SICOT-J最新文献

{"title":"Outcomes of total hip arthroplasty using dual mobility cups following failed internal fixation of proximal femoral fractures at a mean follow-up of 6 years.","authors":"Chahine Assi, Joeffroy Otayek, Jad Mansour, Jimmy Daher, Jacques Caton, Camille Samaha, Kaissar Yammine","doi":"10.1051/sicotj/2023038","DOIUrl":"10.1051/sicotj/2023038","url":null,"abstract":"<p><strong>Introduction: </strong>Performing total hip arthroplasty (THA) after failed internal fixation of proximal femoral fractures (PFF) is known to be associated with high rates of complications. Dual mobility cups (DMC) are known to lower dislocation events in high-risk patients. Very few reports investigated the outcomes of THA using DMC following failure of internal fixation for PFF.</p><p><strong>Methods: </strong>This is a retrospective monocentric continuous study of 31 patients who underwent THA with DMC after failed internal fixation of PFF. The clinical assessment was based on the modified Harris hip score (mHHS) at the last follow-up. The complication rates and radiological analyses were recorded.</p><p><strong>Results: </strong>The mean follow-up period was 5.96 ± 4.2 years. At the last follow-up, the mean mHHS was 92.9 ± 9.1 with 71% of the patients describing their operated hip as a forgotten hip. No dislocation or aseptic loosening events were noted. One patient developed a septic loosening of the implant. No significant radiological changes were recorded. Sixteen stems (51.6%) were placed in a neutral position, 13 (42%) in valgus (2.74 ± 1.72°), and 2 (6.4%) in varus (6.94 ± 2.02°).</p><p><strong>Conclusion: </strong>This study emphasizes the advantage of using DMC following failed internal fixation of PFF in reducing dislocation and complication events in this high-risk population.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"3"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490009","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":"Prior medial meniscus arthroscopy is not associated with worst functional outcomes in patients undergoing primary total knee arthroplasty: A retrospective single-center study with a minimum follow-up of 5 years.","authors":"Vasileios Giovanoulis, Axel Schmidt, Angelo V Vasiliadis, Christos Koutserimpas, Cécile Batailler, Sébastien Lustig, Elvire Servien","doi":"10.1051/sicotj/2024001","DOIUrl":"10.1051/sicotj/2024001","url":null,"abstract":"<p><strong>Introduction: </strong>There have been controversial studies on the impact of prior knee arthroscopy (KA) on outcomes of total knee arthroplasty (TKA). The purpose of this comparative study is to investigate the impact of prior KA of medial meniscus on patients undergoing TKA by evaluating the International Knee Society Score (IKS), the complications, and revisions.</p><p><strong>Methods: </strong>This retrospective study reviewed 84 patients with TKA who had undergone prior KA of the medial meniscus and compared them to 84 cases, without a history of prior KA as a control group. Outcomes were assessed with the original IKS scores and complications. The mean follow-up was 8 years.</p><p><strong>Results: </strong>There was no significant difference between groups with respect to demographics, or pre-operative IKS. The mean pre and postoperative IKS was not different between groups. The all-cause reoperation, revision, and complication rates of the KA group were not significantly higher than those of the control group.</p><p><strong>Conclusion: </strong>The present study seems to reveal that previous KA of the medial meniscus does not negatively affect a subsequent TKA. Nevertheless, larger studies may be necessary to confirm this observation.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"5"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490018","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":"Pre-operative planning for reverse shoulder arthroplasty in low-resource centres: A modified Delphi study in South Africa.","authors":"Pududu Archie Rachuene, Roopam Dey, Ntambue Jimmy Kauta, Sudesh Sivarasu, Jean-Pierre du Plessis, Stephen Roche, Basil Vrettos","doi":"10.1051/sicotj/2024021","DOIUrl":"10.1051/sicotj/2024021","url":null,"abstract":"<p><strong>Background: </strong>Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans.</p><p><strong>Methods: </strong>A working group generated statements on pre-operative imaging and glenoid of glenoid morphology and intra-operative decision-making. The study was conducted in three stages, with virtual consensus meetings in between. Stages 2 and 3 consisted only of closed questions/statements. The statements with over 70% were considered consensus achieved and those with less than 10% were considered disagreement consensus achieved.</p><p><strong>Results: </strong>Twelve shoulder surgeons participated, with 67% having over five years of experience in shoulder arthroplasty. In the absence of glenoid bone loss, the sole use of plain radiographs for pre-operative planning reached consensus and is recommended by these groups, while 100% advise using CT scans when bone loss is present. Most surgeons (70%) recommend using patient-specific instrumentation (PSI) in cases of structural bone loss. Most of the statements on intra-operative decision-making related to component placement and enhancing stability failed to reach consensus.</p><p><strong>Conclusion: </strong>While consensus was achieved on most aspects of pre-operative imaging and planning, technical aspects of surgery lacked consensus. Planning for patients with structural glenoid bone loss necessitates CT scans and planning tools.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"23"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180077","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":"High-concentration continuous local antibacterial perfusion therapy: safety and potential efficacy for acute and chronic periprosthetic knee joint infection.","authors":"Yuki Suzuki, Koji Iwasaki, Zenta Joutoku, Tomohiro Onodera, Masatake Matsuoka, Ryosuke Hishimura, Masanari Hamasaki, Eiji Kondo, Norimasa Iwasaki","doi":"10.1051/sicotj/2024048","DOIUrl":"10.1051/sicotj/2024048","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infections (PJIs) following total knee arthroplasty (TKA) are among the most challenging pathologies to manage. Recently, continuous local antibiotic perfusion (CLAP) therapy has been introduced for treating musculoskeletal infections in orthopedics. This study aimed to determine the outcomes and risks of CLAP therapy combined with conventional treatment for PJIs after TKA.</p><p><strong>Methods: </strong>We retrospectively evaluated 14 patients with PJIs. For acute PJIs, CLAP therapy was performed alongside debridement, intravenous antibiotics, and implant retention. For chronic PJIs, a two-stage revision with CLAP therapy and intravenous antibiotics was performed. Implants were replaced with a cement mold incorporating CLAP therapy, followed by revision surgery after 3 months. For all patients, 120 mg/day of gentamicin (GM) was locally administered into the knee joint for 2 weeks as part of CLAP therapy, in combination with perioperative intravenous antibiotics.</p><p><strong>Results: </strong>Five patients developed acute PJIs, and nine developed chronic PJIs after TKA. The mean follow-up period was 18.4 (15.2-21.1) months. All five patients with PJIs treated with one-stage surgery (debridement and insert exchange only) successfully preserved their implants. Among the nine patients with chronic PJIs, seven underwent CLAP therapy combined with two-stage revision surgery, resulting in successful treatment without relapse, whereas the remaining two patients were initially treated with one-stage surgery and CLAP therapy but failed to retain their implants, and subsequently required additional two-stage revision surgery, which ultimately succeeded. No adverse effects from GM were reported.</p><p><strong>Conclusions: </strong>Our results suggest that CLAP therapy is safe and may be effective for treating acute and most chronic PJIs after TKA.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"51"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717577","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":"Piriformis preserving posterior approach STAR for primary and primary complex total hip arthroplasty: Excellent safety and efficacy in a single blinded prospective single surgeon cohort of 522 patients with a mean follow-up of 2 years.","authors":"Eustathios Kenanidis, Vasileios F Pegios, Eleni Tsamoura, Nikolaos Milonakis, Eleftherios Tsiridis","doi":"10.1051/sicotj/2024030","DOIUrl":"10.1051/sicotj/2024030","url":null,"abstract":"<p><strong>Introduction: </strong>STAR (Superior Transverse Anatomic Reconstruction), a piriformis-preserving posterior approach, has not been extensively studied. Our study aimed to assess the STAR approach's safety and efficacy by recording postoperative complication rates and measuring implantation accuracy in a single surgeon prospective cohort with a mean follow-up of two years.</p><p><strong>Methods: </strong>The study involved 522 patients with elective primary or complex primary total hip arthroplasty (THA) performed by a senior surgeon using the STAR approach between 2019 and 2023. 63.6% of the patients were female. The mean patients' age was 65.6 years. 19.5% of the procedures were primary complex THAs. The mean follow-up and length of stay were 2.13 years and 1.50 days. The ratio of uncemented to hybrid and standard to dual mobility liner THAs were 3:2 and 4:1. Fifty-eight patients received blood transfusions. All patients followed the same postoperative protocol. Two physicians not involved in surgery collected clinical and radiological data. Efficacy was defined as measuring the cup inclination and anteversion, stem alignment, and leg length discrepancy (LLD) using the one-month postoperative standardised supine anteroposterior pelvic X-rays. The postoperative complication rate, including dislocation and infection, defined safety.</p><p><strong>Results: </strong>The mean cup inclination and anteversion were 42.8⁰ (±4.9) and 19.9⁰ (±8.9), respectively. 97.5% of the stems were placed in neutral and 2.5% in varus position. The mean LLD was 3.3 ± 6.3 mm. A single deep infection was managed with two-stage revision with no recurrence, and an early traumatic dislocation in an 80-year-old woman was managed successfully with closed reduction and hip spica. Three superficial wound infections were treated with oral antibiotics.</p><p><strong>Discussion: </strong>The STAR approach is safe and has demonstrated excellent early-to-mid-term efficacy profile outcomes. The unobstructed acetabular and femoral intraoperative view facilitated optimal implant positioning and contributed to excellent dislocation outcomes in combination with piriformis preservation.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"33"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141315","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":"Comparative biomechanical analysis of tibial posterior slope in medial open wedge high tibial osteotomy vs. distal tuberosity osteotomy with and without anterior-posterior screw: a study using porcine tibia.","authors":"Yoshiya Nibe, Tsuneari Takahashi, Hironari Hai, Tomohiro Matsumura, Katsushi Takeshita","doi":"10.1051/sicotj/2024042","DOIUrl":"10.1051/sicotj/2024042","url":null,"abstract":"<p><p>Purpose While increased posterior tibial slope (PTS) is a concern post-medial open wedge high tibial osteotomy (MOWHTO), the ability of distal tuberosity osteotomy (DTO) to maintain postoperative PTS after cyclic loading remains unverified. This study aims to determine whether PTS alterations significantly differ between DTO and MOWHTO following cyclic loading.</p><p><strong>Methods: </strong>Biomechanical evaluations were conducted on thirty porcine tibias using MOWHTO and DTO, with and without an anterior-posterior (AP) screw. To investigate PTS changes, cyclic testing was carried out for MOWHTO and DTO. Displacement along the mechanical axis during cycles 10th, 100th, 500th, 1000th, 1500th and 2000th, variations in anterior and posterior gaps after 2000 cycles and increased PTS after 2000 cycles, were compared across the three groups. The displacement was evaluated by repeated-measures analysis of variance (ANOVA), and changes in AG and PG and increased PTS were evaluated by one-way ANOVA. The sample size for α and β errors were <0.05 and <0.20, and the effect size was 0.60 for one-way ANOVA and 0.46 for repeated-measures ANOVA.</p><p><strong>Results: </strong>There were no significant differences in displacement and anterior gap changes among the groups. A significant difference was observed in the posterior gap changes (P < 0.001) and increased PTS (P = 0.013) among the groups. Post hoc analysis indicated substantial disparities between MOWHTO and DTO without the AP screw (P = 0.035), as well as between MOWHTO and DTO with the AP screw (P = 0.021) concerning the increased PTS.</p><p><strong>Conclusion: </strong>After cyclic loading, MOWHTO exhibited a notably smaller PTS change than DTO regardless of the presence of an AP screw.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"41"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477379","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":"Intraoperative patellar tracking assessment during image-based robotic-assisted total knee arthroplasty: technical note and reliability study.","authors":"Cécile Batailler, Salomé Greiner, Hanna-Lisa Rekik, Flora Olivier, Elvire Servien, Sébastien Lustig","doi":"10.1051/sicotj/2024037","DOIUrl":"10.1051/sicotj/2024037","url":null,"abstract":"<p><strong>Introduction: </strong>Restoration of the anterior knee compartment is increasingly studied with the development of personalized surgery. However, evaluating the patellar tracking during the surgery is still subjective and at the surgeon's discretion. This study aimed 1) to describe the assessment of the patellar tracking during robotic-assisted total knee arthroplasty (TKA), 2) to describe a new measurement technique for evaluating the evolution of this patellar tracking, and 3) to assess its reliability and repeatability.</p><p><strong>Method: </strong>This monocentric study assessed the evolution of patellar tracking for 20 robotic-assisted TKA. The sharp probe was used to perform patellar tracking in all the arcs of knee flexion before and after the bone cuts. The patella positioning was recorded every 10° of flexion between the full extension and 90° knee flexion and was assessed in the coronal and sagittal planes. For the measurements of the patellar tracking, we used a sagittal view and a coronal view of the knee on the MAKO software. From these two views, the difference between the patellar tracking before and after the bone cuts with the definitive implants was measured. Two independent reviewers performed the measurements to assess their reliability. To determine intraobserver variability, the first observer performed the measurements twice.</p><p><strong>Results: </strong>The mean age was 68.7 years old ± 5.2 [61; 75], the mean body mass index was 28.8 kg/m² ± 4.2 [21.4; 36.2], the mean HKA angle was 176.3° ± 3.7° [174.1.4; 179.7]. The radiographic measurements showed very good to excellent intra-observer and inter-observer agreements (0.60 to 1.0).</p><p><strong>Conclusion: </strong>This new measurement technique assessed the evolution of patellar tracking after TKA with good inter and intra-observer reliability.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"44"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548230","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":"Do joint-preserving hip procedures compromise subsequent total hip arthroplasty? A meta-analysis of complications, functional outcome and survivorship.","authors":"En Lin Goh, Oliver R Boughton, Thomas Donnelly, Colin G Murphy, James Cashman, Connor Green","doi":"10.1051/sicotj/2024018","DOIUrl":"10.1051/sicotj/2024018","url":null,"abstract":"<p><strong>Background: </strong>Joint-preserving hip operations can help relieve pain and delay the need for long-term joint arthroplasty. Previous research has not identified procedures that can compromise outcomes following total hip arthroplasty (THA). This meta-analysis aims to evaluate the effect of joint-preserving hip operations on outcomes following subsequent THA.</p><p><strong>Methods: </strong>MEDLINE, EMBASE and Scopus databases were searched from the date of inception until February 2024. All studies comparing outcomes following THA in individuals with (PS) and without prior surgery (NPS) of the femur or pelvis were included. Data on operative time, blood loss, intra- and post-operative complications, functional outcomes, and implant survivorship were extracted.</p><p><strong>Results: </strong>16 studies, comprising 2576 patients were included (PS = 939, NPS = 1637). The PS group was associated with significantly longer operative time [MD: 8.1, 95% CI: 4.6-11.6], significantly greater blood loss [MD: 167.8, 95% CI: 135.6-200.0], and a higher risk of intra-operative peri-prosthetic fracture [RR: 1.9, 95% CI: 1.2-3.0], specifically, with prior femoral osteotomy. There were no differences in terms of risks of dislocation [RR: 1.8, 95% CI: 1.0-3.2], implant loosening [RR: 1.0, 95% CI: 0.7-1.5], or revision surgery [RR: 1.3, 95% CI: 1.0-1.7] between the two groups. The PS group was associated with significantly poorer improvements in functional outcome [MD: -5.6, 95% CI: -7.6-(-3.5)], specifically, with prior acetabular osteotomy. Implant survivorship in the two groups was comparable after one year [HR: 1.9, 95% CI: 0.6-6.2] but significantly inferior in the PS group after five years [HR: 2.5, 95% CI: 1.4-4.7], specifically, with prior femoral osteotomy.</p><p><strong>Conclusion: </strong>Joint-preserving hip operations are associated with greater intra-operative challenges and complications. In subsequent joint arthroplasty, prior acetabular procedures affect functional outcomes while prior femoral procedures influence implant survivorship. Hip pain due to the morphological sequelae of pediatric hip pathology can be debilitating at a young age. Surgical decision-making at that time needs to consider the survivorship of a THA implanted at that young age against the consequences of hip preservation surgery on further THA.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"25"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11160402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284996","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":"Isolated posterior stabilization in type B and C thoracolumbar fractures associated with ankylosing spine disorders: A single center experience with clinical and radiological outcomes.","authors":"Benoit Sulpis, Thomas Neri, Antonio Klasan, Xavier Castel, François Vassal, Marie Charlotte Tetard","doi":"10.1051/sicotj/2024022","DOIUrl":"10.1051/sicotj/2024022","url":null,"abstract":"<p><strong>Introduction: </strong>Fractures in ankylosing spine disorders (ASD) are associated with high complication and mortality rates. During the posterior stabilization of these fractures, reduction is often partial, resulting in the persistence of a significant anterior diastasis. Our objective was to evaluate the safety and efficiency of isolated posterior stabilization in elderly ASD patients, without direct reduction of the anterior diastasis, in terms of clinical and radiological outcomes, complications, and mortality.</p><p><strong>Methods: </strong>This retrospective study included 46 patients, mean age 79.3 years, with ASD, who underwent isolated posterior stabilization, open or percutaneous, for thoracolumbar fractures. The average follow-up was 21.7 months, with a minimum follow-up of 6 months. Autonomy (Parker score) and radiological results (lordotic angulation) were analyzed pre-and post-operatively.</p><p><strong>Results: </strong>Autonomy was maintained at the last follow-up, with no significant difference in Parker's score. The consolidation rate was 94.6%. No implant failure was recorded. Despite the absence of an anterior procedure, lordotic angulation was significantly reduced by 2.6° at 6 months (p = 0.02). The rate of surgical complications following open surgeries was 10.9% (n = 5), of which 6.5% were infections. No surgical complications were reported in percutaneous surgeries. The rate of medical complications was 67.4% (n = 31), with a rate of 88.2% in the open surgery group, compared to 55.2% in the percutaneous surgery group. An open approach was associated with a five-fold higher risk of complications (p = 0.049). Nine patients died during follow-up (19.6%).</p><p><strong>Conclusions: </strong>Isolated posterior stabilization in the treatment of thoracolumbar spine fractures in elderly ASD patients is a safe technique promoting autonomy preservation, and high radiological bony healing with acceptable complication and mortality rates. The persistent anterior gap is partially reduced when the spine is loaded and does not seem to require an anterior procedure, thus decreasing complications. Percutaneous surgery should be the technique of choice to reduce surgical complications.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"26"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976850","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":"Similar complications and outcomes with simultaneous versus staged bilateral total hip arthroplasty with the direct anterior approach: A comparative study.","authors":"Christos Koutserimpas, Edouard Rob, Elvire Servien, Sébastien Lustig, Cécile Batailler","doi":"10.1051/sicotj/2024028","DOIUrl":"10.1051/sicotj/2024028","url":null,"abstract":"<p><strong>Introduction: </strong>Simultaneous bilateral total hip arthroplasty (THA) has demonstrated similar clinical outcomes to staged bilateral THA. However, there is scarce data regarding the early postoperative complications. This study compares simultaneous to staged bilateral THA with the direct anterior approach (DAA) regarding early complications and revision surgeries.</p><p><strong>Methods: </strong>This retrospective case-control study included all bilateral THAs, performed by DAA between 2013 and 2021 with a minimum follow-up of 6 months. A total of 264 THAs (132 patients) were identified [simultaneous group (1T): 58 patients; staged group (2T): 74] with a mean follow-up of 54 months. Complications and revisions, clinical outcomes, and days off work were assessed at the last follow-up. Moreover, blood loss was evaluated by the modified method of Mercuriali and Inghilleri.</p><p><strong>Results: </strong>Blood loss was higher in the 1T group (1003 mL 1T vs. 740 mL 2T; p < 0.001) but there was no significant difference in transfusion rates (5% 1T vs. 3% 2T; p = 0.4). There were no complications in 1T, while the complication rate was 5.2% (n = 6) in 2T (p = 0.012). There were 5 revisions in the 2T group, including 2 debridements with polyethylene exchange and implant retention for early infections, 2 revisions for aseptic loosening in the same patient, and 1 revision due to fracture. Postoperative pain on D3 was equivalent in both groups (4.2 1T vs. 4.3 2T; p = 0.79). The improvement in function according to the HHS at 2 months was better in the 1T group, but not significant (36.8 1T vs. 32.9 2T; p = 0.05). The total number of days off work was significantly higher in the 2T group (82.6 days vs. 178.8; p = 0.025).</p><p><strong>Discussion: </strong>Simultaneous bilateral THA with the DAA seems to be a safe procedure, with no risk of increased early postoperative complications when compared to the staged procedure with similar functional outcomes and significantly fewer complications and days off work.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"31"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037264","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}