Journal of Orthopaedic Surgery最新文献

{"title":"Kinematic alignment versus mechanical alignment in total knee arthroplasty: An up-to-date meta-analysis.","authors":"Gengshuang Tian,&nbsp;Lishan Wang,&nbsp;Linzhou Liu,&nbsp;Yali Zhang,&nbsp;Lixiong Zuo,&nbsp;Jianpeng Li","doi":"10.1177/10225536221125952","DOIUrl":"https://doi.org/10.1177/10225536221125952","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this meta-analysis was to compare the efficacy and imaging parameters of kinematic alignment (KA) and mechanical alignment (MA) in total knee arthroplasty (TKA) and to evaluate whether patients undergoing KA-TKA benefited more than those undergoing MA-TKA.</p><p><strong>Methods: </strong>Studies comparing the efficacy of KA-TKA and MA-TKA were included after searching and screening in the database, including PubMed, Embase, Web of Science and Cochrane Database Library. A total of 1420 patients were enrolled in the study, with 736 MA-TKA and 738 KA-TKA. The primary outcomes were postoperative knee function scores including KSS series, WOMAC, KOOS and OKS. Secondary outcomes included the operative time, the length of hospital stay, knee extension/flexion angle, and some imaging parameters. The risk of bias for included studies was assessed using the Cochrane Collaborative risk-of-bias assessment tool or the Newcastle-Ottawa Scale(NOS).</p><p><strong>Results: </strong>Sixteen studies were included in this meta-analysis (11 randomized controlled studies and 5 cohort studies). Primary outcomes: Knee Society score (KSS, MD = 8.36, 95% Cl: 0.83-15.90) and combined KSS (MD = 15.24, 95% CI: 5.41-25.07) were higher in KA-TKA than in MA-TKA, and other functional scores were not statistically significant in KA-TKA and MA-TKA, including knee injury and osteoarthritis outcome score (KOOS), Oxford knee score (OKS), Knee Function score (KFS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes: KA-TKA resulted in smaller medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) compared to MA-TKA. For other outcome measures, KA-TKA showed similar results compared to MA-TKA, including hip-knee-ankle (HKA) angle, extension/flexion angle, tibial component slope angle, joint line orientation angle (JLOA), the operation time, the length of hospital stay and ligament release rate.</p><p><strong>Conclusions: </strong>In our analysis results, patients undergoing KA-TKA benefit as much as patients undergoing MA-TKA. KA may be a viable reference in total knee replacement.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective case series of prophylactic neurectomy during total knee arthroplasty.","authors":"Christian G Guier,&nbsp;Glenn G Shi,&nbsp;Steven R Clendenen,&nbsp;Michael G Heckman,&nbsp;Lori A Chase,&nbsp;Benjamin K Wilke","doi":"10.1177/10225536221127460","DOIUrl":"https://doi.org/10.1177/10225536221127460","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty is a common operation performed to relieve pain and restore functional activity. While overall widely successful, a subset of patients has continued pain postoperatively with no identifiable cause. Neuroma formation has been identified as a possible contributor to this unexplained pain, often necessitating an additional procedure for neuroma removal. The purpose of our study was to evaluate if prophylactic neurectomy could reduce the occurrence of postoperative pain.</p><p><strong>Methods: </strong>A total of 112 patients were compared, 44 control patients and 68 neurectomy patients. Demographic information, Numerical rating pain scale (NRS) and Knee Society Scores (KSS) were collected pre- and post-operatively. Patients were additional asked if they were overall satisfied with the operation.</p><p><strong>Results: </strong>There were no differences between groups with respect to age (Median: 71 vs 69 years, <i>p</i> = 0.28), male sex (41% vs 44%, <i>p</i> = 0.85), or body mass index (Median: 32.2 vs 31.3, <i>p</i> = 0.80). When comparing the degree of change following surgery there were no statistically significant differences observed in NRS pain scores (Median change: -7 vs -6, <i>p</i> = 0.89) or KSS scores (Median change: +44 vs +40, <i>p</i> = 0.14). Similarly, there was no statistically significant difference in overall patient-reported satisfaction with the knee replacement (82.5% vs 86.6%, <i>p</i> = 0.59).</p><p><strong>Conclusion: </strong>We did not find a statistically significant difference in NRS, KSS, or overall patient satisfaction between the prophylactic neurectomy and control patient groups. Larger studies with evaluation of the nerve diameter will be needed to determine which patients are at risk for symptomatic neuroma development following total knee arthroplasty.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40369858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morinda officinalis polysaccharide attenuates osteoporosis in rats underwent bilateral ovariectomy by suppressing the PGC-1α/PPARγ pathway.","authors":"Kai Rong,&nbsp;Pingbo Chen,&nbsp;Yi Lang,&nbsp;Yaowu Zhang,&nbsp;Zhan Wang,&nbsp;Fengli Wen,&nbsp;Laijin Lu","doi":"10.1177/10225536221130824","DOIUrl":"https://doi.org/10.1177/10225536221130824","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis (OP) is a widespread disease that causes risks of spine and hip fractures. Morinda officinalis polysaccharide (MOP) shows therapeutic potential in OP. This article intended to understand the mechanism by which MOP impacts bone mineral density (BMD) and serum trace elements in OP rats.</p><p><strong>Methods: </strong>OP rat models were established by bilateral ovariectomy (OVX). Rats were intragastrically administered with MOP or ZLN005 [the activator of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α)] since the first day after operation for 8 weeks. Microstructural changes in OP rats were analyzed using micro-computed tomography system. Contents of serum Zn, Cu, Fe, and Mg in rats were measured. Levels of serum superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), GSH, and malondialdehyde (MDA) in rats were determined by Enzyme-linked immunosorbent assay. Protein levels of PGC-1α and peroxisome proliferator-activated receptor γ (PPARγ) in cartilage tissues of rats were determined via Western blotting.</p><p><strong>Results: </strong>MOP enhanced BMD, bone volume per trabecular volume (BV/TV), Tb.N, and Tb.Th and reduced Tb.Sp in the distal femur of OVX rats, elevated levels of serum Cu, Fe, and Mg and contents of SOD, GSH, and GSH-PX and decreased MDA content. Moreover, MOP suppressed the PGC-1α/PPARγ pathway. Activation of PGC-1α partially abolished the action of MOP on ameliorating OP in OVX rats and strengthening anti-oxidation ability.</p><p><strong>Conclusion: </strong>MOP mitigated OP in OVX rats by inhibiting the PGC-1α/PPARγ pathway.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nontuberculous mycobacteria peri-prosthetic joint infection: An outcome analysis for two stage revision arthroplasty.","authors":"Shih-Hui Peng,&nbsp;Sheng-Hsun Lee,&nbsp;Chun-Chieh Chen,&nbsp;Yu-Chih Lin,&nbsp;Yuhan Chang,&nbsp;Pang-Hsin Hsieh,&nbsp;Hsin-Nung Shih,&nbsp;Steve W N Ueng,&nbsp;Chih-Hsiang Chang","doi":"10.1177/10225536221140610","DOIUrl":"https://doi.org/10.1177/10225536221140610","url":null,"abstract":"<p><strong>Purpose: </strong>Nontuberculous mycobacteria periprosthetic joint infection (NTMPJI) is a rare complication of hip or knee joint arthroplasty. The experience for outcomes of NTMPJI treatment is still limited. The objective of this study was to investigate the outcome of hip or knee nontuberculous mycobacteria periprosthetic joint infection following treatment with two-stage exchange arthroplasty.</p><p><strong>Material and methods: </strong>From 1995 to 2020, 12 patients with NTMPJI were treated with two-stage exchange arthroplasty at our institution. We collected and analyzed variables including demographic data, comorbidity, microbiological data, treatment outcome and antibiotic formula in bone cement.</p><p><strong>Results: </strong><i>Mycobacterium abcessus</i> (<i>n</i> = 6) <i>and Mycobacterium chelonae</i> (<i>n</i> = 2) constitute the majority of the cases. Five patients had early-onset PJIs and the other seven patients were late onset. The success rate of two-stage exchange arthroplasty was 66.7% (8 of 12). Three patients experienced infection relapse, and one patient had soft tissue compromise complication. Post-operative antibiotic therapy may not improve the success rate (4 of 6 cases, 66.7%). Based on in vitro study, the most commonly used effective antibiotic in bone cement spacer for nontuberculous mycobacteria was amikacin.</p><p><strong>Conclusions: </strong>nontuberculous mycobacteria is a rare cause of PJIs and should be suspected especially in relatively immunocompromised patients. Resection arthroplasty with staged reimplantation is the preferred approach. Prolonged post-operative antibiotic therapy before reimplantation may not improve the success rate. Delayed revision surgery may not be needed and can be performed once C-reactive protein level is normal after a drug holiday.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the posterior sagging control device to the posterior tibial translation during posterior-stabilized total knee arthroplasty with modified gap technique.","authors":"Akira Maeyama,&nbsp;Isao Asayama,&nbsp;Tetsuro Ishimatsu,&nbsp;Takuaki Yamamoto","doi":"10.1177/10225536221144715","DOIUrl":"https://doi.org/10.1177/10225536221144715","url":null,"abstract":"<p><strong>Purpose: </strong>In modern total knee arthroplasty (TKA), flexion and extension gaps between the femur and tibia are equilibrated before implanting the final components. Uncontrolled intraoperative posterior tibial translation (PTT) could cause an artifactual widening of the flexion gap, which could lead surgeons to alter the femoral component size. We designed an intraoperative posterior sagging control device to prevent intraoperative PTT. In this study, we investigated whether the use of this device could prevent artifactual widening of the flexion gap.</p><p><strong>Methods: </strong>Twenty-five patients, 21 women and four men, aged 74.2 years, were enrolled in this prospective study. All patients underwent postero-stabilized TKA using a navigation system. Intraoperative PTT, flexion and extension gaps with or without using the posterior sagging control device were measured with navigation system. These measurements were compared with or without the posterior sagging control device and after the final implantation also.</p><p><strong>Results: </strong>There were significant differences between the measurements performed with or without the posterior sagging control device when compared to the post-implantation measurements. The use of the device reduced the number of patients with a >3 mm increase in flexion gap from 7 (28%) to 1 (4%).</p><p><strong>Conclusion: </strong>This study suggests that the posterior sagging control device prevents PTT and artificial flexion gap widening. This could prevent an unnecessary increase in component size.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10403829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of hybrid closed wedge high tibial osteotomy for advanced osteoarthritis of the knee compared with total knee arthroplasty.","authors":"Tetsuro Ishimatsu,&nbsp;Ryohei Takeuchi,&nbsp;Hiroyuki Ishikawa,&nbsp;Akira Maeyama,&nbsp;Katsunari Osawa,&nbsp;Natsumi Kimura,&nbsp;Takuaki Yamamoto","doi":"10.1177/10225536221137754","DOIUrl":"https://doi.org/10.1177/10225536221137754","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical outcomes between hybrid closed wedge high tibial osteotomy (HCWHTO) and total knee arthroplasty (TKA) for advanced medial compartmental osteoarthritis of the knee (advanced knee OA).</p><p><strong>Methods: </strong>In more than grade 3 OA based on the Kellgren-Lawrence classification, when patients' age was less than 60 years or activity level was more than level 5 based on the UCLA activity score, 22 knees (18 patients) underwent HCWHTO. The other 22 knees (18 patients) that underwent TKA were evaluated retrospectively. Muscle strength was evaluated preoperatively and at 1 year postoperatively. The visual analogue scale (VAS) and Japanese version of the Knee injury and Osteoarthritis Outcome Score (J-KOOS) were used to evaluate clinical outcomes preoperatively and at a mean 66-months follow-up.</p><p><strong>Results: </strong>All postoperative muscle strength measures improved to preoperative equivalent levels in the HCWHTO group; they were significantly higher in the HCWHTO group than in the TKA group (<i>p</i> < .05). The VAS score and total J-KOOS significantly improved in both groups (HCWHTO, <i>p</i> = .001; TKA, <i>p</i> = .040); there were no significant differences in the scores between the groups at the final follow-up. Hybrid closed wedge HTO significantly improved the activities of daily living and sport/recreation scores, whereas TKA did not at the final follow-up.</p><p><strong>Conclusions: </strong>In advanced knee OA, HCWHTO led to improved muscle strength, and its midterm clinical outcomes were equivalent to those of TKA. To postpone or even to avoid TKA, HCWHTO is considered an appropriate treatment for young and high-activity patients with advanced knee OA.</p><p><strong>Level of evidence: </strong>Therapeutic Level III.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10412956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sonographic posterolateral rotatory stress test: Normal ulnohumeral gap difference in healthy volunteers.","authors":"Nattakorn Mahasupachai,&nbsp;Nutthakorn Samathi,&nbsp;Arnakorn Premsiri,&nbsp;Cholawish Chanlalit","doi":"10.1177/10225536221128861","DOIUrl":"https://doi.org/10.1177/10225536221128861","url":null,"abstract":"<p><p><b>Background:</b> The sonographic posterolateral rotatory stress test may be a good preoperative diagnostic tool for posterolateral rotatory instability, especially in atraumatic or occult cases. However, there is lack of study on the living population or the normal elbow. <b>Hypothesis/Purpose:</b> This study evaluates the ulnohumeral opening gap difference between elbows in resting and stress positions while performing ultrasonography in normal healthy volunteers. The hypothesis is that the normal ulnohumeral opening gap difference is less than 2 mm. <b>Methods:</b> A total of 21 participants (9 males and 12 females) who presented at our institution between May and June 2021 were recruited. First, participants with elbow deformity, major elbow trauma, history of injection or surgery around the elbow, or evidence of elbow instability were excluded. Only healthy elbows without symptoms were included in this study. Participants' both elbows were examined using ultrasonography. The ulnohumeral gap was measured in millimeters, and the difference was calculated from the means of ulnohumeral gap in resting and stress positions. <b>Results:</b> The mean age of participants was 36.14 years old. No samples with hyperlaxity were included. Overall, the means of ulnohumeral gap in resting and stress positions were 2.55 ± 0.69 mm and 3.16 ± 0.80 mm, respectively. The average mean of overall ulnohumeral opening gap difference was 0.61 ± 0.32 mm. There was no statistically significant difference between males and females (<i>p</i> = .989). The intraobserver reliability was 0.89 and 0.9 for resting and stress positions, respectively. <b>Conclusion:</b> The sonographic posterolateral rotatory stress test shows that the ulnohumeral opening gap difference between resting and stress positions is less than 2 mm in healthy volunteers. <b>Clinical Relevance:</b> In patients with inconclusively-diagnosed PLRI, the sonographic posterolateral rotatory stress test may be a reliable preoperative diagnosis tool, providing its non-invasiveness and the ability to assess the contralateral side as a comparison.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40371508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of talar lesions with cement augmentation and autologous bone graft.","authors":"Do Hun Kim,&nbsp;Wanlim Kim,&nbsp;Youngrak Choi","doi":"10.1177/10225536221131159","DOIUrl":"https://doi.org/10.1177/10225536221131159","url":null,"abstract":"<p><strong>Background: </strong>Treatment of bone lesions involved with the articular cartilage at the talus is challenging. We report the management of talus lesions, particularly tumors and avascular necrosis (AVN), at the articular surface through treatment with cement augmentation and autologous bone graft.</p><p><strong>Methods: </strong>Eight benign bone tumors and three cases of AVN were reviewed retrospectively at a mean follow-up of 56 months (range, 12-162). The mean age of all patients was 36.1 years old (range, 15-73) when assessed between February 2005 and November 2021. Curettage of tumorous and necrotic lesions resulted in significant bone defects filled with bone cement augmentation. Cartilage defects of the talar dome were supported with autologous cancellous bone graft. Tolerable weight-bearing ambulation was permitted immediately after surgery. Radiological and functional evaluations were recorded.</p><p><strong>Results: </strong>We observed an increase in the average The American Orthopaedic Foot and Ankle Score (AOFAS) (<i>p</i> = .003) and a decrease in the average Visual Analogue Scale pain score (<i>p</i> = .003). There was no statistically significant decrease in ROM before or after surgery (<i>p</i> = .114). Additionally, no talus collapse of the ankle joint occurred. Talar dome status did not aggravate before or after surgery, except for one patient. Despite no radiographic osteoarthritis exacerbation before or after surgery in six patients, five patients had osteoarthritic change.</p><p><strong>Conclusion: </strong>Cement implantation and autologous bone graft performed simultaneously for benign bone tumors with joint cartilage damage and AVN are technically simple, have good outcomes, and may be a suitable alternative to standard treatments.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40380807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide partial knee replacement uptake is influenced by volume and supplier--A Dutch arthroplasty register study.","authors":"Iris Koenraadt-van Oost,&nbsp;Koen Lm Koenraadt,&nbsp;Alexander Hoorntje,&nbsp;Liza N van Steenbergen,&nbsp;Stefan Bt Bolder,&nbsp;Rutger Ci van Geenen","doi":"10.1177/10225536221144726","DOIUrl":"https://doi.org/10.1177/10225536221144726","url":null,"abstract":"<p><strong>Background: </strong>Despite the established advantages of partial knee replacements (PKR), their usage remains limited. We investigated the effect of hospital knee arthroplasty (KA) volume and the availability of a frequently used PKR by the total KA supplier on the use of PKRs in a hospital.</p><p><strong>Methods: </strong>A total of 190,204 total knee replacements (TKR) and 18,134 PKRs were identified in the Dutch Arthroplasty Register (LROI) from 2007 to 2016. For each hospital we determined the annual absolute KA volume (TKR+PKR) into quartiles (<103, 103-197, 197-292, >292 knee replacements/year), and determined whether the TKR supplier provided a frequently used PKR. Hospitals were divided in routine PKR users (≥13 PKRs/year) or occasional/non PKR users (<13 PKRs/year). Based on these parameters, the effect of total KA volume and supplier on PKR usage was investigated, using chi-square tests. Logistic regression analysis was performed to evaluate the influence of the combination of these factors.</p><p><strong>Results: </strong>In the lowest volume group, around 15% of the hospitals used PKRs, compared to 75% in the highest volume group. Having a TKR supplier that also provides a frequently used PKR resulted in a higher likelihood of performing PKR, especially in low volume hospitals.</p><p><strong>Conclusions: </strong>Hospitals' total KA volume and the availability of a frequently used PKR appear to influence the use of PKR.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10403349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open latarjet procedure versus all-arthroscopic autologous tricortical iliac crest bone grafting for anterior-inferior glenohumeral instability with glenoid bone loss.","authors":"Sam Razaeian,&nbsp;Katja Tegtmeier,&nbsp;Dafang Zhang,&nbsp;Stefan Bartsch,&nbsp;Peter Kalbe,&nbsp;Christian Krettek,&nbsp;Nael Hawi","doi":"10.1177/10225536221133946","DOIUrl":"https://doi.org/10.1177/10225536221133946","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare the open Latarjet procedure versus the all-arthroscopic autologous tricortical iliac crest bone grafting (AICBG) technique for recurrent anterior-inferior glenohumeral instability with glenoid bone loss.</p><p><strong>Methods: </strong>All open Latarjet and AICBG procedures for recurrent anterior-inferior shoulder instability with glenoid bone loss performed at two institutions between September 2015 and April 2019 were retrospectively analyzed. Inclusion criteria were a traumatic etiology, a glenoid surface deficiency >13.5%, and a minimum follow-up (FU) of 18 months. Primary outcomes included the subjective shoulder value, the Western Ontario Shoulder Instability (WOSI), Rowe scores including subdomains, and the four subdomains of the Constant score (pain, activities of daily living, internal rotation, external rotation). Secondary outcomes were subjective shoulder instability, EQ-5D-3 L, pain level on the VAS, level of overall satisfaction, operative time, return-to-work rate, and return-to-sports rate.</p><p><strong>Results: </strong>Forty-three patients were available for final analysis (Latarjet: <i>n</i> = 21; AICBG: <i>n</i> = 22) at an average FU of 34.9 months (range, 22-66 months). Both techniques provided good outcomes and improved stability. The Rowe score, Rowe-range of motion, and CS-internal rotation (<i>p</i> = 0.008, <i>p</i><0.001, <i>p</i> = 0.001) were slightly better in the AICBG group. Furthermore, the WOSI physical symptoms subdomain was significantly better (<i>p</i> = 0.04) in the AICBG group, while its total score did not reach statistical significance (<i>p</i> = 0.07). There was no statistically significant difference in the secondary outcomes besides operative time, which was significantly shorter in the Latarjet procedure group (<i>p</i> = 0.04). Overall complication rate was similar in both groups (Latarjet: 9.5% (<i>n</i> = 2), AICBG: 9.1% (<i>n</i> = 2)).</p><p><strong>Conclusion: </strong>Open Latarjet and AICBG procedures provide comparable clinical outcomes except for significantly better Rowe score, Rowe-range of motion, WOSI physical symptoms subdomain, and internal rotation capacity in the AICBG group. However, these results should be carefully interpreted in the context of known minimal clinically important differences of these scores.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10778036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}