Treatment of medial-sided injuries in patients with early bicruciate ligament reconstruction for knee dislocation.

Purpose: In knee dislocation with bicruciate ligament and medial side injury (KDIIIM), treatment method of medial side injuries is controversial. The purpose of this study was to evaluate the outcomes of non-operative treatment of proximal and midsubstance and operative treatment of distal avulsion medial collateral ligament (MCL) ruptures in patients with early bicruciate reconstruction.

Methods: One-hundred and forty-seven patients with a knee dislocation and bicruciate ligament injury (KDII-KDV) were identified.

Reasons and Risk Factors for Delayed Discharge After Total Knee Arthroplasty Using an Opioid-Sparing Discharge Protocol.

Background: In this study, we aimed to assess the length of hospital stay after total knee arthroplasty in a European healthcare setting. We also aimed to investigate risk factors and reasons for delayed discharge when using an opioid-sparing fast-track protocol.

Methods: From our institutional database, we retrospectively identified all primary elective unilateral total knee arthroplasties performed during January to December 2015.

Infection safety of dexamethasone in total hip and total knee arthroplasty: a study of eighteen thousand, eight hundred and seventy two operations.

Purpose: Dexamethasone has been shown to prevent post-operative nausea and vomiting (PONV) and seems to reduce post-operative pain. Both factors, which can extend the hospital stay, delay rehabilitation, and impact patient satisfaction. Because of the immunosuppressive and glucose-rising effects of dexamethasone, there has been concern of its safety in arthroplasty surgery.

Dislocation of large-diameter head metal-on-metal total hip arthroplasty and hip resurfacing arthroplasty.

Introduction: Dislocation of large-diameter head (LDH) metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA) is a rare complication. This study aimed to determine the incidence and risk factors for dislocation of LDH MoM THAs and HRAs.

Methods: This retrospective analysis considered 4038 cementless LDH MoM THAs and HRAs, 3207 THAs in 2912 patients and 831 HRAs in 757 patients.

Predictors of osteoarthritis following operative treatment of medial tibial plateau fractures.

Purpose: To determine factors influencing the development of posttraumatic osteoarthritis (OA) following medial tibial plateau fractures and to evaluate concomitant injuries associated with these fractures.

Materials And Methods: A chart review of patients with operatively treated medial tibial plateau fractures admitted to our Level I trauma centre from 2002 to 2008 was performed. Of 63 patients, 41 participated in a clinical and radiographic examination.

A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits.

Background: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs.

The current state of orthopaedic residency in 18 European countries.

Purpose: The aim of this study was to compare differences in current orthopaedic and trauma training programs across Europe.

Methods: A questionnaire was sent to the FORTE (Federation of Orthopaedic Trainees in Europe) representatives of 25 different European countries, of which 18 responded. The questionnaire included demographic information and information concerning the structure of the training programs, including duration, selection, and mandatory training requirements.

Revision Total Hip Arthroplasty for Fractured Ceramic Bearings: A Review of Best Practices for Revision Cases.

Background: Total hip arthroplasty revision for a fractured ceramic bearing is rare but offers unique challenges. The purpose of this review was to provide a summary of existing literature on fractured ceramic bearings.

Methods: Two authors performed a literature search of the MEDLINE OVID and PubMed databases with the following search terms: ceramic, fracture, total hip arthroplasty, and revision.

The role of outpatient visit after operative treatment of ankle fractures.

It is a common practice that patients have a scheduled follow-up visit with radiographs following ankle fracture surgery. The aim of this study was to evaluate whether an early outpatient visit (<3 weeks) after ankle fracture surgery resulted in a change in patient management. For this study, 878 consecutive operatively treated ankle fracture patients with an early outpatient clinical-radiological visit were reviewed.

Preoperative planning of total hip arthroplasty on dysplastic acetabuli.

Background: When performing total hip arthroplasty (THA) on a dysplastic hip, proper positioning of the acetabular component may not allow for more than 70% coverage. Structural support in the form of an autograft or a high porosity metal augment may be necessary. The purpose of the study was to investigate the value of preoperative templating and deformity classification in predicting cup coverage and the need for structural support.

The focally constrained liner is a reasonable option for revision of unstable total hip arthroplasty.

Purpose: Revision surgery for a patient with previous recurrent dislocations or abductor muscle dysfunction has been considered to be a complication-prone procedure regardless of the type of constrained implant used. We investigated the survivorship of a focally constrained acetabular liner used for revision total hip arthroplasty in patients with abductor insufficiency or previous recurrent dislocations.

Methods: We retrospectively reviewed 98 patients in whom a focally constrained acetabular liner was used to treat abductor insufficiency or previous recurrent dislocations.

Early aseptic loosening of cementless monoblock acetabular components.

Purpose: Early aseptic loosening of cementless monoblock acetabular components is a rare complication of total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA). The purpose of this study was to evaluate the incidence and risk factors for early aseptic loosening of the cementless monoblock acetabular components.

Methods: This retrospective analysis consisted of 4,043 cementless hip devices (3,209 THAs and 834 HRAs).

Risk Factors for Deep Infection Following Plate Fixation of Proximal Tibial Fractures.

Background: The risk factors are unclear for deep surgical site infection after plate fixation of proximal tibial fractures. The objective of this study was to identify the patient and surgical procedure-related risk factors for infection using established criteria for deep surgical site infection.

Methods: A total of 655 proximal tibial fractures were treated with open reduction and plate fixation at our center between 2004 and 2013.

Role of Cages in Revision Arthroplasty of the Acetabulum.

➤ The outcome of acetabular revision is heavily influenced by the degree of associated bone loss.➤ Uncemented hemispherical acetabular components can be used in the majority of acetabular revisions, although occasionally the degree of bone loss precludes the stability of the hemispherical component at the correct anatomic level or there is minimal bleeding host bone left for biologic fixation.➤ Massive acetabular bone loss resulting in the need for bone grafts or highly porous augments involving more than half of the acetabulum is one of the main indications for the use of cages.

Predictors of Postoperative Wound Necrosis Following Primary Wound Closure of Open Ankle Fractures.

Background: Most open malleolar ankle fracture wounds can be closed primarily after meticulous debridement. However, the development of wound necrosis following operative treatment of open malleolar ankle fractures can have catastrophic consequences. The aim of this study was to identify risk factors predisposing to postoperative wound necrosis following primary wound closure of open malleolar ankle fractures.

Risk factors for intraoperative calcar fracture in cementless total hip arthroplasty.

Background And Purpose: Intraoperative periprosthetic femoral fracture is a known complication of cementless total hip arthroplasty (THA). We determined the incidence of--and risk factors for--intraoperative calcar fracture, and assessed its influence on the risk of revision.

Patients And Methods: This retrospective analysis included 3,207 cementless THAs (in 2,913 patients).

Arthroplasty for Pertrochanteric Hip Fractures.

The mainstay of treatment of pertrochanteric fractures is internal fixation using a sliding hip screw or a cephalomedullary device. However, in patients with ipsilateral hip osteoarthritis or avascular necrosis of the femoral head, or inflammatory arthritis, arthroplasty should be considered as the primary treatment modality to reduce the likelihood of a secondary procedure. Unstable fracture patterns with concomitant poor bone quality represent a challenge for internal fixation, with high rates of lag screw cut-out and hardware failure.

Closed suction drainage has no benefits in revision total hip arthroplasty: a randomized controlled trial.

Purpose: Several studies have failed to show significant benefits of closed suction drainage (CSD) in routine primary total hip arthroplasty (THA). However, blood loss, haematoma formation and wound complications are generally much greater in revision THA as compared to primary THA. The purpose of this study was to determine if CSD is beneficial for revision THA patients.

Complications following conversion of a hip hemiarthroplasty to a total hip arthroplasty.

Purpose: Conversion of hip hemiarthroplasty to total hip arthroplasty (CTHA) is a complication-prone procedure with high dislocation rates and early component loosening. The purpose of this study was to evaluate the complications of CTHA performed using contemporary implants.

Methods: Forty-six patients who had CTHA were retrospectively matched to a control group of 46 patients who had a first-time THA revision.

Arthroplasty for unstable pertrochanteric hip fractures may offer a lower re-operation rate as compared to cephalomedullary nailing.

Purpose: Cephalomedullary (CM) nailing is widely used for the treatment of pertrochanteric hip fractures. Fixation failures with CM nailing tend to occur in unstable fracture patterns often necessitating revision surgery. The purpose of this study was to compare the complications and clinical outcomes of primary arthroplasty to CM nailing for the treatment of unstable pertrochanteric hip fractures.

Contemporary demographics and complications of patients treated for open ankle fractures.

Open ankle fractures are rare injuries with a high likelihood of wound complications and subsequent infections. There is limited information about the complications and outcomes of these injuries in different age groups. The aim of this study was to assess the contemporary demographics and complications related to this injury.