A multidisciplinary approach to post-operative fragility hip fracture care in Thailand - a narrative review.

Introduction: Appropriate care and rehabilitation following surgery for fragility hip fractures in older adults is associated with better outcomes and a greater likelihood of achieving pre-injury functioning. Clinical guidelines specifically for the post-operative care and rehabilitation of patients with hip fractures are scarce; as such, country-specific protocols benchmarked against established guidelines are essential given the wide variation in cultures and beliefs, clinical practice and diverse healthcare systems in Asia. We aimed to provide clinically relevant recommendations for post-operative fragility hip fracture care and rehabilitation to improve patient outcomes and prevent subsequent fractures in Thailand.

Atypical Periprosthetic Femoral Fracture Associated With Prolonged Bisphosphonate Therapy: A Two-Centered Retrospective Case Series and Literature Review.

To date, atypical periprosthetic femoral fractures (APFFs) are not well-understood due to a relatively small number of studies on the topic. Moreover, there is a paucity of guidance regarding the appropriate treatment strategy. We would therefore like to present and analyze a series of five APFF cases (one incomplete APFF and four complete APFFs) that were treated in two university hospitals; a review of the literature is also provided.

Antimicrobial Susceptibility of Neisseria gonorrhoeae in Adult Patients Seeking Care at Military Hospitals in Thailand From 2014 to 2020.

Introduction: The effective dual antibiotics ceftriaxone (CRO) and azithromycin (AZM) have successfully treated Neisseria gonorrhoeae (GC) infection, however, the CRO- and AZM-resistant strains have been sporadically detected globally and in Thailand. Furthermore, there are no currently antimicrobial susceptibility profiles of the GC isolates obtained from soldiers reported in Thailand. Hence, this is the first study to describe the antimicrobial susceptibility profiles of GC isolates obtained from predominately soldiers who seeking care at Military Camp Hospitals, in Thailand from 2014 to 2020.

Functional outcome and complication following THA through modified direct anterior approach correlated to cadaveric study: are there any differences in Asian hip?

Background: Direct anterior approach (DAA) has several advantages including shorter length of hospital stay, faster recovery, and better functional outcome while this approach may cause damage to the lateral femoral cutaneous nerve (LFCN) as high as 81% in the works of literature. Not much data has identified the LFCN pattern in the Asian population. Therefore, the purpose of our study was to identify characteristics of the LFCN patterns representing an Asian hip, which would aid to provide the most appropriate incision of modified direct anterior approach (MDAA) for total hip arthroplasty (THA), and to identify the clinical outcome and complications following THA through MDAA correlated with cadaveric hip in the Asian population.

Effectiveness of Periarticular Injection After Bipolar Hemiarthroplasty for Displaced Femoral Neck Fracture in Elderly Patients: A Double Blinded Randomized, Controlled Study.

Background: Bipolar hemiarthroplasty is a standard treatment for displaced femoral neck fracture in elderly with a normal acetabulum. Several studies have shown controversial results regarding postoperative visual analogue scale, opioid consumption, and the effectiveness of periarticular injection in hip arthroplasty. The purpose of this study is going to identify the effectiveness of periarticular injection after bipolar hemiarthroplasty compared with the patients treated with conventional pain control.

Anterior skin numbness after total knee arthroplasty: A prospective comparison study between diabetic and non-diabetic patients.

Background: Anterior skin numbness from injury of the infrapatellar branch of saphenous nerve (IPBSN) and/or the anterior-inferior branch of the femoral cutaneous nerve (AIBFN) has been reported after TKA. A recent study has demonstrated no difference in skin numbness between minimally invasive and standard approach TKA. The purpose of our study was to compare the area of skin numbness following TKA in the diabetic and non-diabetic patient.

Can urinary CTX-II be a biomarker for knee osteoarthritis?

Background: Early diagnosis of knee osteoarthritis (OA) remains a diagnostic challenge. Urinary C-terminal cross-linked telopeptide of type II collagen (urinary CTX-II) is one of the potential OA biomarkers. However, conclusive evidence regarding the use of this biomarker as a tool for early diagnosis is still lacking.

Subsidence of Hydroxyapatite-Coated Femoral Stem in Dorr Type C Proximal Femoral Morphology.

Background: Good bone quality and proper proximal femoral morphology are thought to be necessary for tapered design, cementless femoral stems to resist subsidence. Using tapered, cementless stem for patients with stovepipe morphology or Dorr type C is controversial. The purpose of this study is to analyze (1) subsidence of the fully hydroxyapatite (HA)-coated, tapered, cementless stem in different morphology according to Dorr classification, (2) subsidence of the stem related to radiographic canal-fill ratio.

10-Year patient satisfaction compared between computer-assisted navigation and conventional techniques in minimally invasive surgery total knee arthroplasty.

Background: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) in total knee arthroplasty have been scientifically linked with surgical benefits. However, the long-term results of these techniques are still controversial. Most surgeons assessed the surgical outcomes with regard to knee alignment and range of motion, but these factors may not reflect subjective variables, namely patient satisfaction.

Chemistry-driven structural alterations in short-term retrieved ceramic-on-metal hip implants: Evidence for in vivo incompatibility between ceramic and metal counterparts.

Ceramic-on-metal (CoM) hip implants were reported to experience lower wear rates in vitro as compared to metal-on-metal (MoM) bearings, thus hinting metal-ion release at lower levels in vivo. In this article, we show a spectroscopic study of two short-term retrieval cases of zirconia-toughened alumina (ZTA) femoral heads belonging to CoM hip prostheses, which instead showed poor wear performances in vivo. Metal contamination and abnormally high fractions of tetragonal-to-monoclinic (t→m) polymorphic transformation of the zirconia phase could be found on both ZTA heads, which contrasted with the optimistic predictions of in vitro experiments.

Neural Anatomy of the Anterolateral Thigh Flap.

The anterolateral thigh (ALT) flap is one of the commonly used sensate flaps for intra-oral, hand, and foot reconstruction. The objective of this study was to describe the anatomic location of the sensory nerves supplying the ALT flap in relation to the surface landmarks and with the vascular pedicles. The dissections were carried out in 28 embalmed specimens.

Rotational alignment of femoral component between custom cutting block and conventional technique in total knee arthroplasty.

Objective: Rotation of femoral components could be optimized to improve function and durability of the knee joint. The purpose of the present study was to assess rotational alignment of femoral component comparing between CT-based, custom cutting blocks and the contemporary total knee arthroplasty, instrument technique.

Material And Method: The prospective control study of 80 patients underwent total knee arthroplasty by using PFC Sigma PS total knee design.

Comparative study of femoral sizing between intraoperative measurement and CT-based PSI in total knee arthroplasty.

Background: Appropriate femoral sizing in total knee arthroplasty (TKA) is an important factor for flexion. An oversized femoral component will decrease flexion gap and postoperative flexion. By using custom cutting blocks technique with computed tomography (CT) imaging to design cutting blocks will help determine sizing of each patient.

Low molecular weight heparin prevents the progression of precollapse osteonecrosis of the hip.

Background: Hypercoaguable state has been indicated as a major risk factor in predisposing the idiopathic osteonecrosis of the hip. Furthermore, many studies have demonstrated that low molecular weight heparin (LMWH) can reverse the pathophysiology of the osteonecrosis of the hip in thrombophilic patients.

Objective: Determine whether LMWH can prevent the progression of idiopathic osteonecrosis of the hip.

The accuracy of component alignment in custom cutting blocks compared with conventional total knee arthroplasty instrumentation: prospective control trial.

Background: The purpose of this study was to assess whether custom cutting blocks improve accuracy of component alignment compared to conventional TKA instrumentation.

Methods: Eighty primary TKA patients were enrolled in an open-label randomized prospective clinical trial and were divided into two groups, 40 custom cutting blocks and 40 conventional TKA instrumentations. The primary outcome was prosthetic alignment with respect to mechanical axis and epicondylar axis.

A comparison of accuracy between step and non-step reamers of femoral intramedullary alignment system in total knee arthroplasty evaluated by computer-assisted navigation.

Limb alignment after total knee replacement has been demonstrated to be one of the most influential in determining long-term survival of the implants. Malalignment can contribute to early prosthesis failure through point loading and premature polyethelene wear. Alignment guides have been developed to improve the accuracy of femoral and tibial cuts during surgery.

Comparative study of anatomical landmark technique and self-aligned tibial component rotation determined by computer-assisted TKA.

Background: An improper femoral and tibial component rotation is one of a major reason leading to a failed TKA. There is controversial on determination of rotational alignment particularly on a tibial component. An anatomical landmarks and a self-aligned technique have been proposed.

The rotational axis of the tibia and relationship to the tibial torsion in varus osteoarthritic knee.

Background: A transepicondylar axis is a useful reference for femoral component rotation and is demonstrated as a functional flexion-extension axis of a knee. Conversely, a rotational orientation of the tibial component was less clearly demonstrated and many anatomical landmarks were proposed. It has been reported that Asian people had more medial torsion of the tibia particularly with an osteoarthritic knee.

Humeral head surface arthroplasty: a case report.

Shoulder osteoarthritis is one of the common causes of the shoulder pain. The shoulder arthroplasty is an effective treatment alternative for the patients at advanced disease stage. We presented the first incident case in Thailand who had been diagnosed with primary glenohumeral osteoarthritis and was surgically treated by the humeral head surface arthroplasty.

The prevalence of thrombophilia in idiopathic osteonecrosis of the hip.

Background: Thrombophilia is the propensity to develop thrombosis (blood clots) within the vein or artery due to an abnormality in the system of coagulation. It is one of the pathophysiological causes of osteonecrosis of femoral head (ONFH). Previous studies showed that the prevalence of thrombophilia was 1-15% in normal population.

Measurement of acetabular cup anteversion with the circle theorem.

Objective: Malposition of the acetabular cup is the major risk factor of dislocation after total hip arthroplasty. Postoperatively, measuring of acetabular cup anteversion is very difficult. The new method for measuring acetabular cup anteversion on the plain radiograph of the hip with one of the circle theorems in the basic geometry was created.

The mortality rate after thromboembolism prophylaxis in the hip fracture surgery.

Background: Although hip fracture surgery treatments have been improved, the mortality rate remains high because of a high risk of complications, such as myocardial infarction and venous thromboembolism. Many studies have identified the benefit of thromboembolism prophylaxis.

Objective: To determine the 1-year mortality rate of thromboembolism prophylaxis and non-prophylaxis after the hip fracture surgery.