Orthopedic Research and Reviews最新文献

{"title":"Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty","authors":"Jon Olansen, Zainab Ibrahim, Roy K Aaron","doi":"10.2147/ORR.S340535","DOIUrl":"https://doi.org/10.2147/ORR.S340535","url":null,"abstract":"Abstract This review compares internal fixation versus arthroplasty in the treatment of nondisplaced femoral neck fractures (FNFs) calling attention to evolving areas of consensus that influence clinical decision-making. The Garden classification system, typically dichotomized into nondisplaced (types I and II) and displaced (types III and IV) fractures, has been used as a guide for surgical decision-making. Conventionally, treatment of nondisplaced FNF in the elderly has been with internal fixation, and treatment of a displaced FNF has been hemi-, or more recently total hip, arthroplasty. Studies over the last decade have raised concern over the appropriate treatment of nondisplaced FNFs due to high rates of reoperation of nondisplaced FNFs treated with internal fixation. Avascular necrosis (AVN), failure of internal fixation, secondary malunion, and pin/nail penetration through the femoral head have all been observed. Several studies have attributed fixation failure to a degree of femoral neck tilt ≥20°, either posteriorly or anteriorly as seen on the lateral X-ray. Because of these observations of fixation failures, the suggestion has been made that arthroplasty be used when the degree of posterior tilt exceeds a threshold of ≥20° tilt with the expectation of diminishing failure of fixation, decreasing the risk of reoperation and preserving function without increasing mortality rate. Frustrating additional analyses are uncertainties over the mechanisms of failure of internal fixation with ≥20° tilt and the persistently substantial 1-year mortality rate after FNF, which has not been influenced by fixation or replacement type. Due to the lack of consensus regarding the determination of the appropriate surgical intervention for nondisplaced FNFs, an improved algorithm for surgical decision-making for these fractures may prove useful.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":" 3","pages":"1 - 20"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393023","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":"Efficacy and Safety Study of Low-Molecular-Weight Heparin and Fondaparinux Sodium After Hip Arthroplasty: A Retrospective Cohort Study.","authors":"Abuduwupuer Haibier, Alimujiang Yusufu, Hang Lin, Aiben Kayierhan, Yimuran Abudukelimu, Tuerhongjiang Abudurexiti","doi":"10.2147/ORR.S431372","DOIUrl":"10.2147/ORR.S431372","url":null,"abstract":"<p><strong>Background: </strong>Low molecular heparin(LMWH) and sodium sulfadiazine heparin(FPX) are commonly used to prevent deep vein thrombosis(DVT) after total hip arthroplasty(THA). In this study, we compared the role of these drugs in preventing DVT after THA.</p><p><strong>Methods: </strong>Patients who underwent unilateral THA at the Sixth Affiliated Hospital of Xinjiang Medical University from April 2020 to December 2022 were retrospectively analyzed for inclusion in this study. According to the anticoagulant drugs used, the patients were divided into LMWH group (n=106) and FPX group (n=97). Changes in perioperative coagulation-related indices, hemoglobin, blood loss And the postoperative complications.</p><p><strong>Results: </strong>The preoperative indexes of the two groups of patients, the difference was not statistically significant (P>0.05); the indexes of Intraoperative blood loss, Visible blood loss, Hidden blood loss, and Total blood loss of the two groups of patients were compared, and the difference was not significant (P>0.05); PT activity and INR in the LMWH group were significantly lower than those in the FPX group on the 1st and 5th postoperative days, and the differences were significant (P<0.05); Platelets, Hemoglobin, Hematocrit, D-dimer, and Fibrinogen were compared between the two groups on the 1st and 5th postoperative days, and the differences were not significant (P<0.05). The differences were not significant (P>0.05). The differences in blood transfusion rate and blood volume between the two groups were not significant (P>0.05); the total hospitalization cost of the LMWH group was significantly lower than that of the FPX group, and the difference was significant (P<0.05); and the differences in the incidence of postoperative complications between the two groups were not significant (P>0.05).</p><p><strong>Conclusion: </strong>In this study, we found that the efficacy and safety of FPX and LMWH in preventing VTE after THA were basically the same, and the total cost of hospitalization in the LMWH group was significantly lower than that in the FPX group; however, due to the limited inclusion of the sample size, high-quality, large-sample, long-term follow-up clinical studies are necessary.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"253-261"},"PeriodicalIF":2.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461375","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":"Arthroscopic Minced Cartilage Repair in the Glenohumeral Joint - Short Term Clinical Outcome in a 33-Year-Old Handyman: A Case Report.","authors":"Roman Frederik Karkosch, Tomas Smith, Gunnar Jensen, Lars Rene Tuecking, Hauke Horstmann","doi":"10.2147/ORR.S418032","DOIUrl":"https://doi.org/10.2147/ORR.S418032","url":null,"abstract":"<p><strong>Objective: </strong>Clinical outcome data for the novel minced cartilage procedure are sparse. While good results have been shown for the knee joint, this is the first report in the current literature regarding this increasingly important procedure in the glenohumeral joint.</p><p><strong>Case description: </strong>A 33-year-old handyman with a cartilage defect in the humeral head underwent an all arthroscopic one-stage cartilage repair with the AutoCart^TM procedure (Arthrex GmbH, Munich, Germany). A senior specialist examined the patient before surgery, five-, 12-and 24-weeks post-surgery. Outcome parameters (Constant-Murley Score, UCLA Shoulder Score and ASES Score) and radiographic imaging were recorded.</p><p><strong>Results: </strong>At six months, follow-up the outcome parameter showed excellent results, the joint pain decreased to numeric rating scale (NRS) 0. The postoperative magnetic resonance imaging (MRI) revealed a thin cartilage layer in the treated area with sufficient integration to the surrounding tissue. The cartilage in the former defect zone presented a homogeneous signal, which was comparable to the intact cartilage.</p><p><strong>Conclusion: </strong>This case report underlines the growing interest in single-stage arthroscopic minced cartilage procedures and shows promising results in the glenohumeral joint. Yet, larger investigations with long-term follow-up are necessary to provide reliable clinical data to determine if comparable results can be achieved over time.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"245-251"},"PeriodicalIF":2.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461373","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":"Outcome of Surgical Management of Dermatofibrosarcoma Protuberance: A Single-Institution Multidisciplinary Approach.","authors":"Abdulrahman Yousef Alhabeeb, Ahmed O Idrees, Thamer S Alhowaish, Moustafa S Alhamadh, Emad Masudi, Abdullah Alanazi, Wazzan Aljuhani","doi":"10.2147/ORR.S437175","DOIUrl":"https://doi.org/10.2147/ORR.S437175","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, and locally aggressive soft tissue tumor with a high recurrence rate and metastatic potential, even with the proper treatment.</p><p><strong>Methods: </strong>This was a retrospective (case series) study that took place at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, to determine the outcomes of and appropriate margin excision for DFSP. All patients who were diagnosed with DFSP from 2016 to 2021 were included. The following variables were assessed: demographics, tumor characteristics, management options, and most importantly, whether patients were managed with an oncology-oriented approach or a non-oncology-oriented approach.</p><p><strong>Results: </strong>There were a total of seventeen patients with DFSP, four of whom had fibrosarcomatous differentiation (FS-DFSP). The majority (N = 13, 76.5%) of the patients were females. The lower extremities and back were the most common locations for DFSP, accounting for 47.1% and 23.5%, respectively. Only two (11.76%) patients had metastatic disease, one of whom had FS-DFSP. The minimum resection margin was 3 cm, and the maximum was 5 cm. Thirteen (76.47%) patients were managed with an oncology-oriented approach (Group I), 23% of whom had post-excision positive margins. However, all patients who were managed with a non-oncology-oriented approach (Group II) had positive margins post-excision. More than three-quarters (76.9%) of group I underwent wide resection. Split-thickness skin grafting and primary closure were the most commonly used reconstruction methods in groups I and II, respectively. The mean planned margins in groups I and II were 3.9 cm and 1.7 cm, respectively.</p><p><strong>Conclusion: </strong>The findings of this study suggest that a planned wide-margin excision with a minimum safe margin of 3-5 cm should be implemented to reduce the recurrence, metastasis, and need for further surgeries in patients with DFSP.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"237-243"},"PeriodicalIF":2.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461376","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":"Clinical Effects of the End-Love Technique in the Treatment of Recurrent Lumbar Disc Herniation 1 Year After Surgery.","authors":"Peng Li, Xiang Li, Lin Ma, Hai Yi He","doi":"10.2147/ORR.S433846","DOIUrl":"https://doi.org/10.2147/ORR.S433846","url":null,"abstract":"<p><strong>Background: </strong>The number of patients with lumbar disc herniation in China is increasing year by year. Percutaneous endoscopic lumbar discectomy (PELD) is currently the main surgical method for treating lumbar disc herniation (LDH). However, with the increase in the number of surgical cases, the number of patients with recurrent lumbar disc herniation (RLDH) is also increasing. Currently, the common method in China is lumbar fusion surgery, but this surgery would cause the loss of fusion segment mobility and considerable postoperative complications. In order to solve the problem above the following technique will be studied: the technique of posterior lumbar laminectomy and nucleus pulposus removal under fully visualized spinal endoscopy (ENDO-LOVE) to treat RLDH. Its clinical effects will be observed in this paper, too.</p><p><strong>Methods: </strong>This series includes RLDH patients treated with ENDO-LOVE technology between January 2017 and January 2021. All patients will undergo at least three follow-up visits one year after surgery. The modified MacNab standard, VAS, JOA, and ODI scores will be used to evaluate clinical efficacy, observe for cerebrospinal fluid leak, nerve root injury, and surgical site infection, and evaluate clinical safety.</p><p><strong>Results: </strong>All 29 patients completed the surgery successfully. Three patients had postoperative pain and numbness in the area of nerve root innervation, and all patients had no serious complications. The VAS, JOA scores and ODI indices of back pain and leg pain 1-day, 3-months, and 1-year postoperatively differed statistically significantly from the preoperative scores (<i>p</i> < 0.05). Efficacy evaluated at 1-year postoperatively using the modified MacNab criteria showed an excellent rate of 89.7%.</p><p><strong>Conclusion: </strong>ENDO-LOVE technology has demonstrated good clinical efficacy and safety in the treatment of patients with RLDH. It should be considered for all patients with this condition.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"225-236"},"PeriodicalIF":2.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461374","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":"Tissue Augmentation Techniques in the Management of Ligamentous Knee Injuries.","authors":"Ashley A Thompson, Ioanna K Bolia, Amir Fathi, Andrew Dobitsch, Christian A Cruz, Rajvarun Grewal, Alexander E Weber, Frank A Petrigliano, George F Hatch Iii","doi":"10.2147/ORR.S385817","DOIUrl":"https://doi.org/10.2147/ORR.S385817","url":null,"abstract":"<p><p>Despite early reports of high failure rates in knee ligament repair techniques resulting in favor of reconstruction, newer advances in surgical technology have shifted the attention back to repair with the addition of various tissue augmentation techniques. Ligament repair preserves proprioceptors in the native ligament and avoids autograft tendon harvest, minimizing the complications associated with donor site ruptures in reconstruction techniques. Tissue augmentation has been successfully used in knee ligamentous and tendon repair procedures, as well as in some upper extremity procedures. This study provides a clinical update on the surgical techniques, biomechanics, and outcomes with the application of various tissue augmentation techniques in the ligaments surrounding the knee joint.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"215-223"},"PeriodicalIF":2.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461377","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":"Incidence and Distribution of Deep Vein Thrombosis Following Total Hip Arthroplasty Using an Anterolateral Supine Approach.","authors":"Junya Itou, Yutaro Munakata, Yujiro Kuramitsu, Hiromi Madarame, Ken Okazaki","doi":"10.2147/ORR.S430145","DOIUrl":"10.2147/ORR.S430145","url":null,"abstract":"<p><strong>Purpose: </strong>Venous thromboembolism (VTE) is a potential major complication in patients undergoing total hip arthroplasty (THA). However, the incidence of VTE following THA using anterolateral supine approach (ALS) has not been reported. The purpose of this study was to investigate the incidence of perioperative VTE and the distribution and characteristics of deep vein thrombosis (DVT) following ALS THA.</p><p><strong>Patients and methods: </strong>This retrospective single-arm study analyzed the 182 consecutive hips of 164 patients who underwent primary ALS THA. Pharmacological prophylaxis consisted of enoxaparin 20 mg twice daily for approximately 6 days starting 24 h postoperatively until duplex ultrasonography was performed to determine whether postoperative DVT was present. DVT was assessed by whole-leg Doppler ultrasound, and the location and characteristics of any thrombus were recorded. If pulmonary thromboembolism was suspected, contrast-enhanced computed tomography was performed.</p><p><strong>Results: </strong>The overall incidence of VTE was 9.9% for DVT (18/182 hips) and 0.5% for pulmonary thromboembolism (1/182 hips). Most DVTs were in the soleal vein on the affected side and showed isoechoic or hypoechoic echogenicity. All thrombi were non-floating.</p><p><strong>Conclusion: </strong>Following ALS THA with standard pharmacological prophylaxis and an early weight-bearing protocol, the incidence of perioperative DVT was approximately 10%, mostly occurring in the lower leg.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"199-205"},"PeriodicalIF":2.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522269","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":"Capital Femoral Epiphysis with Acute Unstable Valgus Type Slip Managed with Closed Reduction and Percutaneous Fixation: A Case Report","authors":"Tim Cheok, Matthew Jennings, Morgan Berman, Kanihska Williams, Jaideep Rawat, Bruce Foster","doi":"10.2147/orr.s429844","DOIUrl":"https://doi.org/10.2147/orr.s429844","url":null,"abstract":"","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"60 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135410140","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":"The Risk of Developing Osteosarcoma After Teriparatide Use: A Systematic Review.","authors":"Ahmed A Abdulelah,&nbsp;Bassem I Haddad,&nbsp;Abdulrahman A Alhajahjeh,&nbsp;Lina M AlQirem,&nbsp;Layla El-Amayreh","doi":"10.2147/ORR.S408718","DOIUrl":"https://doi.org/10.2147/ORR.S408718","url":null,"abstract":"<p><p>Teriparatide is a recombinant human parathyroid hormone analog with anabolic mechanism of action utilized in the treatment of osteoporosis with well-established clinical efficacy. Its use is significantly hindered due to label warnings resulting from pre-clinical rat studies demonstrating an increased risk of osteosarcoma. However, clinical trials and post-marketing surveillance studies did not demonstrate any increased risk of osteosarcoma, even after prolonged periods of surveillance reaching up to 15 years, with most of the identified cases of osteosarcomas being solitary and predominantly attributed to other factors. This systematic review provides a comprehensive overview of the currently available literature and provides the highest level of clinical evidence towards demonstrating the lack of any substantial evidence towards osteosarcoma development in patients utilizing TPTD.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"191-198"},"PeriodicalIF":2.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/40/orr-15-191.PMC10544053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125985","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":"Severe Untreated Scoliosis and Early Onset Breast Cancer in a Patient with Neurofibromatosis Associated with a Nonsense Variant of <i>NF1</i> Gene.","authors":"Vivian Reinhold,&nbsp;Antti Saarinen,&nbsp;Eetu Suominen,&nbsp;Stina Syrjänen,&nbsp;Minna Kankuri-Tammilehto","doi":"10.2147/ORR.S415978","DOIUrl":"https://doi.org/10.2147/ORR.S415978","url":null,"abstract":"<p><strong>Background: </strong>Neurofibromatosis 1 (NF1) is a relatively common genetic disorder linked to skeletal abnormalities and elevated risk of cancer. Early onset scoliosis is common in patients with NF1 although severe scoliosis is rare. Scoliosis complicates the normal development and growth and may lead to thoracic insufficiency syndrome. The increased risk for breast cancer in young NF1 female patients has been recently identified.</p><p><strong>Case presentation: </strong>We describe a NF1 patient with dystrophic scoliosis symptoms emerged at childhood. At 37 years of age major scoliosis curve in the thoracolumbar region was 80 degrees. The patient was diagnosed with breast cancer at the age of 37 years, histologically the breast cancer was ductal, hormone receptor positive and Her2-positive.</p><p><strong>Results: </strong>A novel pathogenic variant in <i>NF1</i> p.(Trp2348*) was identified by next-generation sequencing method. The patient did not have pathogenic variants in <i>BRCA</i> genes or in other currently known hereditary breast cancer genes.</p><p><strong>Conclusion: </strong>Here, we describe a novel pathogenic variant in <i>NF1</i> named p.(Trp2348*) which may cause severe dystrophic scoliosis and deteriorate the quality of life and physical function, as well as Her-2 positive breast cancer. Untreated dystrophic scoliosis in patients with NF1 may result in significant spinal deformity and deteriorate the quality of life and physical function. Genetic counseling is recommended in all patients with NF1. Patients need routine follow-up throughout life. Multidisciplinary consulting is warranted in patients with neurofibromatosis 1.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"183-189"},"PeriodicalIF":2.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/40/orr-15-183.PMC10543094.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139018","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}