Publications by authors named "O Dahduli"

5 Publications

  • Page 1 of 1

Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up.

Acta Orthop Belg 2021 Mar;87(1):111-116

Purpose: distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients. The purpose of the current study was to evaluate a consecutive series of DFPPF treated with DFA, with a minimum 2- year follow-up.

Methods: We performed a retrospective study asses- sing the outcomes of distal femoral arthroplasty (DFA) for patients diagnosed with DFPPF.

Results: Twenty patients were identified. The mean age of patients was 76.3 (SD, 9.41), the average time from the fracture to revision surgery was 6.7 days (SD, 11.35), The average operative time was 93.5 minutes (SD,16.6). The average follow-up time was 50.15 months (SD, 20.87). During this time, two patients (10%) had complications. One patient experienced a knee dislocation and the second patient had recurrent periprosthetic infections. At final follow up, the mean knee society score was 86.25 (SD, 9.44), the mean Forgotten joint score was 62.16(SD, 23.45) and 93.7 percent of patients were ambulatory.

Conclusion: DFA following DFPPF is associated with high success rates and provides patients with the opportunity for return of function in a safe and reliable manner.
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March 2021

Revision total knee arthroplasty for patellar dislocation in patients with malrotated TKA components.

Arch Orthop Trauma Surg 2020 Jun 5;140(6):777-783. Epub 2020 May 5.

Division of Orthopaedic Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Purpose: Patellar dislocation is a serious complication leading to patient morbidity following total knee arthroplasty (TKA). The cause can be multifactorial. Extensor mechanism imbalance may be present and result from technical errors such as malrotation of the implants. We sought to understand the reasons for post-arthroplasty patellar dislocation and the clinical outcomes of patients in whom it occurs.

Methods: This is a retrospective cohort study assessing the outcomes of revision surgery for patellar dislocation in patients with component malrotation in both primary and revision TKAs. Patient demographics, dislocation etiology, presurgical deformity, intraoperation component position, complications, reoperation, and Knee Society Scores (KSS) were collected.

Results: Twenty patients (21 knees) were identified. The average time from primary arthroplasty to onset of dislocation was 33.6 months (SD 44.4), and the average time from dislocation to revision was 3.38 months (SD 2.81). Seventeen knees (80.9%) had internal rotation of the tibial component and seven knees (33.3%) had combined internal rotation of both the femoral and tibial components. Fifteen knees (71.4%) were treated with a condylar constrained implant at the time of revision, and five knees were converted to a hinged prosthesis. The average follow-up time was 56 months. During this time, one patient (4.54%) had a recurrent dislocation episode, requiring further surgery. At final follow up, the mean KSS was 86.2.

Conclusion: Revision TKA following patellar dislocation for patients with malrotated components was associated with high success rates. After revision surgery, patients had a low recurrence of patellar dislocation, low complication rates, and excellent functional outcomes.
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http://dx.doi.org/10.1007/s00402-020-03468-6DOI Listing
June 2020

The effect of patient institutional transfer during the interstage period of two-stage treatment for prosthetic knee infection.

Bone Joint J 2019 Sep;101-B(9):1087-1092

Division of Orthopaedics, Mount Sinai Hospital, Toronto, Canada.

Aims: The aim of this study was to assess the effects of transferring patients to a specialized arthroplasty centre between the first and second stages (interstage) of prosthetic joint infection (PJI) of the knee.

Patients And Methods: A search of our institutional database was performed to identify patients having undergone two-stage revision total knee arthroplasty (TKA) for PJI. Two cohorts were created: continuous care (CC) and transferred care (TC). Baseline characteristics and outcomes were collected and compared between cohorts.

Results: A total of 137 patients were identified: 105 in the CC cohort (56 men, 49 women; mean age 67.9) and 32 in the TC cohort (17 men, 15 women; mean age 67.8 years). PJI organism virulence was greater in the CC cohort (36.2% 15.6%; p = 0.030). TC patients had a higher rate of persisting or recurrent infection (53.6% 13.4%; p < 0.001), soft-tissue complications (31.3 14.3%; p = 0.030), and reduced requirement for porous metal augments (78.1% 94.3%; p = 0.006). Repeat first stage debridement after transfer led to greater need for plastic surgical procedures (58.3% 0.0%; p < 0.001).

Conclusion: Patient transfer during the interstage of treatment for infected TKA leads to poorer outcomes compared with patients receiving all their treatment at a specialized arthroplasty centre. Cite this article: 2019;101-B:1087-1092.
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http://dx.doi.org/10.1302/0301-620X.101B9.BJJ-2019-0279.R1DOI Listing
September 2019

Are we closing the gaps in the management of osteoporosis following fragility fractures of the femur?

J Int Med Res 2019 May 7;47(5):1843-1847. Epub 2019 Jan 7.

3 King Fahd Military Medical Complex, Dhahran, Saudi Arabia.

Objective: The objective of this study was to identify deficiencies in initiating anti-osteoporotic treatment following a fragility femoral fracture.

Methods: All patients ≥55 years of age treated for a fragility femoral fracture between June 2012 and May 2017 were enrolled. Medications at discharge and at 90 days and 1 year of follow up were analyzed. Patients were classified into 4 groups: Group I did not receive any treatment for osteoporosis; Group II received only calcium and vitamin D; Group III received an anabolic agent, calcium, and vitamin D; and Group IV received bisphosphonates, calcium, and vitamin D.

Results: A total of 167 patients with an average age of 65.81±12.55 years were included. There were 88 (52.7%) males and 79 (47.3%) females. At discharge, 107 patients (64.1%) were not prescribed optimal treatment for osteoporosis, and this reduced to 55 (32.9%) at the 90-day follow up. At 1 year, the number of patients receiving suboptimal treatment was further reduced to 25.74%.

Conclusions: Although the number of patients with fragility fractures receiving insufficient treatment was lower in the present study than in previous reports, increased efforts and coordinated treatment plans initiated by a fracture liaison service should be of high priority.
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http://dx.doi.org/10.1177/0300060518819630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567753PMC
May 2019
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