International Orthopaedics

PURPOSE: Acute compartment syndrome (ACS) is an urgent, critical condition that requires immediate fasciotomy once diagnosed. Traditionally, fasciotomy of the forearms and lower leg involves one or two long approaches. Our previous study demonstrated that mini approaches fasciotomy was an effective method to treat ACS. This study is aimed at further evaluating the limb functions and complications of mini approaches combined with vacuum sealing drainage (VSD) for treating ACS caused by fractures in the forearms and lower legs...

PURPOSE: This study is aimed at determining the rates and predictors of re-operation and re-admission in children with septic arthritis treated at an institution without routine clinical practice guidelines. METHODS: This is a retrospective cohort study of patients less than 18 years old who underwent surgery for septic arthritis between January 1, 2009, and January 1, 2019, at a single tertiary-care paediatric institution. Uni- and multivariate analysis was performed to identify any risk factors associated with re-operation or unplanned visits to the emergency department after hospital admission compared to patients who had an uncomplicated post-operative course...

PURPOSE: Bone and joint infections are an important and increasing problem. Whether intraoperatively detected bacteria should be considered relevant or not is often difficult to assess. This retrospective cohort study analyzes the relevance of C. acnes cultured from deep intraoperative specimens. METHODS: All deep tissue samples collected intraoperatively between 2015 and 2020 from a quartiary care provider were evaluated for detection of C. acnes and its therapeutical consequences...

PURPOSE: MR arthrography (MRA) is the most accurate method for preoperatively diagnosing superior labrum anterior-posterior (SLAP) lesions, but diagnostic results can vary considerably due to factors such as experience. In this study, deep learning was used to facilitate the preliminary identification of SLAP lesions and compared with radiologists of different seniority. METHODS: MRA data from 636 patients were retrospectively collected, and all patients were classified as having/not having SLAP lesions according to shoulder arthroscopy...

PURPOSE: To determine the rate and time of return to duty following anterior cruciate ligament reconstruction (ACLR) in military members, and to determine whether their outcomes are influenced by patient characteristics or surgical parameters. METHODS: We prospectively assessed 280 military members that underwent ACLR. 27 were excluded due to multi-ligamentous injuries or revision surgery, two did not provide informed consent and 62 were lost to follow-up. Patient demographics, pre-injury physical workload, complications and whether/when patients resumed duty and sports were noted, as well as clinical outcomes at a minimum follow-up of one year, including Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee score (IKDC), Lysholm, and Tegner scale...

PURPOSE: This is a retrospective study and aims to investigate the clinical outcomes of patients with knee varus deformity and extruded medial meniscus who underwent arthroscopic meniscus centralization and medial opening wedge high tibial osteotomy. METHODS: A total of 24 patients were included in the trial, and arthroscopy intraoperative photographs and standing preoperative and postoperative radiographs were taken to analyze the mechanical tibiofemoral angle and tibial plateau inclination...

PURPOSE: Unlike periprosthetic femoral fractures, periprosthetic acetabular fractures during total hip arthroplasty (THA) have not been evaluated in detail. We prospectively evaluated the incidence, patterns, risk factors, and clinical outcomes of intraoperative periprosthetic acetabular fractures using pre- and postoperative computer tomography (CT). METHODS: In this prospective single-centre study, we evaluated 234 consecutive patients (250 hips) who underwent THA and three-dimensional CT before and after the surgery...

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PURPOSE: Operative approach in total hip arthroplasty (THA) has long been a topic of debate with each approach having unique benefits and disadvantages. One purported benefit of an anterior approach to THA is that it allows for intraoperative positioning using fluoroscopy rather than manual positioning. Proper positioning allows for improved outcomes including leg length discrepancy and acetabular component angle. This study aims to examine if operative approach and use of imaging in intraoperative positioning impact LLD and cup angle post-operatively...

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PURPOSE: The objective of the study was to compare the functional outcomes and the complication rate of the patients with C. acnes contamination at the end of the primary reverse shoulder arthroplasty (RSA) surgery to those patients without C. acnes contamination. METHOD: A total of 162 patients were included. In all cases, skin and deep tissue cultures were obtained. A molecular typing characterization of the C. acnes strains was performed. Functional outcomes were assessed with the Constant score at the two and five year follow-up and all complications were also recorded...

PURPOSE: Obstetric outcomes in women following pelvic injuries requiring surgical fixation is not thoroughly known. We aimed to evaluate if radiographic measurements (RMs) can be used to provide information on delivery methods outcome after these injuries, and to evaluate if metal work removal is required prior to delivery. METHOD: A retrospective study in a level 1 trauma centre of female patients with pelvic fractures treated operatively, aged 16-45 at the time of injury...

PURPOSE: There is a lack of studies investigating the distal tibial rotation (DTR) during medial opening wedge high tibial osteotomy (MOWHTO). This study was designed to evaluate osseous factors influencing DTR in patients who underwent biplane MOWHTO. METHODS: A total of 106 knee joints in 69 patients who underwent surgery for varus malalignment of knee were reviewed. Based on several software, standard and actual hinge positions were defined in pre-operative and post-operative CT data...

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PURPOSE: The present study aims to assess the impact of the local language on the view count of patient-oriented educational Sports Medicine videos in an Orthopaedic and Sports Medicine Hospital in the Middle East and North Africa. METHODS: An observational study on English and Arabic versions of Aspetar's YouTube channel patient-oriented educational video series was conducted in February 2023, comparing the view count and viewer characteristics. Included videos were posted either simultaneously or in English version first, in both languages, and shared on the same media platforms...

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PURPOSE: Individual factors of low rates of return to sport after anterior cruciate ligament (ACL) reconstruction were unclear. We evaluated the impact of various individual factors after ACL reconstruction for return to sport in athletes. METHODS: A prospective study was performed in 1274 athletes, who had undergone ACL autograft reconstruction. Individual factors survey about return to sport was performed during the second year after surgery. Athlete responses were analyzed with a multivariate logistic model adjusted for baseline patient characteristics and an adjusted Cox model...

PURPOSE: In this study, we evaluated the possibility of precise intraoperative localization of the lateral genicular arteries by an orthopaedic surgeon using the transillumination method. METHODS: Twelve patients underwent cemented TKA with patella-friendly Zimmer Biomet NexGen Legacy Posterior Stabilized prostheses (without patellar resurfacing), seven right knees and five left knees. The mean age of patients in the study group was 66.636 ± 7.003 years. The minimal follow-up period was 13 months (mean-16...

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