How to perform correct templating in total hip replacement
AbstractTemplating plays a key role in surgery that is often underestimated. There is a difference between planning and templating: in the first not only the hip is considered but involves the evaluation of the patient in its entirety. Templating instead consists of calculating the position of the implant in order to place it in the best possible position. Fundamental is a correct X-ray of the pelvis, which must follow certain standards. For traditional templating, drawings on appropriately enlarged transparent implants were provided by the prosthesis manufacturer. The implementation of digital software into clinical pract...
Source: Musculoskeletal Surgery - January 11, 2023 Category: Orthopaedics Source Type: research
Tibial tubercle osteotomy: effect of different osteotomy planes on contact surface area and tubercle anteriorization
AbstractIn 1983, Fulkerson introduced a technique of tibial tubercle osteotomy performed according to an inclined plane with respect to frontal plane. Due to obliquity of the osteotomy plane, this procedure allows both anterior and medial transfer of the tibial tubercle. The purpose of the study was to investigate the influence of the different degrees of the oblique plane of osteotomy on anterior displacement and the contact surface area of tibial tubercle. Synthetic bones were used for the study. An osteotomy of the tibial tubercle (TT) was performed in each specimen. Specifically, 3 different degrees of osteotomy planes...
Source: Musculoskeletal Surgery - December 29, 2022 Category: Orthopaedics Source Type: research
Prevalence and risk factors for nerve injury following shoulder dislocation
ConclusionsShoulder dislocation requires careful assessment and timely management in the ED. A 6% rate of nerve injury following shoulder dislocation was at the lower border of reported rates (5 –55%), and primary dislocation and older age were identified as risk factors for nerve injury. We emphasise the importance of referring patients with suspected major nerve injury to specialist services. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - November 29, 2022 Category: Orthopaedics Source Type: research
A novel retrograde technique for ankle osteochodral lesions: the sub-endo-chondral regenerative treatment (secret)
ConclusionsThis technique combines the mini-invasiveness of retrograde drilling with the regenerative properties of biological scaffold soaked with bone marrow concentrate. Despite further research being needed, it seems a new viable solution to treat both subchondral cysts and large osteochondral defects of the ankle, whose management is still controversial. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - November 14, 2022 Category: Orthopaedics Source Type: research
Influence of posterior tibial slope on postoperative outcomes after postero-stabilized and condylar-stabilized total knee arthroplasty
ConclusionWhen performing a PS-TKA, the best result was obtained with a postop-PTS > 5°, but comparable outcomes between the two systems were evident with postop-PTS > 5°. It is crucial to come as close as possible to the indications reported in surgical technique regardless ∆PTS. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - November 12, 2022 Category: Orthopaedics Source Type: research
Correction to: High-grade dysplastic spondylolisthesis: surgical technique and case series
(Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - November 9, 2022 Category: Orthopaedics Source Type: research
Hypersensitivity reactions to metals in spine surgery
AbstractHypersensitivity to orthopedic devices is a rare condition with an underestimated incidence due to the lack of diagnostic guideline and ambiguous clinical manifestations. Although hypersensitivity to metal is common, a few cases of hypersensitivity reactions have been reported after spinal instrumentation. Spinal fusion and stabilization require a wide range of devices such as screws, wires, bands, and artificial disk replacement devices. Spinal instrumented surgeries are different from total joint arthroplasty in several aspects such as degree and pattern of motion, loading environment, and adjacent tissues with d...
Source: Musculoskeletal Surgery - November 7, 2022 Category: Orthopaedics Source Type: research
Management of patella maltracking after total knee arthroplasty: a systematic review
ConclusionPatella maltracking after TKA represents a frequent and challenging problem for orthopedic surgeons. Treatments described in the literature are often able to correct an abnormal patellar tracking; nevertheless, authors report variable percentages of residual knee pain and dissatisfaction in re-treated patients. Therefore, it would be desirable to prevent the maltracking condition at the time of primary arthroplasty, using proper surgical precautions. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - October 5, 2022 Category: Orthopaedics Source Type: research
High-grade dysplastic spondylolisthesis: surgical technique and case series
ConclusionAlthough technically demanding, reduction and fusion with one stage all posterior approach prove to be a safe and effective. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - October 1, 2022 Category: Orthopaedics Source Type: research
Correction to: Reverse shoulder replacement versus hemiarthroplasty for proximal humeral fracture in elderly patients: a systematic review
(Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - September 8, 2022 Category: Orthopaedics Source Type: research
Arthroscopic surgery or exercise therapy for degenerative meniscal lesions: a systematic review of systematic reviews
ConclusionsConservative treatment based on physical therapy should be the first-line management. However, most SRs revealed subgroups of patients that fail to improve after conservative treatment and find relief when undergoing surgery. In the future, randomized controlled trials, evidence should be looked for that APM can be successful in case of the unsatisfactory results after physical therapy. (Source: Musculoskeletal Surgery)
Source: Musculoskeletal Surgery - September 3, 2022 Category: Orthopaedics Source Type: research
High tibial osteotomy in medial compartment osteoarthritis of knee: functional outcome of medial open wedge and lateral closing wedge osteotomies —How does the outliers fare in the medium term?
ConclusionOur study shows that both medial open wedge osteotomy and lateral closing wedge osteotomy are capable of improving knee function in medial compartment osteoarthritis of knee. Medial open wedge with locking plates is a biomechanically more stable construct compared with lateral closing wedge osteotomy. Irrespective of the two techniques chosen, the aim of the osteotomy should be to achieve an overcorrection of 2°–6° of valgus or at least to keep the knee straight (normal mechanical axis). This will give a satisfactory medi um-term result. However, varus alignment and valgus alignment of more than 6° ca...
Source: Musculoskeletal Surgery - August 20, 2022 Category: Orthopaedics Source Type: research
Direct anterior approach in total hip arthroplasty: influence of stem length on clinical and radiological outcomes at medium-term follow-up
ConclusionsBoth groups achieved good and comparable patient-reported outcome measurements (PROMs) and radiographic stability with fixation observed by bone ingrowth. A high rate of undersized stems was found with a correlation between femoral stem length and specific pattern of malposition. Malalignment in Varus was frequent in shorter stems in contact proximally with medial calcar and distally with lateral cortex, while a uniform undersizing was observed for longer ones with a continuous margin around the stem. However, the stems never presented progressive radiolucent lines over the whole surface of the stem. (Source: Mu...
Source: Musculoskeletal Surgery - August 19, 2022 Category: Orthopaedics Source Type: research
Reverse shoulder replacement versus hemiarthroplasty for proximal humeral fracture in elderly patients: a systematic review
AbstractThis systematic review of the literature aims to analyse current knowledge to inform choice between hemiarthroplasty (HA) and reverse total shoulder arthroplasty (rTSA) for managing proximal humerus fractures (PHF) in elderly patients; the aim is to understand if rTSA can be considered the gold standard for treating PHF in the elderly when surgical fixation or conservative treatment is not viable options. Studies reporting outcomes and complications of PHF treated with shoulder arthroplasty in the elderly were included. Studies were in English and published after 2008. Evidence levels I, II, III and IV were include...
Source: Musculoskeletal Surgery - August 16, 2022 Category: Orthopaedics Source Type: research
Total knee replacements using rotating hinge implants in polio patients: clinical and functional outcomes
AbstractLittle evidences are available in the literature concerning the outcomes of total knee replacement (TKR) in poliomyelitis patients with severe knee deformities or degeneration. Encouraging results have been reported concerning the use of constrained implants, i.e., rotating hinge knee prosthesis (RHK), compared to less constrained ones. The purpose of this paper is to report our experience with rotating hinge total knee replacement, using only RHK prosthesis, to determine functional results, complications, and survival of TKR in poliomyelitis patients. We performed a retrospective chart review of 14 patients with a...
Source: Musculoskeletal Surgery - August 10, 2022 Category: Orthopaedics Source Type: research
