Literature regarding osteochondral lesions in patients following elbow dislocation is scarce. The aim of this study was to examine osteochondral lesions on MRI in patients following simple elbow dislocations and evaluate inter-rater reliability between radiologists and orthopedic surgeons at different levels of experience. In this retrospective, single-center study, 72 MRIs of patients following simple elbow dislocations were evaluated.
View Article and Find Full Text PDFBackground And Purpose: Early migration of the uncemented cruciate-sacrificing rotating platform ATTUNE and Low Contact Stress (LCS) tibial components was classified as at-risk for aseptic loosening rates exceeding 6.5% at 15 years based on recent fixation-specific migration thresholds. In this secondary report of a randomized controlled trial (RCT) we aimed to evaluate whether the 5-year migration, inducible displacement, and the clinical outcome of the ATTUNE components were comparable to those of the LCS.
View Article and Find Full Text PDFBackground And Purpose: This study updates 2 parallel systematic reviews and meta-analyses from 2012, which established the 1-year radiostereometric (RSA) migration thresholds for tibial components of total knee replacements (TKR) based on the risk of late revision for aseptic loosening from survival studies. The primary aim of this study was to determine the (mis)categorization rate of the 2012 thresholds using the updated review as a validation dataset. Secondary aims were evaluation of 6-month migration, mean continuous (1- to 2-year) migration, and fixation-specific thresholds for tibial component migration.
View Article and Find Full Text PDFFluoroquinolones (FQs) are considered the most effective antimicrobial treatment for Gram-negative prosthetic joint infection (GN-PJI). Alternatives are needed due to increasing FQ resistance and side effects. We aimed to compare different targeted antimicrobial strategies for GN-PJI managed by debridement, antibiotics, and implant retention (DAIR) or one-stage revision surgery (1SR) and to review the literature of oral treatment options for GN-PJI.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2024
Purpose: This study aimed to calculate region and diagnosis-specific minimal important changes (MICs) of the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM) in patients requiring foot and ankle surgery and to assess their variability across different foot and ankle diagnoses.
Methods: The study used routinely collected data from patients undergoing elective foot and ankle surgery. Patients had been invited to complete the FAOS and FAAM preoperatively and at 3-6 months after surgery, along with two anchor questions encompassing change in pain and daily function.
Background: The primary objective of this study was to investigate the diagnostic characteristics of bone scintigraphy single-photon emission computed tomography/computed tomography (BS-SPECT/CT) for diagnosing aseptic loosening after uncemented total knee arthroplasty (TKA), and to evaluate the following aspects: how to manage inconclusive results, the interobserver reliability, and the location of tracer uptake between symptomatic cases with and without aseptic loosening.
Methods: In this study, 180 patients who had uncemented TKA and persistent knee pain suspected of aseptic loosening were included. As part of routine medical care, BS-SPECT/CT was used, and its results were compared with the reference standard, which involved revision surgery for aseptic loosening or a 12-month follow-up without revision or imaging.
Pulmonary fibrosis (PF) is a severe and progressive condition in which the lung becomes scarred over time resulting in pulmonary function impairment. Classical histopathology remains an important tool for micro-structural tissue assessment in the diagnosis of PF. A novel workflow based on spatial correlated propagation-based phase-contrast micro computed tomography (PBI-microCT), atomic force microscopy (AFM) and histopathology was developed and applied to two different preclinical mouse models of PF - the commonly used and well characterized Bleomycin-induced PF and a novel mouse model for progressive PF caused by conditional Nedd4-2 KO.
View Article and Find Full Text PDFThis study investigated survival, complications, revisions, and patient-reported outcomes (PROs) for unconstrained total knee arthroplasty (TKA) in posttraumatic osteoarthritis (PTO) caused by intraarticular tibial plateau fractures with minimum four years follow-up. Forty-nine patients (71.4% male; 58.
View Article and Find Full Text PDFBackground And Purpose: This updated meta-analysis evaluates the migration pattern of the tibial component of primary total knee replacements measured with radiostereometric analysis (RSA). We aimed to evaluate whether 6-month maximum total point motion (MTPM) values could be used instead of 1-year MTPM for RSA threshold testing and to present the pooled migration patterns for different implant designs that can be used as a benchmark.
Patients And Methods: The search included all published RSA studies on migration patterns of tibial components until 2023.
Hard-tissue histology-the analysis of thin two-dimensional (2D) sections-is hampered by the opaque nature of most biological specimens, especially bone. Therefore, the cutting process cannot be assigned to regions of interest. In addition, the applied cutting-grinding method is characterized by significant material loss.
View Article and Find Full Text PDFBackground: Surgical treatment of distal clavicle fractures Neer type II is challenging. A gold standard has not yet been established, thus various surgical procedures have been described. The purpose of this study is to report the radiological and clinical outcomes using hook plate fixation in Neer type II distal clavicle fractures.
View Article and Find Full Text PDFBackground: The influence of bony morphology on the development of posterior shoulder instability is not well known.
Purpose: To determine if acromial morphology, as measured on magnetic resonance imaging (MRI), is associated with posterior or anterior shoulder instability.
Design: Cross-sectional study; Level of evidence, 3.
Background: Hypothermia is a common perioperative problem that can lead to severe complications. We evaluated whether a heated mattress (HM) is superior to a warm air blanket (WA) in preventing perioperative hypothermia in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA).
Methods: A retrospective cohort study was performed in a teaching hospital and data were collected for all patients undergoing THA or TKA between January 1, 2015 and May 1, 2022.
Background: Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit.
View Article and Find Full Text PDFBackground: The purpose of this study was to investigate outcomes and return to sport metrics in recreational athletes who suffered simple elbow dislocations and were treated operatively or nonoperatively.
Methods: The study included patients between the ages of 16 and 65 who were recreational athletes and had experienced a simple elbow dislocation, with at least 2 years having passed since the injury. Patient-reported outcomes including Mayo Elbow Performance Score (MEPS), Subjective Elbow Value (SEV), Oxford Elbow Score (OES) and Visual Analog Scale (VAS) were collected.
Background: Various surface modifications are used in uncemented total knee arthroplasties (TKAs) to enhance bony ingrowth and longevity of implants. This study aimed to identify which surface modifications are used, whether they are associated with different revision rates for aseptic loosening, and which are underperforming compared to cemented implants.
Methods: Data on all cemented and uncemented TKAs used between 2007 and 2021 were obtained from the Dutch Arthroplasty Register.
Background: Compliance with perioperative anticoagulation guidelines is essential to minimize bleeding and thromboembolic risks in patients undergoing surgery. Compared to vitamin-K antagonists (VKAs), perioperative management of direct oral anticoagulants (DOACs) contains fewer steps. Therefore, we hypothesized that noncompliance with guidelines in VKA users is higher than in DOAC users.
View Article and Find Full Text PDFIntroduction: Patient-specific instrumentation (PSI) for primary total knee arthroplasty (TKA) surgery has been shown to increase accuracy of component positioning. However, it is unclear whether this also translates to actual benefits for patients in terms of better outcomes (efficacy) or less complications such as revisions (safety). We therefore systematically reviewed the literature to determine the efficacy and safety of PSI in primary TKA.
View Article and Find Full Text PDFAims: The primary aim of this study was to compare the migration of the femoral and tibial components of the cementless rotating platform Attune and Low Contact Stress (LCS) total knee arthroplasty (TKA) designs, two years postoperatively, using radiostereometric analysis (RSA) in order to assess the risk of the development of aseptic loosening. A secondary aim was to compare clinical and patient-reported outcome measures (PROMs) between the designs.
Methods: A total of 61 TKAs were analyzed in this randomized clinical RSA trial.
Large bone defects of the lower extremities are challenging for both patients and the treating orthopedic surgeons. The treatment is determined by the size and location of the defect; however, patient-specific factors, such as the soft tissue situation and the presence of systemic comorbidities must be taken into consideration in the treatment strategy. Osteodistraction is an excellent technique especially for large bone defects exceeding 3 cm; however, it is time-consuming and required external fixation prior to the development of motorized distraction nails.
View Article and Find Full Text PDFIntroduction: Non-union occurs when a fracture fails to adequately heal, and requires additional intervention to achieve union. The purpose of this scoping review is to provide a high-level overview of the existing non-union management literature. This review aims to highlight the current literature on non-union management, as well as identify key areas that require future research to provide a better understanding of potential non-union management strategies.
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