Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"The influence in clinical results of lower limb length discrepancy following distal femoral osteotomy.","authors":"Youngji Kim, Shintaro Onishi, Mitsuaki Kubota, Muneaki Ishijima, Ahmed Mabrouk, Christophe Jacquet, Matthieu Ollivier","doi":"10.1016/j.otsr.2024.104034","DOIUrl":"10.1016/j.otsr.2024.104034","url":null,"abstract":"<p><strong>Background: </strong>Distal femoral osteotomy (DFO) improves valgus limb alignment. However, it might affect lower limb length discrepancy (LLD) and influence functional scores. This study aims to evaluate functional scores and radiographic parameters associated with LLD after DFO.</p><p><strong>Hypothesis: </strong>It was hypothesized that the presence of LLD after DFO affects functional scores and associated with femoral length.</p><p><strong>Patients and methods: </strong>A total of 50 patients who underwent DFO, including 24 closed wedge (CW) DFO and 26 open wedge (OW) DFO, were included. Patients were divided into three groups according to the presence of LLD after DFO: LLD-Absent group, LLD-CW group and LLD-OW group. Patient demographics, functional scores (Knee injury and Osteoarthritis Outcome Score (KOOS)), and radiographic parameters were evaluated and compared between the three groups. Multivariable logistic regression analysis was used to assess the radiographic parameter associated with the presence of post-operative LLD.</p><p><strong>Results: </strong>There were no significant differences between the three groups in demographic data, correction angles, complications including hinge fractures, time to osteotomy union, and functional scores. However, the return to sports (RTS) was significantly different between three groups. By further analysis between CWDFO and OWDFO, RTS in CWDFO was faster than those in OWDFO. There were significant differences in post-operative mLDFA and Δ femur length. Additionally, post-operative mLDFA was significantly associated with the presence of LLD (Odds ratio 0.11, 95% confidence interval 0.01 to 0.49, p = 0.03).</p><p><strong>Conclusion: </strong>Functional scores and postoperative outcomes following DFO are not affected by the presence of LLD. RTS is independent of LLD, but rather dependent on the surgical procedure and RTS in CWDFO was faster than those in OWDFO. Postoperative mLDFA is the radiographic parameter associated with the presence of LLD. These findings are clinically relevant and should be accounted for in preoperative planning of DFO.</p><p><strong>Level of evidence iii: </strong>Retrospective with comparative study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of antiplatelet drugs on outcomes of spinal surgery: A systematic review and meta-analysis.","authors":"Yu Jing, Liqiang Hou, Libei Fan, Haomin Wang, Xianzheng Jin, Haifeng Zhou","doi":"10.1016/j.otsr.2024.104035","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.104035","url":null,"abstract":"<p><strong>Introduction: </strong>The management of antiplatelet therapy (APT) in patients undergoing spinal surgery is complex, requiring balancing the risks of thromboembolic events against those of potential perioperative bleeding. This review evaluates the effects of continuing versus discontinuing APT on the surgical outcomes of spinal surgery.</p><p><strong>Hypothesis: </strong>The hypothesis is that continuing antiplatelet therapy (APT) in patients undergoing spinal surgery will not significantly increase intraoperative blood loss, operative time, or postoperative complications compared to discontinuing APT, but may lead to a higher need for postoperative transfusions.</p><p><strong>Material and methods: </strong>Systematic search was done in EMBASE, Scopus, PubMed Central, Google Scholar, and ScienceDirect databases for studies comparing the continuation of APT to its discontinuation in terms of estimated blood loss, operative time, hospital stay length, postoperative transfusion units, postoperative complications, postoperative hematoma, readmission rate, cardiovascular events amongst patients undergoing spinal surgery. Risk of bias was assessed with the Newcastle Ottawa scale and synthesized the data using random-effects meta-analyses, summarizing outcome results as either standardized mean differences (SMDs) or odds ratios (ORs) as appropriate.</p><p><strong>Results: </strong>13 studies were included in meta-analysis. Similar estimated blood losses (SMD = 0.125; 95%CI, -0.087 to 0.337) and operative times (SMD = 0.231; 95%CI, -0.225 to 0.687) were found between the patients who continued and those who discontinued the APT. However, patients who continued APT had a slightly higher chance of requiring postoperative transfusions (SMD = 0.244; 95%CI, 0.030 to 0.458). Similar hospital stay lengths, and postoperative complication or cardiovascular event rates were found.</p><p><strong>Discussion: </strong>Continuing APT during spinal surgery does not significantly increase the risks of intraoperative blood loss or increase the operative time, however; it may increase the need for postoperative transfusions. These findings suggest that for patients at risk of thromboembolic events, the benefits of continuing APT outweigh the risks.</p><p><strong>Level of evidence: </strong>III; Systematic Review and Meta-analysis.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip and knee arthroplasty in one surgical session: early morbi-mortality study","authors":"Henri Favreau ,&nbsp;Jean-Luc Raynier ,&nbsp;Thomas Rousseau ,&nbsp;Sébastien Lustig ,&nbsp;François Bonnomet ,&nbsp;Christophe Trojani","doi":"10.1016/j.otsr.2024.103955","DOIUrl":"10.1016/j.otsr.2024.103955","url":null,"abstract":"<div><h3>Introduction</h3><div>Bilateral prosthetic hip or knee replacement in one surgical session is a procedure that has been widely validated in the literature, whereas hip and knee replacement in one surgical session remains poorly documented. This study reports on the results of these procedures by analyzing early post-operative complications in a retrospective multicenter study.</div></div><div><h3>Material and methods</h3><div>Between 2009 and 2023, 51 patients underwent hip and knee replacement surgery in a single surgical session at 4 French centers. They were 24 men and 27 women, with a mean age of 68.8 years (36–87); 7 patients were ASA 1, 30 were ASA 2 and 14 ASA 3. Prosthetic hip replacement was always performed first, associated 33 times with the ipsi-lateral knee and 18 times with the contralateral knee. All early complications, within the first 90 days post-operatively, were recorded: death, phlebitis, pulmonary embolism, myocardial infarction, surgical site infection (SSI), knee stiffness treated by mobilization under general anesthesia, urinary tract infection, acute urine retention or any other adverse event related to care. Transfusion rates were also reported.</div></div><div><h3>Results</h3><div>The rate of early complications was 9.8% (5/51). No deaths, no phlebitis, no pulmonary embolism and no SSI were observed. Complications included one myocardial infarction, one urinary tract infection, one superficial infection, one haematoma treated by surgical evacuation and one recurrent instability requiring revision surgery (hip arthroplasty). The transfusion rate was 17.6% (9/51). The complication rate of ASA 3 patients was higher than that of ASA 1 and 2 patients, while there was no difference related to age or BMI.</div></div><div><h3>Discussion</h3><div>Our results confirm the feasibility of single-stage hip and knee replacement, with a low complication rate in ASA 1 and 2 patients. This study adds to the few published works on the subject and reports comparable results. The small sample size and the heterogeneity of patients and centers limit the scope of the results, these limitations being relative to the volume expected for a rare procedure.</div></div><div><h3>Conclusion</h3><div>Single-session hip and knee arthroplasty should be reserved for patients selected according to comorbidities: ASA score, age and body mass index. ASA 3 patients have a higher risk of complications.</div></div><div><h3>Level of evidence</h3><div>IV; retrospective</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: “Conservative treatment of fragility fracture of the pelvis: A retrospective study” of T. Kanazawa, T. Ohmori, K. Toda, T. Takigawa, T. Morita, T. Taoaka, T. Ishihara, Y. Ito published in Orthop Traumatol Surg Res 2024;110:103811. doi: 10.1016/j.otsr.2024.103811","authors":"Waseem Jerjes","doi":"10.1016/j.otsr.2024.103992","DOIUrl":"10.1016/j.otsr.2024.103992","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple Hip Value: a simple score to evaluate Hip function","authors":"Alix Addi ,&nbsp;Tristan Duguay ,&nbsp;Eugenie Valentin ,&nbsp;Philippe Anract ,&nbsp;Alexandre Hardy","doi":"10.1016/j.otsr.2024.103952","DOIUrl":"10.1016/j.otsr.2024.103952","url":null,"abstract":"<div><h3>Background</h3><div>Several self-administered questionnaires are available for assessing hip function in clinical practice (HOOS-12, Oxford-12). These questionnaires can be used to assess and monitor patients with hip pathology. However, they are sometimes difficult to deploy in clinical practice. Recent studies on the shoulder and knee have shown that a single-question assessment provides a relevant evaluation of joint function, and correlates with more complex scores. However, this has not yet been evaluated for the hip. We set out to develop a single-question test that would enable patients to assess their hip function between 0 and 100. Therefore, we did a prospective study aiming to assess: (1) the relevance of the SHV (Simple Hip Value) test by comparing it with the Oxford-12 and HOOS-12 scores, (2) the discriminatory capacity and reproducibility of this test.</div></div><div><h3>Hypothesis</h3><div>The hypothesis of this study was that the assessment of hip function by a single-question patient-completed questionnaire (PROM) would be reliable and useful in clinical practice.</div></div><div><h3>Patients and methods</h3><div>We conducted a prospective study including 74 patients operated on for total hip arthroplasty from February 2020 to April 2021 in a high-volume center and 20 healthy subjects. The SHV questionnaire, as well as HOOS-12 and OXFORD-12 were submitted on average 18 months after surgery, with values scaled to 100 points. A second test containing the 3 questionnaires was resubmitted to 20 patients randomly chosen from hip arthroplasty group to evaluate the reproducibility of the test. To evaluate the discrimination capacity of our test, 20 controls were selected to respond to the three questionnaires.</div></div><div><h3>Results</h3><div>Test results were median SHV, Oxford-12 and HOOS-12 scores of 90/100 (Interquartile Range [IQR]: 80–95), 88.5 (IQR: 77.1–95.8) and 79.1 (IQR: 65.1–93.2), respectively. The SHV was strongly correlated with the Oxford-12 (Spearman coefficient: 0.63 [IQR: 0.45−0.76]) and the HOOS-12 (Spearman coefficient: 0.66 [IQR: 0.46−0.79]). The SHV differed significantly from the control group (90.0 vs 100.0 in the control group [p &lt; 0.001]) and had excellent reproducibility (Interclass Correlation Coefficient [ICC]: ICC: 0.82 [CI95%, 0.59−0.93]).</div></div><div><h3>Discussion</h3><div>The SHV test seems to be a reliable, reproducible and discriminating tool for assessing hip function after total hip arthroplasty, thus offering a simplified and practical approach for practitioners. Further testing in different populations would be useful to validate this test.</div></div><div><h3>Level of evidence</h3><div>III; prospective comparative diagnostic study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of age and severity of Lenke 5 or 6 idiopathic scoliosis on postoperative quality of life in adult patients","authors":"","doi":"10.1016/j.otsr.2023.103742","DOIUrl":"10.1016/j.otsr.2023.103742","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracolumbar adolescent idiopathic scoliosis<span><span> can continue to progress beyond skeletal maturity. Ideal timing of surgery remains undefined. Earlier intervention, with shorter instrumentation, incurs early partial loss of lumbar motion. Waiting for progression incurs a greater risk of extensive arthrodesis. The aim of the present study was to assess the quality-of-life impact of age and </span>scoliosis severity at surgery.</span></div></div><div><h3>Material and methods</h3><div><span>Patients with Lenke 5 or 6 adolescent idiopathic scoliosis, aged 16–45</span> <span>years, were analyzed based on a prospective clinical registry. Oswestry Disability Index (ODI) and Scoliosis Research Society (SRS)-22 scores were collected preoperatively and at 6</span> <!-->months, 1<!--> <!-->year and 2<!--> <span>years. Coronal and sagittal alignments were measured on full-spine radiographs, and curve flexibility was assessed on bending radiographs. A mixed linear model was used to assess the impact of age, Cobb angle and flexibility on quality of life.</span></div></div><div><h3>Results</h3><div>Thirty-six patients were included. Mean ODI was 20.5% preoperatively and 13.8% at 2<!--> <!-->years (<em>p</em> <em>=</em> <em>0.017</em>). Mean SRS-22 was 3.2 preoperatively and 3.9 at 2<!--> <!-->years (<em>p</em> <em>&lt;</em> <em>0.001</em>). Mean Cobb angle was 56.6° preoperatively and 23.2° at 2<!--> <!-->years (<em>p</em> <em>&lt;</em> <em>0.001</em>), with mean preoperative reducibility of 68.1%. Age and ODI correlated preoperatively (r<!--> <!-->=<!--> <!-->0.6; <em>p</em> <em>&lt;</em> <em>0.001</em>) and at 6<!--> <!-->months (r<!--> <!-->=<!--> <!-->0.5; <em>p</em> <em>=</em> <em>0.002</em>), as did age and SRS-22 (r<!--> <!-->=<!--> <!-->–0.6; <em>p</em> <em>&lt;</em> <em>0.001</em> and r<!--> <!-->=<!--> <!-->–0.6; <em>p</em> <em>&lt;</em> <em>0.001</em><span>, respectively). Linear regression found a significant negative correlation between thoracolumbar Cobb angle and change in SRS-22 at 6</span> <!-->months.</div></div><div><h3>Discussion</h3><div>In 16–45 year-olds with Lenke 5 or 6 idiopathic scoliosis, age influenced SRS-22 score. Younger patients had better quality of life both pre- and post-operatively. Curve magnitude influenced postoperative score. The present study suggests that early surgical correction in younger patients, where instrumentation can be shorter, does not impair quality of life.</div></div><div><h3>Level of evidence</h3><div>IV; prospective registry study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative duloxetine improves postoperative outcomes after anterior talofibular ligament repair for chronic lateral ankle instability for patients with depression: A prospective randomized clinical trial","authors":"","doi":"10.1016/j.otsr.2024.103837","DOIUrl":"10.1016/j.otsr.2024.103837","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;&lt;span&gt;Recent studies have indicated that depression is associated with persistent postoperative pain and decreased satisfaction following &lt;/span&gt;foot and ankle surgery&lt;span&gt;. This study aimed to evaluate the effect of perioperative duloxetine on postoperative outcomes of anterior talofibular ligament (ATFL) surgical repair for chronic ankle instability (CAI) in patients with depression. We further sought to evaluate patients’ satisfaction and side effects related to duloxetine.&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;&lt;span&gt;Patients undergoing ATFL repair were screened for depression preoperatively with the Patient Health Questionnaire (PHQ-9). Among 249 patients who underwent arthroscopic or open surgical Brostrom repair of the ATFL, 120 patients were identified as being “possibly depressed” and were included in the study. Sixty patients were randomly assigned to the duloxetine group (one day preoperatively and for 6 weeks postoperatively), and the other sixty were randomized to the placebo group. Painkillers and opioid consumption, pain scores, and patient satisfaction were recorded at 12, 24, 48, and 72&lt;/span&gt; &lt;!--&gt;hours postoperatively and at follow-up visits 1, 3, and 6 months after surgery. Patient-reported outcome measures (PROMs) were assessed preoperatively and at 3, 6, 12 and 24 months postoperatively. Duloxetine-related side effects such as nausea/vomiting and fatigue were also recorded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;The patients in the duloxetine group reported a significantly longer time to rescue &lt;/span&gt;analgesic and reduced opioid requirements (including &lt;/span&gt;celecoxib, &lt;/span&gt;pregabalin&lt;span&gt;, acetaminophen, and tramadol). The patients experienced decreased pain intensity and greater satisfaction with their pain management at 24, 48, 72&lt;/span&gt;&lt;/span&gt; &lt;!--&gt;h and 1 and 3 months after surgery (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05). The duloxetine group also had significantly better clinical and functional outcomes at 3 and 6 months of follow-up compared to the placebo group (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05). The occurrence and rate of symptoms of duloxetine side effects were not significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Depression is an important factor to consider and address because its presence before surgery can predict poor postoperative outcomes, including more severe postoperative pain, persistent postoperative pain, and increased consumption of painkillers and opioids.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Perioperative administration of duloxetine following ATFL repair for CAI in patients with depression increased the time to first postoperative rescue analgesic request and reduced both opioid consumption and postoperative pain. This approach also led to a high level of patient satisfaction. In addition, duloxetine improved the quality of recovery without leading to significant side effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of evidence&lt;/h3","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Acceptable Symptom State (PASS) after proximal and distal femoral replacement","authors":"","doi":"10.1016/j.otsr.2024.103931","DOIUrl":"10.1016/j.otsr.2024.103931","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Femoral megaprostheses are used for bone reconstruction surgery in patients with local tumors or who require multiple revisions. Patient reported outcome measures (PROMs) provide a subjective result and, like patient satisfaction, have become an integral part of the outcomes in </span>orthopedics<span><span>. However, the threshold of satisfaction (PASS: Patient Acceptable Symptom State) has not yet been defined in a French population after this type of arthroplasty<span>. This led us to carry out a retrospective study on a population of patients who received a femoral reconstruction megaprosthesis in order to 1) define the PASS for the Harris Hip Score (HHS), </span></span>Knee Society Score<span> (KSS) and the Musculoskeletal Tumor Society score (MSTS), 2) study the complications.</span></span></div></div><div><h3>Hypothesis</h3><div>The PASS threshold for proximal femur<span> and distal femur reconstruction prothesis for the HHS and the KSS, respectively, will be lower than the threshold for these same scores for primary arthroplasty.</span></div></div><div><h3>Materials and methods</h3><div>Forty-four patients who were operated on between 2009 and 2020 were included: 23 received a proximal femur prosthesis and 21 received a distal femur prosthesis. The PASS threshold was defined using an anchoring strategy by analyzing ROC curves for the HSS for the proximal femur, KSS for the distal femur and the MSTS for all the prostheses. Complications were classified according to Henderson.</div></div><div><h3>Results</h3><div>The mean follow-up was 4.5 ± 3.6 (1–12.5) years. The PASS threshold was 47.5 (area under curve (AUC) 0.71 (0.45–0.97)) for the HHS, 69.5 (AUC 0.97 (0.92–1.0)) for the KSS knee and 62.5 (AUC 0.81 (0.61–0.99)) for the KSS function. Thirteen patients (29%) had complications, nine of whom required another surgery (20%). The most frequent were Henderson type 1 (soft tissue lesions, n = 5/44 [11%]) and type 2 (loosening, n = 5/44 [11%]) There was no relationship between satisfaction and postoperative complications (p = 0.071).</div></div><div><h3>Discussion</h3><div>Most of the patients who undergo femoral resection and reconstruction (59%) are satisfied with their function, albeit reduced, despite a high complication rate (29%). Our hypothesis is confirmed for the PASS threshold for the HHS (47.5 versus 93) and the KSS knee and function (69.5 and 62.5 versus 85.5 and 72.5).</div></div><div><h3>Level of evidence</h3><div>IV; retrospective observational single-center study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term safety of total knee arthroplasty in patients with chronic kidney disease in Taiwan: A retrospective cohort study","authors":"","doi":"10.1016/j.otsr.2024.103847","DOIUrl":"10.1016/j.otsr.2024.103847","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease<span> (CKD) is a prevalent condition in Taiwan, and the incidence of total knee arthroplasty (TKA) is on the rise. This study aimed to evaluate the postoperative results of patients with different degrees of CKD after TKA, using data from the Taiwan National Health Insurance Research Database.</span></div></div><div><h3>Methods</h3><div>The study analyzed 3078 patients who received TKA from 2012 to 2017, equally divided into three groups: none-CKD, mild CKD (without dialysis), and severe CKD (with dialysis). Propensity score matching was used to minimize selection bias.</div></div><div><h3>Results</h3><div><span>After TKA, there was no significant difference in the risk of debridement surgery for infection between the three groups (adjusted HR of mild CKD: 0.71 95% CI</span> <!-->=<!--> <!-->0.36–1.38, <em>p</em> <!-->=<!--> <!-->0.3073; adjusted HR of severe CKD: 1.14, 95% CI<!--> <!-->=<!--> <!-->0.63–2.06, <em>p</em> <!-->=<!--> <!-->0.6616). However, CKD patients requiring dialysis had a significantly higher risk of mortality (adjusted HR: 1.98, 95% CI<!--> <!-->=<!--> <!-->1.57–2.50, <em>p</em> <!-->&lt;<!--> <!-->0.001) and readmission within 90<!--> <!-->days of any causes (adjusted HR: 1.83, 95% CI<!--> <!-->=<!--> <!-->1.48–2.26, <em>p</em> <!-->&lt;<!--> <!-->0.001) than non-CKD and mild CKD patients.</div></div><div><h3>Conclusion</h3><div>Severe CKD patients needing dialysis after TKA have a higher risk of mortality and readmission rates than that of the non-CKD or mild CKD patients. If the patient is in the early stage of CKD, their prognosis after receiving TKA is expected to be as good as non-CKD patients.</div></div><div><h3>Level of evidence</h3><div>IV; well-designed cohort study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbon footprint in orthopedic and trauma surgery: towards greener surgery","authors":"François Gouin ,&nbsp;Pierre Ogeron ,&nbsp;Valerie Dumaine ,&nbsp;Baptiste Boukebous","doi":"10.1016/j.otsr.2024.103990","DOIUrl":"10.1016/j.otsr.2024.103990","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}