chapman ,&nbsp;Htin Kyaw ,&nbsp;Lucky Jeyaseelan ,&nbsp;Lauren Greasley ,&nbsp;Isabella Drummond ,&nbsp;Mamdouh Elbannan ,&nbsp;Hiro Tanaka ,&nbsp;Jitendra Mangwani ,&nbsp;Lyndon Mason","doi":"10.1016/j.jor.2024.10.010","DOIUrl":"10.1016/j.jor.2024.10.010","url":null,"abstract":"<div><h3>Introduction/purpose</h3><div>Research on midfoot injuries have primarily concentrated on the central column and the Lisfranc ligament without amassing evidence on lateral column injuries. Classically lateral column injuries were treated with Kirschner wire fixation. Our aim was to analyse midfoot lateral column injuries and their methods of treatment.</div></div><div><h3>Methods</h3><div>Multicentre observational study. Data was retrospectively collected from three centres on surgically treated midfoot fracture dislocations between 2011 and 2021. Radiographs were analysed using departmental PACS. All statistics was performed using SPSS 26.</div></div><div><h3>Results</h3><div>A total of 409 surgically treated midfoot injuries were identified for further investigation. Following analysis, a total of 235 cases were diagnosed as having a lateral column injury, and 222 had data available for further analysis. All but 1 case (234, 99.6 %) of lateral column injury was associated with central column injury and 166 cases (70.6 %) were associated with medial column injuries.</div><div>There were 44 cases where the lateral column underwent Kirschner wire fixation, 23 lateral column plate fixations and 3 lateral column screw fixations. Most patients (147, 63 %) had no fixation for their lateral column injury with only 2.84 % losing alignment at subsequent follow up. The patients undergoing K wire fixation had a greater loss of alignment rate (5.88 %). The use of a bridge plate to fix the central column appears protective and purely ligamentous injury was a higher risk than an injury that included the bone.</div></div><div><h3>Conclusion</h3><div>Lateral column injury occur in over half of midfoot fractures in this study. It rarely occurs alone and is most commonly related to three column injuries. Nevertheless, following stabilisation of the central column, additional fixation of injuries to the lateral unlikely to be required in the majority of cases. In cases where lateral column stabilisation is required, plates and screws may be preferable to K wires.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total knee replacement in severe genu recurvatum. High prosthetic survival rate without deformity recurrence, using rotating hinge prosthesis.","authors":"Germán Garabano,&nbsp;Leonel Perez Alamino,&nbsp;Xavier Arturo Maya Nieto,&nbsp;Cesar Pesciallo","doi":"10.1016/j.jor.2024.10.008","DOIUrl":"10.1016/j.jor.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Genu recurvatum can originate from neurological and non-neurological causes. Its presence associated with knee osteoarthritis represents 1% of the causes of total knee replacement (TKR). The aim of this retrospective study was to show the functional outcomes, recurrence rate and prosthetic survival in patients with genu recurvatum treated with articulated rotating hinge prostheses.</div></div><div><h3>Methods</h3><div>between January of 2008 and December of 2021, we performed 3224 primary TKR, of which 34 (1%) had recurvatum. This was defined as hyperextension ≥10º. Inclusion crirteria were patients with primary TKR and recurvatum that were treated with a rotating hinge prosthesis (Endo Model, Walderman Link, Ham, Germany), and completed a minimum follow-up of 24 months. Final series consisted in 23 patients with 25 TKR with 15 (65.22%) females and a mean age of 66.8 ± 14.2 years old. The median follow-up was 5.0 (range 2.11 – 11.5). Clinical analysis was performed with the use of Knee Society Score (KSS) and Western Ontario &amp; McMaster Universities Osteoarthritis Index (WOMAC). Prosthetic survival rate was calculated with a Kaplan-Meier curve considering as the endpoint of the analysis revision due to any reason. Recurrence was defined as the presence of hyperextension ≥ 5º after surgery.</div></div><div><h3>Results</h3><div>of the 23 patients, 9 (39.13%) had history of neurological disorders. Median recurvatum observed was 20.12º (range 13.0º - 30.2º). A median of 19.6º (range 10.1º - 55.4º) valgus misalignment was observed in 19 patients and 10.7º (range 2.0 – 23.5º) of varus was observed in 6 (24%) patients. Clinical and functional KSS improved significantly after 12 months (from 34.2 ± 9.8 and 40.1 ± 12.6 to 82.1 ± 7.5 and 89.2 ± 6.8 respectively; p&lt;0.01) and at the end of the study (84.3 ± 7.5 and 90.0 ± 11.3; p&lt;0.01). Final mean WOMAC value was 24.1 ± 9.6. One (4.0%) complication was registered after surgery (superficial infection). Four (16.0%) patients had demarcation. Prosthetic survival rate was 100% at the end of the study.</div></div><div><h3>Conclusion</h3><div>The rotating hinge prosthesis restores joint function in patients with severe knee osteoarthritis with and without neurological disorders, without recurrence of misalignment and with excellent survival rates.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of silver-coated implants in periprosthetic infection prevention: A systematic review and meta-analysis","authors":"Halil Ibrahim Bulut ,&nbsp;Erhan Okay ,&nbsp;Enes Kanay ,&nbsp;Sefa Giray Batibay ,&nbsp;Korhan Ozkan","doi":"10.1016/j.jor.2024.10.009","DOIUrl":"10.1016/j.jor.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the implementation of numerous preventive measures in recent years, the persistent challenge of periprosthetic infections remains. Among the various strategies, metallic modification of implants, particularly with silver, has emerged as a promising avenue. Silver's antimicrobial properties, coupled with its low human toxicity, render it an appealing option. However, ongoing debate surrounds its comparative efficacy in infection prevention when contrasted with titanium-coated prostheses.</div></div><div><h3>Methods</h3><div>The PubMed database was systematically searched up to March 2024. Studies in English that met predetermined inclusion/exclusion criteria and utilized \"Megaprosthesis AND infection\" and \" silver-coated AND infection \" as key terms were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided the article selection process.</div></div><div><h3>Results</h3><div>From a pool of 1892 potential papers after literature screening, 11 studies with a total of 1419 patients were meticulously selected for analysis. Among these patients, 638 were treated with silver-coated implants, while 781 received titanium-coated implants, resulting in 166 recorded cases of infection. Remarkably, the infection rate stood at 9.2 % for the silver-coated group, contrasting with 13.4 % for the titanium-coated group. The subsequent analysis unveiled a notable discrepancy in proportions (P difference = −0.0473, 95 % CI: −0.088 to −0.006), signaling a statistically significant decrease in infections within the silver-coated cohort. Furthermore, the I2 statistic, denoting heterogeneity in effect sizes, stood at 21.8 % (95 % CI: 0.0–66.9), indicating a modest degree of variability among the studies. These findings offer compelling insights into the comparative effectiveness of silver-coated implants, suggesting their potential superiority in infection prevention.</div></div><div><h3>Conclusion</h3><div>In conclusion, our systematic review and meta-analysis shed light on the potential of silver-coated implants in mitigating periprosthetic infections. Despite the persistent challenge posed by such infections, our findings suggest a statistically significant decrease in infection rates among patients treated with silver-coated implants compared to those with titanium-coated ones.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of the Universal 2 total wrist arthroplasty","authors":"Alexander Tham,&nbsp;Andrew Ross,&nbsp;Jonathan Wright,&nbsp;David J. Martin,&nbsp;Marc Bransby-Zachary,&nbsp;Duncan J. MacDonald,&nbsp;John W. Kennedy","doi":"10.1016/j.jor.2024.10.004","DOIUrl":"10.1016/j.jor.2024.10.004","url":null,"abstract":"<div><h3>Aims</h3><div>The Universal 2 total wrist arthroplasty (TWA) aims to alleviate wrist pain and restore function. This study investigates the survival time, revision rate, complication rate, and performs radiological analysis on Universal 2 TWAs in the long term.</div></div><div><h3>Methods</h3><div>Forty-seven Universal 2 TWA in 45 patients were performed between 2006 and 2014. Patient satisfaction, DASH score, complications, revision rate and radiological analysis of the TWA were recorded.</div></div><div><h3>Results</h3><div>Mean follow-up was 11.7 years (range 2.5–17.6 years). There was significant improvement in post-operative DASH score (mean 58.3, SD 13) compared to preoperative DASH scores (mean 33, SD 20, p &lt; 0.001). At latest follow-up, 65 % of patients would undergo the procedure, a reduction from 87 % at mid-term follow-up. On radiological analysis, 26 wrists had lucencies of at least one component. Complications occurred in 18 wrists (38 %). Eleven TWA (23 %) were revised at a mean 7.3 years post-operation (range 2.0–13.7 years). Mean survival of the implant was 13.6 years (12.2–15.0 years 95 % CI). Kaplan-Meier analysis identified no significant differences in survivorship between inflammatory arthritis (13.2 years, 11.5–14.9 years 95 % CI) and osteoarthritis (12.9 years, 11.0–14.8 years 95 % CI, p = 0.39).</div></div><div><h3>Conclusion</h3><div>At long-term follow-up, the Universal 2 TWA can produce significant improvements in DASH scores and good satisfaction rates. However, a significant number of implants showed radiological loosening, with a high associated complication and revision rate. Patients should be adequately counselled on these risks pre-operatively.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical burden of venous thromboembolic events (VTEs) in contemporary total knee arthroplasties (TKAs) in US hospitals","authors":"Halil Ibrahim Bulut ,&nbsp;Maria Jose Maestre ,&nbsp;Daniel Tomey","doi":"10.1016/j.jor.2024.10.006","DOIUrl":"10.1016/j.jor.2024.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Total knee arthroplasty (TKA) is a highly demanded procedure in orthopedic surgery, with over 1.3 million joint arthroplasties performed annually in the U.S. The increasing need for TKAs is driven by an aging population, rising obesity rates, and advances in surgical techniques. Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), significantly impacts TKA patients' mortality and morbidity. Despite advances in prophylaxis and Enhanced Recovery After Surgery (ERAS) protocols reducing VTE incidence, survival rates have not markedly improved. This study aims to identify preoperative predictors of PE and DVT in TKA patients and examine their impact on hospital stays and mortality.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, focusing on 367,365 TKA patients from 2016 to 2021. Preoperative variables, including demographic factors, comorbidities, and functional status, were analyzed. Primary endpoints were PE and DVT predictors; secondary endpoints included 30-day mortality and prolonged hospital stay. Univariate and logistic regression analyses were performed using SPSS version 26.</div></div><div><h3>Results</h3><div>Univariate analysis revealed significant associations of male gender, older age, Hispanic ethnicity, smoking, dyspnea, CHF, and COPD with DVT and PE. Multivariate analysis confirmed female sex, younger age, Hispanic ethnicity, and COPD as independent DVT predictors, and independent functional status, smoking, COPD, CHF, and metastatic malignancy as PE predictors. VTE prevalence was 1.09 % (0.67 % DVT, 0.42 % PE), with PE associated with higher mortality (0.78 %) and prolonged hospital stays.</div></div><div><h3>Conclusion</h3><div>Demographic and clinical variables significantly influence VTE risk post-TKA. Tailored interventions and comprehensive preoperative assessments are crucial for optimizing patient outcomes and reducing thrombotic risks.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements of biomaterial in hip replacement technology incorporating ceramic materials","authors":"Zhijun Li","doi":"10.1016/j.jor.2024.09.021","DOIUrl":"10.1016/j.jor.2024.09.021","url":null,"abstract":"<div><div>The increasing prevalence of hip joint diseases is closely linked to improved living standards and an aging population, leading to a rise in conditions like degenerative arthritis and severe hip injuries. These conditions cause significant pain and functional impairments, greatly reducing the quality of life for affected individuals. Total hip arthroplasty (THA) has become a well-established surgical intervention to address these debilitating conditions. Within the realm of hip replacement materials, ceramics have garnered attention for their exceptional wear resistance and ability to minimize complications, such as bone dissolution caused by wear particles. Ceramics, such as alumina and zirconia, offer biocompatibility and low wear rates, making them favourable choices for hip prostheses. However, despite these advantages, the use of ceramics in hip replacements is not without challenges. Issues such as ceramic fragmentation and abnormal joint noise have been noted, posing significant obstacles to their widespread adoption. This review explores the advancements in hip replacement technology with a particular focus on ceramic materials. It delves into the properties that make ceramics suitable for this application, such as their biocompatibility and mechanical strength, enhanced through advanced manufacturing techniques. Additionally, the review addresses the ongoing challenges, including strategies to mitigate the risk of fragmentation through material toughening and improved prosthesis design. Furthermore, it examines the phenomenon of abnormal joint noise, proposing solutions that involve refinements in implant design, surgical techniques, and post-operative patient management. The aim of this review is to provide a comprehensive overview of current advancements and future directions in the use of ceramic materials in hip replacement technology, highlighting the potential for improved patient outcomes and the need for continued research and innovation in this field.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary ACL repair in a selected patient cohort: A prospective single cohort study","authors":"Ibtihal Al Kindi ,&nbsp;Salim Al Rawahi ,&nbsp;Ahmed Al Ghaithi ,&nbsp;Said Al Yarubi ,&nbsp;Sultan Al Maskari ,&nbsp;Mohammed Al Mutani","doi":"10.1016/j.jor.2024.09.020","DOIUrl":"10.1016/j.jor.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) tears are common knee injuries, particularly in physically active individuals. While ACL reconstruction (ACL-R) is the standard treatment, it has notable limitations. Recent interest in primary ACL repair offers a potential alternative, especially for specific tear types and patient demographics.</div></div><div><h3>Purpose</h3><div>To evaluate the outcomes of primary ACL repair in a selected patient cohort with strict inclusion and exclusion criteria, focusing on the survival of the procedure, functional outcomes, and factors influencing success rates.</div></div><div><h3>Methods</h3><div>This prospective single cohort study included 61 patients who underwent primary ACL repair between June 2016 and June 2022. Patients were 50 years or younger, with recent ACL injuries and no previous knee surgeries or multiligament injuries. The primary outcomes were the survival of the repair beyond two years, measured by revision rates, and functional outcomes assessed using the Lysholm knee score, Tegner activity scale, and Lachmeter stability measurements.</div></div><div><h3>Results</h3><div>Fifty-four patients completed a minimum follow-up of three years (average 49.6 months). The overall success rate was 82.2 %, with Sherman type 1 tears showing significantly fewer failures compared to type 2 (4.3 % vs. 31.8 %). The mean Lysholm score for successful repairs was 96, and the Tegner score dropped from a pre-injury average of 6 to 5. Adolescents had the highest failure rate (50 %), while other age groups showed better outcomes. The mean side-to-side difference in stability was 1.4 mm, favoring the control side.</div></div><div><h3>Conclusion</h3><div>Primary ACL repair is a viable option for selected patients, particularly those with Sherman type 1 tears. While age and tear type significantly affect outcomes, the procedure shows promising results with high functional scores in successful repairs. Further research with larger cohorts and extended follow-ups is necessary to validate these findings and refine patient selection criteria. Primary ACL repair offers a less invasive alternative to ACL reconstruction, with potential for comparable outcome.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}