Efort Open Reviews最新文献

Neurogenic bladder pathophysiology, assessment and management after lumbar diseases.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-24-0087

Jiayu Hao, Jian Jiang, Qiaoyue Han, Kui Wang, Yuefeng Sun, Hong Wang

引用次数: 0

Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-2024-0077

Luca Bianco Prevot, Riccardo Accetta, Stefania Fozzato, Philipp Moroder, Giuseppe Basile

{"title":"Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.","authors":"Luca Bianco Prevot, Riccardo Accetta, Stefania Fozzato, Philipp Moroder, Giuseppe Basile","doi":"10.1530/EOR-2024-0077","DOIUrl":"https://doi.org/10.1530/EOR-2024-0077","url":null,"abstract":"Purpose: No literature consensus was found about the best treatment of acute Rockwood type III acromioclavicular joint (ACJ) dislocation. In particular, the advantages and disadvantages between conservative treatment and surgery are not sufficiently quantified in the current literature.Methods: A systematic literature search was conducted using PubMed, Web of Science and Embase in March 2024. We selected studies comparing surgical and conservative treatment in acute Rockwood III ACJ dislocations. The two treatment methods were compared in terms of Constant score; Disabilities of the Arm, Shoulder, and Hand (DASH); American Shoulder and Elbow Surgeons (ASES) score; Acromioclavicular Joint Instability Score (ACJIS); subjective shoulder value (SSV); radiographical findings; reported complications; and return to sports activity. The risk of bias and quality of evidence were assessed using Cochrane guidelines.Results: A total of 1844 articles were evaluated, and ten were included in the study for a total of 397 patients. The results of the meta-analysis showed no significant differences between the two groups in terms of Constant score (P = 0.31), DASH (P = 0.52), ASES (P = 0.66) and SSV (P = 0.21), while it highlighted a statistically significant difference in terms of ACJIS (P = 0.00) and acromioclavicular (P = 0.00) and coracoclavicular distance (P = 0.00).Conclusion: The results showed no significant differences in terms of patient-reported or objective functional outcomes between the two treatment groups. Nonetheless, it highlights a difference in terms of radiographical outcomes and type of complications. While surgical intervention is able to improve joint reduction, it adds the risk for surgical complications.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"141-150"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of pediatric femoral neck fractures from classification to surgery: a review of indications based on anatomic and radiographic features of the proximal femur.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 DOI: 10.1530/EOR-2024-0129

WenTao Wang, Federico Canavese, Zhu Xiong, ShengPing Tang, ShunYou Chen, ShengHua He

{"title":"Management of pediatric femoral neck fractures from classification to surgery: a review of indications based on anatomic and radiographic features of the proximal femur.","authors":"WenTao Wang, Federico Canavese, Zhu Xiong, ShengPing Tang, ShunYou Chen, ShengHua He","doi":"10.1530/EOR-2024-0129","DOIUrl":"https://doi.org/10.1530/EOR-2024-0129","url":null,"abstract":"This review focuses on the anatomic and radiographic characteristics of the pediatric proximal femur and the advantages and disadvantages of different protocols for the management of pediatric femoral neck fractures (PFNFs) in terms of fracture classification, reduction methods, reduction quality and fixation methods, with the goal of proposing an optimal treatment protocol for PFNFs to reduce the incidence of postoperative complications. The anatomic and radiographic characteristics of the pediatric proximal femur, including the presence of an active growth plate, an immature femoral calcar, greater trabecular density and plasticity and a relatively immature blood supply are very different from those of the adult proximal femur. Treatment protocols for PFNFs must differ from those for adult femoral neck fractures. PFNFs with posterior translation, and those with comminuted medial-posterior columns, are associated with a higher postoperative complication rate. This review suggests that the degree of damage to the nutrient vessels along the posterior femoral neck and the stability of the medial-posterior column of the femoral neck should be well assessed in patients with PFNFs for both classification and treatment purposes. Anatomic reduction through an anterior approach, placement of a small number of implants in the mid-inferior part of the femoral neck and additional external support are effective in reducing postoperative complications in patients with PFNFs.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"125-140"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pre-operative management of fracture blisters: a systematic review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-2024-0074

Ishtar Redman, Kapil Sugand, Aashtad Daruwalla, Andrew Clark

{"title":"Pre-operative management of fracture blisters: a systematic review.","authors":"Ishtar Redman, Kapil Sugand, Aashtad Daruwalla, Andrew Clark","doi":"10.1530/EOR-2024-0074","DOIUrl":"https://doi.org/10.1530/EOR-2024-0074","url":null,"abstract":"Purpose: The pre-operative management of fracture blisters is an area of uncertainty within trauma and orthopaedic surgeries. Management strategies vary significantly between and within orthopaedic departments across the United Kingdom. The purpose of this systematic review was to comprehensively appraise and synthesize the existing literature pertaining to this topic, highlighting current practices and areas for ongoing research.Methods: Extensive electronic literature searches were performed on PubMed/MEDLINE (January 1946-May 2024), Embase (January 1974-May 2024) and Cochrane library (January 1933-May 2024) databases. The search terms were as follows: (fracture blister OR bone blister*) AND (dress* OR drain* OR aspirat* OR deroof* OR manage*). These keywords were searched in the subject headings, in title and in abstract.Results: The results of the search methodology revealed five articles, which represented the best evidence to the clinical question. These papers reported on rates of wound healing and post-operative infection, time to surgical readiness and treatment costs, following varying treatment modalities in 1162 patients. The authors, publication dates, countries, patient groups, study outcomes and results of these papers are tabulated in Supplementary Table 1.Conclusion: Fracture blisters pose a significant challenge in clinical practice, leading to delays in surgery, suboptimal surgical approaches and complications in wound healing post-operatively. Currently, there is no consensus describing the optimal management of these blisters. This review challenges the conventional belief that fracture blisters are sterile, highlighting that the application of topical agents to the deroofed blister bed may expedite surgical readiness.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"166-171"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unilateral biportal endoscopy: review and detailed surgical approach to extraforaminal approach.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-24-0137

João Pedro Gomes Reis, Eduardo Moreira Pinto, Artur Teixeira, Ricardo Frada, Diogo Rodrigues, Raquel Cunha, António Miranda

引用次数: 0

Ochronotic arthropathy: skeletal manifestations and orthopaedic treatment.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-2023-0112

Khaled Hamed Salem, Alyaa Diaa Elmoghazy

{"title":"Ochronotic arthropathy: skeletal manifestations and orthopaedic treatment.","authors":"Khaled Hamed Salem, Alyaa Diaa Elmoghazy","doi":"10.1530/EOR-2023-0112","DOIUrl":"https://doi.org/10.1530/EOR-2023-0112","url":null,"abstract":"Alkaptonuria is an extremely rare disorder of tyrosine metabolism caused by an autosomal recessive enzymatic deficiency of homogentisic acid (HGA) oxidase, causing its accumulation in collagenous structures, especially in hyaline cartilage. It is characterized by a triad of homogentisic aciduria, bluish-black discoloration of connective tissues (ochronosis) and arthropathy of the spine and large weight-bearing joints. Several clinical manifestations were described including coronary and valvular calcification, aortic stenosis, limited chest expansion, and renal, urethral and prostate calculi as well as ocular and cutaneous pigmentation. Skeletal affection usually presents as spondylotic changes of the spine. The knee is the most common peripheral joint to be involved. Enthesopathy or tendon ruptures may occur, and reduced bone density is not unusual. A low-protein diet and ascorbic acid may reduce HGA levels. Nitisinone can safely and effectively reduce HGA production and urinary excretion. In severe ochronotic arthropathy, joint arthroplasty can offer reliable pain relief and excellent functional outcomes. Cementless fixation is successful in young patients.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"75-81"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical management of metastatic lesions in the proximal femur: a systematic review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-24-0138

Afrim Iljazi, Mads Sten Andersen, Stig Brorson, Michael Mørk Petersen, Michala Skovlund Sørensen

{"title":"Surgical management of metastatic lesions in the proximal femur: a systematic review.","authors":"Afrim Iljazi, Mads Sten Andersen, Stig Brorson, Michael Mørk Petersen, Michala Skovlund Sørensen","doi":"10.1530/EOR-24-0138","DOIUrl":"https://doi.org/10.1530/EOR-24-0138","url":null,"abstract":"Purpose: The proximal femur is a frequent site of cancer dissemination in the extremities. Patients treated surgically for skeletal metastases have poorer overall health compared to other orthopedic patients, with only one-third expected to survive two years post-surgery. Choosing a treatment that minimizes revision risk and ensures the implant outlives the patient is therefore crucial. We conducted a systematic review to assess the revision rate following internal fixation (IF) or endoprosthetic reconstruction (EPR) of the proximal femur for metastatic bone disease (MBD).Methods: This study adhered to the PRISMA guidelines. MEDLINE and Embase were searched, identifying 10,299 records. After removing duplicates, 7731 unique records were screened, 334 of which were retrieved for full-text screening. We included 34 studies in the qualitative synthesis. The MINORS instrument was used for quality assessment.Results: The quality of the included studies was low to moderate, with median scores of 6/16 for non-comparative studies and 10/24 for comparative studies. We therefore refrained from a comparative analysis. Revision rates varied between 0 and 12.4% following EPR (25 studies) and between 0 and 26.7% following IF, while implant removal rates ranged between 0 and 8.3% and 0 and 26.7%, respectively.Conclusions: Revision and implant removal rates for various methods of EPR and IF are satisfactory. However, a meta-analysis or comparison between IF and EPR is not feasible due to a lack of prospective studies, randomized trials and high-quality studies.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"104-114"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consensus document on the management of wound closure in orthopaedic surgery.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-24-0002

Pablo Sanz-Ruiz, José Ramón Caeiro-Rey, Juan Carlos Martínez-Pastor, José Luis Martín-Alguacil, Antonio Murcia-Asensio, Jesús Moreta

{"title":"Consensus document on the management of wound closure in orthopaedic surgery.","authors":"Pablo Sanz-Ruiz, José Ramón Caeiro-Rey, Juan Carlos Martínez-Pastor, José Luis Martín-Alguacil, Antonio Murcia-Asensio, Jesús Moreta","doi":"10.1530/EOR-24-0002","DOIUrl":"https://doi.org/10.1530/EOR-24-0002","url":null,"abstract":"Wounds in orthopaedic surgery differ from wounds in other surgical fields in various ways. Tissues that are highly affected due to the trauma itself, the presence of an orthopaedic implant and the performance of prosthetic surgery in patients with many comorbidities make these wounds need special consideration. Complications of the surgical wound in orthopaedic surgery are not unusual, being the main cause of medical care and readmission in the first 90 days. There is no consensus on the best way to perform closure in orthopaedic surgery. The national 'Adequate Wound Management in Orthopaedic Surgery' survey has shown interindividual variability in wound closure and soft tissue management in orthopaedic surgery at the local level. This consensus document, generated by a group of experts in soft tissue management in orthopaedic surgery, proposes recommendations based on evidence (using the GRADE methodology) to promote best practices in this field. This document considers recommendations for surgical wound closure, dressing management and haemostasis. In addition, some of the 32 questions in the national survey, plus others relevant to the subject, were taken as a starting point for developing the contents.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"82-94"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-2023-0121

Al-Achraf Khoriati, Tony Antonios, Zien Alabdin Fozo, Aliya Choudhury, Magnus Arnander, Eyiyemi Pearse, Duncan Tennent

{"title":"Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review.","authors":"Al-Achraf Khoriati, Tony Antonios, Zien Alabdin Fozo, Aliya Choudhury, Magnus Arnander, Eyiyemi Pearse, Duncan Tennent","doi":"10.1530/EOR-2023-0121","DOIUrl":"https://doi.org/10.1530/EOR-2023-0121","url":null,"abstract":"Purpose: To evaluate the clinical and biomechanical evidence for the addition of acromioclavicular (AC) ligament repair and reconstruction in the surgical management of high-grade AC joint (ACJ) dislocation.Methods: This is a systematic review of biomechanical and clinical studies that describe AC reconstructive or reparative techniques. The search ranged from 1946 to 2024 and included OVID, MEDLINE, PubMed, CINAHL, Embase, Google Scholar and the Cochrane Library databases. Clinical and biomechanical outcomes were evaluated.Results: Thirty-two eligible studies were identified. Of these, four biomechanical studies focused on the ACJ exclusively. Twenty-eight other studies (15 clinical and 13 biomechanical) were identified involving reconstruction of the ACJ in addition to the treatment of the coracoclavicular (CC) ligaments. There was clinical evidence of improved outcomes with ACJ repair and reconstruction, although comparison was difficult. In comparative studies, ACJ-specific Taft and acromioclavicular joint instability scores were improved in patients with ACJ reconstruction. Constant score and subjective shoulder value also increased, although this was observed in studies lacking a control group. The biomechanical studies provide evidence of increased translational and rotational stability with ACJ repair and reconstruction, but the optimal technique has not been identified.Conclusion: ACJ repair and reconstruction, in addition to CC repair, results in improved biomechanical and functional outcomes and should be considered when treating high-grade ACJ injuries. There is insufficient evidence in the literature to be able to recommend a specific technique to treat ACJ injuries.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"115-124"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total knee arthroplasty following previous hardware implantation: do hardware removal strategies influence periprosthetic joint infections? A systematic review and meta-analysis.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-24-0100

Domenico De Mauro, Chiara Comisi, Enrico Festa, Tiziana Ascione, Massimo Mariconda, Giovanni Balato

{"title":"Total knee arthroplasty following previous hardware implantation: do hardware removal strategies influence periprosthetic joint infections? A systematic review and meta-analysis.","authors":"Domenico De Mauro, Chiara Comisi, Enrico Festa, Tiziana Ascione, Massimo Mariconda, Giovanni Balato","doi":"10.1530/EOR-24-0100","DOIUrl":"https://doi.org/10.1530/EOR-24-0100","url":null,"abstract":"Purpose: Total knee arthroplasty (TKA) in patients who underwent previous knee surgeries can be a challenging procedure both technically and for the complication rate. Conversion TKA is affected by a higher risk of infection compared to primary TKA. The aims of this meta-analysis are i) to compare the infectious risk among patients undergoing TKA after a prior hardware implantation, evaluating removal vs maintenance of the hardware, and ii) within the removal group, to compare staged vs concurrent procedure.Methods: In accordance with the PRISMA guidelines, a systematic literature review was conducted up to January 2024. The review was registered in the PROSPERO database: CRD42024510444. The inclusion criteria comprised the following: i) patients aged 18 years or older, ii) individuals who had undergone total knee replacement and iii) those with a history of prior nonabsorbable hardware implantation. The pooled incidence of periprosthetic joint infections (PJI) was reported using odds ratios with corresponding 95% confidence intervals (CIs).Results: The investigation of database and references identified 284 studies. PJI risks differed significantly among groups, with a higher risk in the removal group (z = 3.5630, P = 0.0004). Furthermore, within the removal group, the risk of PJI was lower in cases of staged removal compared to concurrent removal (z = 2.0931, P = 0.0363).Conclusions: TKA following a previous knee hardware implantation indicates a higher PJI risk when the hardware is removed compared to leaving it in place. If hardware removal is necessary, staged removal is recommended. The presence of minor hardware is the only scenario where, if removal is necessary, one-stage approach is preferred.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"95-103"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0