Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Poorer clinical outcomes after THA in patients with a spinal scoliotic deformity: a case-control study of 268 patients assessed with PROMS.","authors":"Sena Boukhelifa, Marie Protais, Clélia Thouement, Elhadi Sariali","doi":"10.1016/j.otsr.2024.104004","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.104004","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal deformities can lead to specific complications after total hip arthroplasty (THA), such as functional leg length discrepancy due to a fixed pelvic obliquity, as well as an increased risk of prosthetic instability due to a lack of adaptive pelvic mobility, but these issues were not investigated in large comparative series. Therefore a retrospective case-control study was done aiming: 1) to analyze the impact of a preoperative scoliotic deformity on the functional outcomes of patients who underwent THA with a minimum 1-year follow-up, 2) to measure the prevalence of scoliosis in both the case and control groups 3) to screen other factors that may be correlated with poorer clinical outcomes in patients who underwent THA, including age, gender, Body Mass index (BMI), American Society of Anesthesiologists (ASA) score, primary THA etiology and postoperative complication occurrence.</p><p><strong>Hypothesis: </strong>The presence of scoliosis would have a negative impact on THA outcomes as assessed by PROMs.</p><p><strong>Materials and methods: </strong>A case-control study was conducted using prospectively collected data including 268 patients who underwent THA between January 2009 and December 2021 through a direct anterior approach by the same senior surgeon. Cases were identified based on a 1-year follow-up modified Harris Hip score (mHHS) lower than 81 while controls were defined as patients with an excellent 1-year follow-up mHHS score (equal to or higher than 81). Three controls were randomly matched with each case based on the surgery period. To assess the impact of a concurrent scoliosis on clinical outcomes, a mathematical univariate and multivariate logistic model was used, including other confounding factors (age, gender, ASA score, BMI, Complication occurrence, etiology), to calculate the adjusted odds-ratio.</p><p><strong>Results: </strong>In the multivariate analysis, scoliosis was found to be a significant risk factor, with a three-fold higher adjusted odds-ratio of lower mHHS score (adjOR = 3.1; 95 CI:1.4-7, [p < 0.01]). The mean mHHS score was significantly lower in the scoliosis group compared to the non-scoliosis group (77 vs. 84 [p = 0.01]) as well as the mean Oxford Hip Score (36 vs. 43 [p < 0.001]). Among the other assessed risk factors, only the occurence of a postoperative complication was associated with an increased odds ratio of poorer mHHS scores (adjOR = 7.1; 95 CI: 2.78-18.24, [p < 0.001]). The prevalence of scoliosis in our practice was 19%.</p><p><strong>Discussion: </strong>Given the prevalence of 19% found in our study, we recommend screening for scoliosis in all patients scheduled for THA. Our results indicate that patients who had scoliosis experienced lower PROMs scores compared to those who had not. Surgeons should consider delivering this information to patients who have scoliosis undergoing THA to mitigate patient dissatisfaction.</p><p><strong>Level of evidence: </strong>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332553","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":"Change in lower limb length following total knee arthroplasty.","authors":"Simon Marmor, Younes Kerroumi, Guillaume Rigoulot, Pierre-Alban Bouché","doi":"10.1016/j.otsr.2024.104005","DOIUrl":"10.1016/j.otsr.2024.104005","url":null,"abstract":"<p><strong>Background: </strong>Length variations of the lower limbs after total knee arthroplasty (TKA) constitute a poorly evaluated parameter and can be associated with worse functional outcomes. The objectives of this study were to: (1) describe the variations in the lower limb length after TKA according to the digital accuracy of the computerized navigation system used for prosthesis implantation, (2) describe patient sensation of limb length modification at 3 months postoperatively and to identify its risk factors, (3) identify factors affecting lower limb length modification and to analyze the predictive value causing in the patient the sensation of lower limb discrepancy.</p><p><strong>Hypothesis: </strong>We hypothesize that there may be a lower limb length discrepancy after TKA, which may cause some distress to the patient.</p><p><strong>Patients and methods: </strong>This prospective study included 100 TKAs implanted with navigation gap-balanced adjusted mechanical alignment. Were compared the length of the lower limb before and after implantation and the patient's changes in leg length perception at 3 months postoperatively. A subgroup analysis was performed according to preoperative knee deformities: varus knee was an HKA < 177 °, normal knee was an HKA between 117° and 183 ° and valgus was an HKA >183 °.</p><p><strong>Results: </strong>Ninety-seven out of 100 patients experienced lengthening compared to the preoperative ipsilateral length, and twenty-three experienced lengthening greater than 10 mm. The mean lengthening was 7.3 mm (maximum 24.8 mm). Lengthening was significantly greater in valgus knees 9.9 mm [range, 2.0-24.8] than in varus 7.2 mm [range, 1.46-19.4] and normal knees 4.11 mm [range, 0.4-11.4] (p < 0.05). The correction of frontal and sagittal deformation were risk factors for limb length modification (OR = 0.595; 95% CI [0.544-0.816] [p = 0.001], OR = 0.396; 95% CI [0.351-0.653] [p = 0.001]). Twenty-two patients reported a sensation of limb length change: 11 (50%) reported equalization, whereas the remainder reported lengthening with a leg length difference. The preoperative sensation of lower limb length inequality was the unique factor affecting the patient's perception post-surgery (OR = 37.50; 95% CI [9.730-144.526] [p = 0.0001]). A threshold value of 6.6 mm was identified for the sensation of limb length modification.</p><p><strong>Conclusion: </strong>Navigation is a tool for describing ipsilateral leg length variations after TKA. These variations are significant and perhaps explain some patient dissatisfaction. A partial correction of the frontal deformity according to the knee phenotype could limit the risk of modification of the native length.</p><p><strong>Level of evidence: </strong>IV; Descriptive therapeutic prospective study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332549","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":"Comparison of open and endoscopic techniques of isolated calcaneoplasty in the surgical treatment of insertional tendinopathy of the Achilles tendon.","authors":"Alexis Thiounn, Guillaume Cordier, Yves Tourne, Thomas Bauer, Olivier Boniface, Nicolas Cellier, Frederic Leiber, Ronny Lopes, François Molinier, Giovanni Padiolleau, Alexandre Hardy, David Ancellin, Michael Andrieu, The Francophone Arthroscopy Society Sfa","doi":"10.1016/j.otsr.2024.104003","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.104003","url":null,"abstract":"<p><strong>Introduction: </strong>Insertional Achilles tendinopathy (IAT) is primarily caused by mechanical overload. Running and obesity are major risk factors. Medical treatment is limited, and surgery, particularly calcaneoplasty, is sometimes necessary. However, the choice between an endoscopic and open approach remains controversial.</p><p><strong>Hypothesis: </strong>This study is based on the hypothesis that endoscopic surgery would allow for better functional recovery with a faster return to sports activity compared to traditional open techniques.</p><p><strong>Materials and methods: </strong>Our multicenter prospective study compared the outcomes of endoscopic (Endo) and open (Open) calcaneoplasty in patients with IAT resistant to medical treatment. Clinical outcomes were assessed using the EFAS (daily life and sports) and VISA-AF scores. The radiological criteria studied were the calcaneal slope and the X/Y ratio. An MRI was used to quantify tendon involvement.</p><p><strong>Results: </strong>Of the 85 patients included, 51 underwent endoscopic surgery, and 34 had open surgery. The two groups were comparable in terms of demographic, clinical, and radiographic characteristics. At 3 months postoperatively, significantly more patients had returned to sports in the Endo group (41.6% vs. 20.6% in the Open group; p = 0.004), and the EFAS sports score showed a significant difference in favor of the Endo group at 6 months postoperatively (9.3 vs. 5.7/16; p = 0.008).</p><p><strong>Discussion: </strong>The results confirm faster recovery after endoscopic surgery, with comparable complication rates between the two approaches. However, long-term, the differences between the two techniques diminish, with similar functional outcomes at 12 months postoperatively.</p><p><strong>Conclusion: </strong>Endoscopic calcaneoplasty is a safe and effective option for the treatment of IAT. However, further studies with longer follow-up are needed to confirm these results and assess recurrence rates.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332551","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":"Diagnostic criteria of forearm Chronic Exertional Compartment Syndrome: A systematic review.","authors":"Thomas Hirardot, Germain Pomares, Pierre Menu, Jérôme Grondin, Marc Dauty, Alban Fouasson-Chailloux","doi":"10.1016/j.otsr.2024.104001","DOIUrl":"10.1016/j.otsr.2024.104001","url":null,"abstract":"<p><strong>Background: </strong>Chronic Exertional Compartment Syndrome (CECS) of the forearm is characterized by an increase of the pressure in the forearm compartments during repeated activities. Its diagnosis is challenging because of the lack of clearly established diagnostic criteria.</p><p><strong>Purpose: </strong>We aimed to provide a comprehensive description of the diagnostic methods used for CECS of the forearm, to assess if a more effective diagnosis strategy could be identified.</p><p><strong>Methods: </strong>We used PubMed, Google Scholar, Cochrane Library and Science Direct databases to search articles. We carried out multiple searches using the mesh terms (\"Chronic Exertional Compartment Syndrome\" OR \"Chronic compartment syndrome\" OR \"Exertional compartment\") AND (\"forearm\" OR \"upper limb\"). Inclusion criteria were prospective or retrospective studies on CECS of the forearm including case reports. We used PRISMA guidelines. The included studies were critically appraised using GRADE approach.</p><p><strong>Results: </strong>A total of 625 articles were screened and 33 studies were included. It represented 590 patients (505 men and 85 women), with a mean age of 26.6 years old. Among them, 282 competed at an elite level. Motorcycling and motocross were the most frequent sports (66%). Six diagnostic methods were employed. Intra-compartmental pressure (ICP) measurement was the most frequently used method in 26 studies. Magnetic resonance imaging was performed in 9 studies, while electromyography was employed in only 2 studies. One study reported the measurement of grip strength using a manual dynamometer, one study compared forearm circumference before and after effort, and one used myotonometry. Various exercise protocols were observed. Stress-testing using a hand-grip was the most common protocol in 14 studies. Exercise duration varied from 2 min to 60 min.</p><p><strong>Conclusion: </strong>Existing data do not provide sufficient evidence to favor an alternative diagnostic method over ICP measurements that should be used cautiously given the absence of formal validation. Non-invasive methods might be easier to use, but should be subjected to further research.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309064","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":"Lag screw versus locking plate fixation for traumatic displaced medial malleolar fractures: a systematic review and meta-analysis.","authors":"Ting-Han Tai, Bing-Kuan Chen, El-Wui Loh, Wei-Cheng Chen, Yu-Min Huang, Ka-Wai Tam","doi":"10.1016/j.otsr.2024.104000","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.104000","url":null,"abstract":"<p><strong>Background: </strong>Lag screw fixation (LSF) or locking plate fixation (LPF) are both recommended for the treatment of medial malleolar fractures (MMFs). However, no standard has been established for attaining optimal surgical treatment or functional recovery. We hypothesized that LPF for MMFs would result in superior outcomes compared to LSF. To test this hypothesis, we conducted a systematic review and meta-analysis of the clinical outcomes of LSF and LPF in the treatment of MMF.</p><p><strong>Patients and methods: </strong>We searched for studies published prior to November 2023 across the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. Standardization of individual effect sizes was conducted; subsequently, pooled effect sizes were derived by employing random-effects models.</p><p><strong>Results: </strong>Five retrospective studies involving 394 patients were reviewed. American Orthopedic Foot and Ankle Society (AOFAS) scores were significantly higher among patients who received LPF (mean difference [MD]: 2.21; 95% confidence interval [CI]: 0.37-4.04; p = 0.02) than among those who received LSF. Pain scores were significantly lower among patients who received LPF (MD: -0.35; 95% CI: -0.64 to -0.05; p = 0.02) than among those who received LSF. No significant differences in delayed union was observed between the groups (Relative risk [RR]: 1.43; 95% CI, 0.37-4.04; p = 0.42). Fixation failure was slightly higher in patients who received LSF than in those who received LPF (RR: 3.11; 95% CI, 0.88-11.01; p = 0.08).</p><p><strong>Discussion: </strong>Compared with LSF, LPF yields superior functional outcomes, superior patient comfort, and comparative complication rates. LPF is also better able to prevent rotation and apply compressive forces across fracture sites, which can facilitate the management of different types of MMF. Additional randomized controlled trials with larger sample sizes are warranted.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301161","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":"What does the SOFCOT-RENACOT 2024 hip prosthesis register tell us?","authors":"Christian Delaunay,Christian Brand,Antoine Poichotte,Alexandre Poignard,Stéphane Boisgard","doi":"10.1016/j.otsr.2024.103996","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.103996","url":null,"abstract":"INTRODUCTIONThe French Society of Orthopedic and Traumatology Surgery (SOFCOT) multicenter register of hip prostheses (HP) has been collecting data from nearly 100 centers in France since 2006. After 18 years of collection, this analysis was carried out to deduce the main conclusions.HYPOTHESISDespite its low representativeness (3%), this register provides instructive information on the evolution of hip arthroplasty techniques and implants in France.MATERIAL AND METHODSAs of the 31st of December 2023, 58,314 primary HP were recorded, mainly for primary osteoarthritis (44,535 hips, 76.4%), followed by femoral neck fractures (4,880, 8.4%). The mean age was 71 years (SD, 11.6) with 57% (33,305) women. In total, 73% of the implants were uncemented and 170 brand names were listed. Over the same period, 5,853 first reoperations were recorded. Social security number matching identified 777 revisions of an already registered primary HP. The revision index for 100 components observed per year (RCOY) allows the performance of implants to be compared (alert threshold if &gt;1.3).RESULTSThe causes of these 777 early first revisions at a short mean follow-up (MF) of 1.4 years were: dislocation (191/777, 24.6%), peri-prosthetic fracture (175, 22.5%), aseptic loosening (103, 13.3%) and acute infection (101, 13%). The RCOY for all primary HP was 0.25 at 5.4 years of MF. This index: (i) Depended on the type of implant: 0.23 for HP with dual-mobility cups (DMC) at 4.7 years of MF; 0.25 for HP with short femoral stems at 4.4 years; and 0 for resurfacing after only 2.5 years (due to the creation of a specific mandatory register, since 2015, which put an end to the voluntary inclusion of resurfacing in this general register). (ii) Depended on the method of fixation: 0.21 for completely cemented HP at 7.8 years of MF and 0.29 at 4.9 years for completely uncemented HP. (iii) Based on the friction torque: 0.12 for conventional metal-metal HP at 9.7 years of MF and 0.29 at 5.1 years for alumina-alumina HP. (iv) Finally, 3 arthroplasties with 3 uncemented stems had an RCOY &gt; 1.3.DISCUSSIONAlthough the RCOY of HP with conventional cemented femoral stems is only 0.16 at 6.6 years of MF, while that of HP with conventional uncemented stems is 0.29 at 4.9 years, the trend towards uncemented femoral fixation has continued to intensify. Resurfacing gives good results following careful selection of implants but with a short MF of 2.5 years. Conventional metal-metal bearings continue to give excellent results at almost 10 years of MF. The 10-year survival of HP with short femoral stems is favorable compared to that of HP with conventional stems. There is no significant difference between the survival of HP with conventional versus highly cross-linked polyethylene liner.CONCLUSIONDespite its low representativeness, this register provides information on the techniques and implants used in France. The addition of clinical monitoring and PROM within the new SOFCOT-RENACOT registry as wel","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262213","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":"Acetabular revision for iliopsoas impingement: a study of 55 cases at 3 years of follow-up. Does the procedure achieve the Minimal Clinically Important Difference (MCID) in the Oxford-12 score in more than 80% of cases?","authors":"Pierre Martinot, Alexandre Baujard, Julien Dartus, Xavier Demondion, Julien Girard, Henri Migaud","doi":"10.1016/j.otsr.2024.103995","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.103995","url":null,"abstract":"<p><strong>Introduction: </strong>Several surgical options can be offered to manage iliopsoas impingement. Research published on cup replacements often concerns a small population size or multicentre studies, suggesting a variety of indications. We conducted a retrospective single centre study screening according to a specific protocol of a population of patients who had a cup replacement for iliopsoas impingement. The objectives were: 1) to specify the functional outcomes and the achievement of the Minimal Clinically Important Difference (MCID) and the Patient Acceptable Symptom State (PASS) according to the Oxford-12 score, and 2) to assess the complication rate.</p><p><strong>Hypothesis: </strong>Our hypothesis was that acetabular replacements achieve a Minimal Clinically Important Difference (MCID) in more than 80% of cases.</p><p><strong>Patients and methods: </strong>Fifty-five hips underwent acetabular revision between 2011 and 2020. Forty-three were performed as first-line surgery, eight after failed tenotomy and four after failed anterior hip capsule thickening plasty. A CT scan of all the hips revealed a median overhang of 9 mm (7; 12) and a 7 ° cup anteversion (2; 19). Follow-up included assessment of the Oxford-12 score using MCID and PASS, the Merle d'Aubigné score, an assessment of hip flexion muscle strength using the Medical Research Council scale, and an assessment of satisfaction and complications.</p><p><strong>Results: </strong>At a mean follow-up of 3 years (2-10), the difference in the Oxford score before and at follow-up was 18 points (15; 27) (p < 0.001), the median Medical Research Council score was 4.5 (4; 5) and patients were satisfied or very satisfied in 73% of cases (40/55). The MCID was achieved for 87% of the hips (48/55), and the PASS was achieved in 67% of cases (33/55). The rate of complications involving surgical revision was 10.9% (6/55) with respectively: two anterior dislocations, one early infection on day 10 resolved after wound irrigation and appropriate antibiotic therapy, one intraoperative fracture of the trochanter requiring osteosynthesis and one arthroscopic revision to remove a free cement fragment.</p><p><strong>Conclusion: </strong>Due to a good functional outcome but a high complication rate, a cup replacement can be offered for iliopsoas impingement associated with acetabular malposition or significant overhang.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301160","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: “Impact of social distancing on Traumatic injury incidence during the COVID-19 pandemic: A study using nationwide data from South Korea from 2018 to 2020” of K Bae, S-S Park, MS Kang Published in Orthop & Trauma Surg & Res 2024, 110(3):103571. doi: 10.1016/j.otsr.2023.103571","authors":"Shu Li, Yong-Gang Bao, Bin Wu","doi":"10.1016/j.otsr.2024.103994","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.103994","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262211","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":"Recent progress in dual mobility total hip arthroplasty: an irresistible French icon","authors":"Michel-Henry Fessy ,&nbsp;Anthony Viste ,&nbsp;Remi Philippot ,&nbsp;Etienne L. Belzile","doi":"10.1016/j.otsr.2024.103993","DOIUrl":"10.1016/j.otsr.2024.103993","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262212","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":"Zirconia ageing is related to total hip arthroplasty aseptic loosening. A study of 45 retrieved zirconia heads.","authors":"Bertrand Boyer,Juliana Uribe,Manon Launay,Jean-Luc Aurelle,Rémi Philippot,Jean Geringer","doi":"10.1016/j.otsr.2024.103991","DOIUrl":"https://doi.org/10.1016/j.otsr.2024.103991","url":null,"abstract":"BACKGROUNDY-TZP zirconia heads were recalled by the Food and Drug Administration (FDA) in 2001 and zirconia alone was no longer used in orthopedics. Tunnel furnace sintering was suspected of producing defects responsible for early material failure. As Zirconia Toughened Alumina (ZTA) matrices are widely used as bearing material and contain zirconia grains, there remains a need to better understand the in vivo ageing process of zirconia and its clinical implications when the material is produced by batch furnace sintering, the validated sintering process.QUESTIONS/OBJECTIVESIs there an association between the ageing of batch furnace produced zirconia and THA revision?METHODS45 retrieved femoral heads, batch furnace sintered only, were analyzed. Roughness was measured by 3D profilometry, phase transfer by μRaman spectroscopy. Clinical data were compared with material characteristics.RESULTSIrrespective of the cause of revision, all heads showed a crystallographic phase transition from tetragonal to monoclinic over 19.5%. A correlation was found between the phase change, roughness increase and aseptic loosening, with a threshold set at 24.5% of monoclinic phase.CONCLUSIONSThe ageing process of zirconia may lead to aseptic loosening, which, in the absence of contrary evidence, prohibits its use as the sole component of orthopedic materials. ZTA matrices should be clinically monitored, especially in young patients, and better in vitro modelling needs to be performed.LEVEL OF EVIDENCEIV; Case series.","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208872","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}