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The infected total knee replacement: the worst and unfortunately most frequent complication 感染全膝关节置换术：最严重和最常见的并发症
Orthopaedics and Trauma Pub Date : 2025-02-01 DOI: 10.1016/j.mporth.2024.12.006
Lee M Jeys, Romir Patel, Thomas Jenkins, Semay Baydar, Joseph Pagkalos
{"title":"The infected total knee replacement: the worst and unfortunately most frequent complication","authors":"Lee M Jeys,&nbsp;Romir Patel,&nbsp;Thomas Jenkins,&nbsp;Semay Baydar,&nbsp;Joseph Pagkalos","doi":"10.1016/j.mporth.2024.12.006","DOIUrl":"10.1016/j.mporth.2024.12.006","url":null,"abstract":"<div><div>Periprosthetic joint infection (PJI) is the most common reason for early revision following total knee replacement surgery. It is associated with poor patient outcomes, prolonged inpatient stay, costly surgical interventions and extended treatment in the community. Despite advances in surgical technique, implants and operating room technology, PJI is an unresolved problem in arthroplasty. As the volume of knee replacement procedures continues to increase, PJI continues to be a significant burden for the health service. Treatment of PJI has historically been with two-stage exchange, but with single-stage revision surgery increasing in popularity for selected cases. In this review we aim to follow the patient journey from presentation to diagnosis and treatment, and discuss contemporary management strategies when treating this devastating complication.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 42-54"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142940","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}
引用次数: 0
The National Joint Registry 22 years on: what have we learned about knee replacements? 22年过去了：我们对膝关节置换术学到了什么？
Orthopaedics and Trauma Pub Date : 2025-02-01 DOI: 10.1016/j.mporth.2024.12.008
Paul M Sutton, James S Murray
{"title":"The National Joint Registry 22 years on: what have we learned about knee replacements?","authors":"Paul M Sutton,&nbsp;James S Murray","doi":"10.1016/j.mporth.2024.12.008","DOIUrl":"10.1016/j.mporth.2024.12.008","url":null,"abstract":"<div><div>The National Joint Registry (NJR) of England and Wales was established in 2002 to collect, analyse and report high-quality data about joint replacement surgery. Submission of knee arthroplasty data has been mandated since 2003 in the private sector, and 2010 in the NHS, making the NJR the largest orthopaedic registry in the world. This powerful audit tool collects information on preoperative, intraoperative and postoperative variables, enabling advancement in most of, if not every, facet of the procedure. These data can be used to inform surgeons and other healthcare providers, healthcare commissioners, industry, and patients themselves about outcomes and best practice, ensuring informed decision-making. Drawing from NJR reports, as well as work from external authors using these data, the aim of this review is to highlight what knee surgeons can learn from 22 years of the NJR. We will discuss trends in knee surgery, changes in surgical technique, surgical outcomes and future developments.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 74-80"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142945","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}
引用次数: 0
Off-the-shelf knee replacements versus robotics versus customized implants: the reality versus the hype 现成的膝关节置换、机器人技术、定制植入物：现实与炒作
Orthopaedics and Trauma Pub Date : 2025-02-01 DOI: 10.1016/j.mporth.2024.12.005
Ian D McDermott, Gregory M Martin
{"title":"Off-the-shelf knee replacements versus robotics versus customized implants: the reality versus the hype","authors":"Ian D McDermott,&nbsp;Gregory M Martin","doi":"10.1016/j.mporth.2024.12.005","DOIUrl":"10.1016/j.mporth.2024.12.005","url":null,"abstract":"<div><div>With traditional ‘off-the-shelf’ implants for knee replacement surgery, 15–20% of patients end up unhappy with their knee. At least part of the reason for this may be the significant differences that can exist between individuals in their distal femoral and proximal tibial geometries. This article explains how patient-specific customized knee implants can address many of the deficiencies that may exist with off-the-shelf designs. Evidence is presented of how customized knee implants can lead to better alignment, better coverage, better knee kinematics, less bone resection, improved efficiency in theatre, fewer complications, better patient-reported outcomes and increased long-term prosthetic survivorship, all without any significant overall additional costs. This article also dispels some of the myths and the hype that surround the current trend towards robotic-assisted knee replacement surgery.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 33-41"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143078","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}
引用次数: 0
Focal resurfacing of the knee 局部膝关节置换术
Orthopaedics and Trauma Pub Date : 2025-02-01 DOI: 10.1016/j.mporth.2024.12.002
Francesca de Caro
{"title":"Focal resurfacing of the knee","authors":"Francesca de Caro","doi":"10.1016/j.mporth.2024.12.002","DOIUrl":"10.1016/j.mporth.2024.12.002","url":null,"abstract":"<div><div>In the past decade, three distinct systems for addressing focal cartilage lesions in the knee through resurfacing have emerged, namely the Hemicap/Unicap, BioPoly and Episealer systems. These technologies provide a new approach for treating patients who might not be suitable candidates for other biological treatment options. Specifically, they target individuals considered too old to benefit from biologic repair methods, but who are also too young for a unicompartmental knee arthroplasty. The three systems have demonstrated promising clinical outcomes, with the literature showing that they can effectively relieve pain and restore knee function, with success rates comparable to other established treatments for cartilage injuries. An additional advantage of these surface replacement systems is their relatively short rehabilitation period, which allows for a quicker return to daily activities. In conclusion, they are an ideal option for ‘gap-age’ patients, representing a valuable alternative for managing knee cartilage defects in this specific patient cohort.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 9-14"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142473","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}
引用次数: 0
CME questions on Knee Arthroplasty 关于膝关节置换术的CME问题
Orthopaedics and Trauma Pub Date : 2025-02-01 DOI: 10.1016/j.mporth.2024.12.010
{"title":"CME questions on Knee Arthroplasty","authors":"","doi":"10.1016/j.mporth.2024.12.010","DOIUrl":"10.1016/j.mporth.2024.12.010","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 81-82"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142941","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}
引用次数: 0
Legg–Calvé–Perthes disease: pertinent information for orthopaedic exam candidates Legg-Calvé-Perthes 病：骨科考试考生的相关信息
Orthopaedics and Trauma Pub Date : 2024-11-01 DOI: 10.1016/j.mporth.2024.10.004
Samuel W King
{"title":"Legg–Calvé–Perthes disease: pertinent information for orthopaedic exam candidates","authors":"Samuel W King","doi":"10.1016/j.mporth.2024.10.004","DOIUrl":"10.1016/j.mporth.2024.10.004","url":null,"abstract":"<div><div>Legg–Calvé–Perthes (LCP) disease is a common topic for final professional examinations. It is an important differential diagnosis to recognize in children presenting with a limp. Its diagnosis requires the exclusion of diagnoses requiring more immediate action, such as infection or malignancy. It may also present with subtle, or no, signs on routine investigations. LCP disease may resolve spontaneously without long term sequelae or result in debilitating hip pathology requiring operative management. Its aetiology and most appropriate management are topics for debate, and knowledge of the classical papers and commonly used classification systems allow candidates to discuss these in more depth.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 360-364"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698505","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}
引用次数: 0
Congenital lower limb differences: an overview and common presentations 先天性下肢差异：概述和常见表现形式
Orthopaedics and Trauma Pub Date : 2024-11-01 DOI: 10.1016/j.mporth.2024.10.002
Jemma Oberman, Olivia Byrne, Maheshi P Wijesekera, Patrick Foster
{"title":"Congenital lower limb differences: an overview and common presentations","authors":"Jemma Oberman,&nbsp;Olivia Byrne,&nbsp;Maheshi P Wijesekera,&nbsp;Patrick Foster","doi":"10.1016/j.mporth.2024.10.002","DOIUrl":"10.1016/j.mporth.2024.10.002","url":null,"abstract":"<div><div>Congenital lower limb differences are rare but can cause significant effects on the developing child. The term encompasses a broad spectrum of conditions, with varying degrees of severity. When evaluating these conditions, children should be managed on an individual basis due to the variety of presentations. This review provides the reader with an introduction to congenital limb differences of the lower limb, describing the common presentations, classifications and the orthopaedic management of these conditions.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 399-404"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698510","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}
引用次数: 0
Developmental hip dysplasia: which osteotomy, when? 发育性髋关节发育不良：何时截骨？
Orthopaedics and Trauma Pub Date : 2024-11-01 DOI: 10.1016/j.mporth.2024.09.003
Sarah Rubin, Christopher Edward Bache
{"title":"Developmental hip dysplasia: which osteotomy, when?","authors":"Sarah Rubin,&nbsp;Christopher Edward Bache","doi":"10.1016/j.mporth.2024.09.003","DOIUrl":"10.1016/j.mporth.2024.09.003","url":null,"abstract":"<div><div>Developmental hip dysplasia is a common problem encountered in orthopaedic practice; early diagnosis and closed containment of the femoral head in younger children aims to allow remodelling to occur. For older children, with less remodelling potential, surgical intervention with femoral and/or pelvic/acetabular osteotomies may be required. There are many osteotomies described, all with a common goal of normalizing anatomy and preventing long term degenerative changes. Individual osteotomies can be classified as redirectional or salvage subtypes, then indications by the age of the child/degree of skeletal maturity. The osteotomy options and outcomes from available literature are explained and a flowchart to summarize the authors recommended choices is provided.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 349-359"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698504","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}
引用次数: 0
Deformity planning: a primer for exam candidates 畸形规划：考生入门指南
Orthopaedics and Trauma Pub Date : 2024-10-30 DOI: 10.1016/j.mporth.2024.09.004
Marjan Raad, Kyle James, Enis Guryel, Alastair Robertson
{"title":"Deformity planning: a primer for exam candidates","authors":"Marjan Raad,&nbsp;Kyle James,&nbsp;Enis Guryel,&nbsp;Alastair Robertson","doi":"10.1016/j.mporth.2024.09.004","DOIUrl":"10.1016/j.mporth.2024.09.004","url":null,"abstract":"<div><div>This article will discuss the basic principles of lower limb deformity correction. Many final professional examinations in Trauma and Orthopaedic Surgery, including the UK Intercollegiate Fellowship Examination FRCS (Tr&amp;Orth), require a basic understanding of deformity planning and this article aims to be an essential tool for preparation. It provides a framework for clinical and radiographic assessment of lower limb deformity, and how to plan for lower limb deformity correction using the Centre of Rotation and Angulation (CORA) method, providing a pocket-sized guide for all trauma and orthopaedic trainees working towards their exams.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 386-398"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698509","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}
引用次数: 0
Slipped capital femoral epiphysis: diagnosis, classification and controversies in management 股骨头骺滑脱：诊断、分类和治疗争议
Orthopaedics and Trauma Pub Date : 2024-10-30 DOI: 10.1016/j.mporth.2024.09.002
Benjamin Dougal Chatterton, Kyle James
{"title":"Slipped capital femoral epiphysis: diagnosis, classification and controversies in management","authors":"Benjamin Dougal Chatterton,&nbsp;Kyle James","doi":"10.1016/j.mporth.2024.09.002","DOIUrl":"10.1016/j.mporth.2024.09.002","url":null,"abstract":"<div><div>Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting adolescents, and can be encountered by any surgeon who sees children as part of their on-call commitment. There are a number of diagnostic and management challenges associated with this condition, in particular in how to manage children with severe and unstable disease. This article covers the diagnosis and classification of SCFE, allowing recognition of those patients requiring specialist paediatric referral. The surgical management of SCFE, including complex cases, is also discussed.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 365-370"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698506","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}
引用次数: 0
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