Archives of Orthopaedic and Trauma Surgery

INTRODUCTION: Arthrodesis of the tibiotalar and subtalar joints is a salvage procedure that has been used successfully for years. Treatment options include internal procedures and external procedures. Retrograde intramedullary nailing is considered a safe procedure with a high degree of stability and comfort. Nevertheless, there are cases in which this internal arthrodesis fails and another procedure must be considered. Ilizarov fixator treatment could be a solution for those patients in whom intramedullary nailing has failed...

INTRODUCTION: The older generation of high thickness metal-backed glenoid prostheses had a high failure rate. The goal of our study was to analyze the medium-term clinical and radiological results of a technically modified generation of metal backed glenoids with 35% decrease in thickness. METHODS: Thirty-nine patients (43 shoulders) with a mean age of 66.5 years at surgery were examined from two to ten years (mean 71.2 months) using the Constant-Score, Subjective Shoulder Value and X-ray in a...

INTRODUCTION: Knee osteoarthritis is a prevalent condition frequently necessitating knee replacement surgery, with demand projected to rise substantially. Partial knee arthroplasty (PKA) offers advantages over total knee arthroplasty (TKA), yet its utilisation remains low despite guidance recommending consideration alongside TKA in shared decision making. Radiographic decision aids exist but are underutilised due to clinician time constraints. MATERIALS AND METHODS: This research develops a novel radiographic artificial intelligence (AI) tool using a dataset of knee radiographs and a panel of expert orthopaedic surgeons' assessments...

INTRODUCTION: The combination of anterior large glenoid rim fractures (GRF) and proximal humerus fractures (PHF) is rare, with limited data available on specific treatments for these glenohumeral combination fractures (GCF). This study aimed to evaluate the treatment approaches for GCF, analyze patient outcomes, and outline surgical management strategies for different fracture types. MATERIALS AND METHODS: This retrospective study included patients with GCF, excluding those with fossa glenoidalis fractures, isolated greater tuberosity fractures, or small glenoid rim fractures (< 5 mm)...

Anterior approaches to the acetabulum can be distinguished into extrapelvic, intrapelvic and combined extrapelvic and intrapelvic approaches. Historically, the extrapelvic ilioinguinal approach was introduced in the French, English and German literature during the late 60s and became gradually the Gold-standard in treating anterior acetabular fractures. In the meantime, the intrapelvic approach, introduced by the Helsinki group, is favored by many surgeons with ongoing interest allowing direct antero-medial access to the true pelvis below the linea terminalis, to the quadrilateral plate and medial side of the posterior column...

No abstract text is available yet for this article.

PURPOSE: Periprosthetic loosening is a major complication after total hip and knee arthroplasty. Early and accurate diagnosis is essential to choose the right therapeutic path and to avoid further complications. The aim of the study was to evaluate the diagnostic performance of 68 Gallium-Zoledronate ([68 Ga]Ga-DOTAZol ) PET/CT in detecting periprosthetic loosening in total hip (THA) and total knee arthroplasty (TKA). METHODS: This retrospective study included 26 patients with painful prosthesis (THA n = 17; TKA n = 16) and clinical suspicion of periprosthetic loosening, but without a confirmed diagnosis...

Femoral head fractures are rare, which limits the experience of individual surgeons with these injuries. This overview examines historical data, injury mechanisms, and classification systems, as well as epidemiological data from larger patient cohorts. Significant controversies persist regarding the optimal surgical approach and fracture-type-specific treatment for Pipkin fractures. The literature is often inconsistent, as many studies fail to differentiate between specific fracture types and instead report aggregated results, leading to ambiguous conclusions about the most effective treatment strategies...

Acetabular fractures are prognostic relevant fractures in terms of function and daily activities. Open reduction and internal fixation (ORIF) is still the gold-standard in treating these injuries. Over recent years, several reports are dealing with outcome evaluations but have the main disadvantage of combining several fracture types., Thus, it remains unclear to discuss a fracture-based prognosis. This analysis evaluated fracture-type specific results in terms of clinical and radiological outcome. Analyzing elementary fracture types, pure transverse and isolated posterior column fractures are associated with relevant functional impairments...

BACKGROUND: Total hip arthroplasty (THA) using a portable navigation system (PNS) incurs costs per procedure. However, it does not require a large console. This study aimed to compare the accuracy of acetabular cup placement using a pelvic alignment guide (PAG) attached to the pelvis and an accelerometer-based PNS in THA performed in the lateral decubitus position. METHODS: We retrospectively analyzed 100 hips that underwent primary THA in the lateral decubitus position between July 2018 and January 2021...

INTRODUCTION: Many patients who have undergone a periacetabular osteotomy (PAO) for developmental dysplasia of the hip (DDH) have had jobs preoperatively. Postoperative return to work and work productivity are important for livelihood security and the social economy. However, there is a lack of evidence on work productivity after PAOs. Therefore, this study investigated the return to work rates and influence of workload, clinical, and radiographic parameters on work productivity after a curved PAO...

PURPOSE: Although arthroscopic repair of the anterior talofibular ligament (ATFL) is widely performed, the effect of posterior talofibular ligament (PTFL) injury on clinical outcomes remains unclear. This study aimed to evaluate the magnetic resonance imaging (MRI) findings of the PTFL in chronic lateral ankle instability (CLAI) and determine whether the presence or absence of PTFL injury affected the postoperative outcomes of arthroscopic ATFL repair. MATERIALS AND METHODS: Forty ankles of 35 patients who underwent arthroscopic repair for CLAI were included in this study as the experimental group, together with 25 ankles of 24 patients without CLAI as the control group...

INTRODUCTION: Duloxetine as an adjunct analgesic has shown effective results in trials of patients undergoing total knee arthroplasty (TKA). However, the regimen has not been standardized. We, therefore, evaluated the analgesic efficacy of low-dose duloxetine after TKA. MATERIALS AND METHODS: We conducted a double-blind, randomized controlled trial of patients undergoing unilateral primary TKA, comparing 30 mg/d of duloxetine for 6 weeks as an additive medication for pain control to modern multimodal analgesia after TKA...

INTRODUCTION: We aimed to investigate the anatomical and clinical advantages of an Asian-specific femoral component design with a high femoral aspect ratio, compared with the conventional femoral component design. MATERIALS AND METHODS: A retrospective analysis of the operation and outpatient clinic records of 239 knees operated on using an anatomically modified femoral component design (MFCD, Group A) and 153 knees operated on using a conventional femoral component design (CFCD, Group B) in Korean patients was performed...

INTRODUCTION: X-rays are regularly performed after primary total knee arthroplasty (TKA). While soft tissue management and ligament tension cannot be evaluated, important information, such as inadequate component positioning and loose cement location, as well as subsequent loosening, can be detected. The aim of this study was to correlate radiological findings, referring to the radiological grading system (previously published by the same study group, henceforth abbreviated as "RGS"), with long-term outcomes and implant survival...

INTRODUCTION: A high-energy trauma impact is generally considered the crucial factor causing native hip dislocation. However, femoroacetabular variations are assumed to contribute to low-energy posterior hip dislocations, especially in adolescent athletes. The study aimed to analyze the femoroacetabular morphology of adults who sustained traumatic posterior hip dislocations, comparing high-energy, sports-related, and low-energy trauma mechanisms. MATERIALS AND METHODS: One hundred forty-one patients with traumatic posterior hip dislocations were analyzed and matched to a control group of 141 patients with high-energy trauma mechanisms without hip or pelvic injury, matched for age, gender, and Body Mass Index (BMI)...

BACKGROUND: The European Foot and Ankle Score EFAS and the Self-reported Foot and Ankle Score SEFAS are two Patient Reported Outcome Measures (PROMs) used in foot and ankle surgery. The EFAS has been published in recent years, while the SEFAS is a validated questionnaire based on the New Zealand total ankle questionnaire. METHODS: We compared the EFAS to the SEFAS, Short Form 36 (SF-36) and Numeric Rating Scale (NRS) regarding reliability and validity based on the results of 126 patients undergoing foot and ankle surgery in a single center...

No abstract text is available yet for this article.

INTRODUCTION: Amongst low- to middle income countries (LMIC), outdated and poorly documented orthopedic interventions may pose patients at risk for complications, serious adverse events (SAE) and unsatisfactory results, contradicting the World Health Organization's (WHO) Safe Surgery mandates. Use cases of conditions managed inadequately in LMIC environments are necessary to increase awareness of stakeholders and overcome deficiencies in collaboration with high-income countries (HIC)...

PURPOSE: To systematically review the literature on the outcomes of above knee amputation as a salvage procedure after periprosthetic joint infection in total knee arthroplasty. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Medline, Scopus, Web of Science, and Embase electronic databases were utilized to identify all studies evaluating clinical outcomes of patients with above knee amputation following PJI from inception to June 24, 2023...