Advances in Orthopedics最新文献

{"title":"The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery.","authors":"Mahmoud Ganjifard,&nbsp;Samaneh Kouzegaran,&nbsp;Reza Abdi,&nbsp;Mohsen Naseri,&nbsp;Elahe Allahyari,&nbsp;Amir Sabertanha,&nbsp;Batool Zeinali","doi":"10.1155/2021/2027421","DOIUrl":"https://doi.org/10.1155/2021/2027421","url":null,"abstract":"<p><strong>Methods: </strong>In this randomized controlled clinical trial, 34 patients with lower limb surgery admitted at the orthopedic ward of Imam Reza Hospital, Birjand, Iran, were selected by the available sampling method. They were randomly divided into two groups as follows: general anesthesia (<i>n</i> = 17) and spinal anesthesia (<i>n</i> = 17). Venous blood samples were taken from the patients of both groups at baseline (before the use of tourniquet) and 12 and 24 hours after reperfusion. Interleukin-6 (IL-6), tumor necrotizing factor-<i>α</i> (TNF-<i>α</i>), high-sensitivity C-reactive protein (hs-CRP), and ferritin were measured and recorded. The data were analyzed using independent <i>t</i>-test, chi-square, and repeated measure at the significant level of 0.05.</p><p><strong>Results: </strong>The results showed that hs-CRP and IL-6 significantly increased during the study (<i>p</i> < 0.001); however, the mean changes of TNF-<i>α</i> and ferritin were not significant during the study. Moreover, none of the inflammatory cytokines indicated significant differences between these two study groups (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>According to the results, the use of tourniquet can lead to inflammation, and the inflammation is similar in both groups.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"2027421"},"PeriodicalIF":1.3,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39503035","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":"Proposed Geometrical Tool for Cases of Laterally Adapted Tibial Tubercle during Total Knee Replacement.","authors":"Umaima R Khairy,&nbsp;Sadiq J Hamandi,&nbsp;Ahmed S Abid Ali","doi":"10.1155/2021/5244034","DOIUrl":"https://doi.org/10.1155/2021/5244034","url":null,"abstract":"<p><p>The alignment of tibial component in total knee replacement operation must be achieved in three planes to ensure optimum results. In coronal plane, the alignment depends on three anatomical landmarks. These landmarks are tibial tuberosity, leg shin, and midtalar point. In eastern community, people get used to sit cross-legged which causes additional tension in the quadriceps muscle which is attached distally to the tibial tuberosity. This tension causes adaptation of the tuberosity laterally. Tuberosity adaptation causes the three anatomical landmarks being not collinear. In this work, eight cases of lateral adapted tubercle were diagnosed of this condition before the surgery and their X-ray images after the surgery were checked regarding tibial alignment. Tibial alignment has been checked by measuring the medial proximal tibial angle (MPTA) which is the angle between the mechanical tibial axis and the tibial component plateau. MPTAs for the eight cases were (86.9°-93.6°). Three cases had MPTA less than 90° indicating varus alignment and five of them had MPTA more than 90° indicating valgus alignment. A geometrical tool was designed using the DesignSpark Mechanical software as a proposed solution to solve the adaptation problem. The tool can give a method for fixing the tibial component precisely without any varusvalgus malalignment.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5244034"},"PeriodicalIF":1.3,"publicationDate":"2021-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39329110","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":"Double Endoprosthesis in the Management of Refractory Metastatic Primary Bone Tumors in Children and Young Adults.","authors":"Anna Raciborska,&nbsp;Iwona Malesza,&nbsp;Katarzyna Bilska,&nbsp;Tomasz Koziński,&nbsp;Bartosz Pachuta","doi":"10.1155/2021/9944702","DOIUrl":"https://doi.org/10.1155/2021/9944702","url":null,"abstract":"<p><strong>Background: </strong>Although not all children can be cured yet, much more emphasis is placed on the quality of life during and after cancer treatment. In the case of recurrence, mutilating treatment is still the prevalent option. In our study, we explored the role of limb salvage surgery for young patients with metastatic malignant bone tumors after endoprosthesis reconstruction during the first line of treatment and evaluated the impact of the local control modality in disease control and functional outcomes.</p><p><strong>Materials and methods: </strong>Eleven patients with bone tumor treated between 2007 and 2018 were included in this study. Both during primary treatment and during recurrence, limb salvage surgery was performed using a modular or expandable custom-made replacement system. Peri- and postoperative care for both surgeries were similar. All patients were given chemotherapy before and after both surgeries, according to the oncological guidelines.</p><p><strong>Results: </strong>Seven patients (63.6%) are alive with a median follow-up of 6.5 years from diagnosis. None had local recurrence. Five-year estimates of event-free survival and overall survival were 36.27% and 79.55%, respectively. Median time between the first and second surgery was 2.7 years. Three patients presented with postoperative complications following both surgeries and required resurgical intervention. Three months following the second surgery, the Musculoskeletal Tumor Society Scale (MSTS) scores were 15-27 points (21 points on average-60%).</p><p><strong>Conclusions: </strong>Limb salvage surgery is feasible and offers good chance of cure with a reasonable rate of complications and good function in patients with recurrent bone sarcoma after endoprosthesis reconstruction during the first line of treatment.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"9944702"},"PeriodicalIF":1.3,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273866","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":"Functional and Radiological Outcome Analysis of Osteoperiosteal Decortication Flap in Nonunion of Tibia.","authors":"Vineet Kumar,&nbsp;Shah Waliullah,&nbsp;Sachin Avasthi,&nbsp;Swagat Mahapatra,&nbsp;Ajai Singh,&nbsp;Sabir Ali","doi":"10.1155/2021/7980602","DOIUrl":"https://doi.org/10.1155/2021/7980602","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of long bone shaft nonunions is challenging. The technique of osteoperiosteal decortications flap for approaching the nonunion site coupled with fixation modalities was first described by Judet in 1963. Despite promising clinical and radiological union, this technique is not popular among orthopaedic surgeons. Our study aimed to evaluate the radiological union and functional results of shaft tibia nonunions treated by the osteoperiosteal decortication approach.</p><p><strong>Methods: </strong>This retrospective study included all the cases with established tibial shaft nonunion following stringent inclusion and exclusion criteria and operated upon by following the principle of osteoperiosteal flap technique from April 2015 to July 2019. Further subgroups were made based on nonunions complexity based on nonunion scoring system (NUSS) score. The outcome measures included radiological union scale in tibial fractures (RUST) and lower extremity functional scale (LEFS). The preoperative scores for union and function were recorded, and the subsequent scores were obtained at three, six, and nine months and one year. Appropriate statistical analysis of the data was done.</p><p><strong>Results: </strong>Thirty-four cases were shortlisted for analysis, fulfilling our inclusion and exclusion criteria. There were 22 males (64.7%) and 12 females (35.3%) with a mean age of 34.17 ± 10.3 years. Subgroup analysis based on the complexity of nonunion (NUSS score) revealed 14 cases in group A, 10 cases in group B, 10 cases in group C, and 0 cases in group D. The average time from fracture to surgery in these cases was 14.6 months. The average time to achieve union was 9.6 months, with patients in groups A, B, and C, having a mean duration of 9, 10.5, and 12 months, respectively. Statistically, significant improvement was seen in both RUST scores and LEFS score. Complications included infection in seven cases, wound dehiscence in two cases, and four cases of persistent nonunion.</p><p><strong>Conclusion: </strong>Osteoperiosteal decortication remains a highly effective surgical technique in the management of nonunion of long bones. NUSS scoring is an essential tool for prognosticating nonunion cases. This score is inversely related to the radiological union (RUST score) of the bone and functional recovery (LEFS score) of the patient.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"7980602"},"PeriodicalIF":1.3,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273458","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":"Robotic Assistance in Unicompartmental Knee Arthroplasty Results in Superior Early Functional Recovery and Is More Likely to Meet Patient Expectations.","authors":"Meredith P Crizer,&nbsp;Amer Haffar,&nbsp;Andrew Battenberg,&nbsp;Mikayla McGrath,&nbsp;Ryan Sutton,&nbsp;Jess H Lonner","doi":"10.1155/2021/4770960","DOIUrl":"https://doi.org/10.1155/2021/4770960","url":null,"abstract":"<p><p>Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (<i>n</i> = 39) or robotic methods (<i>n</i> = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR.), VR/SF-12, Visual Analog Scale (VAS) pain scores, and perioperative opioid consumption. Patients in the robotic cohort had superior early functional outcomes, with greater LEFS (conventional = 23; robotic = 31) at 1 week post-op (<i>p</i>=0.015) and KOOS-JR (conventional = 74; robotic = 81) at up to 6 months post-op (<i>p</i>=0.037); these two values remained statistically significant after mixed-model regression analysis (<i>p</i>=0.010; <i>p</i>=0.023), respectively. At 1 year post-op, expectations were more likely to be met in those who received robotic assistance (<i>p</i>=0.06). No differences were reported with respect to postoperative opioid usage (<i>p</i>=0.320), reoperations (<i>p</i>=1.00), and complications (<i>p</i>=0.628). Robotic-assisted UKA resulted in more rapid recovery and less early postoperative pain and were more likely to meet expectations than conventional UKA, although functional differences equilibrated by 1 year postoperatively. Further follow-up is necessary to determine if implant durability is impacted by robotics.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"4770960"},"PeriodicalIF":1.3,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273457","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":"Comparison of Functional Outcome of Total and Unicompartmental Knee Arthroplasty Using Computer-Assisted Patient-Specific Templating.","authors":"Atef Mohamed Morsy,&nbsp;Emad Gaber Elbana,&nbsp;Ahmed Gaber Mostafa,&nbsp;Mark Ashraf Edward,&nbsp;Mahmoud A Hafez","doi":"10.1155/2021/5524713","DOIUrl":"https://doi.org/10.1155/2021/5524713","url":null,"abstract":"<p><strong>Background: </strong>Knee arthroplasty surgeries are in ever-increasing demand. With unicompartmental knee arthroplasty (UKA), patients may benefit from a higher range of flexion and a better Knee Society Score (KSS).</p><p><strong>Aim: </strong>In this study, we compared the short-term clinical outcomes of total knee arthroplasty (TKA) and UKA using the patient-specific templating (PST) technique.</p><p><strong>Methods: </strong>Two groups of 20 knees each were divided into UKA and TKA groups depending on the Oxford criteria of UKA. Only patients with medial compartmental osteoarthritis were included. KSS, functional knee score (FKS), and ROF were assessed preoperatively and at 6 months postoperatively.</p><p><strong>Results: </strong>The TKA group has shown a significant improvement compared to the UKA group in KSS (MD = 39.35 vs. 31.2, respectively, <i>p</i>=0.003). Both TKA and UKA have shown no significant difference concerning both the FKS (MD = 32 and 31.75, respectively, <i>p</i>=0.926) and ROF (MD = 10.25 and 7.25, respectively, <i>p</i>=0.072). <i>Discussion</i>. The higher improvement of KSS in the TKA group can be attributed to the fact that patients in the TKA had significantly worse KSS preoperatively. Also, the small improvement in ROF in the UKA group might be related to their wider preoperative ROF.</p><p><strong>Conclusion: </strong>Preoperatively, the TKA group had lower KSS and ROF compared to UKA. The improvement of KSS from preoperative to postoperative was more significant in TKA. However, the TKA group has shown less range of flexion postoperatively.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5524713"},"PeriodicalIF":1.3,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39181850","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":"Predicting Fracture Risk in Patients with Metastatic Bone Disease of the Femur: A Pictorial Review Using Three Different Techniques.","authors":"Shannon M Kaupp,&nbsp;Kenneth A Mann,&nbsp;Mark A Miller,&nbsp;Timothy A Damron","doi":"10.1155/2021/5591715","DOIUrl":"https://doi.org/10.1155/2021/5591715","url":null,"abstract":"<p><p>One of the key roles of an orthopedic surgeon treating metastatic bone disease (MBD) is fracture risk prediction. Current widely used impending fracture risk tools such as Mirels scoring lack specificity. Two newer methods of fracture risk prediction, CT-based structural rigidity analysis (CTRA) and finite element analysis (FEA), have each been shown to be more accurate than Mirels. This case series illustrates comparative Mirels, CTRA, and FEA for 8 femurs in 7 subjects. These cases were selected from a much larger data set to portray examples of true positives, true negatives, false positives, and false negatives as defined by CTRA relative to the fracture outcome. Case illustrations demonstrate comparative Mirels and FEA. This series illustrates the use, efficacy, and limitations of these tools. As all current tools have limitations, further work is needed in refining and developing fracture risk prediction.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5591715"},"PeriodicalIF":1.3,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39147774","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":"Quality of Life and Clinical Evaluation of Calcaneoplasty with a Balloon System for Calcaneal Fracture at 5 Years of Follow-Up.","authors":"Giuseppe Maccagnano,&nbsp;Giovanni Noia,&nbsp;Giuseppe Danilo Cassano,&nbsp;Antonio Luciano Sarni,&nbsp;Raffaele Quitadamo,&nbsp;Costantino Stigliani,&nbsp;Francesco Liuzza,&nbsp;Raffaele Vitiello,&nbsp;Vito Pesce","doi":"10.1155/2021/5530620","DOIUrl":"https://doi.org/10.1155/2021/5530620","url":null,"abstract":"<p><p>Calcaneal fractures are a challenging clinical problem. Management of this type of injury remains controversial, especially in the context of intra-articular fractures. Surgical treatment with open reduction and internal synthesis (ORIF) is considered the standard treatment for CF, but it is associated with many complications. Several minimally invasive techniques such as balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation have been proposed to avoid the frequent and recurrent postoperative problems related to these fractures. We retrospectively examined 20 patients (mean age was 54.5), all undergoing minimally invasive calcaneoplasty surgery at our Department of Orthopaedics and Traumatology between 2012 and 2016. X-ray and CT scan were performed preoperatively and at 5 years of follow-up (57.9 ± 6 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical examination, and the Short-Form (36) Health Survey (SF-36) score and Visual Analogue Scale (VAS) were used to assess the Health-Related Quality of Life (HRQoL). All 20 patients were available at the final follow-up. The mean AOFAS score was 82.25/100. The VAS results attest an overall average of 2.7/10 (0-9). The average of the parameters \"Physical Health\" and \"Mental Health\" was, respectively, 81.25 and 83.55. In terms of postoperative complications, we observed no cases of superficial or deep infections. Clinical response after balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation has shown a comparable or better outcome according to the AOFAS and VAS score. Quality-of-life scores, obtained according to the SF-36 questionnaire, are considered high. From both a clinical and quality-of-life point of view, our study highlights that there is not gender distinction. Further comparative studies with a higher number of patients are needed which assess the quality of life in the various techniques used to treat calcaneal fractures.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5530620"},"PeriodicalIF":1.3,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139898","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":"Influence of Timing on Surgical Outcomes for Acute Humeral Shaft Fractures.","authors":"Ryogo Furuhata,&nbsp;Yusaku Kamata,&nbsp;Aki Kono,&nbsp;Yasuhiro Kiyota,&nbsp;Hideo Morioka","doi":"10.1155/2021/8977630","DOIUrl":"https://doi.org/10.1155/2021/8977630","url":null,"abstract":"<p><p>Surgical treatment for humeral shaft fractures has been reported to yield satisfactory results; however, there may be complications, such as delayed bone union, nonunion, iatrogenic radial nerve injury, and infection. The risk factors for postoperative complications remain largely unknown. This study aimed to investigate the influence of timing of surgery on the incidence of postoperative complications of acute humeral shaft fractures. We retrospectively reviewed 43 patients who underwent osteosynthesis for acute humeral shaft fractures between 2006 and 2020. The patients were divided into early (21 patients) and delayed (22 patients) treatment groups based on the timing of the surgical intervention (within or after four days). Outcomes were the incidences of complications (delayed union, nonunion, iatrogenic radial nerve injury, and infection) and postoperative fracture gaps. We evaluated the outcomes using plain radiographs and clinical notes. In addition, we performed subgroup analyses on outcomes in a subgroup of patients who underwent intramedullary nailing and one who underwent plate fixation. The frequency of delayed union was significantly higher in the delayed group (<i>P</i>=0.046), and the postoperative fracture gap size was also significantly greater in the delayed group (<i>P</i>=0.007). The subgroup analyses demonstrated a significant association between the increased incidence of delayed union and delayed surgical interventions only in the intramedullary nailing subgroup (<i>P</i>=0.017). This study suggests that performing surgery within four days after acute humeral shaft fracture is recommended to reduce the occurrence of delayed union, particularly in cases requiring intramedullary nailing fixation.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"8977630"},"PeriodicalIF":1.3,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39089182","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":"Clinical and Radiological Outcomes of Total Knee Arthroplasty Performed with Midvastus and Medial Parapatellar Approaches in Obese Patients.","authors":"Olcay Guler,&nbsp;Gürkan Gümüşsuyu,&nbsp;Hakan Sofu,&nbsp;Hüseyin Bahadır Gökçen","doi":"10.1155/2021/5512930","DOIUrl":"https://doi.org/10.1155/2021/5512930","url":null,"abstract":"<p><strong>Background: </strong>The use of total knee arthroplasty (TKA) for primary osteoarthritis of the knee has remarkably increased recently. We aimed to compare the clinical and radiological outcomes of TKA in obese patients (>30 kg/m²) operated with midvastus (MV) or medial parapatellar (MPP) approaches.</p><p><strong>Methods: </strong>This retrospective study was performed using data derived from 80 patients (70 women; 10 men) with an average age of 66.17 ± 5.42 (range: 54 to 77). Patients were allocated into 2 groups as for the type of approach conducted during TKA: group I (<i>n</i> = 41) underwent TKA by MV approach, while the MMP technique was used in group II (<i>n</i> = 39).</p><p><strong>Results: </strong>Demographic, clinical, and radiological parameters included age, side of involvement, sex, BMI, diameters of thigh and calf, length of incision, duration of operation, amount of bleeding and transfusion, duration of hospitalization and follow-up, complications, and range of motion, as well as Knee Society Score (KSS) and Knee Society Function Score (KSFS). Patients with a higher BMI (≥35 kg/m²) experienced more profound bleeding and needed more transfusion of erythrocyte suspension. The range of motion was more favorable in groups with BMI <35 kg/m². The functional outcomes as reflected in KSS and KSFS were much better in patients with BMI <35 kg/m².</p><p><strong>Conclusions: </strong>Our data indicated that obesity can adversely influence the clinical and radiological outcomes after TKA performed by both MV and MPP approaches. A careful analysis of patient characteristics and selection of appropriate operative procedures is critical. Further randomized, controlled trials on larger series must be designed to elucidate the relationship between obesity and therapeutic outcomes after TKA with different approaches.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5512930"},"PeriodicalIF":1.3,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579827","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}