Orthopaedic Surgery最新文献

{"title":"Feasibility and Safety of the C1 \"Zero Angle\" Screw: A Novel \"In-Out-In\" Technique for Atlantoaxial Dislocation.","authors":"Zexing Chen, Xinzhao Huang, Xiaobao Zou, Peirong Lian, Guoqiang Liu, Junlin Chen, Changrong Zhu, Xiangyang Ma","doi":"10.1111/os.14309","DOIUrl":"https://doi.org/10.1111/os.14309","url":null,"abstract":"<p><strong>Objectives: </strong>To minimize the risk of V3 segment of vertebral artery (VA) injury in the atlantoaxial dislocation (AAD) patients with C1 pedicle height less than 4.0 mm and provide a strong toggle force in irreducible AAD and revision surgery. We evaluated the feasibility of C1 \"Zero Angle\" screw (C1ZAS) and safe entry point with \"in-out-in\" technique as an alternative option for C1 pedicle screw (PS) in cases with AAD.</p><p><strong>Methods: </strong>Sixty-one patients with AAD or atlantoaxial instability (AAI) (45 male and 16 female) who underwent cervical computed tomography and magnetic resonance imaging scans in our center between January 1, 2022 and December 31, 2023 were retrospectively reviewed. Measurements were made around the ideal trajectory and entry point of C1ZAS using computerized tomography (CT) and magnetic resonance imaging (MRI) in 61 patients. Radiographic measurements included (A) the distance from the recess to the transverse foramen (RTF); (B) the tricortical screw zone (TSZ); (C) the lateral mass height along the C1ZAS trajectory (LMH); (D) the screw length of C1ZAS (ZSL); (E) the screw length of C1 PS (PSL); (F) the distances from the recess to the dura (RD); (G) the distance from the recess to the spinal cord (RSC); (H) the distance from the inner of lateral mass to the spinal cord (ILMSC). During the period of January 1, 2022 to December 31, 2023, C1ZAS placement with \"in-out-in\" technique was used as an alternative option for C1 PS in 8 patients with AAD and unilateral/bilateral narrow C1 pedicles.</p><p><strong>Results: </strong>The average RTF, TSZ, LMH, ZSL, RD, RSC, and ILMSC were 7.71, 6.14, 8.32, 33.23, 4.68, 10.02, and 2.91 mm respectively. The entry point of the C1ZAS was defined as the projection point of the inner of the recess to the posterior arch and the trajectory should be angled cephalad by 8.7° and medially by 0°. The 61 patients (122 sides) with AAD or AAI were classified into three groups: the low-risk (76 sides, 62%), the intermedial-risk (18 sides, 15%), and the high-risk (28 sides, 23%) groups. Satisfactory C1ZAS placement and atlantoaxial reduction were achieved in all eight patients with AAD and unilateral/bilateral narrow C1 pedicles. No instance of C1ZAS placement-related VA injury or dural laceration was observed.</p><p><strong>Conclusions: </strong>When the placement of C1 PS is not feasible in patients with AAD and unilateral/bilateral narrow C1 pedicles, C1ZAS placement with \"in-out-in\" technique can be considered an effective alternative option, providing tricortical or quadricortical purchase for rigid fixation of the atlas.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oblique Lumbar Interbody Fusion Combined With Anterolateral Fixation and Cement Augmentation for the Treatment of Degenerative Lumbar Diseases in the Elderly Population: A Retrospective Study.","authors":"Weiqi Han, Lei He, Fei Wang, Xiaofeng Zhao, Cong Jin","doi":"10.1111/os.14315","DOIUrl":"https://doi.org/10.1111/os.14315","url":null,"abstract":"<p><strong>Objectives: </strong>Cage subsidence is a common complication of oblique lumbar interbody fusion (OLIF), particularly in elderly patients with osteoporosis or osteopenia. While bilateral pedicle screw fixation (BPS) is effective in reducing subsidence, it is associated with longer operative times, increased blood loss, and greater tissue trauma. In contrast, anterolateral fixation (AF) is less invasive but linked to higher subsidence rates. Ensuring both minimal invasiveness and adequate stability in OLIF-assisted fixation remains a significant challenge. This study aimed to evaluate the efficacy of combining AF with cement augmentation (AF + CA) in reducing cage subsidence and improving clinical outcomes compared with AF and BPS.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 138 elderly patients with degenerative lumbar diseases treated with OLIF. Patients were divided into three groups: AF + CA (32 patients), AF (32 patients), and BPS (74 patients). Clinical and radiographic outcomes were compared among the groups, and logistic regression analyses were performed to identify risk factors for cage subsidence after OLIF.</p><p><strong>Results: </strong>At 1 year postoperatively, the disc height of the AF + CA group was significantly greater than that of the AF group. The cage subsidence rate in the AF + CA group was 24.3%, significantly lower than that in the AF group (48.8%, p < 0.05) and comparable to the BPS group (30.4%). Survivorship curve analysis showed better outcomes in reducing cage subsidence in the AF + CA group compared with the AF group, with no significant difference between the AF + CA and BPS groups. Compared with the AF + CA and BPS groups, the AF group had significantly higher grades and severity of cage subsidence. Fusion rates at 1 year were 91.9% in the AF + CA group, 90.2% in the AF group, and 95.1% in the BPS group, with no significant differences. The AF + CA group had significantly shorter operative times, less intraoperative blood loss, lower VAS scores at 3 days and 1 year postoperatively, and lower ODI scores at 3 days and 3 months compared with the BPS group. Multivariate regression analysis revealed that AF was a significant risk factor for cage subsidence, with an odds ratio of 3.399 compared with AF + CA.</p><p><strong>Conclusions: </strong>AF + CA effectively reduces cage subsidence in OLIF surgeries, offering results comparable to BPS while providing advantages such as shorter surgical time, reduced blood loss, and improved early postoperative outcomes. AF + CA is a viable alternative, especially for elderly patients with comorbidities who may not tolerate the longer operative durations or greater blood loss associated with BPS.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal Inclination Angle of the Graft Affects Graft Maturity and Knee Stability After Anterior Cruciate Ligament Reconstruction.","authors":"Ming Li, Fangang Meng, Dianbo Long, Dorje Wencheng, Yanlin Zhong, Yan Kang, Peihui Wu, Aishan He","doi":"10.1111/os.14305","DOIUrl":"https://doi.org/10.1111/os.14305","url":null,"abstract":"<p><strong>Objective: </strong>The influence of the graft sagittal inclination angle (SIA) on knee stability, biomechanics, and graft maturity has been elucidated. However, no study has comprehensively described the effects of SIA on the aforementioned postoperative prognostic indicators. So, we aimed to determine whether the sagittal inclination angle (SIA) of a graft is associated with postoperative graft maturity, joint stability, and joint function after anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Patients who had undergone ACL reconstruction between April 2019 and February 2022 and those with intact ACL were eligible. Using magnetic resonance imaging, graft maturity was evaluated as the mean signal-to-noise quotient (SNQ) measured in three regions. Anterior tibial translation (ATT) was used to evaluate knee stability. Correlation analysis was conducted for the SIA, ATT, and clinical outcome scores. Multivariate stepwise regression analysis was used on the SIA and potential risk factors to determine their association with the graft SNQ. The SIA threshold of knee instability was calculated by receiver-operating characteristic curves.</p><p><strong>Results: </strong>Sixty-three postoperative patients were enrolled. The SIA was significantly negatively associated with graft SNQ value. A multivariate stepwise regression analysis showed that SIA and body mass index were significant influencing factors associated with the graft SNQ. Correlations between the SIA and medial and lateral ATT were statistically significant. A larger SIA resulted in a decreased probability of medial and lateral ATT ≥ 5 mm. The SIA threshold of an increased risk of lateral ATT ≥ 5 mm was < 44.4°. A positive correlation was observed between SIA and subjective symptom subscales in the KOOS.</p><p><strong>Conclusions: </strong>A low SIA is not conducive to graft maturation after ACL reconstruction. A larger graft SIA was correlated with better postoperative knee stability. However, the effect of the SIA on joint function was only significant in terms of symptoms. Therefore, these new findings provide new ideas for preoperative assessment and intraoperative determination of the ideal graft inclination.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Preoperative Autologous Blood Donation for Surgical Treatment of Thoracic Spinal Stenosis: A Propensity-Matched Cohort Study.","authors":"Junbo Qi, Yuanyu Hu, Xiaoyan Niu, Yanlei Dong, Xin Zhang, Nanfang Xu, Zhongqiang Chen, Weishi Li, Yun Tian, Chuiguo Sun","doi":"10.1111/os.14249","DOIUrl":"10.1111/os.14249","url":null,"abstract":"<p><strong>Objective: </strong>Thoracic spinal stenosis (TSS) surgeries necessitate a substantial amount of allogeneic blood resources. However, the efficacy of preoperative autologous blood donation (PABD) in TSS surgery has not been clearly evaluated. Therefore, we aimed to evaluate the efficacy of PABD for TSS surgery.</p><p><strong>Methods: </strong>This study is a retrospective study. Totally 397 patients who underwent TSS surgeries at our institution from January 2019 to June 2023 were included. Propensity score matching (PSM) was used to make the PABD and Non-PABD groups comparable at baseline. Regarding outcome measures, the incidence and amount of allogeneic blood transfusion, changes in postoperative hemoglobin and hematocrit levels, occurrence of postoperative complications, medical costs, drainage time, length of hospital stay, and postoperative neurological function were analyzed. The outcomes were compared between the matched PABD (n = 79) and Non-PABD (n = 79) groups. Univariate analysis methods were used for statistical analysis, including independent samples t-test, Wilcoxon rank-sum test, and chi-square test.</p><p><strong>Results: </strong>The incidence of allogeneic blood transfusion (8.9% vs. 25.3%, p = 0.006) and volume of intraoperative red blood cell (RBC) transfusion (10.12 ± 54.52 vs. 122.78 ± 275.00 mL, p < 0.001) in the PABD group were significantly lower than those in the Non-PABD group. The PABD group had significantly higher average postoperative hemoglobin and hematocrit levels than the Non-PABD group at 1, 3, and 5 days after surgery (p < 0.05). Similarly, the PABD group exhibited a smaller reduction in hemoglobin and hematocrit levels compared with the Non-PABD group on 1, 3, and 5 days postoperatively. There were no significant intergroup differences in terms of transfusion-related complications, medical expenses, neurological function, length of hospital stay, or drainage time. Notably, PABD was an independent protective factor of allogeneic transfusion in the multivariate regression analysis (OR = 0.334, 95%CI = 0.051-0.966).</p><p><strong>Conclusions: </strong>PABD can effectively reduce the incidence of allogeneic blood transfusion and amount of allogeneic blood in TSS surgeries with safety. It also significantly improved the postoperative hemoglobin and hematocrit levels. Under the premise of clear indications, PABD is worth promoting for the surgical treatment of TSS.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"3068-3077"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Temporary Hemiepiphysiodesis for Non-idiopathic Coronal Angular Deformity of the Knee in Children: A Comparison of Hinge Eight-Plate and Traditional Eight-Plate.","authors":"Zhen-Zhen Dai, Tai-Chun Li, Han Zhou, Qin Zhang, Hai Li","doi":"10.1111/os.14254","DOIUrl":"10.1111/os.14254","url":null,"abstract":"<p><strong>Objective: </strong>Temporary hemiepiphysiodesis (TH) is a very common technique for coronal angular deformity of the knee in children, especially non-idiopathic. However, there is currently a dearth of comparative research on the hinge eight-plate (HEP) and traditional eight-plate (TEP). This study aimed to assess the clinical effectiveness and implant-related complication rates of TH using TEP and HEP for non-idiopathic coronal angular deformity, as well as to identify clinical factors affecting correction velocity.</p><p><strong>Methods: </strong>We retrospectively observed a consecutive series of patients with non-idiopathic coronal angular deformity of the knee who underwent TH using HEP or TEP and completed the deformity correction process from July 2016 to July 2022. According to the kind of eight plates, we divided those patients into the HEP group and the TEP treatment group. Relevant clinical factors, including the mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), screw divergence angle (SDA), angle of plate and screw (APS), hinge angle of HEP (HA), and the knee zone location of the lower extremity mechanical axis, were documented. Additionally, deformity correction velocity, complications, and clinical efficacy were assessed. Categorical variables were analyzed using the chi-squared test, Fisher exact test, or Wilcoxon test, while continuous variables were evaluated using the t-test or analysis of variance (ANOVA).</p><p><strong>Results: </strong>There were 29 patients in the HEP treatment group (seven girls and 22 boys) and 33 patients (12 girls and 21 boys) in the TEP treatment group. In all, 91.86% (79/86 knees) of the genu angular deformities were completely corrected, 6.98% (6/86 knees) had the overcorrection condition, and 10.47% (9/86 knees) had screw loosening. The swayback HEP rate was 11.29% (7/62 HEPs), which was related to the screw loosening in the HEP group (p < 0.001). The overall correction velocities and screw divergence angle change speeds in the HEP group were all significantly faster than those in the TEP group (p < 0.05). The initial APS of the HEP implanted was higher than that of TEP (p < 0.01), and multisite changes of APS during deformity correction of the HEP group were smaller than that of the TEP group.</p><p><strong>Conclusion: </strong>HEP proved to be an appropriate device for TH for non-idiopathic coronal angular deformities of the knee with high correction velocity in children. Avoiding the occurrence of the swayback phenomenon may reduce the complications of HEP.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"3107-3117"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in the Application of Porous Tantalum Metal in Hip Joint Surgery.","authors":"Kaiming Ma, Zhijie Ma, Liangliang Cheng, Dewei Zhao","doi":"10.1111/os.14255","DOIUrl":"10.1111/os.14255","url":null,"abstract":"<p><p>Porous tantalum metal is a new orthopedic implant material made of tantalum metal that has been processed by porous treatment. This material has various advantages, including high hardness, good ductility, good biocompatibility, and strong bone integration ability. Porous tantalum metal has performed well in clinical application, demonstrating excellent medium- to long-term curative effects. The use of implant products made of porous tantalum metal, such as porous tantalum rods, porous tantalum hip prostheses, and porous tantalum augments (MAs), is gradually increasing in the clinical application of hip surgery, and these products have achieved excellent therapeutic effects in the middle and late stages of various hip diseases. In recent years, the combined application of porous tantalum metal and three-dimenional (3D) printing technology to create personalized 3D-printed porous tantalum metal has led to new development directions for the treatment of complex hip joint surgical diseases. This review presents a summary of the application of porous tantalum metal in hip surgery in recent years, including clinical treatment effects and existing problems. In addition, the prospect of progress in this field is promoted.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"2877-2886"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender, BMI, and Age-Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis.","authors":"Songlin Li, Xi Chen, Sen Liu, Hongjun Xu, Yang Yu, Shanni Li, Zhaojing Yin, Yiyang Du, Miaomiao Zhang, Peilai Liu, Wenwei Qian","doi":"10.1111/os.14253","DOIUrl":"10.1111/os.14253","url":null,"abstract":"<p><strong>Objectives: </strong>Research on the distribution of and the variation in coronal plane alignment of the knee (CPAK) in the Chinese osteoarthritis population is limited. We aimed to establish the CPAK classification based on the characteristics of lower limb alignment in the Chinese osteoarthritis population. We also investigated variations in lower limb alignment parameters and CPAK phenotypes based on gender, body mass index (BMI), and age.</p><p><strong>Methods: </strong>A retrospective study was conducted on a total of 944 knees diagnosed with osteoarthritis in 479 patients from January 2017 to December 2023. A scatterplot was used to describe the distribution of the CPAK classification, and the differences in lower limb alignment parameters and the CPAK classification were compared across genders (male, female), ages (middle-aged/<65 years, elderly/≥65 years), and BMI categories (normal/<25 kg/m², overweight and obese/≥25 kg/m²) using the chi-squared test or Fisher's exact test.</p><p><strong>Results: </strong>The average arithmetic hip-knee-ankle angle and joint line obliquity (JLO) were -3.03° ± 5.69° and 174.45° ± 4.29°, respectively. There was a higher prevalence of constitutional varus alignment in males and the overweight or obese group, while constitutional valgus alignment was more common in females and the normal BMI group (p < 0.05). Additionally, females had a greater apex distal JLO than males (p < 0.05). There were no statistically significant differences in lower limb alignment parameters among different age groups (p > 0.05). Although there were variations in alignment parameters across different genders and BMI categories in the knee osteoarthritis population, the predominant CPAK classifications were type I (38.03%), followed by type II (20.02%) and type IV (17.06%).</p><p><strong>Conclusion: </strong>The most common CPAK types were I, II, and IV, and they were not influenced by gender, BMI, or age, indicating that the CPAK classification can reliably reflect constitutional alignment. A better understanding of native alignment variability can aid in providing patient-specific recommendations when considering orthopedic alignment strategies.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"3098-3106"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Postoperative Outcomes after Arthroscopic Partial Meniscectomy: A Retrospective Analysis.","authors":"Fan Lin, Lu Hengli, Kunpeng Zhu, Yuchen Bao, Jianfeng Pan","doi":"10.1111/os.14218","DOIUrl":"10.1111/os.14218","url":null,"abstract":"<p><strong>Objective: </strong>Arthroscopic partial meniscectomy is a widely used surgical technique for treating meniscus injuries, while individual differences in postoperative outcomes remain a significant concern. This retrospective study aimed to identify the factors influencing clinical outcomes following arthroscopic partial meniscectomy.</p><p><strong>Methods: </strong>We retrospectively examined the clinical data of 52 patients who underwent arthroscopic partial meniscectomy at our institution from January to May 2022. Observation indicators, including gender, age, type of medical insurance, various surgeons, the self-pay portion of hospital costs, and total hospital costs, were systematically recorded. Subjective symptoms were evaluated with ΔTenger, ΔLysholm, and International Knee Documentation Committee (IKDC) scores during follow-up. The trends of the above questionnaires and potential predictors were statistically evaluated through regression analysis.</p><p><strong>Results: </strong>Binary logistic analysis revealed that female patients (OR: 32.42; 95% confidence interval [CI]: 2.22, 473.86) and higher preoperative visual analog scale (VAS) (odds ratio [OR]: 3.58; 95% CI: 1.55, 8.28) were significantly associated with FP Lysholm score. Similarly, patients with elevated preoperative VAS (OR: 1.47; 95% CI: 1.01, 2.15) were significantly more likely to have FP IKDC scores. Multiple linear regression analysis revealed that traumatic meniscus tear (β = -0.324; 95% CI: -0.948, -0.036; p = 0.035) emerged as a negative independent predictor of ΔTegner, while higher preoperative VAS scores (β = 0.330; 95% CI: 0.013, 0.217; p = 0.028) were identified as positive independent predictors of ΔTegner. The duration of symptoms (β = -0.327; 95% CI: -0.010, -0.001; p = 0.023) had a negative impact on the ΔLysholm scores. Factors such as body mass index (BMI) (β = -0.250; 95% CI: -1.000, -0.020; p = 0.042), duration of symptoms (β = -0.302; 95% CI: -0.009, -0.001; p = 0.014), and preoperative VAS (β = -0.332; 95% CI: -1.813, -0.250; p = 0.011) were negatively associated with ΔIKDC scores.</p><p><strong>Conclusion: </strong>The study offers insights into multiple factors for patient outcomes after arthroscopic partial meniscectomy. Orthopedic surgeons need to consider variables such as gender, BMI, duration of symptoms, preoperative VAS, and the traumatic/degenerative types of meniscal tears to optimize postoperative outcomes.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"2924-2932"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Femoral Offset after Closed Reduction and Dynamic Hip Screw Osteosynthesis Via Lateral Approach in Patients with Medial Femoral Neck Fracture: A Retrospective Analysis.","authors":"Marc-Pascal Meier, Mark-Tilmann Seitz, Dominik Saul, Roland Gera, Paul Jonathan Roch, Katharina Jäckle, Wolfgang Lehmann, Thelonius Hawellek","doi":"10.1111/os.14220","DOIUrl":"10.1111/os.14220","url":null,"abstract":"<p><strong>Objective: </strong>Closed reduction and dynamic hip screw (DHS) osteosynthesis are preferred as joint-preserving therapy in case of medial femoral neck fractures (MFNFs). A change in the femoral offset (CFO) can cause gait abnormality, impingement, or greater trochanteric pain syndrome. It is unknown whether the femoral offset (FO) can be postoperatively fully restored. The aim of the study was to investigate the extent of a possible CFO in hip joints after DHS osteosynthesis in the case of an MFNF.</p><p><strong>Methods: </strong>In this retrospective study, 104 patients (mean age: 71.02 years, men: n = 50, women: n = 54) with MFNF who underwent closed reduction and DHS osteosynthesis were analyzed by postoperative x-rays to assess CFO between the operated (OS) and nonoperated joint side (NOS). The studies covered the time period 2010-2020. A statistical comparison was performed between the mean values of FO between OS and NOS, taking into account patient age, gender, and fracture severity.</p><p><strong>Results: </strong>All operated hip joints showed a CFO. In 76.0% (79 of 104), the FO decreased (FOD), and in 24.0% (25 of 104), the FO increased (FOI). A critical CFO (>15% CFO) was detected in 52.9% (55 of 104). In hip joints with postoperative FOD, the mean FO between NOS (49.15 mm [±6.56]) and OS (39.32 mm [±7.87]) and in hip joints with postoperative FOI the mean FO between NOS (41.59 [±8.21]) and OS (47.27 [±6.68]) differed significantly (p < 0.001). Preoperative FO (r _S: -0.41; p > 0.001) and caput-collum-diaphyseal angle (CCD; r _S: 0.34; p > 0.001) correlated with postoperative CFO. FOD was found in hip joints with a preoperative FO >44 mm and CCD <134° vice versa FOI in hip joints with a preoperative FO <44 mm and CCD >134°.</p><p><strong>Conclusion: </strong>Closed reduction and DHS osteosynthesis in patients with MFNF result in a clustered significant CFO. The individual FO should be taken into account pre- and intraoperatively to avoid a postoperative extensive CFO.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"3118-3128"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative 3D Navigation Module for Precise Unilateral Pedicle Screw Combined with Contralateral Translaminar Facet Screw Placement in Lumbar Spine Surgery.","authors":"Xu Chen, Hanhao Dai, Jun Luo, Huaizhi Zhang, Chao Song, Zhibo Deng, Yanyan Zhang, Xing Li, Jianhui Dai, Jie Xu","doi":"10.1111/os.14241","DOIUrl":"10.1111/os.14241","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of degenerative diseases of the lumbar spine has increased in recent years. Unilateral pedicle screw combined with contralateral translaminar facet screw fixation offers the advantages of less trauma, better stability, and fewer complications. However, the surgical difficulty and suboptimal pinning accuracy of translaminar facet screw placement in clinical practice limit its use. Therefore, in this study, we designed a novel suspended 3D-printed navigation module to facilitate fast and accurate intraoperative screw placement. The aim of this study is to investigate the digital design, precise implementation, and evaluation methods for placing unilateral pedicle screws in the lumbar spine combined with translaminar facet screw placement using a new suspended 3D navigation module.</p><p><strong>Methods: </strong>This retrospective study included 46 patients with single-level lumbar lesions who underwent spine surgery at the Affiliated Hospital of Putian University between June 2022 and December 2023. The suspended navigation module was designed digitally. Preoperative screw placement was simulated using 3D printed models, followed by an intraoperative accurate screw placement facilitated by the navigation module and a postoperative evaluation of the accuracy of screw placement. The absolute difference in three-dimensional coordinates of the inlet and outlet points of the preoperative design and the postoperative screw-nail channel served as the precision index.</p><p><strong>Results: </strong>In a study involving 46 patients, surgery was successful with 92 pedicle screws and 46 translaminar facet screws placed without any penetration of the cortex. The difference in coordinates before and after screw insertion was minimal, with entry points varying between 1.21 to 1.36 mm and exit points between 1.97 to 2.46 mm. When screw accuracy met certain thresholds, there was no significant difference between preoperative design and postoperative coordinates, indicating precise replication of the surgical plan.</p><p><strong>Conclusion: </strong>The new suspended 3D navigation module enables the precise placement of unilateral pedicle screws in the lumbar spine combined with translaminar pedicle screws for precise surgery.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"3026-3035"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}