Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Comparison Static and Dynamic Ultrasound Techniques of DDH: The Role of the Patient's Position.","authors":"Mohammad Reza Yousefi, Mojgan Yazdanprast, Hashem Neshati, Reza Abdi, Mohammad Hasanian, Seyed Ali Alamdaran","doi":"10.22038/ABJS.2023.69347.3264","DOIUrl":"https://doi.org/10.22038/ABJS.2023.69347.3264","url":null,"abstract":"<p><strong>Objectives: </strong>The ultrasound examination of the hip joint is performed in the static (Graf) technique in the lateral recumbent position and in the dynamic technique in the supine position. This study compares the two static and dynamic techniques and assesses the role of the patient's position in the examination of DDH.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 2020-2021 at Akbar Hospital, Mashhad University of Medical Sciences, Iran. 126 patients suspected of having DDH (199 hip) infants were enrolled in the study. All ultrasound examinations were performed with two static and dynamic techniques by a pediatric radiologist.</p><p><strong>Results: </strong>In the static and dynamic ultrasound examinations, the average alpha angle was 51.57 ± 6.41 degrees, and 53.41 ± 6.94 degrees, respectively. These changes were not statistically significant (P = 0.312). The relationship and agreement between instability with dynamic technique and instability with static technique (IIC unstable, D, III, and IV) were investigated. Significant agreement (Kappa=0.77 (95% CI: 0.66-0.87) with excellent clinical significance was obtained between the two ultrasound examination method. Also, in terms of DDH types in the static method with instability types in the dynamic method, a substantial agreement was found between the two examination methods (Kappa =0.67; (95% CI: 0.59-0.75) with good clinical significance.</p><p><strong>Conclusion: </strong>In the ultrasound examination of DDH with static and dynamic techniques, the change in the alpha angle was not statistically significant. Therefore, the hand of the radiologist is open in measuring alpha angles and there is no need to emphasize a specific position. The type of DDH in the static technique completely corresponded to the type of stability or instability in the dynamic technique.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"191-197"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869394","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":"Plantaris Tendon Autograft Can Restore Patellar Stability in Adolescent Medial Patellofemoral Ligament Reconstruction: A Technical Note.","authors":"Josip Vlaic, Mario Josipovic, Dinko Nizic, Marko Simunovic, Zdravko Schauperl, Mislav Jelic","doi":"10.22038/ABJS.2024.75154.3476","DOIUrl":"10.22038/ABJS.2024.75154.3476","url":null,"abstract":"<p><p>Medial patellofemoral ligament reconstruction is a standard treatment option for patients with patellar instability. The main purpose of this study was to determine whether isolated anatomic medial patellofemoral ligament reconstruction using double folded, four-strand plantaris tendon autograft restores patellar stability in adolescent patients. Plantaris tendon autografts were harvested through proximal approach and used in four adolescent patients. A four-strand autograft was prepared in a double-limbed configuration and fixed on the patella and the femur with suture anchors and interference screws, respectively. The mean Kujala score improved significantly from 44 ± 24 SD (range, 19 to 69) points preoperatively to 94 ± 10 SD (range, 78 to 100) points postoperatively (P< 0.001). All patients reported excellent subjective outcomes and returned to their pre-injury level of sporting activities. The use of a four-strand plantaris tendon autograft in isolated anatomic medial patellofemoral ligament reconstruction can restore patellar stability in adolescents.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 4","pages":"283-288"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Diagnostic, and Therapeutic Characteristics of Posterior Glenohumeral Instability.","authors":"Akshay Khanna, Mohamad Y Fares, Jonathan Koa, Peter Boufadel, Ryan D Lopez, Joseph A Abboud","doi":"10.22038/ABJS.2024.81046.3697","DOIUrl":"10.22038/ABJS.2024.81046.3697","url":null,"abstract":"<p><p>Posterior shoulder instability (PSI) is a shoulder pathology that is challenging to diagnose, leading to treatment delay and exacerbation of symptoms. Etiology can be both traumatic and atraumatic, and a comprehensive clinical history plays a significant role in achieving diagnosis. Imaging in the setting of PSI can reveal a reverse-Bankart lesion, a reverse Hill-Sachs lesion, posterior labral cysts, and potentially glenoid or lesser tuberosity fractures. Both conservative and surgical options exist for patients with PSI, and management often depends on case severity, extent of bone loss, and patient goals and expectations. Holistic patient education regarding the etiologies, mechanisms and possible treatment options available is pivotal for achieving high levels of patient satisfaction and optimal outcomes.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 12","pages":"820-825"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885769","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 Large Ankle Mass in a Figure Skater: A Case Report.","authors":"Richard David James Smith, Dale Davis, Jeremy T Smith","doi":"10.22038/ABJS.2023.74241.3436","DOIUrl":"10.22038/ABJS.2023.74241.3436","url":null,"abstract":"<p><p>A 19-year-old male competitive figure skater presented to clinic with a 3-year history of right ankle swelling. Exam demonstrated a ~6cm diameter mass over the medial malleolus. MRI revealed a well-circumscribed fluid-filled mass. After failing conservative management, the patient underwent surgical excision. Anatomic pathology revealed a pseudocyst with pseudosynovial metaplasia, consistent with malleolar bursitis. Competitive figure skaters can develop significant medial malleolar bursitis due to excessive shear forces from ill-fitting skates. If non-operative management is ineffective, patients can be managed successfully with surgical excision. The patient made a full recovery and has returned to competitive skating without recurrence.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 1","pages":"66-68"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693219","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":"Modular Well-Fixed Hip Revision Stem Fracture: A Case Report and Literature Review.","authors":"Fabio Pessina, Carlo Cazzaniga, Beatrice Manzini, Carlo Cardile","doi":"10.22038/ABJS.2024.80313.3666","DOIUrl":"10.22038/ABJS.2024.80313.3666","url":null,"abstract":"<p><p>This study presents a case of repeated prosthetic fractures in a modular hip prosthesis in a 56-year-old male patient. After the initial implantation of a modular total hip prosthesis in 2006, the patient experienced two instances of prosthetic implant fractures over seventeen years. In this study, we analyze the clinical case, explore potential underlying causes of this complication, and delve into current indications and strategies for the revision of fractured prosthesis stems. The discussion is informed by a literature review and underscores the significance of selecting appropriate revision techniques to address this challenge.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"735-741"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550100","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":"Anesthesia Type and Short-Term Outcomes in Open Treatment of Hand Fractures.","authors":"Robert L Dalcortivo, Benjamin A Yarbrough, Dominick V Congiusta, Irfan H Ahmed, Michael M Vosbikian","doi":"10.22038/ABJS.2024.67440.3200","DOIUrl":"10.22038/ABJS.2024.67440.3200","url":null,"abstract":"<p><strong>Objectives: </strong>The hand is one of the most commonly fractured parts of the body. Many of these injuries are treated operatively. This study compares short-term outcomes between general anesthesia and other forms of anesthesia in the open treatment of hand fractures.</p><p><strong>Methods: </strong>Procedures related to the open treatment of carpal, metacarpal, and phalangeal fractures from the years 2005-2017 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Outcome measures included 30-day reoperation rate, length of stay (LOS), minor complications, and major complications. Chi-squared tests were used to identify significant demographics and comorbidities. Significant variables were included in a logistic regression model.</p><p><strong>Results: </strong>A total of 5,907 patients were included, of which 4,547 (77%) received general anesthesia, and 1,360 (23%) received local anesthesia, regional anesthesia, sedation, or monitored anesthesia care. Patients treated with general anesthesia were younger and more likely to be male. Operative time was longer with general anesthesia (65.0 vs. 59.8minutes, P<0.01). Anesthesia technique had no statistically significant association with thirty-day rate of reoperation, minor complications, or major complications (P=0.32, 0.91, and 0.07, respectively). General anesthesia had greater odds for LOS exceeding the 75th percentile (OR 2.05, P<0.01).</p><p><strong>Conclusion: </strong>In the open treatment of hand fractures, short-term complication rates are similar between general anesthesia and other forms of anesthesia, but extended LOS is more likely with general anesthesia. When practical, surgeons can consider local anesthesia, regional anesthesia, sedation, and monitored anesthesia as reasonably safe alternatives to general anesthesia.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"721-727"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548240","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":"Anterior Versus Posterior Surgical Approaches to Pediatric Supracondylar Humerus Fracture.","authors":"Mehdi Teimouri, Mohammad Ali Tahririan, Hasan Rezaei, Mahdi Shahsavan, Mansour Moradi, Mohammad Alaei, Mohammad Shahsavan","doi":"10.22038/ABJS.2024.77301.3572","DOIUrl":"10.22038/ABJS.2024.77301.3572","url":null,"abstract":"<p><strong>Objectives: </strong>Gartland type III supracondylar humerus fractures frequently occur as traumatic injuries in children and often require surgical intervention. This study aimed to compare the efficacy of anterior and posterior surgical approaches to treating these fractures.</p><p><strong>Methods: </strong>This retrospective study analyzed 48 patients under the age of 10 with Gartland type III fractures. These patients were treated with either the anterior (n=23) or the posterior approach (n=25). At three and six months post-surgery, elbow range of motion (ROM), complications, and functional/cosmetic outcomes were assessed using Flynn's criteria.</p><p><strong>Results: </strong>No significant differences were found between the groups regarding age or gender. At three months, the anterior group showed significantly better extension (-8.26° vs. -13.20°, P=0.032), but this difference was not significant at six months. No significant differences were observed in flexion, pronation, or supination at any time point. Both groups showed significant ROM improvements from three to six months (P<0.001); however, these improvements were slightly below the normative values (P<0.05). The overall complication rates were low and comparable between the two approaches (anterior: 8.70%; posterior: 12.00%; P=0.700), primarily comprising reversible ulnar nerve injuries and superficial infections. Furthermore, based on Flynn's criteria, there were no significant differences in functional or cosmetic outcomes, with most patients achieving excellent or good results in both groups.</p><p><strong>Conclusion: </strong>Both anterior and posterior approaches for pediatric Gartland type III supracondylar humerus fractures resulted in satisfactory outcomes. Therefore, the choice of surgical approach will depend on patient-related factors and surgeons' preferences.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"728-734"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548241","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":"Comparison of Functional Outcomes of Two Knee Arthroplasty Techniques (Total Knee Arthroplasty and Unicompartmental Knee Arthroplasty) for the Treatment of Osteoarthritis, simultaneously done in the Same Patients.","authors":"Mohsen Latifpoor, Mohammad Mahdi Sarzaeem, Farzad Amouzadeh Omrani, Sina Raissi Dehkordi","doi":"10.22038/ABJS.2024.75050.3469","DOIUrl":"10.22038/ABJS.2024.75050.3469","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to provide a comprehensive comparative analysis of functional outcomes between Unicompartmental Knee Arthroplasty (UKA) and Total Knee Arthroplasty (TKA) in patients diagnosed with bilateral knee osteoarthritis. Both procedures were performed simultaneously on separate knees to evaluate their respective efficacy.</p><p><strong>Methods: </strong>The study included 25 patients (18 women and 7 men) with a mean age of 59.6 years, all meeting the criteria for administering UKA on one knee and TKA on the other. Radiographic and clinical data were collected over a two-year period, with assessments conducted at 6 months, 1 year, and 2 years postoperatively. Data included age, gender, and body mass index, medical history, surgical procedures, and various scores and measurements related to knee function.</p><p><strong>Results: </strong>The UKA group exhibited significant improvements in functional scores compared to the TKA group. Specifically, the Western Ontario and McMaster Universities Osteoarthritis Index score for the UKA knee was 24.5% higher than that of the TKA knee, indicating better functional outcomes. Radiographically, the tibio-femoral angle was more than two times greater in the UKA method, while the Varus angle was significantly greater in the TKA method. No post-operative complications were reported.</p><p><strong>Conclusion: </strong>This study underscored the safety and efficacy of both UKA and TKA procedures in the treatment of bilateral knee osteoarthritis. UKA demonstrated superior functional outcomes, while TKA displayed distinct advantages in radiographic alignment. Individual patient characteristics and preferences should guide the selection of the most appropriate surgical approach.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"695-700"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548243","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":"Bilateral Anterior Shoulder Dislocation: A Systematic Review.","authors":"Andrew W Kuhn, Emma K Landes, Justin K Yu, Paul M Inclan, J Ryan Hill, Alexander W Aleem","doi":"10.22038/ABJS.2024.67743.3211","DOIUrl":"10.22038/ABJS.2024.67743.3211","url":null,"abstract":"<p><strong>Objectives: </strong>To compile the existing literature on bilateral anterior shoulder dislocation (BASD) and analyze patient demographics, mechanisms of injury, injury characteristics, management, and outcome.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. Online databases, including Ovid Medline 1946-, Embase.com 1947-, Scopus 1960-, Cochrane Central, and Clinicaltrials.gov were systematically queried. Studies eligible for inclusion were case reports or case-series, documenting BASD. Two reviewers independently screened and applied a set of a priori exclusion criteria to each returned study. Data were extracted, compiled, and synthesized from each reported case of BASD. Contingency tables/Chi-Square Analyses, T-tests, and univariate regression analyses were conducted to assess relationships between different variables.</p><p><strong>Results: </strong>Eighty-one studies (87 cases of BASD) were included. Patients were 41.1 (SD± 19.5) years old and most were male (n=63; 72.4%). Around a quarter of patients (28.7%) had a history of epilepsy/seizures or were being worked-up for such. Younger males were more likely to have BASD due to a seizure or electrocution (P<0.05). Close to a third of cases (n=27; 31.0%) were delayed in presentation. Those sustaining seizures or electrocutions were more likely to be delayed in presentation (P=0.013). Most events resulted in simple dislocations that were closed reduced successfully. BASD resulting from seizures or electrocutions were more likely to be fracture-dislocations (P=0.018); and in younger patients with fracture-dislocations, closed reduction was more often to fail or not be attempted (P<0.05). Median follow-up was 6 months (IQR: 3 months - 12 months). Seven patients (10.6%) had complications and 4 (2.3%) demonstrated recurrent instability.</p><p><strong>Conclusion: </strong>In young males presenting with BASD without known trauma, suspicion should be high for a convulsant event. In patients with a known seizure disorder who present with chronic bilateral shoulder or arm pain, BASD should be considered and work-up should be expedited to avoid misdiagnosis.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 5","pages":"306-327"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180460","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 Efficacy of Bone Wax in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Mohammad Daher, Gaby Haykal, Ali Ghoul, Jean Tarchichi, Amer Sebaaly","doi":"10.22038/ABJS.2024.73243.3392","DOIUrl":"10.22038/ABJS.2024.73243.3392","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis was conducted to study the hemostatic efficacy of bone wax in total joint arthroplasty (TJA) defined in this manuscript as total knee arthroplasty and total hip arthroplasty.</p><p><strong>Methods: </strong>PubMed, Embase, Google Scholar (page 1-20), and Scopus were searched updated to November 2023. Only comparative studies were included. The clinical outcomes evaluated were the transfusion rate, total blood loss, and the loss of hemoglobin on day 1, 3, and 5 post-operatively.</p><p><strong>Results: </strong>Only 3 studies met the inclusion criteria and were included in this meta-analysis. Bone wax was associated with a reduced transfusion rate (p=0.01), reduced total blood loss (p=0.001), and a decrease in hemoglobin loss on day 1 (p<0.00001), day 3 (p<0.0001), and day 5 (p<0.00001) after the surgery.</p><p><strong>Conclusion: </strong>Bone wax reduced the rate of transfusion, total blood loss, and hemoglobin loss after the surgery. This may induce a reduction the cost of correcting post-operative anemia as well as decrease hospital stay and improving functional outcomes in patients undergoing TJA. Better-conducted randomized controlled studies and cost-effectivity studies could strengthen these findings.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 5","pages":"298-305"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180706","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}