Orthopedic Research and Reviews最新文献

{"title":"Short Stem for Total Hip Arthroplasty (THA) – Overview, Patient Selection and Perspectives by Using the Metha® Hip Stem System","authors":"B. Ishaque","doi":"10.2147/ORR.S233054","DOIUrl":"https://doi.org/10.2147/ORR.S233054","url":null,"abstract":"Abstract Short stem hip replacement has not only gained attention but also significance over the past decades. However, there still remains uncertainty regarding the correct indications for these stems. Even companies, producing implants, have varying recommendations that are more likely based on a well-meant advice than on statistically evaluated data. Thus, it is important to evaluate the advantages and disadvantages of a short stem prosthesis. The goal of this paper is to reveal some of the existing uncertainty in this field, by analyzing the Metha® short hip stem system. This paper does not only focus on general aspects but also discusses some more specific problems, such as avascular necrosis and post-rheumatic diseases, as well as hip dysplasia and coxarthrosis. The aim is also to convey the opportunity to indicate this type of implant for elderly and obese patients as well as for femoral misalignments following post-Perthes disease, post-traumatic deformities or other malpositions of the hip.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 1","pages":"77 - 89"},"PeriodicalIF":2.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42080085","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":"Short versus Long-Leg Hip Spica After Closed Reduction in Developmental Dysplasia of the Hip: A Retrospective Comparative Study","authors":"Mohamad S Yasin, Mohammed S Alisi, Y. Hammad, Omar Q Samarah, Freih O Abu Hassan","doi":"10.2147/ORR.S353279","DOIUrl":"https://doi.org/10.2147/ORR.S353279","url":null,"abstract":"Purpose Closed reduction (CR) is a standard treatment for developmental dysplasia of the hip (DDH) after failed conservative treatment. After CR, the affected hip is held in the reduced position by a spica cast that typically extends below the knee (long). Above knee (short) spica cast is an alternative technique utilized by some pediatric orthopedic surgeons. We aimed to compare short versus long spica cast after CR in terms of success rate and complications. Methods Patients who underwent CR with short or long hip spica cast over a 3-year period (2016–2019) were evaluated for the success (sustainability of the reduction) and complications. The acute and long-term success were recorded retrospectively. Acute success was defined as concentric reduction of the hip confirmed by intraoperative arthrogram and immediate postoperative CT scan. Long-term success was defined as maintained reduction at 12 months’ post reduction. Results Forty-seven patients were included in our study. Long spica casts were used in 24 patients and short ones in the remaining 23. The overall acute and long-term success rates were 83% and 66%, respectively. The acute success rate of long spica was 87.5%, while short spica achieved 78.2%. On the long term, the success rate of short spica was higher than long one (73.9% vs 58.3%). Cox regression analysis showed that the type of cast (short vs long spica) was not correlated with acute success (P = 0.405), long-term success (P = 0.263), residual dysplasia (P = 0.405), or avascular necrosis (P = 0.053). Conclusion CR in DDH is an important line of management in the younger patient population and can save them an invasive open surgery later in life. A short leg spica could represent an easier and likely as successful alternative to the traditional long spica. More prospective future research is needed to validate our observational findings. Level of Evidence III.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 1","pages":"71 - 76"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49438075","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 Radiological Complications of Short-Segment Pedicle Screw Fixation Combined with Transforaminal Interbody Fusion in the Treatment of Unstable Thoracolumbar Burst Fracture: A Retrospective Case Series Study in Vietnam","authors":"Ngoc Quyen Nguyen, Trong Hau Phan","doi":"10.2147/ORR.S356296","DOIUrl":"https://doi.org/10.2147/ORR.S356296","url":null,"abstract":"Background The radiological complications including correction loss and hardware failure of short segment posterior pedicle screw fixation in the treatment of unstable thoracolumbar burst fractures remain a main concern. Several procedures aiming to reinforce the anterior column have been introduced to solve these limitations, including transforaminal interbody fusion (TIF). The purposes of this study were to evaluate the radiological complications of short-segment pedicle screw fixation in combination with transforaminal interbody fusion in the treatment of unstable thoracolumbar burst fractures. Methods This retrospective case series study enrolled patients with isolated unstable thoracolumbar burst fractures, who were treated by posterior short fixation with TIF between January 2013 and January 2017. Patients were followed up for a minimum of one and half years. For evaluation of correction loss, % loss of anterior vertebral body height (%AVB), vertebral kyphotic angle (VA) and regional kyphotic angle (RA) were collected preoperatively, postoperatively and at the final follow-up. Hardware failure was assessed on radiological images at the last follow-up. Results There were 36 patients who met the inclusion criteria with a mean follow-up duration of 53 months. The mean correction loss of %AVB, VA and RA were 10.2%, 2.9° and 5.6°, respectively. There were 6 patients (16.7%) with hardware failure at the final follow-up. Conclusion Short-segment posterior pedicle screw fixation with TIF using bone chip grafts does not completely prevent hardware failure and progressive kyphosis in the treatment of unstable thoracolumbar burst fractures.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 1","pages":"91 - 99"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43800754","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":"Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management","authors":"T. Thangarajah, I. Lo","doi":"10.2147/ORR.S348726","DOIUrl":"https://doi.org/10.2147/ORR.S348726","url":null,"abstract":"Abstract Partial thickness rotator cuff tears have been diagnosed with increased frequency due to heightened awareness and an improvement in diagnostic modalities. When >50% of the tendon thickness has ruptured, intra-tendinous strain of the residual tendon increases. Surgery is generally confined to patients who have failed non-operative measures and have persistent symptoms. The rationale for repairing partial thickness tears lies in their limited self-healing capacity, and propensity to enlarge over time and progress to a full thickness defect. Although tear debridement and acromioplasty can improve pain and function, tear progression can occur, in addition to worse results being noted in bursal-sided defects. Several surgical strategies have been recommended but there is a lack of evidence to advocate one form of treatment over another. The aim of this narrative review is to discuss the treatment options for partial thickness tears of the rotator cuff.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 1","pages":"59 - 70"},"PeriodicalIF":2.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47663461","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":"Postoperative Fluid Collections in Total Joint Arthroplasty: A Narrative Review","authors":"Dylan Smith, G. Berdis, Vishavpreet Singh, Alexander Caughran, Matthew W. Bullock","doi":"10.2147/ORR.S348919","DOIUrl":"https://doi.org/10.2147/ORR.S348919","url":null,"abstract":"Abstract A post-operative fluid collection (POFC) represents a common finding in both primary and revision total joint arthroplasty (TJA). Fortunately, most resolve on their own, but in instances where they become symptomatic, prompt identification and management are paramount, especially when they occur adjacent to a joint arthroplasty because of the increased the risk of developing a periprosthetic joint infection. A strong clinical suspicion with appropriate clinical exam is required along with select imaging modalities to arrive at a diagnosis. Meticulous surgical technique is crucial to prevent POFC, but new emerging treatments continue to evolve. This article presents an updated overview of incidence, pathophysiology, diagnosis, and management of POFC in the setting of TJA. We review the role of select imaging modalities as well as summarize current literature regarding new treatments such as sclerotherapy agents, acellular dermal matrices, and negative pressure wound therapy. Future studies are necessary to explore the interplay of inflammatory mediators in POFC formation and to define their role in fluid collection resolution.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 1","pages":"43 - 57"},"PeriodicalIF":2.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42564252","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":"Gunshot Wounds: Ballistics, Pathology, and Treatment Recommendations, with a Focus on Retained Bullets.","authors":"Gracie R Baum,&nbsp;Jaxon T Baum,&nbsp;Dan Hayward,&nbsp;Brendan J MacKay","doi":"10.2147/ORR.S378278","DOIUrl":"https://doi.org/10.2147/ORR.S378278","url":null,"abstract":"<p><p>As the epidemic of gunshot injuries and firearm fatalities continues to proliferate in the United States, knowledge regarding gunshot wound (GSW) injury and management is increasingly relevant to health-care providers. Unfortunately, existing guidelines are largely outdated, written in a time that high-velocity weapons and deforming bullets were chiefly restricted to military use. Advances in firearm technology and increased accessibility of military grade firearms to civilians has exacerbated the nature of domestic GSW injury and complicated clinical decision-making, as these weapons are associated with increased tissue damage and often result in retained bullets. Currently, there is a lack of literature addressing recent advances in the field of projectile-related trauma, specifically injuries with retained bullets. This review aims to aggregate the available yet dispersed findings regarding ballistics, GSW etiology, and treatment, particularly for cases involving retained projectiles.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 ","pages":"293-317"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/ff/orr-14-293.PMC9462949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642034","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":"Management of Syndesmosis Injury: A Narrative Review.","authors":"Jiayong Liu,&nbsp;Daniel Valentine,&nbsp;Nabil A Ebraheim","doi":"10.2147/ORR.S340533","DOIUrl":"https://doi.org/10.2147/ORR.S340533","url":null,"abstract":"<p><p>The syndesmosis is an important fibrous joint that plays a crucial role in normal ankle weight-bearing and movements. Syndesmosis injuries include disruption of one or more of the ligaments comprising the distal tibiofibular syndesmosis and are commonly associated with ankle fractures. The treatment of grade 1 syndesmosis injury should be conservative, such as immobilization for one to three weeks followed by gradual return to activity. For the treatment of grade 2 syndesmosis injury, if it was stable enough, the patients still could be managed with conservative therapies. But majority of them strongly favor surgical treatment. For the treatment of grade 3 syndesmosis injury, it should treat with surgical reconstruction. If syndesmosis injury is associated with ankle fractures, surgical reduction, fixation, and reconstruction are usually required. Common surgical treatment methods include syndesmosis screws, composed of either metallic or bioabsorbable material; fibula intramedullary nails; and dynamic button-suture fixation, TightRope or ZipTight. Each method has advantages and disadvantages which must be considered while determining which treatment will provide the best outcomes depending on the patient's needs. Continued exploration of new materials, devices, and methods for surgical fixation is necessary for advancement in this field.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 ","pages":"471-475"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/43/orr-14-471.PMC9749496.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748699","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":"Radiation in Adolescent Idiopathic Scoliosis Management: Estimated Cumulative Pre-Operative, Intra-Operative, and Post-Operative Exposure.","authors":"Alexander Duke,&nbsp;Richard Marchese,&nbsp;David E Komatsu,&nbsp;James Barsi","doi":"10.2147/ORR.S387369","DOIUrl":"https://doi.org/10.2147/ORR.S387369","url":null,"abstract":"<p><strong>Background: </strong>Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis affecting adolescents, with approximately 2-4% of children being diagnosed. Crucial to the diagnosis and management are radiographic imaging, which allow physicians to assess and treat - from initial visits through surgical planning and post-operative management. While initial stages require low levels of exposure to radiation, via x-rays, as patients progress in disease severity exposure becomes larger with pre-operative, intra-operative and post-operative CT scans. While many studies have evaluated exposure during AIS treatment, few have assessed the cumulative radiation exposure adolescents receive during their evaluation. The purpose of our study is to complete a comprehensive review on cumulative radiation exposure and determine what stages in AIS treatment expose patients to the highest level of radiation over a duration of 2 years.</p><p><strong>Methods: </strong>A retrospective chart review of 109 AIS cases (29M, 80F), mean age 14.9 ± 2.3 years was completed to assess and quantify each imaging modality used. Employing a radiation detector, each imaging modality was then assessed, and estimated radiation exposures were determined. Statistical analysis was completed utilizing averaged patient exposures during each selected period in AIS management.</p><p><strong>Results: </strong>Mean estimated radiation doses (StDev) were 60.94 mrem (±0.609 mrem) for two x-rays (full-length AP and lateral radiograph of the entire spine), 12.92 mrem (±1.292 mrem) for each fluoroscopy exposure, and 1340.60 mrem (±13.406 mrem) per CT scan. Based on these values, estimated subject exposures were calculated. The total estimated radiation exposure over a 2-year period was 5572.74 mrem (±1428.88 merm) or 2786.37 mrem (±714.43 mrem) per year.</p><p><strong>Conclusion: </strong>The two-year cumulative radiation exposure is below the recommended exposure by Nuclear Regulatory Commission and OSHA. As expected, CT exposure presents the largest radiation exposure to patients with AIS throughout their operative management.</p><p><strong>Level of evidence: </strong>III, retrospective study.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 ","pages":"487-493"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/36/orr-14-487.PMC9809375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860569","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":"Lower Back Pain Caused by the Impact of COVID-19 Quarantine on Physical Activity and Daily Sitting Among Adult Saudi Arabian Populations in Jeddah: A Cross-Sectional Study.","authors":"Lutf Ahmed Abumunaser,&nbsp;Kawther Ali Alfaraj,&nbsp;Lujain Khalid Kamal,&nbsp;Renad Abdullah Alzahrani,&nbsp;Maram Misfer Alzahrani,&nbsp;Alzahraa Bader AlAhmed","doi":"10.2147/ORR.S386995","DOIUrl":"https://doi.org/10.2147/ORR.S386995","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 quarantine period, most outdoor activities and events were banned, resulting in a decrease in physical activity (PA) and prolonged sitting (PS) time, which are significant factors in the development of lower back pain (LBP). The aim of this study was to evaluate the association between physical inactivity and daily sitting time during quarantine with LBP among the Saudi Arabian population.</p><p><strong>Patients and methods: </strong>In this cross-sectional study conducted at King Abdulaziz University Hospital, 288 participants were recruited using an online, self-administered questionnaire in Arabic. It consisted of 21 questions assessing back pain, PA, and daily sitting time before and during quarantine. The main outcome measures included demographics, low back pain levels, daily sitting time, and PA level.</p><p><strong>Results: </strong>The participants consisted of 236 women and 52 men aged 18-65 years. During quarantine, 74% of participants sat most of the time and did not exercise or performed less exercise. Furthermore, almost half of the participants did not engage in PA both before and during the quarantine. There was an increase in the prevalence of LBP, with only 44.8% of participants presenting with LBP before quarantine and 59.4% having it during quarantine. A statistically significant association was found between daily sitting time and LBP (P=0.007) and PA and LBP (P=0.045) during quarantine. However, there was no significant association between age and painkiller use for LBP (P=0.251).</p><p><strong>Conclusion: </strong>Our study highlights the relationship of physical inactivity and PS during quarantine with an increase in the prevalence and intensity of LBP. The limitations of the study include the use of self-reports, a small sample size, and unequal survey distribution. A well-distributed survey with a larger sample size is necessary to obtain an adequate representation of the entire Saudi population.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 ","pages":"477-485"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/6d/orr-14-477.PMC9759024.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10461857","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 New Test for the Advanced Diagnosis of Lateral Elbow Tendinopathy with Concomitant Intrasubstance Tear: Failure to Resist Extension Effort (the Free Test).","authors":"Cristóbal Greene,&nbsp;Guillermo Droppelmann,&nbsp;Nicolás García,&nbsp;Carlos Jorquera,&nbsp;Arturo Verdugo","doi":"10.2147/ORR.S364050","DOIUrl":"https://doi.org/10.2147/ORR.S364050","url":null,"abstract":"<p><strong>Background: </strong>Lateral elbow tendinopathy (LET) is one of the most common causes of musculoskeletal pain. The diagnosis is based on the clinical history and different physical maneuvers. Ultrasound (US) is a complementary diagnostic method to detect degenerative tendon changes and intrasubstance tears (IST). To date, there is no available physical maneuver to identify an IST in patients with LET.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy of an index test to detect an IST confirmed by ultrasound in patients with LET.</p><p><strong>Methods: </strong>A diagnostic retrospective study was performed. Patients who presented medical records with LET were recruited. Two orthopaedic surgeons developed the physical maneuver. The index test was considered positive when the position failed to resist the wrist extension maximum effort. Clinical findings were associated with confirmation of IST by US. Data were calculated using diagnostic accuracy, sensitivity, and specificity with 95% confidence intervals.</p><p><strong>Results: </strong>Thirty-nine patients (39 elbows) were analyzed, 25 (64%) women and 14 (36%) men, with an average age of 47.7 years. The index test's sensitivity was 0.86 (95% CI, 0.67-0.96). Accuracy was 0.79 (95% CI, 0.64-0.91), and the specificity was 0.64 (95% CI, 0.31-0.89).</p><p><strong>Conclusion: </strong>The index test presented very good sensitivity and good accuracy in patients with LET with US diagnostic confirmation of IST.</p><p><strong>Level of evidence: </strong>Diagnostic study, Level III.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"14 ","pages":"495-503"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/c5/orr-14-495.PMC9809378.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10857051","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}