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Arch Orthop Trauma Surg 2022 May 25. Epub 2022 May 25.

Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

Introduction: In cases of limited medical resources, elective total knee arthroplasty (TKA) sometimes needs to be performed after typical work hours. However, surgeon fatigue and logistical factors may potentially affect outcomes. This study aimed to detect whether after-hour procedures impair outcomes after TKA. Read More

Arch Orthop Trauma Surg 2022 May 25. Epub 2022 May 25.

Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Germany.

Background: The aim of this study was to assess the role of sonication fluid cultures in detecting musculoskeletal infections in orthopedic revision surgery in patients suspected of having peri-prosthetic joint infection (PJI), fracture-related infections (FRI), or postoperative spinal implant infections (PSII).

Methods: Between 2016 and 2019, 149 cases with a data set including sonication fluid cultures and tissue specimen and histological analysis were included. Accuracy of each diagnostic tool as well as the influence of antibiotic therapy was analyzed. Read More

Arch Orthop Trauma Surg 2022 May 21. Epub 2022 May 21.

Centre for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Strasse 51, 81547, Munich, Germany.

Introduction: Even though an increased interest in the use of the EFAS Score (European Foot and Ankle Society) has been observed, no data comparing it with radiological findings has been presented in the literature. Accordingly, the aim of this study is to investigate how the post-operative integration of the AMIC (autologous matrix-induced chondrogenesis)-membrane for osteochondral lesion of the talus using the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) - Score is related to the clinical satisfaction of the patients.

Material And Methods: A group of 24 patients aged between 17 and 63 (with a mean age of 35. Read More

Arch Orthop Trauma Surg 2022 May 20. Epub 2022 May 20.

Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany.

Arch Orthop Trauma Surg 2022 May 20. Epub 2022 May 20.

Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Gødstrup Hospital, Gødstrupvej 43, 7400, Herning, Denmark.

Introduction: Hip fracture patients are fragile, and the majority fail to fully recover to their pre-fracture functional level, resulting in an increase in institutionalization. We aimed to investigate risk factors for being dependent at discharge and for failure to return to independent living 12 months after a hip fracture.

Materials And Methods: From 2011 to 2017, all surgically treated hip fracture patients admitted from their own homes were included in this prospective cohort study. Read More

Arch Orthop Trauma Surg 2022 May 19. Epub 2022 May 19.

Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA.

Background: Due to the surge of COVID-19 cases in the US in early March 2020, health care facilities temporarily suspended elective and non-urgent medical procedures such as joint replacement surgeries. The aim of this study was to analyze the impact of the COVID-19 associated shutdown on orthopedic patient care at a specialized orthopedic hospital located at the epicenter of the COVID-19 pandemic.

Methods: Patient volume of outpatient visits and joint replacement surgeries were analyzed and compared for 2019 and 2020. Read More

Arch Orthop Trauma Surg 2022 May 19. Epub 2022 May 19.

Joint Replacement Unit, Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, MI, Italy.

Introduction: Unicompartmental knee arthroplasty (UKA) has an infection rate of 0.1-0.8%. Read More

Arch Orthop Trauma Surg 2022 May 17. Epub 2022 May 17.

Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Joseph-Stelzmann Strasse 24, 50931, Cologne, Germany.

Introduction: In regard of surgical training, the reproducible simulation of life-like proximal humerus fractures in human cadaveric specimens is desirable. The aim of the present study was to develop a technique that allows simulation of realistic proximal humerus fractures and to analyse the influence of rotator cuff preload on the generated lesions in regards of fracture configuration.

Materials And Methods: Ten cadaveric specimens (6 left, 4 right) were fractured using a custom-made drop-test bench, in two groups. Read More

Arch Orthop Trauma Surg 2022 May 14. Epub 2022 May 14.

Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Introduction: There is no uniform consensus on the gold standard therapy for acute Achilles tendon rupture. The aim of this pilot study was to compare operative and conservative treatment regarding imaging findings and clinical outcome.

Materials And Methods: Surgically or conservatively treated patients with acute Achilles tendon rupture were retrospectively evaluated. Read More

Arch Orthop Trauma Surg 2022 May 14. Epub 2022 May 14.

Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.

Objective: To evaluate the long-term clinical outcome of the treatment of complete arthroscopic synovectomy combined with low-dose external radiotherapy in the knee affected by primary intra-articular diffuse tenosynovial giant cell tumor (TGCT).

Methods: From May 2009 to January 2016, 18 patients with intra-articular diffuse TGCT underwent complete arthroscopic synovectomy and low-dose external-beam radiotherapy in Zhongnan Hospital were enrolled in this retrospective study. The preoperative symptoms of patients, the complications during or after the arthroscopic procedure and the recurrence were collected and recorded. Read More

Arch Orthop Trauma Surg 2022 May 13. Epub 2022 May 13.

Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Introduction: This study aimed to (1) evaluate the short-term clinical outcomes of patients who underwent non-operative treatment for partial anterior cruciate ligament (ACL) tears diagnosed using the outpatient-based diagnostic criteria and (2) investigate the radiographic predictors distinguishing patients at risk of non-operative treatment failure.

Methods: From 2010 to 2019, patients diagnosed with partial ACL tears and treated with non-operative treatment were reviewed retrospectively. Patients were then classified into two groups: those who successfully responded to non-operative treatment (group S) and those who failed to respond to non-operative treatment and required surgical reconstruction within 6 months after injury (group F). Read More

Arch Orthop Trauma Surg 2022 May 13. Epub 2022 May 13.

Division of Adult Reconstruction, NYU Langone Orthopedic Hospital, Hospital for Joint Diseases, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.

Purpose: Aseptic loosening is a common cause of implant failure following total knee arthroplasty (TKA). Cement penetration depth is a known factor that determines an implant's "strength" and plays an important role in preventing aseptic loosening. Tourniquet use is thought to facilitate cement penetration, but its use has mixed reviews. Read More

Arch Orthop Trauma Surg 2022 May 12. Epub 2022 May 12.

Klinik Für Orthopädie Und Unfallchirurgie Klinikum, Buger Straße 80, 96049, Bamberg, Germany.

Introduction: A 'inwardly pointing knee' syndrome is a combined torsional deformity with increased femoral internal and tibial external torsion. After clinical and radiological verification of the torsional deformity and unsuccessful conservative therapy approach, a combined (double level) torsional osteotomy of femur and tibia might be the appropriate treatment. Here, we present the diagnostic algorithms, treatment, and outcome of combined torsional osteotomies of femur and tibia. Read More

Arch Orthop Trauma Surg 2022 May 12. Epub 2022 May 12.

Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.

Introduction: Optimization of patient outcomes and identification of factors to improve the surgical workflow are increasingly important. Operating room time is one modifiable factor that leads to greater hospital efficiency as well as improved outcomes such as shorter length of stay and fewer infections and readmissions. The aim of this study was to identify factors associated with operative time disparities in total knee arthroplasty (TKA). Read More

Arch Orthop Trauma Surg 2022 May 10. Epub 2022 May 10.

NYU Langone Health, Division of Adult Reconstruction, Department of Orthopedic Surgery, Hospital of Joint Diseases, NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.

Background: The knee-hip-spine syndrome has been well elucidated in the literature in recent years. The aim of this study was to evaluate the effect of total knee arthroplasty (TKA) on spinopelvic sagittal alignment in patients with and without pre-TKA lumber spinal fusion.

Methods: This is a retrospective cohort study of 113 patients who underwent TKA for primary osteoarthritis. Read More

Arch Orthop Trauma Surg 2022 May 10. Epub 2022 May 10.

Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St. Marguerite Hospital, Aix Marseille University, APHM, CNRS, ISM, Marseille, France.

Introduction: To our knowledge, no papers have reported the results of robotic-assisted surgery for sequential bilateral Total Knee Arthroplasty (TKA). Indeed, sequential bilateral TKA present several benefits, as one single anesthesia, surgical episode, hospitalization, and rehabilitation. The purpose of our study was to evaluate peri-operative outcomes and compare the complication rates, clinical outcomes, and implant positioning of sequential bilateral TKA performed with a robotic-assisted system versus a conventional technique. Read More

Arch Orthop Trauma Surg 2022 May 10. Epub 2022 May 10.

Dept. of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Background: To determine the clinical outcome of patients who had been treated with bone allografts during open reduction and internal fixation (ORIF) of tibial head fractures.

Methods: Patients who suffered a medial, lateral, or bicondylar fracture of the tibial plateau and underwent surgical treatment by open reduction and internal fixation (ORIF) using human femoral head bone allografts were included. Patients were invited to provide information for the following: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol Five Dimension score (EQ-5D), Lower Extremity Functional Scale (LEFS) and Parker Mobility Score. Read More

Arch Orthop Trauma Surg 2022 May 9. Epub 2022 May 9.

Department of Orthopedic Surgery and Traumatology, Charité, University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Introduction:  A devastating complication after total hip arthroplasty (THA) is chronic periprosthetic joint infection (PJI). Most frequently spacers (Sp) with or without antibiotics are implanted in a two-stage procedure even though not always indicated due to unknown pathogen, femoral and acetabular defects or muscular insufficiency.

Materials And Methods:  A retrospective analysis of a prospectively collected database was conducted, analyzing the treatment of 44 consecutive cases with chronic PJI undergoing two-stage revision using a Girdlestone situation (GS) in the interim period between 01/2015 and 12/2018. Read More

Arch Orthop Trauma Surg 2022 May 9. Epub 2022 May 9.

Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.

Introduction: This study investigated the anatomic feasibility of a new surgical therapy option for radial head arthrosis using an autologous vascularized bone graft of the second metatarsal and proximal fibula to recreate the proximal radiohumeral joint.

Materials And Methods: Upper and lower extremities of eleven body donors were evaluated using CT prior to anatomic dissection. Several distinct anatomic parameters were measured on the ipsi- and contralateral radial and fibular head and the second metatarsal base: bone diameter, articular surface diameter, head height, metaphyseal (neck) diameter, articular surface radius, total articular surface area, and angulation of the articular surfaces (facet). Read More

Arch Orthop Trauma Surg 2022 May 6. Epub 2022 May 6.

Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.

Introduction: Although several surgical approaches, with or without capsular repair, can be used during total hip arthroplasty (THA), there is no clear evidence that capsular repair provides a clinical advantage post-surgery, regardless of surgical approach. This systematic review and meta-analysis evaluated whether capsular repair using various surgical approaches provides a clinical advantage over capsular resection post-THA.

Methods: This study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist for systematic reviews and meta-analyses. Read More

Arch Orthop Trauma Surg 2022 May 6. Epub 2022 May 6.

Department of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore, Singapore.

Introduction: This study aims primarily to characterize the sequelae and morbidity associated with tibial pilon injuries from the patients' perspectives in terms of multiple surgical interventions, duration of hospital stay, downtime from work, loss of productivity and impact on patients' lives. The secondary aim is to review the associated risk factors for these morbidities.

Materials And Methods: All patients with surgically treated tibial pilon fractures from 1st July 2007 to 30th June 2017 were included. Read More

Arch Orthop Trauma Surg 2022 May 6. Epub 2022 May 6.

Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Avenue, Chengdu, 610041, Sichuan, China.

Purpose: Severe calcaneal malunion is a clinical conundrum for the difficulty of calcaneal reconstruction without soft tissue complications. The aim of this study is to introduce the treatment strategy and preliminary results of staged Illizarov distraction histogenesis and corrective reconstruction for severe malunion of calcaneal fractures.

Methods: From June 2014 to May 2020, 14 patients with severe calcaneal malunion treated with the staged strategy were retrospectively analyzed. Read More

Arch Orthop Trauma Surg 2022 May 5. Epub 2022 May 5.

Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

Introduction: Chronic pain of various origin is known to be associated with selective cognitive impairment. Osteoarthritis (OA) of the hip is one of the leading causes of chronic pain in the adult population, but its association with cognitive performance has not been evaluated. Here, we investigate the effect of chronic pain due to unilateral OA of one hip and no further source of chronic pain on cognitive performance. Read More

Arch Orthop Trauma Surg 2022 May 5. Epub 2022 May 5.

Department of Spine Surgery, University Hospital of Basel, Spitalstrasse 21, 4051, Basel, Switzerland.

Background: Given the lack of guidelines regarding the operative management of elderly patients needing lumbar spine fusion for degenerative disease, it is often difficult to balance between invasiveness respecting the fragile spine and geriatric comorbidities.

Aim: To compare reoperation rates and clinical outcome in patients above 70 years of age undergoing Transforaminal Lumbar Interbody Fusion (TLIF) with titanium rods or posterior stabilization with Polyetheretherketone (PEEK) rods for the treatment of one-level lumbar spine degenerative disease.

Methods: Retrospective review of baseline characteristics, reoperation rates as well as the clinical and radiological outcomes of patients, older than 70 years, undergoing posterolateral fusion with PEEK rods (n = 76, PEEK group) or TLIF with titanium rods (n = 67, TLIF group) for a single-level lumbar degenerative disease from 2014 to 2020. Read More

Arch Orthop Trauma Surg 2022 May 4. Epub 2022 May 4.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Introduction: Complications after total hip arthroplasty (THA) may result in readmission or reoperation and impose a significant cost on the healthcare system. Understanding which patients are at-risk for complications can potentially allow for targeted interventions to decrease complication rates through pursuing preoperative health optimization. The purpose of the current was to develop and internally validate machine learning (ML) algorithms capable of performing patient-specific predictions of all-cause complications within two years of primary THA. Read More

Arch Orthop Trauma Surg 2022 May 4. Epub 2022 May 4.

Center for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Background: A preoperative pathogen detection is considered a prerequisite before undergoing one-stage exchange for prosthetic joint infection (PJI) according to most guidelines. This study compares patients with and without preoperative pathogen detection undergoing one-stage exchange for PJI of the hip. The authors put up the hypothesis that a preoperative pathogen detection is no prerequisite in selected cases undergoing one-stage exchange. Read More

Arch Orthop Trauma Surg 2022 May 4. Epub 2022 May 4.

Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany.

The aim of the study was to examine the noise exposure for operating theater staff during total knee arthroplasty (TKA) with three different robot systems. There is already evidence that noise exposure during TKA performed manually exceeds recommended guidelines for occupational noise. Therefore, if surgical staff is exposed to it for several years, the development of noise-inducing hearing loss (NIHL) is significantly increased. Read More

Arch Orthop Trauma Surg 2022 May 4. Epub 2022 May 4.

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Introduction: Revision total hip arthroplasty (THA) represents a technically demanding surgical procedure which is associated with significant morbidity and mortality. Understanding risk factors for failure of revision THA is of clinical importance to identify at-risk patients. This study aimed to develop and validate novel machine learning algorithms for the prediction of re-revision surgery for patients following revision total hip arthroplasty. Read More

Arch Orthop Trauma Surg 2022 May 2. Epub 2022 May 2.

Department of Pharmacy, OhioHealth Doctors Hospital, 5100 West Broad Street, Columbus, OH, 43228, USA.

Background: Use of multimodal analgesia (MMA) prior to orthopedic surgery has been adopted by many practitioners as a strategy to minimize use of opioid medications. The purpose of this investigation was to quantify the effect of a preemptive three-drug regimen (acetaminophen, celecoxib, and gabapentin) in terms of post-operative opioid consumption and pain control in the field of total joint arthroplasty.

Methods: A retrospective chart review was conducted on 1691 patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) and stratified by whether they received a preemptive three medication analgesic therapy (acetaminophen, celecoxib, and gabapentin) within 30 to 60 min prior to entering the operating room. Read More

Arch Orthop Trauma Surg 2022 Apr 30. Epub 2022 Apr 30.

Department of Trauma and Orthopaedics, South Tees NHS Foundation Trust, Middlesbrough, UK.

Introduction: When performing a high tibial osteotomy (HTO) for genu varum deformity, it is not always easy to obtain the correct amount of overcorrection. The aims of this study were to review the results of a simple and reproducible method of correction that we have called "1 mm equals 1°". We have applied this technique to the medial opening wedge osteotomy. Read More