How a Gauze Sponge Roll Enhances Surgical Exposure in Thumb Carpometacarpal Arthroplasty: A Technical Note.

Thumb carpometacarpal arthroplasty has become a widely used standard technique in the surgical treatment of thumb carpometacarpal osteoarthritis. One of the most critical steps during this procedure is proper surgical exposure of the trapezium and the base of the first metacarpal to allow for prosthesis implantation. This article introduces a surgical technique in which a roll constructed from gauze sponges tightly wrapped with medical tape facilitates several steps in thumb carpometacarpal arthroplasty.

Learning curve comparison between switching approach and switching implant in cementless short stem total hip arthroplasty.

Introduction: Implementing new approaches or new implants is always related with a certain learning curve in total hip arthroplasty (THA). Currently, many surgeons are switching to minimally invasive approaches combined with short stems for performing THA. Therefore, we aimed to asses and compare the learning curve of switching from an anterolateral Watson Jones approach (ALA) to a direct anterior approach (DAA) with the learning curve of switching from a neck-resecting to a partially neck-sparing short stem in cementless THA.

Cementless short stem total hip arthroplasty in patients older than 75 years: is it feasible?

Background: In recent years, the indication for cementless short stem total hip arthroplasty (THA) has been widened to elderly patients as they might profit by the advantages of the short-curved implant design as well. Therefore, this study was conducted to evaluate the clinical and radiological outcome of a cementless short stem in elderly patients (≥ 75 years) compared to a young control group (≤ 60 years).

Methods: A retrospective cohort of 316 THAs performed between 2014 and 2017 was prospectively examined.

Intra-Articular Application of Autologous, Fat-Derived Orthobiologics in the Treatment of Knee Osteoarthritis: A Systematic Review.

The aim of this study was to review the current literature regarding the effects of intra-articularly applied, fat-derived orthobiologics (FDO) in the treatment of primary knee osteoarthritis over a mid-term follow-up period. A systematic literature search was conducted on the online databases of Scopus, PubMed, Ovid MEDLINE, and Cochrane Library. Studies investigating intra-articularly applied FDO with a minimum number of 10 knee osteoarthritis patients, a follow-up period of at least 2 years, and at least 1 reported functional parameter (pain level or Patient-Reported Outcome Measures) were included.

Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty.

Purpose: The aim of this study was to analyse the functional outcome and the conversion rate to total knee arthroplasty (TKA) after surgically treated tibial plateau fractures (TPF).

Methods: All patients undergoing surgical treatment of TPF at a single institution between January 2003 and December 2019 were retrospectively reviewed. The Knee injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale (TAS) were collected.

Gender differences in cementless short stem total hip arthroplasty: significantly higher femoral lengthening in female patients.

Modern cementless short stems in total hip arthroplasty (THA) enable a precise reconstruction of the native pre-arthritic hip geometry. While gender differences have been reported for older generation straight hip stems, there are hardly reports regarding modern cementless short hip stems. Therefore, we aimed to evaluate the influence of gender differences in hip anatomy in cementless short stem THA.

The Effect of Cerclage Banding Distally to a Clamshell Fracture Pattern in Total Hip Arthroplasty-A Biomechanical Study.

Objectives: As currently there is no existing biomechanical work on the topic of interest, the aim of the current study was to investigate the effect of cerclage banding distally to an intraoperatively occurring proximal periprosthetic femoral clamshell fracture versus a non-fractured femur after total hip arthroplasty.

Methods: A diaphyseal anchoring stem was implanted in twenty paired human cadaveric femora, assigned to a treatment and a control group. In the treatment group, each specimen was fitted with a cerclage band placed 3 mm distally to a clamshell fracture, created with an extent of 40% of the anchoring length of the stem.

Long-term Results of Developmental Hip Dysplasia Under Therapy With Pavlik Harness.

Introduction: The Pavlik harness is a commonly used treatment for developmental dysplasia of the hip (DDH) of types IIc or worse, based on the Graf classification. This study aimed to assess the long-term follow-up outcomes after treating DDH with the Pavlik harness.

Methods: Between 1995 and 2006, ultrasound screening was conducted on 7372 newborns within the first days of life.

A neck-sparing short stem shows significantly lower blood loss in total hip arthroplasty compared to a neck-resecting short stem.

Short stems are associated with a significantly lower blood loss (BL) compared to straight stems in total hip arthroplasty (THA). Different types of stems differ in design, fixation and level of femoral neck osteotomy. Therefore, we sought to evaluate the difference regarding the perioperative BL between two short stems with different designs in direct anterior approach (DAA).

Not all questions are created equal: the weight of the Oxford Knee Scores questions in a multicentric validation study.

Background: The Oxford Knee Score (OKS) has been designed for patients with knee osteoarthritis and has a widespread use. It has 12 questions, with each question having the same weight for the overall score. Some authors have observed a significant ceiling effect, especially when distinguishing slight postoperative differences.

Second-Line Antibiotic Agents in Patient-Reported Penicillin or Cephalosporin Allergy Have No Negative Impact on Antibiotic Resistance After Hip and Knee Arthroplasty.

Background: The aim of the present study was to compare causative bacteria and their antibiotic resistance profiles in patients developing a periprosthetic joint infection (PJI) based on preoperative prophylactic antibiotic regimens in primary total hip (THA) and primary total and unicompartmental knee arthroplasty (TKA/UKA).

Methods: We reviewed all cases of PJI occurring after primary THA and primary TKA/UKA, between 2011 and 2020 in a tertiary referral hospital. The standard preoperative prophylactic antibiotic for primary joint arthroplasty was cefuroxime and recommended second-line agent was clindamycin.

Failed Attempt to Recommend Noise Cancelling Headphones for Knee Arthroplasty Surgeons-Results of a Pilot Study.

: Noise exposure during total knee arthroplasty (TKA) has been demonstrated to exceed thresholds that are deemed as over-exposure by industry noise level standards. With orthopedic surgeons being at risk of suffering from Noise Induced Hearing Loss, the purpose of this pilot study was to evaluate the viability of the use of industry grade active noise cancelling headphones (ANCH) during TKA. In this prospective pilot study, 10 TKA were performed.

High Complication Rate and High Percentage of Regressing Radiolucency in Magnesium Screw Fixation in 18 Consecutive Patients.

(1) Background: Magnesium-based implants use has become a research focus in recent years. Radiolucent areas around inserted screws are still worrisome. The objective of this study was to investigate the first 18 patients treated using MAGNEZIX CS screws.

Midterm results of stemless impaction shoulder arthroplasty for primary osteoarthritis: a prospective, multicenter study.

Background: Stemless shoulder arthroplasty using 4 open-fin press-fit anchors has been showing promising short-term clinical and radiographic results for patients' primary osteoarthritis. This prospective, multicenter study presents 5-year postoperative clinical and radiological outcomes of a stemless shoulder arthroplasty for primary osteoarthritis.

Methods: Between November 2012 and December 2015, 100 patients were treated for primary osteoarthritis with the Sidus stem-free shoulder system at 7 European centers.

A propensity score-matched analysis on the impact of patient and surgical factors on early periprosthetic joint infection in minimally invasive anterolateral and transgluteal total hip arthroplasty.

Introduction: Increased risk of periprosthetic joint infection (PJI) in minimally invasive (MIS) total hip arthroplasty (THA) is still debated. This study aimed to identify differences in surgical and patient-related risk factors for PJI between an MIS anterolateral approach and transgluteal-modified Hardinge approach.

Methods: A retrospective cohort of 5315 THAs performed between 2006 and 2019 at a single institution was screened.

The Impact of Patient-Reported Penicillin or Cephalosporin Allergy on the Occurrence of the Periprosthetic Joint Infection in Primary Knee and Hip Arthroplasty.

Reducing the risk of periprosthetic joint infections (PJI) requires a multi-pronged strategy including usage of a prophylactic antibiotic. A history of penicillin or cephalosporin allergy often leads to a change in prophylactic antibiotic regimen to avoid serious side effects. The purpose of the present retrospective study was to determine incidence of PJI based on perioperative antibiotic regimen in total hip arthroplasty (THA), total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA).

Periprosthetic Femoral Fractures in Cementless Short Versus Straight Stem Total Hip Arthroplasty: A Propensity Score Matched Analysis.

Background: Recent studies indicate a decreased risk of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) for short compared to straight stems. However, the results are still inconclusive. Therefore, we retrospectively investigated the rate of PFFs within the first year between cementless short and straight stem THA.

The learning curve in robotic assisted knee arthroplasty is flattened by the presence of a surgeon experienced with robotic assisted surgery.

Purpose: The purpose of this study was to investigate the learning curve associated with robotic assisted knee arthroplasty (RAS KA). Therefore, the evaluation of the influence of an experienced surgeon on the overall team performance of three surgeons regarding the learning curve in RAS KA was investigated. It was hypothesized that the presence of an experienced surgeon flattens the learning curve and that there was no inflection point for the learning curve of the surgical team.

Minimally invasive Oxford medial unicompartmental knee replacement in patients 50 years of age or younger.

Introduction: The aim of the present study was to assess clinical outcome and mid-term survivorship of mobile-bearing unicompartmental knee arthroplasty in patients 50 years of age or younger.

Methods: This study reports the results of 119 patients (130 knees) following mobile-bearing medial UKA. Primary indication was advanced osteoarthritis or avascular necrosis of the femoral condyle.

Bioabsorbable implants in forefoot surgery: a review of materials, possibilities and disadvantages.

Bioabsorbable and biodegradable implants offer new possibilities in orthopaedic and trauma surgery. As soon as the initial stability of the degradable implants has reached the qualities of conventional materials, new devices may find usage in younger and more demanding patients. Residual conventional osteosynthetic material or the necessity to remove metal increasingly seems to be more of an adverse event than daily practice in forefoot surgery.

Cementless femoral stem revision in total hip arthroplasty: The periprosthetic clamshell fracture. A biomechanical investigation.

To biomechanically evaluate the stability of a diaphyseal anchored, cementless stem in presence of a proximal periprosthetic femoral medial wall defect compared to the stability of the same stem in an intact femur. Twenty-two paired human cadaveric femora were pairwise assigned either to a fracture group, featuring a proximal medial wall defect involving 40% of the stems medial anchorage distance, or a control group with native specimens. The specimens were tested under a monotonically increasing cyclic axial loading protocol.

Effects of Different Basal Cell Culture Media upon the Osteogenic Response of hMSCs Evaluated by Tc-HDP Labeling.

The osteogenic differentiation of mesenchymal stem cells is now a standard procedure in modern bone tissue engineering. As this is a promising field for future clinical applications, many cell culture media exist to promote osteogenic differentiation. Prior to differentiation, cells must be expanded to obtain sufficient numbers for experiments.

Short Term Radiological Outcome of Combined Femoral and Ilium Osteotomy in Pelvic Reconstruction of the Child.

Background and Objectives: Reconstruction of the pelvic joint is a common way to address developmental dysplasia of the hip (DDH), as well as neurogenic dislocation of the hip (NDH) and Legg−Calvé−Perthes disease (LCPD) in children. The purpose of this study was to analyze the short-term radiologic outcome after hip reconstructive surgery either treated with sole osteotomy of the femur or in combination with iliac osteotomy in patients with DDH, NDH and LCPD. Materials and Methods: X-rays of 73 children, aged 2−18 years, with DDH, NDH and LCPD after hip reconstructive surgery were measured retrospectively and compared to the preoperative x-rays concerning various parameters to define hip geometry.