Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2024
An anteromedial stabilization procedure has the most protective effect on the anterior cruciate ligament in tibial external rotation. A human knee model study.
Anterior cruciate ligament (ACL) reconstruction remains associated with the risk of re-rupture and persisting rotational instability. Additional extraarticular anterolateral stabilization procedures stabilize the tibial internal rotation and lead to lower ACL failure rate and improved knee stability. However, data for additional stabilization of tibial external rotation is lacking and the importance of an anteromedial stabilization procedure is less well evaluated. Aim of this study is to investigate the influence of an extraarticular anteromedial stabilization procedure for the stabilization of the tibial external rotation and protection of the ACL from these rotational forces. ⋯ This study showed that an additional anteromedial stabilization procedure secures the tibial external rotation and has the most protective effect on the ACL during these external rotational forces.
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Arch Orthop Trauma Surg · May 2024
Treatment of femoral neck fractures using actis stem: complication rate in 188 uncemented hemiarthroplasties.
Cemented hemiarthroplasty (HA) is preferred in treating dislocated femoral neck fractures in elderly, osteoporotic patients, since uncemented HA was associated with mechanical complications more frequently. Cementation can conversely cause cardiopulmonary complications, leading to demand on safe, uncemented implants addressing osteoporosis. This study is set up as a retrospective feasibility study on the use of an uncemented, collared wedge implant (Actis®, DePuy Synthes, Warsaw, IN), for HA in elderly patients, focusing on complication rate. ⋯ Our data provide proof of concept, that Actis® Stem allows an alternative, uncemented treatment option for displaced femoral neck fractures with HA. In case of preoperative or intraoperative medial cortical bone defects, stability of this implant is deteriorated.
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Arch Orthop Trauma Surg · May 2024
The Impact of Epidural Analgesia on Immobility and extended Hospital Stay After Periacetabular Osteotomy.
Early mobilisation after periacetabular osteotomy (PAO) represents an important goal after surgery. The purpose of this study was to determine whether the use of epidural aznalgesia (EA) is associated with prolonged immobility and an increased length of stay (LOS) after PAO surgery. ⋯ Opting against the use of EA in patients undergoing PAO is advisable, as it will result in extended postoperative immobility and the associated risks. Additionally, the active participation of the surgeon in the mobilisation process is strongly recommended.
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Arch Orthop Trauma Surg · May 2024
Long-term outcomes of the mayo conservative hip system in patients aged 30 years or less with osteonecrosis of the femoral head: mean follow-up of more than 10 years.
Historically, total hip arthroplasty (THA) in very young patients has been associated with lower survivorship. However, the long-term outcomes of THA using short stems for osteonecrosis of the femoral head (ONFH) in very young patients remain unclear. Therefore, this study aimed to investigate the long-term outcomes of the Mayo conservative hip system, a short metaphyseal stabilised stem, in patients with ONFH aged ≦30 years. ⋯ The use of short stems in patients aged ≤ 30 years with ONFH showed favourable long-term outcomes.