SICOT-J最新文献

{"title":"Functional alignment is a feasible alignment strategy in robotic assisted total knee arthroplasty for knee osteoarthritis with extra-articular deformity - A case series.","authors":"Wei Cheong Eu, Jade Pei Yuik Ho, G Kunalan","doi":"10.1051/sicotj/2024059","DOIUrl":"10.1051/sicotj/2024059","url":null,"abstract":"<p><strong>Introduction: </strong>Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA). FA technique involves the adjustment of components positioning that least compromise the soft tissue envelope while restoring the limb alignment and joint obliquity to create a balanced knee. The aim is to study the outcome of intra-articular correction by robotic assisted TKA using Functional Alignment (FA) technique.</p><p><strong>Methodology: </strong>This is a single surgeon series of 8 patients with extraarticular deformity who underwent robotic assisted total knee arthroplasty (TKA) with FA technique. Soft tissue release was gradually released and followed by adjustments of implant positioning in order to achieve a balanced medio-lateral gap.</p><p><strong>Results: </strong>Postoperatively, the lower limb alignment of all patients were restored within 6° (mean 4.54°) based on functional alignment boundaries. Knee phenotype and joint line obliquity (JLO) were restored in comparison to contralateral lower limb. There were 6 varus and 2 valgus malalignment. 7 patients were implanted with posterior stabilized implants while 1 was implanted with cruciate retaining implant. Arc of knee flexion and extension improved (P = 0.002). There was a large postoperative improvement in the Knee Society Score (KSS) (P < 0.001).</p><p><strong>Discussion: </strong>Intraarticular correction by TKA for EAD with knee arthritis is technically reliable with robotic technology. It allows intraoperative adjustment following functional alignment philosophy, thereby, restoring pre-arthritic alignment, knee phenotype and joint line obliquity.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"2"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972730","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":"Limited accuracy of transtibial aiming for anatomical femoral tunnel positioning in ACL reconstruction.","authors":"Dimitrios Mastrokalos, Anastasios G Roustemis, Dimitrios Koulalis","doi":"10.1051/sicotj/2025002","DOIUrl":"10.1051/sicotj/2025002","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) rupture is a common knee injury, and with advancements in knee arthroscopy, ACL reconstruction has become common. Techniques like single-double bundle and femoral tunnel drilling via transtibial or anteromedial portal approaches are available. This study evaluates the accuracy of femoral tunnel placement via these approaches in single-bundle ACL reconstruction.</p><p><strong>Materials and methods: </strong>Forty-three ACL reconstructions using hamstring grafts were analyzed. Initially, femoral tunnels were drilled via the anteromedial portal from 09:30 to 10:00 (14:00 to 14:30 for left knees). Tibial tunnels (mean anteroposterior angle: 63.5°, sagittal: 64.2°) were then created with the same diameter, accompanied by radiological documentation. A femoral aiming device was used to place a K-wire at the center of the femoral tunnel, recorded photographically. Tunnel diameters included 7 mm (20 cases), 7.5 mm (11 cases), 8 mm (7 cases), 8.5 mm (3 cases), and 9 mm (1 case). Two observers evaluated all radiological and photographic data, focusing on the deviation of the transtibial K-wire from the femoral tunnel center.</p><p><strong>Results: </strong>Of 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.</p><p><strong>Conclusion: </strong>Transtibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"8"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383692","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":"The rectus abdominis tendon insertion to the pubic bone and its clinical implications: A cadaveric study.","authors":"Evangelos A Tourvas, Aristidis H Zibis, Michail E Klontzas, Apostolos H Karantanas, Johannes D Bastian, Theodoros H Tosounidis","doi":"10.1051/sicotj/2024053","DOIUrl":"10.1051/sicotj/2024053","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study is to determine the rectus abdominis tendon (RAT) insertional anatomy and consequently clarify the extension of secure mobilization of the tendon from the pubic bone in the setting of anterior approaches in pelvic and acetabular reconstruction surgery.</p><p><strong>Materials and methods: </strong>Eleven fresh frozen cadaveric pelvises were dissected by two fellowship-trained orthopaedic trauma surgeons utilizing the anterior intrapelvic approach (AIP). The RAT at the pubic body was dissected, and its footprint on the pubic bone was defined, marked, and measured.</p><p><strong>Results: </strong>Nineteen (19) RAT insertions were analyzed. The average total medial vertical length was 33 mm (range 26-42 mm), and the average total lateral vertical length was 36.5 mm (range 26-46 mm). The total width of the proximal insertion on both sides was measured at an average of 20.42 mm (range 14-24 mm). The average width of the tendon at the transition area between the cranial and caudal areas of the pubic bone was 16.45 mm (range 12-22 mm). The average distal insertion width of the RAT was less than the proximal and middle widths, measuring 10.45 mm (range 8-13 mm).</p><p><strong>Conclusion: </strong>The tendon can be safely mobilized up to an average total medial vertical length of 33 mm (and in no case more than 42 mm) and to an average total lateral vertical length of 36.5 mm (and in no case more than 46 mm). This piece of anatomical information will equip orthopaedic surgeons with a better understanding of the insertional anatomy of the RAT and subsequent safer surgical release when performing anterior approaches to the pelvic ring.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013879","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":"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":"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}