European journal of orthopaedic surgery & traumatology : orthopedie traumatologie最新文献

{"title":"Use of elevated liners in primary total hip arthroplasty: a systematic review of the literature.","authors":"Ioannis Gkiatas, Theofilos Karasavvidis, Abhinav K Sharma, William Xiang, Michael-Alexander Malahias, Brian P Chalmers, Seth A Jerabek, Peter K Sculco","doi":"10.1007/s00590-021-03023-y","DOIUrl":"10.1007/s00590-021-03023-y","url":null,"abstract":"<p><strong>Purpose: </strong>Instability remains one of the most frequent complications requiring revision surgery after primary total hip arthroplasty (THA). Elevated liners are often utilized to reduce the risk of dislocation; however, the literature is inconclusive, with no systematic reviews summarizing the data. Thus, this systematic review aimed to establish a consensus for the efficacy of elevated liners in primary THA by determining rates of overall revision and revision specifically for recurrent dislocation.</p><p><strong>Materials and methods: </strong>This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible randomized-controlled trials and observational studies reporting on the use of elevated liners in primary total hip arthroplasty were identified through May 2020. A random effects model meta-analysis was conducted, and the I² statistic was used to assess for heterogeneity.</p><p><strong>Results: </strong>Eight studies met inclusion criteria, and overall, 26,507 patients undergoing primary THA with use of an elevated liner were included. In aggregate, the most common cause of revision was recurrent hip dislocation (1.3%, N = 82/6,267) followed by joint infection (1.2%, N = 45/3,772) and acetabular loosening (0.3%, N = 10/3,772). Notably, elevated liners were associated with a lower risk of revision for recurrent dislocation compared to neutral liners (HR: 0.74; 95% CI: 0.55-1.00; p = 0.048).</p><p><strong>Conclusion: </strong>This review found that after primary THA with the use of elevated liners, hip dislocation and prosthetic joint infection continued to be the most frequent reasons for revision surgery. However, elevated liners had a lower risk of revision for recurrent dislocation compared to neutral liners.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"587-594"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39030389","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":"Does a combined screw and dowel construct improve tibial fixation during anterior cruciate ligament reconstruction?","authors":"Pierre Laumonerie, Meagan E Tibbo, Gregoire Laumond, Dominique Barbier, Pauline Assemat, Pascal Swider, Franck Accadbled","doi":"10.1007/s00590-021-03049-2","DOIUrl":"10.1007/s00590-021-03049-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of the present study were to compare the biomechanical properties of tibial fixation in hamstring-graft ACL reconstruction using interference screw and a novel combination interference screw and dowel construct.</p><p><strong>Material and methods: </strong>We compared the fixation of 30 (2- and 4-stranded gracilis and semitendinosis tendons) in 15 fresh-frozen porcine tibiae with a biocomposite resorbable interference screw (Group 1) and a screw and dowel construct (Group 2). Each graft was subjected to load-to-failure testing (50 mm/min) to determine maximum load, displacement at failure and pullout strength.</p><p><strong>Results: </strong>There were no significant differences between the biomechanical properties of the constructs. Multivariate analysis demonstrated that combination constructs (β = 140.20, p = 0.043), screw diameter (β = 185, p = 0.006) and 4-strand grafts (β = 51, p = 0.050) were associated with a significant increase in load at failure. Larger screw diameter was associated with increased construct stiffness (β = 20.15, p = 0.020).</p><p><strong>Conclusion: </strong>The screw and dowel construct led to significantly increased fixation properties compared to interference screws alone in a porcine model. Increased screw diameter and utilization of 4-strand ACL grafts also led to improvement in load-to-failure of the construct. However, this is an in vitro study and additional investigations are needed to determine whether the results are reproducible in vivo.</p><p><strong>Level of evidence: </strong>Level V; Biomechanical study.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"759-765"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092115","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":"Locked fracture dislocations of the proximal humerus: postoperative results and a proposed modification of the classification.","authors":"Jonas Schmalzl,&nbsp;Annika Graf,&nbsp;Fabian Gilbert,&nbsp;Michael Kimmeyer,&nbsp;Christian Gerhardt,&nbsp;Lars-Johannes Lehmann","doi":"10.1007/s00590-021-03022-z","DOIUrl":"https://doi.org/10.1007/s00590-021-03022-z","url":null,"abstract":"<p><strong>Background: </strong>Locked dislocations of the glenohumeral joint are disabling and often painful conditions and the treatment is challenging. This study evaluates the functional outcome and the different prosthetic treatment options for chronic locked dislocations of the glenohumeral joint and a subclassification is proposed.</p><p><strong>Methods: </strong>In this single-center retrospective case series, all patients with a chronic locked dislocation treated surgically during a four-year period were analyzed. Constant score (CS), Quick Disabilities of Shoulder and Hand Score (DASH), patient satisfaction (subjective shoulder value (SSV)), revision rate and glenoid notching were analyzed.</p><p><strong>Results: </strong>26 patients presented a chronic locked dislocation of the glenohumeral joint. 16 patients (62%) with a mean age of 75 [61-83] years were available for follow-up at 24 ± 18 months. CS improved significantly from 10 ± 6 points to 58 ± 21 points (p < 0.0001). At the final follow-up, the mean DASH was 27 ± 23 and the mean SSV was 58 ± 23 points. The complication rate was 19% and the revision rate was 6%; implant survival was 94%. Scapular notching occurred in 2 (13%) cases (all grade 1).</p><p><strong>Conclusion: </strong>With good preoperative planning and by using the adequate surgical technique, good clinical short-term results with a low revision rate can be achieved. The authors suggest extending the Boileau classification for fracture sequelae type 2 and recommend using a modified classification to facilitate the choice of treatment as the suggested classification system includes locked posterior and anterior dislocations with and without glenoid bone loss.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"683-692"},"PeriodicalIF":1.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-03022-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39061719","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":"Letter to the editor regarding \"Does vitamin C supplementation improve rotator cuff healing? A preliminary study\".","authors":"Peter W Stubbs, Arianne P Verhagen, Alana B McCambridge","doi":"10.1007/s00590-021-03040-x","DOIUrl":"10.1007/s00590-021-03040-x","url":null,"abstract":"","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"785-786"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39104385","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":"Letter to the editor 'Intramedullary percutaneous fixation of metacarpal fractures: screw versus connected K-wires'.","authors":"Metin Uzun","doi":"10.1007/s00590-021-03034-9","DOIUrl":"10.1007/s00590-021-03034-9","url":null,"abstract":"","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"783"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39063899","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":"Osteotomies around the knee lead to corresponding frontal realignment of the ankle.","authors":"Christian Konrads,&nbsp;Alexander Eis,&nbsp;Sufian S Ahmad,&nbsp;Ulrich Stöckle,&nbsp;Stefan Döbele","doi":"10.1007/s00590-021-03016-x","DOIUrl":"https://doi.org/10.1007/s00590-021-03016-x","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the fact that osteotomies around the knee represent well-established treatment options for the redistribution of loads and forces within and around the knee joint, unforeseen effects of these osteotomies on the ankle are still to be better understood. It was therefore the aim of this study to determine the influence of osteotomies around the knee on the coronal alignment of the ankle. We hypothesize that osteotomies around the knee for correction of genu varum or valgum lead to a change of the ankle orientation in the frontal plane by valgisation or varisation.</p><p><strong>Materials and methods: </strong>Long-leg standing radiographs of 154 consecutive patients undergoing valgisation or varisation osteotomy around the knee in 2017 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy site. The hip knee ankle angle (HKA), the mechanical lateral distal femur angle (mLDFA), the mechanical medial proximal tibia angle (mMPTA) and five angles around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann-Whitney test.</p><p><strong>Results: </strong>One hundred fifty-four patients (96 males, 58 females) underwent osteotomies around the knee for coronal realignment. The mean age was 51 ± 11 years. Correction osteotomies consisted of 73 HTO, 54 DFOs, and 27 double level osteotomies. Of all osteotomies, 118 were for valgisation and 36 for varisation. For valgisation osteotomies, the mean HKA changed from 5.8° ± 2.9° preoperatively to - 0.9° ± 2.5° postoperatively, whereas the mMPTA changed from 85.9° ± 2.7° to 90.7° ± 3.1° and the malleolar-horizontal-orientation-angle (MHA) changed from 16.4° ± 4.2° to 10.9° ± 4.2°. For varisation osteotomies, the mean HKA changed from - 4.3° ± 3.7° to 1.1° ± 2.2° postoperatively, whereas the mLDFA changed from 85.7° ± 2.2° to 89.3° ± 2.3° and the MHA changed from 8.8° ± 5.1° to 11.2° ± 3.2°.</p><p><strong>Conclusion: </strong>Osteotomies around the knee for correction of coronal limb alignment not only lead to lateralization or medialization of the weight-bearing line at the knee but also lead to a coronal reorientation of the ankle. This can be measured at the ankle using the MHA. When planning an osteotomy around the knee for correction of genu varum or valgum, the ankle should also be appreciated-especially in patients with preexisting deformities, ligament instabilities, or joint degeneration around the ankle.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"675-682"},"PeriodicalIF":1.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-03016-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38980873","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":"Preliminary outcomes of the cementless UNITED hip system for primary total hip arthroplasty at a minimum 2-year follow-up.","authors":"Fernando Díaz-Dilernia, Agustín M García-Mansilla, Agustín Albani-Forneris, Pablo A Slullitel, Gerardo Zanotti, Fernando Comba, Francisco Piccaluga, Martin Buttaro","doi":"10.1007/s00590-021-03038-5","DOIUrl":"10.1007/s00590-021-03038-5","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to report the initial results of the cementless UNITED hip system in primary total hip arthroplasty (THA) with a minimum follow-up of 2 years.</p><p><strong>Methods: </strong>We retrospectively studied a consecutive series of 203 cementless THAs in 180 patients operated between 2015-2017. We included 89 female and 91 male patients with a mean age of 67 (28 to 89) years. The mean follow-up was 40 (29 to 62) months. Clinical outcome scores and radiographs were measured. Survival was calculated defining failure as the need for any further femoral or acetabular revision, irrespective of the reason.</p><p><strong>Results: </strong>No femoral component loosening was detected. One patient had a Vancouver-B1 intraoperative periprosthetic femoral fracture treated with implant retention and cerclage wires. Two acetabular components were revised for aseptic loosening. Three patients suffered an acute infection treated with debridement, antibiotics, and implant retention. The mean Merle d'Aubigné et Postel scores improved from 13 (4 to 16) points preoperatively to 17 (12 to 18) points at the latest follow-up (p < 0.001). At a mean time of 40 months of follow-up, the survival was 99% and 100% for the acetabular and the femoral components, respectively.</p><p><strong>Conclusion: </strong>This cementless design showed excellent preliminary outcomes in terms of fixation and patient satisfaction, comparable to that of other well-known similar systems.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"745-752"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39087092","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":"Correction to: Medial patellofemoral ligament reconstruction with and without trochleoplasty for patients with patella instability-correlation of trochlear dysplasia and patient outcome, classification and outcome measure in the past decade-a systematic review.","authors":"Cheryl Marise Peilin Tan,&nbsp;Yanan Zhu,&nbsp;Liang Guo,&nbsp;Sir Young James Loh","doi":"10.1007/s00590-021-03063-4","DOIUrl":"https://doi.org/10.1007/s00590-021-03063-4","url":null,"abstract":"","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"609"},"PeriodicalIF":1.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-03063-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39115767","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":"Enhanced recovery protocol after single-stage bilateral primary total knee arthroplasty decreases duration of hospital stay without increasing complication rates.","authors":"Md Quamar Azam, Tarun Goyal, Souvik Paul, Arvind Kumar Yadav, Nishith Govil","doi":"10.1007/s00590-021-03031-y","DOIUrl":"10.1007/s00590-021-03031-y","url":null,"abstract":"<p><strong>Purpose: </strong>With an increasing number of total knee arthroplasty (TKA), protocols for better standard of patient care and shorter duration of hospital stay are necessary. Enhanced recovery (ER) protocols are becoming popular to meet these objectives. The current study aims to evaluate the clinical outcome of fast-track TKA using ER protocol in terms of length of hospital stay, perioperative complications and functional outcomes.</p><p><strong>Methods: </strong>Patients undergoing single-stage bilateral primary TKA were prospectively included in the study. All patients went through a pre-defined ER protocol of TKA. Length of hospital stay, readmission rates, pain scores and functional scores of patients operated under ER protocol were compared with another matched historical control-group. Factors delaying the discharge of the patients by 48 h after the surgery were noted.</p><p><strong>Results: </strong>We compared 275 patients undergoing single-stage bilateral primary TKA through ER protocol (Group 1) with 190 patients who had undergone bilateral primary TKA before the ER protocol was initiated (Group 2). The length of hospital stay (3.9 ± 2.1 days in group 1 and 7.5 ± 3.2 days in group 2, p 0.0001) and post-operative pain scores at 12 h (5.2 ± 2.9 in group 1 and 5.7 ± 2.1 in group 2, p 0.03) and 24 h (4.1 ± 1.6 in group 1 and 4.6 ± 1.4 in group 2, p 0.0005) were found to be significantly better with ER protocol. There was no difference in Oxford knee scores, infection rates, readmissions or mortality between the two groups.</p><p><strong>Conclusion: </strong>ER protocol in single-stage bilateral primary TKA resulted in decreased length of hospital stay without increasing complications and compromising the clinical outcome. It requires an integrated approach and adherence to clinical pathways.</p><p><strong>Level of evidence: </strong>Level II, Prospective comparative study.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"711-717"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39001731","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":"Distal metatarsal osteotomy and dorsal neutralization plate in the treatment of hallux valgus.","authors":"Tahsin Olgun Bayraktar, Ali Yüce, Mustafa Yerli, Ali Cagri Tekin, Hakan Gürbüz","doi":"10.1007/s00590-021-03044-7","DOIUrl":"10.1007/s00590-021-03044-7","url":null,"abstract":"<p><strong>Purpose: </strong>Hallux valgus is a disease that can be treated with many different surgical procedures. In our study, we aimed to compare patients with and without dorsal neutralization plate after distal metatarsal osteotomy and fixation with compression screws.</p><p><strong>Methods: </strong>The files of 59 patients with 89 feet operated with the diagnosis of moderate degree hallux valgus have been examined retrospectively. Hallux valgus angles, AOFAS, VAS and satisfaction scores, time to return to work of both groups were compared. The cases in which only screw fixation was performed were mobilized with the hallux valgus apparatus for 6 weeks postoperatively, while the cases in which dorsal neutralization plate was performed were immediately mobilized full weightbearing without using an additional apparatus. Patients with a minimum follow-up of 2 years were included in the study.</p><p><strong>Result: </strong>There was no statistically significant difference between the two groups in terms of being bilateral (p = 0.457), mean age (p = 0.105) and gender data (p = 0.105). There was no significant difference in the preop and postop second year hallux valgus angles, AOFAS, VAS and satisfaction scores of the patients. There was a significant difference in the time to return to work (p < 0.001) and the 6th week AOFAS (p < 0.001), VAS (p < 0.001) and postop satisfaction (p < 0.001) scores between the two groups.</p><p><strong>Conclusion: </strong>The dorsal neutralization plate performed in addition to the compression screw after distal metatarsal osteotomy can cause painless early postoperative results that do not require the use of an additional apparatus, and early good functional results.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"753-758"},"PeriodicalIF":1.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39106815","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}