Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Managing the arthritic wrist: Complication prevention and management","authors":"Camelia Qian Ying Tang ,&nbsp;Margaret Woon Man Fok ,&nbsp;Sze-Ryn Chung ,&nbsp;Muntasir Mannan Choudhury ,&nbsp;Andrew Yuan Hui Chin","doi":"10.1016/j.jcot.2024.102877","DOIUrl":"10.1016/j.jcot.2024.102877","url":null,"abstract":"<div><div>Wrist arthroscopy presents a significant learning curve, necessitating various precautions to avoid complications like tendon laceration or nerve injury. Arthroscopic procedures become even more challenging in arthritic wrists due to altered anatomy and reduced joint space, which in turn increase the risk of complications. In this review article, we offer tips and tricks to minimize these risks. Despite the challenges, wrist arthroscopy remains a valuable diagnostic and therapeutic tool when performed by an experienced surgeon with thorough preoperative planning and careful patient selection.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"62 ","pages":"Article 102877"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054268","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":"Challenges and complications in arthroscopic ankle ligament repair: Current concepts","authors":"Juan Ignacio Crosa,&nbsp;Mauro Andres Goveo,&nbsp;Juan Ignacio Peralta,&nbsp;Fernando Vago Anaya,&nbsp;Emiliano Loncharich","doi":"10.1016/j.jcot.2025.102906","DOIUrl":"10.1016/j.jcot.2025.102906","url":null,"abstract":"<div><div>Arthroscopic ligament repair has gained popularity as a minimally invasive alternative for addressing ankle instability, due to its minimally invasive nature, which offers significant advantages over traditional open procedures. These benefits include smaller incisions, reduced soft tissue dissection, and the ability to concurrently manage intra-articular pathology, contributing to its popularity among surgeons and patients alike. Despite these advantages, the procedure presents a range of technical challenges and potential complications that can impact patient outcomes. Persistent instability, improper tensioning, and issues related to suture anchors are some of the primary concerns. Understanding these complexities and employing targeted strategies to mitigate them is essential for improving patient outcomes. Continued research and refinement of surgical techniques will play a key role in enhancing the safety and efficacy of this procedure.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"62 ","pages":"Article 102906"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069489","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":"Clinical and functional outcomes of utilising nail cement spacer as a frugal method of reconstruction for tumours of the proximal humerus","authors":"Zeeshan Khan ,&nbsp;Zainab Aqeel Khan ,&nbsp;Muhammad Ibrahim","doi":"10.1016/j.jcot.2024.102854","DOIUrl":"10.1016/j.jcot.2024.102854","url":null,"abstract":"<div><h3>Background</h3><div>The shoulder girdle and proximal humerus are common sites for neoplastic lesions be it benign or malignant. We aimed to evaluate the outcomes of a frugal method of reconstruction of the proximal humerus for neoplastic lesions at short to medium term follow-up.</div></div><div><h3>Methods</h3><div>Data for this retrospective case series was collected from an electronic data base held at the primary authors institution. All patients who had resection of the proximal humerus for any neoplastic lesion and reconstructed with a nail cement spacer were included in the study from January 2016 to January 2023. The functional outcomes were measured by Musculoskeletal tumour society score (MSTS) and the Toronto extremity salvage score (TESS). The survivorship and post-operative complications were also reported.</div></div><div><h3>Results</h3><div>Twenty-two patients were available at final follow up with a mean follow-up time of 37 ± 18 months (range 12–81 months) with Ewing's sarcoma, giant cell tumour, osteosarcoma and metastatic disease as the commonest indications for surgery with a mean age of 29 ± 17 years. The Kaplan–Meier estimates indicated that the survival rate for 22 patients with endpoint (event) taken as death was 63.6 % and for endpoint taken (event) as implant failure was 95.5 % with mean survival time of 58.1 and 77 months respectively. At final follow up, the mean MSTS score was 23.6 ± 2.9 (78.7 %). One patient had superficial infection which settled with a short course of oral antibiotics and one patient had breakage of nail, which was revised.</div></div><div><h3>Conclusion</h3><div>These results prove that this frugal method of reconstruction is comparable with endoprosthesis when considering clinical and functional outcomes but significantly cost effective and should be considered for the individual patient.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102854"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886285","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":"Risk factors for infection after primary reverse shoulder arthroplasty - A systematic review with meta-analysis","authors":"Girinivasan Chellamuthu ,&nbsp;S. Samundeeswari ,&nbsp;Thamizhmathi Thangaraju ,&nbsp;Saseendar Shanmugasundaram","doi":"10.1016/j.jcot.2024.102833","DOIUrl":"10.1016/j.jcot.2024.102833","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infections (PJIs) following primary Reverse Shoulder Arthroplasty (RSA) are associated with significant economic burdens and complications. While numerous reviews have explored PJIs after RSA, a comprehensive analysis of risk factors specifically after primary RSA is lacking.</div></div><div><h3>Objective</h3><div>This systematic review aims to provide a comprehensive summary of the incidence and risk factors associated with PJIs after primary RSA.</div></div><div><h3>Methods</h3><div>Following Cochrane and PRISMA guidelines, a systematic search was conducted across multiple databases. Twenty-five articles meeting inclusion criteria were included for analysis.</div></div><div><h3>Results</h3><div>The incidence of PJIs after primary RSA was found to be 1.4%, with Staphylococcus species and Cutibacterium acne as common pathogens. Eleven modifiable and six non-modifiable risk factors were identified. Modifiable factors included pathological weight loss, obesity, metabolic syndrome, and steroid injections within one month before RSA. Non-modifiable factors included a history of previous shoulder surgery, inflammatory arthritis, male sex, and younger age.</div></div><div><h3>Conclusion</h3><div>Proactive management of modifiable risk factors and careful consideration of non-modifiable factors are essential in reducing PJIs after primary RSA. Strategies such as optimizing systemic health conditions and implementing meticulous surgical techniques may contribute to improved outcomes and reduced infection rates in RSA patients.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102833"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098021","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":"Minimum twenty-year follow-up of fixed-vs mobile-bearing total knee arthroplasty: Double blinded randomized trial","authors":"Maha L. Khan ,&nbsp;William Oetojo ,&nbsp;William J. Hopkinson ,&nbsp;Nicholas Brown","doi":"10.1016/j.jcot.2024.102864","DOIUrl":"10.1016/j.jcot.2024.102864","url":null,"abstract":"<div><h3>Introduction</h3><div>Mobile-bearing (MB) inserts, designed to minimize aseptic loosening and to reduce contact stresses leading to polyethylene wear, are an alternative to fixed-bearing (FB) inserts. Most studies have shown no significant difference between MB and FB constructs, and there is limited long-term data comparing the two constructs [1,2,3,4]. The purpose of this study was to report the outcomes of a randomized controlled trial comparing MB versus FB inserts on patients with minimum 20-year follow-up.</div></div><div><h3>Methods</h3><div>Between 2002 and 2003, 132 patients were randomized intra-operatively to the rotating-platform (RP) prosthesis group or the FB prosthesis group. 40 patients from the previous minimum 12-year follow-up were evaluated to obtain information on implant survival and satisfaction. Basic univariate statistics were used.</div></div><div><h3>Results</h3><div>26 patients were deceased, and 4 patients were lost to follow-up. This left 10 remaining knees (FB = 5, RP = 5) for inclusion. The mean age at surgery was 56.8 years, and the mean follow-up was 21 years overall for both groups. There were four failures and two revisions in total for each group 12. The RP revisions were for patellar component loosening and deep infections. The revisions on FB knees were for patella fracture and dislocation, pain from an oversized femoral component, and a loose tibial baseplate. The remaining patients expressed satisfaction with their replaced knees. No additional revisions were reported in this follow-up study. With the numbers available for study, there was no difference in ROM at 122° ± 12.5° for RP knees and 119° ± 6.5° for FB knees (p = 0.92).</div></div><div><h3>Conclusions</h3><div>There were few revisions, and most patients, in both RP and FB groups, expressed satisfaction and limited wear with their knees. While a safe, viable option for TKA, RP inserts did not result in long-term clinical benefit compared to FB.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102864"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933614","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":"Strategies to mitigate complications in arthroscopic rotator cuff repair","authors":"Guido Fierro ,&nbsp;Gabriela Gómez Romero ,&nbsp;Jorge Rojas Lievano ,&nbsp;Juan David Lacouture ,&nbsp;Juan Carlos González","doi":"10.1016/j.jcot.2024.102852","DOIUrl":"10.1016/j.jcot.2024.102852","url":null,"abstract":"<div><div>The rotator cuff, a vital group of tendons and muscles in the shoulder, is essential for stabilizing the joint and enabling a wide range of arm movements. Rotator cuff tears, common across all age groups, often cause significant pain and functional limitations. Rotator cuff repair surgery aims to alleviate pain, restore function, and improve quality of life. Recent advances, particularly in arthroscopic techniques, have enhanced surgical outcomes and shortened recovery times. Nevertheless, risks remain, including surgical site infections, tendon retears, stiffness, severe postoperative pain, and nerve injuries.</div><div>This article explores the complexities of rotator cuff repair, dividing complications into intraoperative and postoperative categories. Key challenges in arthroscopic techniques include ensuring optimal visualization, preventing anchor pullout, and managing chondral damage. Postoperative concerns such as infections, stiffness, and retears are also discussed, with an emphasis on preoperative skin preparation and emerging interventions like benzoyl peroxide application and platelet-rich plasma. By incorporating surgical innovations, evidence-based protocols, and comprehensive patient management, clinicians can enhance outcomes and recovery rates. The ongoing exploration of new treatments and collaborative research efforts are crucial for refining treatment protocols and advancing orthopedic patient care.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102852"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932251","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":"The influence of the number of postoperative radiological outliers on the survival and clinical outcome of total knee arthroplasty","authors":"D.M.J. Theeuwen ,&nbsp;Y.F.L. Bemelmans ,&nbsp;B. Boonen ,&nbsp;I. Haveman ,&nbsp;W. van der Weegen ,&nbsp;M.G.M. Schotanus","doi":"10.1016/j.jcot.2024.102834","DOIUrl":"10.1016/j.jcot.2024.102834","url":null,"abstract":"<div><h3>Introduction</h3><div>After total knee arthroplasty (TKA), dissatisfaction rates are described up to 30 %. Optimal alignment of the prosthesis in TKA is believed to improve clinical outcome and survival rates. Radiological outliers after TKA are used to define this alignment. Limited evidence is available on the cumulative effect of these outliers on survival or clinical outcome. The purpose of this study is to assess whether the amount of postoperative femoral and/or tibial radiological outliers, measured in different planes, influences the survival and clinical outcome after TKA.</div></div><div><h3>Methods</h3><div>Prospective data were used from a previously published randomized trial, with a mean follow-up of 5-years after surgery. Data of 168 patients who received TKA were assessed. Patients were divided into four groups: 0, 1, 2 or ≥3 postoperative radiological outliers of the femoral and/or tibial component in different planes (e.g. frontal, sagittal). Revision rates were analysed and clinical outcome was assessed using PROMs. The study used a general linear model for repeated measures to compare the difference of each questionnaire over time between the groups.</div></div><div><h3>Results</h3><div>No statistically significant differences were found between patients with 0, 1, 2 or ≥3 outliers regarding improvement of postoperative PROMs. Data was underpowered to detect a possible relationship between the number of outliers and the survival of the prosthesis.</div></div><div><h3>Conclusion</h3><div>The number of postoperative radiological outliers did not influence clinical outcome after TKA. High-powered studies are needed to examine the influence of these outliers on survival rates.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102834"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932529","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":"Reviewer Acknowledgment-2024","authors":"","doi":"10.1016/j.jcot.2024.102896","DOIUrl":"10.1016/j.jcot.2024.102896","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102896"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098540","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":"Complications following shoulder arthroplasty: A review of the recent literature","authors":"Giles Faria ,&nbsp;Zaid Ali ,&nbsp;Muhammed Rasheed ,&nbsp;Ali Abdelwahab ,&nbsp;Hariharan Mohan ,&nbsp;Nik Bakti ,&nbsp;Bijayendra Singh","doi":"10.1016/j.jcot.2024.102850","DOIUrl":"10.1016/j.jcot.2024.102850","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102850"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933610","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":"Osteoporosis Knowledge Assessment Tool – Tamil (OKAT-T) in postmenopausal women: A validity and reliability study","authors":"Lalithambigai Chellamuthu ,&nbsp;J Jenifer Florence Mary ,&nbsp;Suvathi Palanichamy","doi":"10.1016/j.jcot.2024.102845","DOIUrl":"10.1016/j.jcot.2024.102845","url":null,"abstract":"<div><h3>Introduction</h3><div>Osteoporosis is a silent disease that is more prevalent among postmenopausal women (PMW) due to hormonal transition. Various toolkits, including the Osteoporosis Knowledge Assessment Tool (OKAT), were available for the knowledge assessment. The Osteoporosis-related knowledge is crucial for preventing osteoporosis, but there is no validated, reliable questionnaire in Tamil to measure this knowledge.</div></div><div><h3>Aim</h3><div>To validate the Tamil version of the OKAT (OKAT-T) and its psychometric properties to measure the knowledge of osteoporosis for use in postmenopausal women.</div></div><div><h3>Methodology</h3><div>This cross-sectional study was done in two phases, as translation of OKAT in Tamil and validation of OKAT-T among 430 postmenopausal women in both rural and urban regions. Reliability was examined by the Flesch reading ease (FKRE&amp;G) and McNemar's test, along with difficulty index, item discrimination and item-total correlations, inter-item consistency (Cronbach's alpha coefficient).</div></div><div><h3>Result</h3><div>The overall mean age of the 430 PMW was 59.53 ± 9.83 years. The results showed a good and satisfactory face validity and FKRE&amp;G score (55.9). The Cronbach's alpha for the overall scale was calculated as 0.85 and considered to be good and satisfactory. As per the difficulty index, 19 items had a 0.3 to 0.7, implying that the questionnaire was easy to understand and satisfactory. Similarly, a test-retest was assessed, which was statistically significant for only six items out of 26, showing that the tool has stable reliability.</div></div><div><h3>Conclusion</h3><div>The management of chronic disorders such as osteoporosis has become more challenging for patients especially among PMW and healthcare professionals due to the increasing life expectancy and urbanization. The use of an Osteoporosis Knowledge Assessment tool that has been tailored to people's understanding and developed in the local language can raise awareness levels about osteoporosis, encourage the adoption of osteoprotective strategies, and provide guidance on treatment options.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"60 ","pages":"Article 102845"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933556","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}