Navigated versus conventionally instrumented total knee arthroplasty techniques: No difference in functional alignment or balance.

Purpose: Much debate exists about the superiority of navigated versus conventional instrumentation for achieving optimal balance and alignment during total knee arthroplasty (TKA). Recent registry data indicate no long-term survivorship benefit for TKAs performed using technology assistance, despite the added resource and financial costs. However, outcome comparisons are confounded by varying surgeon techniques and targets for ideal balance and alignment.

Identifying Critical Evidence Gaps in Wound Closure and Incision Management After Total Knee Arthroplasty: Delphi Panel Insights.

Background: Effective surgical wound management in total knee arthroplasty (TKA) is crucial for optimal healing and patient outcomes. Despite surgical advances, managing wounds to prevent complications remains challenging. This study aimed to identify and address evidence gaps in TKA wound management, including preoperative optimization, intraoperative options, and postoperative complication avoidance.

Conventionally instrumented inverse kinematic alignment for total knee arthroplasty: How is it done?

Purpose: For primary total knee arthroplasty (TKA), there is an increasing trend towards patient-specific alignment strategies such as kinematic alignment (KA) and inverse kinematic alignment (iKA), which by restoring native joint mechanics may yield higher patient satisfaction rates. Second, the most recent Australian joint registry report describes favourable revision rates for conventionally instrumented TKA compared to technology-assisted techniques such as those using navigation, robotics or custom-cutting blocks. The aim of this technique article is to describe in detail a surgical technique for TKA that: (1) utilises the principles of iKA and (2) uses conventionally instrumented guided resections thereby avoiding the use of navigation, robotics or custom blocks.

Inverse kinematic total knee arthroplasty using conventional instrumentation restores constitutional coronal alignment.

Purpose: Restricted inverse kinematic alignment (iKA) is a contemporary alignment strategy for total knee arthroplasty (TKA), commonly performed with robotic assistance. While superior clinical results are reported for kinematic-type alignment strategies, registry data indicate no survivorship benefit for navigation or robotic assistance. This study aimed to determine the efficacy of an instrumented, restricted iKA technique for achieving patient-specific alignment.

International Delphi Study on Wound Closure and Incision Management in Joint Arthroplasty Part 2: Total Hip Arthroplasty.

Background: This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures.

Methods: An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty).

International Delphi Study on Wound Closure and Dressing Management in Joint Arthroplasty: Part 1: Total Knee Arthroplasty.

Background: The purpose of this modified Delphi study was to obtain consensus on wound closure and dressing management in total knee arthroplasty (TKA).

Methods: The Delphi panel included 20 orthopaedic surgeons from Europe and North America. There were 26 statements identified using a targeted literature review.

Mechanical outcomes of the TFNA, InterTAN and IMHS intramedullary nailing systems for the fixation of proximal femur fractures.

Introduction: Hip fractures have become a major public health priority due to their increasing incidence. Intramedullary (IM) nailing has gained popularity as a surgical technique for managing these fractures. However, comparative studies with extramedullary devices indicate potentially increased mechanical complications associated with IM nailing.

Does lucency equate to revision? A five-year retrospective review of Attune and Triathlon total knee arthroplasty.

Purpose: The Attune total knee arthroplasty system was introduced in 2013 to address lingering issues of patient dissatisfaction. However, recent literature reports concerns of early tibial tray debonding. The aim of this study was to compare the incidence of radiolucent lines, survivorship and patient reported outcome-measures between the Attune system and the well-established Triathlon system.

Distal radial fractures in adults: 4 versus 6 weeks of cast immobilisation after closed reduction, a randomised controlled trial.

Purpose: In this study, we aim to evaluate whether the functional outcome of Distal Radius Fractures (DRFs) could be enhanced by shortening the period of immobilisation from six weeks to four weeks.

Methods: This study is a single blinded randomised controlled trial. Four week plaster cast immobilisation was compared with six week plaster cast immobilisation in adult patients (older than 18 years) with adequately reduced DRFs.

Perspective on the integration of optical sensing into orthopedic surgical devices.

Significance: Orthopedic surgery currently comprises over 1.5 million cases annually in the United States alone and is growing rapidly with aging populations. Emerging optical sensing techniques promise fewer side effects with new, more effective approaches aimed at improving patient outcomes following orthopedic surgery.

The role of joint line position and restoration of posterior condylar offset in revision total knee arthroplasty : a systematic review of 422 revision knees arthroplasty.

The aim of this systematic review was to evaluate the evidence on reservation of Posterior Femoral Condylar Offset (PFCO) and Joint Line (JL) after Revision Total Knee Arthroplasty (RTKA) for im- proved functional outcomes. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted, with papers published from the inception of the database to October 2020 included. All relevant articles were retrieved, and their bibliographies were hand searched for further references on Posterior condylar offset and revision total knee arthroplasty.

Pilot study of micromotion nailing for mechanical stimulation of tibial fracture healing.

Aims: The study objective was to prospectively assess clinical outcomes for a pilot cohort of tibial shaft fractures treated with a new tibial nailing system that produces controlled axial interfragmentary micromotion. The hypothesis was that axial micromotion enhances fracture healing compared to static interlocking.

Methods: Patients were treated in a single level I trauma centre over a 2.

Femoral head penetration in Vitamin-E polyethylene liner versus conventional liners in total hip arthroplasty: systematic review and meta-analysis of randomised control trials.

Background: Debate encompasses the use of Vitamin E Polyethylene or conventional Polyethylene liner in primary hip arthroplasty. Does the Inclusion of Vitamin E in PE give adequate protection from oxidation and maintains lower rates of wear?

Patients And Methods: We performed this study following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Studies were included from any region, written in any language.

Does bicompartmental knee arthroplasty hold an advantage over total knee arthroplasty? Systematic review and meta-analysis.

Introduction: The role of bicompartmental knee arthroplasty (BKA) in the treatment of medial patellofemoral osteoarthritis (MPFOA) has been debated by orthopaedic surgeons for years. The BKA is a cruciate ligament retaining prosthesis designed to mimic the kinematics of the native knee that requires resurfacing of only two knee compartments. In this study, we aim to assess the patient recorded outcome measures (PROMs), range of motion (ROM), perioperative morbidity, and implant revision rate in patients undergoing BKA and compare them to those undergoing total knee arthroplasty (TKA) for bicompartmental knee osteoarthritis (OA).

The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis.

Knee osteochondral defects are a common problem among people, especially young and active patients. So effective joint preserving surgeries is essential to prevent or even delay the onset of osteoarthritis for these group of patients. This study aims to critically appraise and evaluate the evidence for the results and effectiveness of femoral condyle resurfacing (HemiCAP/ UniCAP) in treatment of patients with focal femoral condyle cartilage defect.

Nontraumatic Tibial Polyethylene Insert Cone Fracture in Rotating-Platform Total Knee Arthroplasty.

We report a case of a fracture through the polyethylene (PE) insert cone in a rotating-platform (RP) primary total knee arthroplasty (TKA) implant. This is the first reported case of cone fracture with this particular implant. This case highlights a 65-year-old female presenting with a 4-month history of knee pain and symptoms of instability 10 years after primary RP TKA.

The decline of hip fracture incidence rates over a 10-year period: A single centre experience.

Aims: Accurate epidemiological hip fracture data is essential for healthcare planning and targeted prevention strategies. Limited reports of hip fracture incidence rates in the Republic of Ireland (ROI) exist. The aim is to calculate the current age- and gender-specific incidence of hip fractures in a level 1 Trauma Centre in the ROI, and the difference in these rates over a 10 year period.

Midterm results of modern patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis: systematic review and meta-analysis of comparative studies.

Background: Both Patellofemoral Arthroplasty (PFA) and Total Knee Arthroplasty (TKA) are accepted surgical options for end-stage isolated patellofemoral osteoarthritis (PFOA). We performed a systematic review and meta-analysis to compare outcomes of PFA and TKA by evaluation of the patient-reported outcome measures (PROMs).

Methods: We systematically identified publications reporting on patients that underwent either TKA or modern PFA for isolated PFOA.

Harrington rods for periacetabular pathological lesion: is it an option?

Advancement in cancer treatment has prolonged the survival of cancer patients; as a result, there are an increased number of patients with bone metastases and pathological fractures referred to orthopaedic surgeons for surgical intervention for a better quality of life. Metastasis around the hip joint can be painful and intervene with patients' daily activity, and reconstruction of the hip joint with periacetabular metastasis is complex and challenging especially longer cancer survivals might out-live their fixation. Several acetabular reconstruction techniques and implants have been described to overcome this problem; acetabular reconstruction and total hip arthroplasty still remains the standard surgical treatment, to relief pain and to improve function and quality of life.

Polyethylene liner dissociation in a DePuy pinnacle cup with a manufacturer analysis of the failed component.

A 74-year-old patient presented to the emergency department with acute atraumatic hip pain 9 years after her primary left total hip arthroplasty (THA). Plain radiographic imaging demonstrated lateralisation of the femoral head within the acetabular shell-indicating an issue with the polyethylene liner. The patient required revision of the acetabular component and the femoral head, as well as a new polyethylene liner.

Trabecular Metal Augments for Severe Acetabular Defects in Revision Hip Arthroplasty: A Long-Term Follow-Up.

Background: Paprosky type IIIa and IIIb acetabular defects remain technically challenging during revision hip arthroplasty. Numerous surgical options exist to counter extensive acetabular bone loss with high postoperative complication and revision rates reported. Our aim was to report comprehensive long-term outcomes of our experience with Trabecular Metal (TM) augments for these difficult cases.

Perioperative dexamethasone administration reduces 'on-demand' opioid requirements in bilateral total hip arthroplasty.

Background: Bilateral joint arthroplasty is currently not common, but its usage is expected to increase in the future. This may result in larger amounts of opioids being consumed by patients due to anticipated increased pain and prolonged recovery from this procedure.

Aim: We describe the impact of perioperative steroid administration in a cohort of bilateral total hip arthroplasties (THAs) (44 hips) in relation to post-operative opioid consumption.

Perioperative steroid administration improves knee function and reduces opioid consumption in bilateral total knee arthroplasty.

Introduction: The benefits of steroid usage have been well described for unilateral total knee arthroplasty (TKA), however it's benefits in bilateral TKA has not been well published in the literature. We describe the impact of perioperative steroid administration in a cohort of bilateral TKAs (74 knees) with regard to immediate postoperative knee function, postoperative knee strength and opioid consumption.

Materials And Methods: We report on a single-surgeon consecutive case series of simultaneously-performed bilateral TKAs.

Pediatric Trauma and the COVID-19 Pandemic: A 12-Year Comparison in a Level-1 Trauma Center.

Background: The effect of COVID-19 on pediatric trauma rates is still largely under investigation. With the potential need to reallocate human and financial resources at this challenging time, it will be useful to have detailed descriptions of the rates of pediatric trauma and understanding of how the pandemic affects these rates.

Questions/purposes: We sought to describe the effect of the COVID-19 pandemic on the number of acute pediatric trauma admissions and procedures performed in a level-I trauma center in Cork University Hospital, Ireland.