Journal of orthopaedics最新文献

{"title":"The effect of adductor canal block on outcomes of total knee arthroplasty: A single centre, historical cohort study","authors":"Tania Elhage ,&nbsp;Matthew C. Lyons ,&nbsp;Justin P. Roe ,&nbsp;Luc Nguyen ,&nbsp;Lucy J. Salmon ,&nbsp;Ben Olesnicky","doi":"10.1016/j.jor.2024.12.008","DOIUrl":"10.1016/j.jor.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Adductor canal blocks (ACBs) have been associated with reduced pain following total knee arthroplasty (TKA). There is a paucity of evidence regarding whether these early differences impact longer term outcomes. This study aimed to identify whether using ACB in TKA was associated with improvements in both early and late outcomes.</div></div><div><h3>Methods</h3><div>Patients who underwent a unilateral TKA between 2021 and 2022 were retrospectively assessed for pain scores, time to first mobilization and opioid use over the first 72 h. At 6 weeks, complications, pain scores and opioid use were assessed. At 12 months validated patient reported outcome measures (PROMs) and patient satisfaction with their surgery were assessed.</div></div><div><h3>Results</h3><div>262 unilateral TKA, of whom 129 received ACB (ACB group) and 133 did not (control group) were assessed. The ACB group had significantly lower median day 1 pain (median difference −0.44 (−0.09 to −0.79), p = 0.015). There was no significant difference between groups for pain after 24 h, time to mobilization or opioid use over 72 h. There was no significant difference in pain (p = 0.892), opioid use (p = 0.913) or complications (p = 0.348) at 6 weeks, or median change in PROMs (p = 0.436 and p = 0.307), opioid use (p = 0.187), or satisfaction with surgery (p = 0.262) at 12 months.</div></div><div><h3>Conclusion</h3><div>ACBs were associated with a clinically insignificant difference in median pain on day 1. there was no association with pain after 24 h, opioid use, time to mobilization or longer term outcomes. Our findings do not support the use of routine ACB during TKA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 31-35"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971265","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":"Meta-analysis of complications and functional outcomes in cosmetic limb lengthening","authors":"Halil Bulut ,&nbsp;Omer Altin ,&nbsp;Irem Salduz ,&nbsp;Ahmet Salduz","doi":"10.1016/j.jor.2024.12.012","DOIUrl":"10.1016/j.jor.2024.12.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Short stature, defined as height below the 3rd percentile for age and gender, affects approximately 200 million people worldwide. It can have profound psychological effects, influencing self-esteem, social interactions, and overall life satisfaction, particularly during adolescence. These individuals often face challenges in both professional and romantic lives, increasing their risk of depression and suicidal ideation. Surgical interventions such as limb lengthening can provide life-changing results for individuals facing psychological distress due to short stature. This meta-analysis reviews the literature on cosmetic stature surgery, focusing on Paley outcomes and psychosocial satisfaction, and compares external fixation (EF) and intramedullary nailing (IMN) techniques.</div></div><div><h3>Methods</h3><div>This study adhered to PRISMA guidelines. Eligibility criteria included studies with more than five patients, the use of the Paley classification for outcome assessment, and a focus on cosmetic limb lengthening with either EF or IMN. Data from PubMed were extracted using standardized forms and analyzed for complication rates, functional outcomes, and psychosocial satisfaction. The Paley complication system categorized problems, obstacles, and complications, and risk of bias was assessed using the STROBE checklist. Data synthesis was performed using JAMOVI software with effect size and confidence interval calculations.</div></div><div><h3>Results</h3><div>Seven studies were included, with a total of 489 patients undergoing EF or IMN for cosmetic limb lengthening. Procedure-related mortality was zero across all studies. EF was associated with higher rates of Paley problems (56 %), obstacles (48 %), and complications (10 %) compared to IMN, which had 37 % problems and 42 % obstacles, with no significant complications reported. Patient satisfaction was generally high, with EF studies reporting satisfaction rates of up to 95 %.</div></div><div><h3>Conclusion</h3><div>EF and IMN are both viable options for cosmetic limb lengthening. While EF may present more complications, it maintains high patient satisfaction, whereas IMN offers a safer profile with fewer complications. A collaborative approach, combining surgical options with psychosocial and psychiatric support, can help individuals achieve improved physical and emotional well-being.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 41-45"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971343","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":"Is calcification integral to enthesopathy and tendinopathy rather than a separate disease process?","authors":"Amin Razi ,&nbsp;David Ring","doi":"10.1016/j.jor.2024.12.011","DOIUrl":"10.1016/j.jor.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>The pathophysiology of enthesopathy and tendinopathy is mucoid degeneration, which includes chondroid metaplasia. The chondroid metaplasia can be associated with calcification. Inflammation is typically absent unless calcification triggers a self-limited immune response representing acute calcific tendinitis. It is therefore important to address the hypothesis that calcific deposits within various entheses and tendons throughout the body are an inconsequential epiphenomenon of enthesopathy and tendinopathy and do not merit a distinct diagnosis or specific treatment.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Web of Science for studies that address the prevalence of calcium in tendons and entheses with or without symptoms of tendinopathy, specifically excluding likely acute calcific tendinitis, and analyzed 35 studies meeting inclusion and exclusion criteria. Response variables included prevalence of calcification in and enthesis or tendon among people with no symptoms, among people seeking care for symptoms, and in the opposite asymptomatic limb, and the association between calcification and rotator cuff degeneration.</div></div><div><h3>Results</h3><div>Calcification of tendons and entheses was present on between 2.7 % and 8.6 % of radiographs of the shoulder, elbow, and ankle among people without symptoms and not seeking care, with higher percentages in older populations. Calcification was common among patients with symptoms: 44 % for rotator cuff tendinopathy, 25 % for enthesopathy of the origin of the extensor carpi radialis brevis, and 53 % for medial elbow enthesopathy. Most people with calcification had it bilaterally. Among people with calcification of the rotator cuff on MRI, nearly all of them (96 %) had tendon degeneration.</div></div><div><h3>Conclusions</h3><div>The collective evidence regarding calcification in tendons and entheses suggests that it is related to mucoid degeneration and is not a separate disease process. Acute calcific tendinitis rapidly runs its course and is treated only to alleviate symptoms. It's not clear that acute calcific tendinitis or rotator cuff tendinopathy with calcification benefit from specific treatment of the calcium deposits.</div></div><div><h3>Level of evidence</h3><div>Not applicable.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 46-50"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971329","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":"Intraoperative tranexamic acid reduces postoperative haemarthrosis and improves early functional outcomes in double-bundle anterior cruciate ligament reconstruction","authors":"Li Cen,&nbsp;Hua Liu,&nbsp;Ming Li,&nbsp;Yun-Feng Zhang,&nbsp;Hao-Jun Zhang,&nbsp;Zhe-Yu Huang","doi":"10.1016/j.jor.2024.12.005","DOIUrl":"10.1016/j.jor.2024.12.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Double-bundle anterior cruciate ligament reconstruction (ACLR) has biomechanical advantages but is associated with increased intraoperative bleeding. The role of tranexamic acid (TXA) in reducing postoperative joint haemarthrosis and improving the short-term outcomes of double-bundle ACLR has not yet been thoroughly investigated. This study aimed to assess the effects of intraoperative TXA on postoperative joint haemarthrosis and short-term functional outcomes in patients who underwent double-bundle ACLR.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 80 male patients who underwent double-bundle ACLR between January 2019 and December 2022. The patients were divided into two groups: those who received TXA and those that did not. The TXA group received 50 mL of TXA (10 mg/mL) intravenously approximately 10 min before tourniquet release, followed by an intra-articular injection of 50 mL TXA (10 mg/mL) immediately after wound closure, prior to tourniquet release, whereas the control group did not receive TXA. Primary outcomes included postoperative haemarthrosis volume, assessed using Coupens and Yate (CY) values; and short-term functional recovery, evaluated using range of motion (ROM), quadriceps strength, and visual analogue scale (VAS) pain scores on day 1, day 15, week 6, and week 12 postoperatively.</div></div><div><h3>Results</h3><div>Intraoperative administration of TXA in patients undergoing double-bundle ACLR reduced postoperative haemarthrosis, as measured by a lower CY value on postoperative day 1 (P = 0.004) and day 15 (P &lt; 0.001). Compared to patients in the control group, patients in the TXA group reported lower VAS pain scores on day 1 (P &lt; 0.001), day 15 (P &lt; 0.001), and week 6 (P = 0.028), together with improved quadriceps strength (P = 0.043, day 1; P = 0.009, day 15) and ROM (P &lt; 0.001, 12 weeks postoperatively) during the early postoperative period.</div></div><div><h3>Conclusion</h3><div>The use of TXA during double-bundle ACLR may reduce postoperative joint haemarthrosis and enhance short-term functional outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 51-56"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971325","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":"Robotic-assisted Bohlman's technique using SI-LOK implants for high-grade L5-S1 Spondylolisthesis: A case series of three patients","authors":"Nalin Zadoo ,&nbsp;Eric Rebich","doi":"10.1016/j.jor.2024.12.001","DOIUrl":"10.1016/j.jor.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>High-grade Isthmic Spondylolisthesis often requires surgical intervention for spinal realignment and decompression. This study describes a modified Bohlman procedure utilizing robotic-assisted navigation and a Globus SI-LOK interbody device.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on three patients who underwent the modified Bohlman procedure for high-grade spondylolisthesis at a single hospital between 2022 and 2023. Clinical parameters (age, sex, presenting symptoms, post-operative symptoms), radiographic parameters (lumbar lordosis, pelvic incidence, Wiltse classification), and perioperative data (fusion levels, posterior instrumentation, interbody device, use of DBM, estimated blood loss, complications) were collected.</div></div><div><h3>Results</h3><div>The study included two males and one female, with a mean age of 67 years. Two patients had high-grade L5-S1 Isthmic Spondylolisthesis, and one had grade II L5-S1 Isthmic Spondylolisthesis with L4-L5 degenerative stenosis. All patients presented with low back pain and bilateral lower extremity radiculopathy. The modified procedure involved robotic-assisted placement of pedicle screws and SI-LOK implants. All patients achieved solid L5-S1 fusion without complications or slip progression.</div></div><div><h3>Conclusion</h3><div>The modified Bohlman procedure using robotic-assisted navigation and SI-LOK implants shows promise for managing high-grade isthmic spondylolisthesis, with successful outcomes and no complications in this small cohort.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 36-40"},"PeriodicalIF":1.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971262","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":"Impact of changes in native coronal plane alignment of the knee (CPAK) on patient-reported outcome measures (PROMS). A bilateral single implant study","authors":"Aida Orce Rodríguez ,&nbsp;Ishaan Jagota ,&nbsp;Jonathan Baré ,&nbsp;Andrew Shimmin","doi":"10.1016/j.jor.2024.12.002","DOIUrl":"10.1016/j.jor.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>A contemporary trend favours a restricted kinematic alignment (rKA) strategy, incorporating safe boundaries to restore a variable percentage of a patient's natural alignment.</div><div>This study aims to compare preoperative and postoperative coronal plane knee alignment (CPAK) in patients undergoing bilateral TKA with SAIPH implants (MatOrtho, UK). The concept was to control the implant (same prosthesis both sides), patient (bilateral model) and assess what effect any surgical alteration in alignment had on patient's outcomes measured by patient-reported outcome measures (PROMS) and patient satisfaction.</div></div><div><h3>Method</h3><div>A total of 70 patients and 140 knees who underwent bilateral sequential TKA with a SAIPH implant between 2012 and 2022 were included in this study. PROMS, clinical assessment, pre and postoperative CT scans and plain x-rays were obtained. The CPAK phenotype, lateral distal femoral angle, medial proximal tibial angle, joint line obliquity (JLO), and arithmetic Hip-Knee-Ankle (aHKA) angle were measured pre and postoperatively.</div></div><div><h3>Results</h3><div>Postoperative CPAK phenotype recreation was achieved in 27.9 %, while in 72.1 % it was not. PROMS did not significantly differ when CPAK phenotype was not recreated. Additionally, isolated changes to aHKA or JLO did not significantly impact outcomes, nor was a TKA that recreated the native coronal alignment more likely to be the patient's preferred side.</div></div><div><h3>Conclusion</h3><div>Tailoring alignment approaches to individual patient characteristics may be crucial for optimal functional outcomes but in this study, we were not able to show a difference between those with CPAK recreated versus those who did not have native CPAK recreated following TKA when using PROMS as the outcome measure.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 64-70"},"PeriodicalIF":1.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971321","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 meniscus extrusion on preoperative MRI and its impact upon mid-term clinical outcomes following mobile-bearing unicompartmental knee arthroplasty","authors":"Yasuhiro Fukai,&nbsp;Takafumi Hiranaka,&nbsp;Motoki Koide,&nbsp;Takaaki Fujishiro,&nbsp;Koji Okamoto","doi":"10.1016/j.jor.2024.11.026","DOIUrl":"10.1016/j.jor.2024.11.026","url":null,"abstract":"<div><h3>Background</h3><div>The presence of full-thickness cartilage in the lateral compartment on valgus stress radiography is a criterion for medial mobile-bearing unicompartmental knee arthroplasty (UKA). However, the appropriateness of medial UKA is uncertain when preoperative MRI shows extrusion of the lateral meniscus. We therefore assessed how preoperative MRI-detected lateral meniscus extrusion affects mid-term functional outcomes after mobile-bearing UKA.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the records of our patients that underwent mobile-bearing medial UKA between January 2017 and December 2019. Crema's classification system was used to assess MRI of the lateral meniscus, categorizing patients as either grade 0 or ≥ grade 1. We preoperatively evaluated patient-reported outcomes using the Oxford knee score and Knee Society functional score, and then again at the latest follow-up. We also measured range of motion pre- and postoperatively. We compared preoperative individual data with outcome data obtained for at least three years.</div></div><div><h3>Results</h3><div>The lateral meniscus extrusion group included 19 knees, and the remainder included 98 knees. Clinical outcomes were similar between these groups (<em>p</em> &gt; 0.05). No progression of lateral arthritis was observed in either group during the follow-up period.</div></div><div><h3>Conclusion</h3><div>Excluding UKA as an option for cases with lateral meniscus extrusion findings on preoperative MRI may require reconsideration.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 15-19"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877189","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":"Ensuring safety and optimization in total joint arthroplasty of cancer patients: A comprehensive analysis of complication risks and modifiable risk factors","authors":"Tara Korbal ,&nbsp;Robert Branstetter IV ,&nbsp;Matthew Cable ,&nbsp;Deryk Jones ,&nbsp;Lizheng Shi ,&nbsp;Lauren Hall ,&nbsp;Andrew Chapple","doi":"10.1016/j.jor.2024.11.027","DOIUrl":"10.1016/j.jor.2024.11.027","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>The primary objective of this study is to determine whether an active cancer diagnosis results in an increased risk of perioperative TJA complications and postoperative mortality. The secondary objective is to analyze the effects of demographic factors on perioperative complication rates in cancer patients undergoing TJA.</div></div><div><h3>Materials &amp; methods</h3><div>Patients with active cancer diagnoses undergoing total joint arthroplasty from 2014 to 2020 were included in this retrospective analysis. Patient data was obtained through ReachNet, which consisted of data from the University Medical Center, Tulane University Medical Center, Ochsner Health System, and Baylor Scott &amp; White Health. ICD-9/10 codes were tagged for active cancer diagnoses within 365 days before surgery or 30 days after surgery to establish our active cancer population. Acute surgical complications within 30 days were identified by ICD codes.</div></div><div><h3>Results</h3><div>Patient demographics included predominantly male (51.5 %), white (83 %), and non-Hispanic (96.5 %) patients followed by black individuals (15.9 %) with 47.5 % of patients being smokers. Cancer patients did have a higher acute complication rate (2.6 % vs 1.7 %), but this difference was not significant (p = .139). This difference was higher but also not significant after adjustment (aOR = 1.32, 95 % CI = 0.71–2.43, p = .377). After adjustment, increased Charlson Comorbidity Index (CCI), white race and non-elective surgery were significant contributors to complication risk. Complication rates decreased significantly with year. Nonelective surgeries were also associated with higher complication rates (8.2 % vs. 1.8 %, p = .014).</div></div><div><h3>Conclusion</h3><div>Patients with active cancer diagnoses demonstrated higher unadjusted rates of TJA acute surgical complications and increased adjusted CCI when compared to non-cancer patients. Identifying risk factors and demographics correlated with increased perioperative complications may provide physicians with necessary information to avoid negative TJA outcomes in cancer patients.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 8-14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877181","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":"A suture technique combining annulus fibrosis with posterior longitudinal ligament for lumbar disc herniation under endoscopy","authors":"Bo He ,&nbsp;Minghui Dong ,&nbsp;Quan Zhang ,&nbsp;Jinhui Bu ,&nbsp;Long Xu ,&nbsp;Sen Huang ,&nbsp;Zhenfei Wang ,&nbsp;Xiangbo Bu ,&nbsp;Mengzi Hu ,&nbsp;Guangpu Liu ,&nbsp;Jun Liang ,&nbsp;Chao Ma ,&nbsp;Guangwang Liu","doi":"10.1016/j.jor.2024.11.015","DOIUrl":"10.1016/j.jor.2024.11.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the clinical feasibility, efficacy and safety of a suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation.</div></div><div><h3>Methods</h3><div>Retrospective case-control study. A total of 412 patients with lumbar disc herniation treated in our hospital from January 2020 to November 2022 were enrolled and analyzed. There were 208 males and 204 females, aged from 26 to 54 years old(average 39.9 ± 5.1). 208 patients were treated with combining annulus fibrous suture with posterior longitudinal ligament after percutaneous lumbar discectomy(PELD) (observation group)0.204 patients were treated with percutaneous lumbar discectomy(PELD) alone(control group). Operation time, blood loss, Visual Analogue scale(VAS), Oswestry disability index(ODI),Japanese Orthopedic Association(JOA), modified MacNab criteria and imaging examination were used to evaluate.</div></div><div><h3>Results</h3><div>All the 412 patients successfully completed the surgery. Complete follow-up time was 12–18 months, with an average of 15.2 ± 1.6 months. Postoperative symptoms were all significantly relieved. There was no statistically significant difference in baseline data between groups (P &gt; 0.05). The scores of VAS,ODI and JOA at different postoperative follow-up visits were significantly lower than those before surgery (P &lt; 0.05). There was significant difference in each group before and after surgeries (P &lt; 0.05). The postoperative recurrence rates and reoperation rates between groups were significant different(P &lt; 0.05). According to MacNab, the excellent and good rate was 96.2 % (200/208) in observation group and 90.7 % (185/204) in control group(P &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>The suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation has satisfactory short- and mid-term clinical effect,and can effectively reduce postoperative recurrence rate, which is a safe and ideal suture technique for annulus fibrosus rupture.</div></div><div><h3>Clinical trial number</h3><div>not applicable.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 24-30"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915151","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":"Safe tibial subsidence pattern of a medial pivot knee. An RSA study","authors":"Nils Oscar Nivbrant,&nbsp;Piers J. Yates","doi":"10.1016/j.jor.2024.11.021","DOIUrl":"10.1016/j.jor.2024.11.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Micromotion analysis predicts component fixation survival in Total Knee Arthroplasty (TKA) but a paucity of literature exists for medial pivot designs. This clinical study examined the tibial component micromotion in a second-generation medial pivot TKA.</div></div><div><h3>Methods</h3><div>This prospective single-center clinical cohort trial involved 35 patients with a mean patient age of 71 years. Operations were performed by one experienced arthroplasty surgeon using the Saiph implant (MatOrtho). All patients received fully cemented fixation with patella resurfacing. Other variables were standardized. Radiostereometric Analysis was performed at 6 weeks, 12 and 24 months to monitor tibial component behavior.</div></div><div><h3>Results</h3><div>Benign, minor micromotion was shown with cemented fixation. At 12 months median subsidence was 0.04 mm and Median Maximal Total Point Motion was 0.44 mm. At 24 months the median subsidence was 0.02 mm and Median Maximal Total Point Motion was 0.46 mm. No tibial components were revised.</div></div><div><h3>Conclusion</h3><div>Low degrees of subsidence and Maximum Total Point Motion imply stable fixation of these medial pivot implants and high patient satisfaction was achieved. This is consistent with favorable long-term performance.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"65 ","pages":"Pages 20-23"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877206","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}