Efort Open Reviews最新文献_第7页

Systematic review and meta-analysis of single-stage versus two-stage revision for periprosthetic joint infection after knee arthroplasty: a call for a randomised trial. 膝关节置换术后假体周围感染单阶段翻修与两阶段翻修的系统回顾和荟萃分析：呼吁开展随机试验。

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2024-06-03 DOI: 10.1530/EOR-23-0147

Chengxin Xie, Wenjun Pan, Shouli Wang, Xueli Yan, Hua Luo

{"title":"Systematic review and meta-analysis of single-stage versus two-stage revision for periprosthetic joint infection after knee arthroplasty: a call for a randomised trial.","authors":"Chengxin Xie, Wenjun Pan, Shouli Wang, Xueli Yan, Hua Luo","doi":"10.1530/EOR-23-0147","DOIUrl":"10.1530/EOR-23-0147","url":null,"abstract":"Purpose: Knee arthroplasty is an effective treatment for severe knee degeneration; however, periprosthetic joint infection (PJI) is one of its serious complications. Single- and two-stage revision are common treatments, but few studies have compared single- and two-stage revision for PJI after knee arthroplasty. This study aimed to compare the reinfection and reoperation rates of single- and two-stage revision through meta-analysis.Methods: The review process was conducted according to the PRISMA guidelines. We searched the PubMed, Medline, Embase and Cochrane Central Register of Controlled Trials databases for trials comparing single- and two-stage revision for PJI after knee arthroplasty from the respective inception dates to April 2023. Two researchers individually screened the studies, performed the literature quality evaluation and data extraction and used Stata 17 software for data analysis.Results: The meta-analysis showed that the reinfection rate was significantly lower in the single-stage revision group than in the two-stage revision group. While the reoperation rates demonstrated no statistically significant difference between the two groups. We presented descriptive results because the discrepancies in the knee function scores and data reported in the studies meant that these data could not be combined in the meta-analysis.Conclusion: Based on the available research, single-stage revision is a reliable option for PJI after knee arthroplasty. However, when developing the best treatment strategy, it is still necessary to consider the individual circumstances and needs of the patient, as well as the risks of postoperative rehabilitation and complications.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 6","pages":"479-487"},"PeriodicalIF":4.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does earlier bathing increase the risk of surgical site infection? A meta-analysis of 11 randomized controlled trials. 提前洗澡会增加手术部位感染的风险吗？11 项随机对照试验的荟萃分析。

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2024-06-03 DOI: 10.1530/EOR-23-0062

Yu Ren, Hui Yu, Zhangfu Wang, Wenjun Pan, Lin Chen, Hua Luo

{"title":"Does earlier bathing increase the risk of surgical site infection? A meta-analysis of 11 randomized controlled trials.","authors":"Yu Ren, Hui Yu, Zhangfu Wang, Wenjun Pan, Lin Chen, Hua Luo","doi":"10.1530/EOR-23-0062","DOIUrl":"10.1530/EOR-23-0062","url":null,"abstract":"Purpose: For many decades, patients recovering from wound closure have been instructed not to bathe. Although studies have shown that earlier postoperative bathing does not increase the risk of wound infection, it remains rare in practice for patients to be allowed earlier postoperative bathing. We performed this meta-analysis to determine how earlier bathing affected rates of wound infection, other complications, and patient satisfaction.Methods: This systematic review conforms to PRISMA guidelines. The PubMed, EMBASE, Medline, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from their inception dates to December 31, 2022. We estimated pooled values for the efficacy of trial of earlier bathing versus delayed bathing using the odds ratio and their associated 95% CI, and we used the I 2 statistic to assess heterogeneity between studies contributing to these estimates.Results: Of the 1813 articles identified by our search, 11 randomized controlled trials including 2964 patients were eligible for inclusion. The incidence of wound infection did not differ significantly between the earlier bathing and delayed bathing groups, nor did rates of other wound complications such as redness and swelling, or wound dehiscence. However, the incidence of hematoma in the delayed bathing group was higher than in the earlier bathing group. Reported patient satisfaction was significantly higher in the earlier bathing group.Conclusion: The medical community, health authorities, and government should create and disseminate clinical practice guidelines to guide patients to evidence-based beneficial treatment.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 6","pages":"458-466"},"PeriodicalIF":4.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews. 骨肿瘤导致的腓骨远端切除术后的重建手术：PROSPERO 国际系统综述登记册的手术策略和结果技术报告。

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2024-06-03 DOI: 10.1530/EOR-23-0159

Andrea Angelini, Ivan Bohacek, Mihovil Plecko, Carlo Biz, Giulia Trovarelli, Mariachiara Cerchiaro, Giuseppe Di Rubbo, Pietro Ruggieri

{"title":"Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews.","authors":"Andrea Angelini, Ivan Bohacek, Mihovil Plecko, Carlo Biz, Giulia Trovarelli, Mariachiara Cerchiaro, Giuseppe Di Rubbo, Pietro Ruggieri","doi":"10.1530/EOR-23-0159","DOIUrl":"10.1530/EOR-23-0159","url":null,"abstract":"Purpose: Primary bone tumors of the fibula are rare. Distal fibular resection has a significant impact on ankle biomechanics and gait, possibly leading to complications such as ankle instability, valgus deformity, and degenerative changes. Question: Is there a need for reconstructive surgery after distal fibular resection, and what reconstructive procedures are available?Materials and methods: The review is registered with the PROSPERO International Register of Systematic Reviews. Inclusion criteria consisted of all levels of evidence, human studies, patients of all ages and genders, publication in English, and resection of the distal portion of the fibula due to tumor pathology. The reviewers defined four different categories of interest by method of treatment. Additional articles of interest during full-text review were also added.Results: The initial search resulted with a total of 2958 records. After screening, a total of 50 articles were included in the study. Articles were divided into 'No reconstruction', 'Soft tissue reconstruction', 'Bone and soft tissue reconstruction', and 'Arthrodesis, arthroplasty or other reconstruction options' groups.Conclusion: Limb salvage surgery should be followed by reconstruction in order to avoid complications. Soft tissue reconstructions should always be considered to stabilize the joint after fibular resection. Bone reconstruction with reversed vascularized fibula is the preferred technique in young patients and in cases of bone defects more than 3 cm, while arthrodesis should be considered in adult patients. Whenever possible for oncologic reason, if a residual peroneal malleolus could be preserved, we prefer augmentation with a sliding ipsilateral fibular graft.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 6","pages":"503-516"},"PeriodicalIF":4.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bosworth ankle fracture-dislocation: current concept review. 博斯沃思踝关节骨折-脱位：当前概念回顾。

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2024-06-03 DOI: 10.1530/EOR-23-0050

Jan Bartoníček, Stefan Rammelt, Michal Tuček

{"title":"Bosworth ankle fracture-dislocation: current concept review.","authors":"Jan Bartoníček, Stefan Rammelt, Michal Tuček","doi":"10.1530/EOR-23-0050","DOIUrl":"10.1530/EOR-23-0050","url":null,"abstract":"Bosworth fracture (BF) is a special type of locked ankle fracture-dislocation, characterized by displacement of a fragment of the fractured fibula from the fibular notch behind the posterior surface of the distal tibia. BF is a complex injury affecting multiple structures of the ankle joint, which is still frequently misjudged even today, potentially leading to severe complications. CT examination, including 3D reconstructions, should be the diagnostic standard in BF, as it provides a complete picture of the fracture pathoanatomy, most prominently the morphology of the frequently associated posterior malleolar fracture. BF requires early reduction of the displaced fibular fragment without repeated attempts on closed reduction. Non-operative treatment of BF almost always fails. The standard treatment procedure is early open reduction internal fixation. Due to the relative severity and paucity of the injury, BF seems to be particularly prone to soft tissue complications, including compartment syndrome. The results of operative treatment are mixed. Many studies report persistent pain even after a short time interval, with limitations of the range of motion or even stiffness of the ankle joint, and development of degenerative changes. Larger studies with long-term results are still missing.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 6","pages":"448-457"},"PeriodicalIF":4.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artifical intelligence in surgery: ethical considerations in the light of social trends in the perception of health and medicine. 外科手术中的人工智能：从健康和医学观念的社会趋势看伦理问题。

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0029

Heiner Fangerau

引用次数: 0

Long bone uninfected non-union: grafting techniques. 未感染的长骨非连接：移植技术。

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0032

Enrique Gómez-Barrena, Christian Ehrnthaller

{"title":"Long bone uninfected non-union: grafting techniques.","authors":"Enrique Gómez-Barrena, Christian Ehrnthaller","doi":"10.1530/EOR-24-0032","DOIUrl":"10.1530/EOR-24-0032","url":null,"abstract":"Long bone non-unions represent a serious clinical and socioeconomical problem due to the prolonged episodes, frequent sequelae, and variable treatment effectiveness. Bone grafts, classically involving the autologous iliac crest graft as the 'gold standard' bone graft, enhance bone regeneration and fracture healing incorporating osteoconductive and/or osteoinductive/osteogenic capacity to the non-union under treatment. Structural alternatives to autologous bone grafts include allografts and bone substitutes, expanding the available stock but loosing biological properties associated with cells in the graft. Biological alternatives to autologous bone grafts include bone marrow concentration from iliac crest aspiration, bone marrow aspiration from reaming of the diaphyseal medullary canal in the long bones, and isolated, expanded mesenchymal stem cells under investigation. When the combination with natural and synthetic bone substitutes allows for larger volumes of structural grafts, the enhancement of the biological regenerative properties through the incorporation of cells and their secretoma permits to foresee new bone grafting solutions and techniques.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 5","pages":"329-338"},"PeriodicalIF":3.4,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application. 噬菌体疗法在肌肉骨骼感染中的应用：从基础科学到临床应用。

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0042

Tristan Ferry, Jolien Onsea, Tiphaine Roussel-Gaillard, Cécile Batailler, Thomas Fintan Moriarty, Willem-Jan Metsemakers

{"title":"Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application.","authors":"Tristan Ferry, Jolien Onsea, Tiphaine Roussel-Gaillard, Cécile Batailler, Thomas Fintan Moriarty, Willem-Jan Metsemakers","doi":"10.1530/EOR-24-0042","DOIUrl":"10.1530/EOR-24-0042","url":null,"abstract":"The treatment of musculoskeletal infections (MSIs), including periprosthetic joint infection (PJI) and fracture-related infection (FRI), is often complicated by biofilm-related challenges necessitating multiple revision surgeries and incurring substantial costs. The emergence of antimicrobial resistance (AMR) adds to the complexity of the problem, leading to increased morbidity and healthcare expenses. There is an urgent need for novel antibacterial strategies, with the World Health Organization endorsing non-traditional approaches like bacteriophage (phage) therapy. Phage therapy, involving the targeted application of lytic potent phages, shows promise in the treatment of MSIs. Although historical clinical trials and recent case studies present significant milestones in the evolution of phage therapy over the past century, challenges persist, including variability in study designs, administration protocols and phage selection. Efforts to enhance treatment efficacy consist of personalized phage therapy and combination with antibiotics. Future perspectives entail addressing regulatory barriers, standardizing treatment protocols, and conducting high-quality clinical trials to establish phage therapy's efficacy for the treatment of MSIs. Initiatives like the PHAGEFORCE study and the PHAGEinLYON Clinic programme aim to streamline phage therapy, facilitating personalized treatment approaches and systematic data collection to advance its clinical utility in these challenging infections.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 5","pages":"339-348"},"PeriodicalIF":3.4,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Individualized megaimplants in acetabular revision arthroplasty: what have we learned in the last 15 years? 髋臼翻修关节置换术中的个性化巨型植入物：过去 15 年我们学到了什么？

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0064

Thorsten Gehrke, Mustafa Citak, Mustafa Akkaya

引用次数: 0

Joint line and knee osteotomy. 关节线和膝关节截骨术

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0037

Andrea Pratobevera, Romain Seil, Jacques Menetrey

引用次数: 0

Which radial head fractures are best treated surgically? 哪些桡骨头骨折最适合手术治疗？

IF 3.4 2区医学

Efort Open Reviews Pub Date : 2024-05-10 DOI: 10.1530/EOR-24-0035

Anna E van der Windt, Lisette C Langenberg, Joost W Colaris, Denise Eygendaal

{"title":"Which radial head fractures are best treated surgically?","authors":"Anna E van der Windt, Lisette C Langenberg, Joost W Colaris, Denise Eygendaal","doi":"10.1530/EOR-24-0035","DOIUrl":"10.1530/EOR-24-0035","url":null,"abstract":"Despite the common occurrence of radial head fractures, there is still a lack of consensus on which radial head fractures should be treated surgically. The radial head is an important secondary stabilizer in almost all directions. An insufficient radial head can lead to increased instability in varus-valgus and posterolateral rotatory directions, especially in a ligament-deficient elbow. The decision to perform surgery is often not dictated by the fracture pattern alone but also by the presence of associated injury. Comminution of the radial head and complete loss of cortical contact of at least one fracture fragment are associated with a high occurrence of associated injuries. Nondisplaced and minimally displaced radial head fractures can be treated non-operatively with early mobilization. Displacement (>2 mm) of fragments in radial head fractures without a mechanical block to pronation/supination is not a clear indication for surgery. Mechanical block to pronation/supination and comminution of the fracture are indications for surgery. The following paper reviews the current literature and provides state-of-the-art guidance on which radial head fractures should be treated surgically.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 5","pages":"413-421"},"PeriodicalIF":3.4,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0