European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Demonstration of the effectiveness of complete decongestive treatment in secondary lymphedema developing after total knee arthroplasty.","authors":"Cansın Medin Ceylan, Sedef Ersoy, Fatma Nur Kesiktas, Armagan Özokur","doi":"10.1007/s00590-024-04167-3","DOIUrl":"https://doi.org/10.1007/s00590-024-04167-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study is to demonstrate the treatment results of patients with lymphedema that developed after total knee arthroplasty (TKA) and to compare these results with those of patients with secondary lymphedema non-TKA.</p><p><strong>Methods: </strong>A total of 63 patients diagnosed with secondary lymphedema and who received complete decongestive treatment (MLD + bandaging + exercise) at the lymphedema treatment unit of Istanbul Physical Medicine and Rehabilitation Training Research Hospital between June 1, 2023, and February 1, 2024, were included in our retrospective study. The circumference of both metatarsophalangeal joints was measured, and leg diameter measurements were made from the lateral malleolus to the proximal 10th, 20th, and 30th centimeters.</p><p><strong>Results: </strong>Of the 63 patients included in this study, the average age in the TKA group (n = 17) was 69.23 ± 8.27 years, and the BMI was 38.60 ± 6.52. In the non-TKA group (n = 46), the average age was 63.50 ± 14.05 years, and the BMI was 34.57 ± 9.17. There was no statistical difference between the two groups in terms of demographic data, affected sides, and initial measurements of the patients (p > 0.05). The response to continued decongestive treatment was significantly higher in both the TKA and non-TKA groups (p < 0.05). However, there was no statistically significant difference in treatment response between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>Complete decongestive treatment is an effective method for treating lymphedema that develops after total knee arthroplasty. No difference in treatment response was found between patients with lymphedema following TKA and those with secondary lymphedema from other causes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"45"},"PeriodicalIF":1.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of software-assisted and freehand methods of rotational assessment for diaphyseal femur fractures.","authors":"Christian Blough, Kevin Huang, John Garlich, Milton Little, Charles Moon, Geoffrey Marecek","doi":"10.1007/s00590-024-04121-3","DOIUrl":"10.1007/s00590-024-04121-3","url":null,"abstract":"<p><strong>Objective: </strong>Accurate rotational reduction following femoral shaft fracture fixation is absent in up to 28% of cases yet is critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of rotational reduction with software-assisted rotational reduction.</p><p><strong>Methods: </strong>Four fellowship-trained orthopedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance using (1) their method of choice (MoC) and (2) software assistance (SA). After correction, deviation from baseline rotation was calculated.</p><p><strong>Results: </strong>The mean difference between the two methods (MoC-SA) was 1.1 which was not significant when comparing all raters and between raters individually. SA had significantly less variability compared to MoC. The rate of clinically relevant rotational deformity (> 15°) was 28% using MoC and 11% using SA.</p><p><strong>Conclusion: </strong>Rotational assessment of diaphyseal femur fractures in this cadaveric model was not significantly different when compared between method of choice and software augmentation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"43"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873189","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 impact of pathogen sensitivity to antibiotics loaded in cement on the number of revisions and costs in the treatment of periprosthetic knee infection.","authors":"Cumhur Deniz Davulcu, Mete Özer, Muhammed Yusuf Afacan, Cansu Elibollar, Gökhan Kaynak, Mehmet Can Ünlü","doi":"10.1007/s00590-024-04166-4","DOIUrl":"https://doi.org/10.1007/s00590-024-04166-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the impact of the pathogen's sensitivity to the loaded antibiotics on infection resolution, the number of revisions, and the associated costs in patients undergoing revision total knee arthroplasty (rTKA) due to PJI.</p><p><strong>Material and methods: </strong>We reviewed the treatment and follow-up processes of 61 patients who underwent rTKA for late-stage PJI following primary total knee arthroplasty in our clinic. The study included 11 patients in the resistant group and 50 in the sensitive group in line with the power analysis results. Patients' demographic characteristics and comorbidities were recorded. All patients received dual antibiotic-loaded cement. Microbiological examinations of patients were analyzed, and the number of revision surgeries each patient underwent was determined. We analyzed all surgeries related to infection treatment, including open irrigation, debridement, polyethylene exchange, implant extractions, antibiotic-loaded cement spacer placements, spacer changes, and debridements, and the implantation of revision prostheses, including tumor prostheses. The total number of surgeries each patient underwent was recorded. We also reviewed hospital system records of total protocol costs during patient admissions.</p><p><strong>Results: </strong>Of 61 patients undergoing revision total knee arthroplasty (rTKA) for periprosthetic joint infection, 11 had antibiotic-resistant infections and 50 had antibiotic-sensitive infections. The groups had similar demographics. Polymicrobial infections were more frequent in the resistant group (p = 0.017), with all resistant cases showing gentamicin resistance and two showing teicoplanin resistance. The resistant group required more surgeries (average 3.91 ± 2.7 vs. 2.34 ± 1.3, p = 0.043) compared to the sensitive group, with teicoplanin resistance doubling revision surgeries (p = 0.005). Costs were similar between groups, averaging $6536.96. Gram-negative infections led to more revisions (p = 0.013). Polymicrobial infections did not significantly affect the number of surgeries or costs compared to single strain infections.</p><p><strong>Conclusions: </strong>Our study demonstrates that in rTKA surgeries using dual antibiotic-loaded bone cement, infections caused by antibiotic-resistant microorganisms are more challenging and time-consuming to treat. This underscores the necessity of exploring new methods to enhance local efficacy by loading cement with antibiotics based on specific pathogen culture and sensitivity results, while also providing clinical evidence of the effectiveness of current treatment methods against sensitive microorganisms.</p><p><strong>Level of evidence: </strong>Level 3 (a retrospective cohort study).</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"42"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crush injuries to the lower limbs at a major UK trauma centre: a retrospective observational study.","authors":"Essam Rama, Saania Jayawant, James Zhang, Matija Krkovic","doi":"10.1007/s00590-024-04164-6","DOIUrl":"10.1007/s00590-024-04164-6","url":null,"abstract":"<p><strong>Purpose: </strong>Crush injuries result from the physical compression of muscles and may lead to crush syndrome. Early fluid resuscitation and surgical intervention is key. Few studies have reported the outcomes of crush injuries in the non-disaster setting. This retrospective study aims to characterise such cases.</p><p><strong>Methods: </strong>Patients with lower limb crush injuries were identified from an internal database. Non-crush injuries and patients under the age of 18 were excluded. Types of injuries, management, and complications were extracted.</p><p><strong>Results: </strong>27 patients were included. The right leg (n = 10) was the most frequently injured site. Mechanisms included being run over by vehicles (n = 10) and being crushed by, between, or inside vehicles (n = 8). Fractures were the most common acute injuries (n = 16), while other injuries included rhabdomyolysis, compartment syndrome and degloving. Fluid resuscitation was required in 17 patients. 58 surgeries were performed on 18 patients, with wound debridement and amputations being common. Complications such as acute kidney injury, hyperkalaemia, and sepsis were noted during hospitalisation. Individuals with injuries to the leg or thigh experienced a greater burden of injury and incidence of in-hospital complications compared to those with isolated injuries to the foot.</p><p><strong>Conclusion: </strong>Crush injuries in the non-disaster setting show distinct mechanisms and injury patterns. Those with crush injuries to the leg or thigh more closely resemble a patient cohort seen in the disaster setting compared to those with isolated foot injuries.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"44"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873193","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":"Re-rupture rate and complications after percutaneous Tenolig® repair in acute midsubstance rupture of Achilles tendon.","authors":"Pierre Capdevielle, Alexandre Couraudon, Laurie Steinmuller, Camille Fabbri, Mathias Kirsch, Didier Mainard","doi":"10.1007/s00590-024-04115-1","DOIUrl":"https://doi.org/10.1007/s00590-024-04115-1","url":null,"abstract":"<p><strong>Purpose: </strong>Acute midsubstance Achilles tendon ruptures are the most common tendon injuries in adults and the choice of surgical technique is still debated. The objective of this study is to evaluate the rate of iterative ruptures and postoperative complications at a minimum follow-up of one year of percutaneous sutures of the Achilles tendon, as well as to investigate the risk factors for rupture.</p><p><strong>Methods: </strong>In this single-center retrospective study, 142 patients (119 men and 23 women, mean age of 46 years) were reviewed at a mean follow-up of 24 (12-38) months. Percutaneous sutures with the Tenolig® device was performed by several senior surgeons. We studied the rate of re-ruptures, scar-related complications, sural nerve damage, and thromboembolic complications. The mechanism leading to the rupture was also identified, as were the risk factors.</p><p><strong>Results: </strong>3 patients (2.11%) presented a re-rupture. No damage of the sural nerve was found. Three superficial skin ulcerations were identified, and three patients presented superficial venous thrombosis of the lower limb. Football was the highest risk activity (34.51%). The risk factors for a first episode of rupture were smoking and a BMI over than 25 kg/m². Nevertheless, no statistically significant risk factors could be identified for re-ruptures.</p><p><strong>Conclusion: </strong>Percutaneous sutures of the Achilles tendon using Tenolig® provides a low risk of re-rupture, a low complication rate, particularly scar-related complications, and a respect for tendon vascularization.</p><p><strong>Level of clinical evidence: </strong>3.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"41"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe corridors for sacroiliac fixation in pediatric patients.","authors":"Felipe B Mantovani, Heloísa Z Faggion, Jamil F Soni, Weverley R Valenza, Matheus U S Klipp, Christiano S Uliana","doi":"10.1007/s00590-024-04154-8","DOIUrl":"https://doi.org/10.1007/s00590-024-04154-8","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic ring fractures are rare in the pediatric population and can be treated using sacroiliac screws when needed. The aim of this study was to identify safe anatomical corridors for sacroiliac fixation in different pediatric age groups and also to determine the prevalence of sacral dysmorphism in the study sample.</p><p><strong>Method: </strong>We measured the dimensions of the horizontal and oblique S1 corridors and the horizontal S2 corridor in pelvic computed tomography scans of 138 children aged 1 to 16 years. The patients were divided into three groups (Group 1, 1-6 years old, Group 2, 6-11 years old; and Group 3, 11-16 years old) to identify safe corridors in each age group. We compared the corridors in terms of cross-sectional areas and estimated the prevalence of dysmorphic sacral bones in the study sample.</p><p><strong>Results: </strong>Data are presented as medians. For each group, the height, depth, and length were, respectively: Group 1: 9.1 mm, 13.9 mm, and 47 mm; Group 2: 13.5 mm, 15.7 mm, and 55 mm; and Group 3: 15.7 mm, 16.8 mm, and 72 mm. The prevalence of sacral dysmorphism was high (44.2%).</p><p><strong>Conclusion: </strong>In Group 3, 7.0 mm screws were safe in all three corridors. For Group 2, the oblique S1 corridor could accommodate 7.0 mm screws, whereas in the other studied corridors, the 3.5 mm screw would be better indicated. For Group 1, the oblique S1 corridor was best suited, and only for the 3.5 mm screw.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"37"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes after tibial plateau fracture: infection confers greatest risk of poor outcome.","authors":"Dillon C O'Neill, Eleanor H Sato, Lillia N Steffenson, Devin L Froerer, Thomas F Higgins, David L Rothberg, Lucas S Marchand, Justin M Haller","doi":"10.1007/s00590-024-04160-w","DOIUrl":"https://doi.org/10.1007/s00590-024-04160-w","url":null,"abstract":"<p><strong>Introduction: </strong>Limited patient-reported outcome measurement (PROM) data exist in peri-articular trauma populations. The purpose of this study was to characterize functional mid-term PROMs and to determine relevant predictors of final PROMs and return to work following tibial plateau fracture.</p><p><strong>Methods: </strong>Patients with a tibial plateau fracture were identified by Current Procedural Terminology (CPT) codes 27535 and 27536. Retrospective chart review was performed to verify diagnosis and collect relevant demographic and perioperative data. PROMIS PF, KOOS Activities of Daily Living (KOOS ADL), PROMIS Preference (PROPr) scores, and return to work were compared between groups. Multivariate regression was used to determine predictors of PROMs and return to work.</p><p><strong>Results: </strong>Two hundred and seven patients had minimum 10-month follow-up (67.9% response rate). There were 114 unicondylar and 93 bicondylar injuries. Twenty patients (9.7%) had a post-operative infection. Body mass index (BMI) (B = -0.22; p = 0.021) and post-operative infection (B = -4.3; p = 0.047) were independent predictors of PROMIS-PF. BMI (B = -0.52, p = 0.008), the presence of an ipsilateral lower extremity injury (B = 10.47, p = 0.038), diabetes (B = -10.60; 0.038), and post-operative infection (B = -10.88; p = 0.014) were independent predictors of KOOS ADL. Final PROMIS-PF, KOOS ADL, and post-operative infection were independent predictors of return to work. In a subgroup analysis, infection was associated with markedly lower rate of return to work (39% vs 81%, p = 0.001), PROMIS-PF score (39.8.4 ± 8.6 vs 46.7 ± 8.6; p = 0.002), KOOS ADL score (67.3 ± 25.3 vs 84.6 ± 17.5; p = 0.003), and PROPr score (0.33 ± 0.30 vs 0.52 ± 0.20; p = 0.003).</p><p><strong>Conclusion: </strong>After operative treatment of tibial plateau fractures, post-operative infection results in large decreases in PROMs and rates of return to work that persist at mid-term follow-up. Future studies should focus on infection prevention strategies in the tibial plateau fracture population.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"34"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the role of smoking on clinical outcomes after arthroscopic surgery of the hip: a systematic review and meta-analysis.","authors":"Omkar S Anaspure, Shiv Patel, Anthony N Baumann, Theodor Lenz, Nicolas Pascual-Leone, Albert T Anastasio, Brian C Lau","doi":"10.1007/s00590-024-04145-9","DOIUrl":"10.1007/s00590-024-04145-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the impact of smoking on clinical outcomes following hip arthroscopy (HA) through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>This systematic review and meta-analysis queried PubMed, Scopus, Cochrane, and CINAHL from inception to April 30, 2024, for articles related to smoking and HA outcomes. A random-effects model meta-analysis using relative risk (RR) and 95% confidence intervals was performed to compare smokers and nonsmokers for conversion to total hip arthroplasty (THA) and revision hip arthroscopy (RHA).</p><p><strong>Results: </strong>Twenty observational studies (n = 115,203 patients; 66.95% female; mean age: 36.93 ± 6.53 years; mean follow-up: 22.10 ± 7.56 months) were included. Nine studies investigated smoking and conversion to THA, six examined smoking and RHA, eight assessed smoking and postoperative patient-reported outcomes, and eight evaluated smoking and postoperative complications. Regarding conversion to THA, 5 studies (55.56%) found a significant association, while 4 (44.44%) did not. Meta-analysis from four studies found no significant association between smoking and THA conversion (p = 0.48, OR: 1.02; 95% CI: [0.98-1.06]) or smoking and RHA (p = 0.305, OR: 1.00; 95% CI: [0.97-1.03]). Only 2 studies (33.33%) found a significant association between smoking and RHA, whereas four did not. Six studies found smoking significantly implicated in complications such as HA failure, increased opioid use, infection risk, and venous thromboembolism (VTE). THA conversion rates were 6.54% (n = 14/214) among smokers versus 3.57% (n = 13/364) among nonsmokers.</p><p><strong>Conclusion: </strong>This study found no statistically significant association between smoking and THA conversion, though smokers were observed to experience higher conversion rates overall. Similarly, no significant association was observed for smoking and RHA at 2-year follow-up. However, trends suggest that smokers experience greater risks of adverse outcomes, particularly VTE and HA failure, which should be considered in clinical decision-making.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"35"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814602","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":"Optimizing management strategies for malunion and nonunion of Hoffa fractures: a detailed case series with a proposed treatment algorithm.","authors":"Robinson E Pires, Guido S Carabelli, Jorge Barla, Fernando Bidolegui, Rodrigo Pires E Albuquerque, Vincenzo Giordano","doi":"10.1007/s00590-024-04163-7","DOIUrl":"https://doi.org/10.1007/s00590-024-04163-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to refine management strategies for malunion and nonunion of Hoffa fractures, as these rare complications present significant clinical challenges.</p><p><strong>Methods: </strong>We conducted a case series involving seven patients with Hoffa fracture complications, including four cases of malunion and three cases of nonunion. Each patient underwent individualized surgical treatment, depending on the nature of their complication. Treatment strategies varied from intra-articular osteotomies for malunions to revision surgery or total knee arthroplasty for nonunions. Postoperative outcomes were monitored, with follow-up ranging from 1 to 15 years (mean follow-up time was 6.7 years).</p><p><strong>Results: </strong>In all malunion cases, intra-articular osteotomies restored the articular surface, leading to improved function and bone healing. In nonunion cases, two patients with non-reconstructible nonunions underwent total knee arthroplasty, while one patient achieved union with surgical revision. Overall, six out of seven patients showed significant functional improvements post-surgery, although some experienced mild residual pain or deformities.</p><p><strong>Conclusion: </strong>The management of malunion and nonunion in Hoffa fractures remains challenging, but the individualized strategy based on fracture type and patient-specific factors leads to favourable outcomes. The proposed treatment algorithm provides a useful framework for orthopaedic trauma surgeons in addressing these complications, with emphasis on stable fixation, early intervention, and personalized surgical planning.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"36"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic ACL repair with suture tape augmentation: clinical, functional, and gait analysis outcomes at minimum 3-year follow-up.","authors":"Rachit Saggar, Vikram Arun Mhaskar, Rohit Bansal","doi":"10.1007/s00590-024-04161-9","DOIUrl":"https://doi.org/10.1007/s00590-024-04161-9","url":null,"abstract":"<p><strong>Introduction: </strong>Recent advancements in surgical techniques have led to renewed interest in ACL repair, particularly for acute, proximal tears. Suture tape augmentation (STA) has emerged as a promising technique to support ACL healing while preserving native tissue and potentially improving outcomes. This study aims to evaluate the outcomes of ACL repair with STA in patients with acute, proximal ACL tears.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent ACL repair with STA between June 2018 and October 2020. Inclusion criteria were acute (< 6 weeks) ACL rupture, Sherman type I tears, and minimum follow-up of 3 years. Exclusion criteria included mid-substance or distal ACL tears and previous knee surgeries. Clinical evaluation involved stability tests, PROMs, and gait analysis using Prokin WalkerView. Second-look arthroscopy and histological analysis were conducted on a subset of patients.</p><p><strong>Results: </strong>Twelve consecutive patients (7 males and 5 females) with a mean age of 27.4 ± 7.9 years and mean BMI of 23.3 ± 1.6 kg/m²were included. Time to operation was 19.5 ± 8.7 days. Mean follow-up duration was 53.2 ± 9.4 months. One patient experienced a traumatic re-rupture. One had a contralateral ACL tear and one experienced hardware irritation. Clinical tests were negative for instability in all patients. Post-operative IKDC, Lysholm, and FJS-12 scores showed significant improvement (p < 0.001). All patients (100%) achieved minimal clinically important difference for all PROMs. Walking gait analysis revealed high symmetry indices for range of motion (93.50%) and step length (95.80%) with near symmetrical loading. Second-look arthroscopy showed intact repairs with healthy tissue morphology and integration. Histology revealed increased cellularity, high nuclear density, and preservation of vascular and neural components indicated by CD34 and S-100 markers.</p><p><strong>Conclusions: </strong>Arthroscopic ACL repair with STA provides favourable clinical, functional, and histological outcomes with low re-rupture rates when performed on acute, proximal ACL tears. This technique demonstrates fair-to-good PROMs, functional stability, and near-normal gait parameters.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"39"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}