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Definitive surgery of primary lesion should be prioritized over preoperative chemotherapy to treat high-grade osteosarcoma in patients aged 41 –65 years
ConclusionsThis study shows that administration of high-dose intensity preoperative chemotherapy was difficult in middle-aged and older patients due to their high rate of acute kidney injury by CDDP. For cases of osteosarcoma in middle-aged and older patients, if the primary lesion is resectable, preoperative chemotherapy should be minimized to prioritize the resection of the primary lesion. It was considered that, with appropriate measures to prevent complications, adjuvant chemotherapy may lead to improved prognosis.Level of evidenceV. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - August 30, 2020 Category: Orthopaedics Source Type: research

No rest for elderly femur fracture patients: early surgery and early ambulation decrease mortality
ConclusionsEarly surgery in femur fracture became a priority in health systems, but early postoperative physiotherapy also plays a major role in prevention of mortality: independently from surgical timing, patients who did not walk again within 10  days from surgery showed mortality rates higher than those of patients who did.Level of evidenceIV. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - August 29, 2020 Category: Orthopaedics Source Type: research

To heal or not to heal: the ACL dilemma
(Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - August 28, 2020 Category: Orthopaedics Source Type: research

Retrospective analysis of risk factors for deep infection in lower limb Gustilo –Anderson type III fractures
ConclusionEarly flaps rather than skin grafting should be used to cover G –A type IIIB fractures, because skin grafting resulted in the highest failure rate among soft-tissue reconstructions in open fractures. Longer duration of antibiotic use had a significant impact not only on deep infection rates but also on the presence of drug-resistant bacteria. These findings s uggest that prolonged use of antibiotics should be avoided in cases of open fractures.Level of evidenceLevel  IV retrospective observational study. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - July 17, 2020 Category: Orthopaedics Source Type: research

Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature
ConclusionsPrimary TKA for select tibial plateau fractures has acceptable clinical outcomes but does not appear to be superior to ORIF. It may be appropriate to treat certain geriatric patients with TKA to allow for early mobilization and reduce the need for reoperation. Other factors may need to be considered in deciding the optimal treatment.Level of evidenceLevel III. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - May 24, 2020 Category: Orthopaedics Source Type: research

Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CL ® )
ConclusionsThe results of the current study demonstrate a 5% incidence of IFF when using the LINK SP-CL® femoral stem in THA. The radiographic morphology of the proximal femur was an important predictor of IFF and should be assessed when using SP-CL®.Level of evidenceLevel 4. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - May 24, 2020 Category: Orthopaedics Source Type: research

Bone density of first and second segments of normal and dysmorphic sacra
ConclusionsOur results would indicate that, based on BMD alone, fixation should be maximized in S1 prior to fixation in S2. In cases where S2 fixation is required, we recommend that transsacral fixation should be strongly considered if possible to bypass the S2 body and achieve fixation in the cortical bone of the ilium and sacrum.Level of evidenceLevel III. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - May 24, 2020 Category: Orthopaedics Source Type: research

Bioabsorbable magnesium screw versus conventional titanium screw fixation for medial malleolar fractures
ConclusionsBioabsorbable Mg and titanium screws had similar therapeutic efficacy in MM fracture fixation regarding functional and radiological outcomes. However, the rate of implant removal was higher with titanium screws. Bioabsorbable Mg screws may be a favorable fixation option since secondary implant removal procedures can be prevented.Level of evidenceLevel IV, Retrospective case series. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - May 24, 2020 Category: Orthopaedics Source Type: research

Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction
ConclusionsSelective reconstruction of partial ACL injury is a method to bear in mind because it offers quick functional recovery. Specific technical and diagnostic steps should be performed and discussed with patients preoperatively.Level of evidenceLevel 4, retrospective study. (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - March 27, 2020 Category: Orthopaedics Source Type: research

Reliability and reproducibility of the new AO/OTA 2018 classification system for proximal humeral fractures: a comparison of three different classification systems
ConclusionsThe results showed that the Neer system still represents the more reliable and reproducible classification. However, the new AO/OTA 2018 classification improved the agreement among observers compared with the AO/OTA 2007 system, while still maintaining substantial descriptive power and simplifying the coding process. The universal modifiers and qualifications, despite their possible complexity, allowed a more comprehensive fracture definition without negatively affecting the reliability or reproducibility of the classification system.Level of evidence: Level III, diagnostic studies (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - March 11, 2020 Category: Orthopaedics Source Type: research

Limb lengthening history, evolution, complications and current concepts
AbstractLimb lengthening continues to be a real challenge to both the patient and the orthopaedic surgeon. Although it is not a difficult operative problem, there is a long and exhausting postoperative commitment which can jeopardize early good results. I aim to review the history, evolution, biology, complications and current concepts of limb lengthening. Ilizarov ’s innovative procedure using distraction histeogenesis is the mainstay of all newly developing methods of treatment. The method of fixation is evolving rapidly from unilateral external fixator to ring fixator, computer assisted and finally lengthening intrame...
Source: Journal of Orthopaedics and Traumatology - March 4, 2020 Category: Orthopaedics Source Type: research

C-reactive protein is not a screening tool for late periprosthetic joint infection
ConclusionsSerum CRP level should not be used as a screening tool to rule out late PJI.Level of evidenceLevel 2 (diagnostic study). (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - February 23, 2020 Category: Orthopaedics Source Type: research

Measuring the placebo effect in carpal tunnel syndrome
ConclusionsThese results show an improvement in the studied parameters by up to 20%, but when compared with those published in literature, these show great variability due to the wide variety of factors involved in the placebo effect. Several factors that affect the placebo effect are discussed, and the present work tries to quantify it in carpal tunnel syndrome.Level of EvidenceLevel 2 of evidence according to “The Oxford 2011 Level of Evidence.” (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - January 27, 2020 Category: Orthopaedics Source Type: research

Femoroacetabular impingement: question-driven review of hip joint pathophysiology from asymptomatic skeletal deformity to end-stage osteoarthritis
AbstractFemoroacetabular impingement (FAI), together with its two main pathomechanisms, cam and pincer, has become a trending topic since the end of the 1990s. Despite massive academic research, this hip disorder still conceals obscure aspects and unanswered questions that only a question-driven approach may settle. The pathway that leads a FAI asymptomatic morphology through a FAI syndrome to a FAI-related osteoarthritis is little known. Contact mechanics provides a shareable and persuasive perspective: cam FAI is based on shear contact stress at joint level with consequent cartilage wear; pincer FAI, contrariwise, determ...
Source: Journal of Orthopaedics and Traumatology - November 3, 2019 Category: Orthopaedics Source Type: research

Mid-term results of a new-generation calcar-guided short stem in THA: clinical and radiological 5-year follow-up of 216 cases
ConclusionsThe rate of stem revision (0%) at the mid-term follow-up was remarkable and indicates the principle of using a calcar-guided short stem as being a safe procedure. However, signs of bone-remodelling, indicating some amount of stress-shielding, must be acknowledged at 5  years depending on stem alignment and type of anchorage.Level of evidenceIV, Prospective observational studyTrial registration German Clinical Trials Register, DRKS00012634, 07/07/2017 (retrospectively registered) (Source: Journal of Orthopaedics and Traumatology)
Source: Journal of Orthopaedics and Traumatology - October 30, 2019 Category: Orthopaedics Source Type: research