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ORTHOPEDICS AND TRAUMATOLOGY (150 journals)                     

Showing 1 - 152 of 152 Journals sorted alphabetically
Acta Orthopaedica     Open Access   (Followers: 32)
Advances in Orthopedics     Open Access   (Followers: 9)
American Journal of Orthodontics and Dentofacial Orthopedics     Hybrid Journal   (Followers: 9)
American Journal of Orthopedics     Partially Free   (Followers: 3)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 9)
Archives of Osteoporosis     Hybrid Journal   (Followers: 1)
Arthritis und Rheuma     Hybrid Journal  
Arthroplasty Today     Open Access   (Followers: 1)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 5)
BMC Musculoskeletal Disorders     Open Access   (Followers: 29)
Bone & Joint 360     Full-text available via subscription   (Followers: 18)
Bone Research     Hybrid Journal   (Followers: 2)
Burns & Trauma     Open Access   (Followers: 11)
Cartilage     Hybrid Journal   (Followers: 5)
Case Reports in Orthopedic Research     Open Access  
Case Reports in Orthopedics     Open Access   (Followers: 6)
Chinese Journal of Traumatology     Open Access  
Cleft Palate-Craniofacial Journal     Hybrid Journal   (Followers: 8)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3)
Clinical Orthopaedics and Related Research     Hybrid Journal   (Followers: 78)
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Concussion     Open Access  
Craniomaxillofacial Trauma and Reconstruction     Hybrid Journal   (Followers: 1)
Current Orthopaedic Practice     Hybrid Journal   (Followers: 14)
Current Reviews in Musculoskeletal Medicine     Open Access   (Followers: 13)
Der Orthopäde     Hybrid Journal   (Followers: 6)
Die Wirbelsäule     Hybrid Journal  
Duke Orthopedic Journal     Open Access   (Followers: 5)
East African Orthopaedic Journal     Full-text available via subscription  
EFORT Open Reviews     Open Access   (Followers: 1)
Egyptian Orthopaedic Journal     Open Access   (Followers: 1)
EMC - Técnicas Quirúrgicas - Ortopedia y Traumatología     Full-text available via subscription  
EMC - Tecniche Chirurgiche - Chirurgia Ortopedica     Full-text available via subscription  
Ergonomics     Hybrid Journal   (Followers: 22)
European Journal of Orthopaedic Surgery & Traumatology     Hybrid Journal   (Followers: 9)
European Journal of Podiatry / Revista Europea de Podología     Open Access   (Followers: 1)
European Spine Journal     Hybrid Journal   (Followers: 24)
Foot & Ankle International     Hybrid Journal   (Followers: 10)
Foot & Ankle Orthopaedics     Open Access   (Followers: 3)
Gait & Posture     Hybrid Journal   (Followers: 17)
Geriatric Orthopaedic Surgery Rehabilitation     Open Access   (Followers: 5)
Global Spine Journal     Open Access   (Followers: 12)
Hip International     Hybrid Journal  
Indian Journal of Orthopaedics     Open Access   (Followers: 8)
Informationen aus Orthodontie & Kieferorthopädie     Hybrid Journal  
Injury     Hybrid Journal   (Followers: 20)
International Journal of Orthopaedic and Trauma Nursing     Hybrid Journal   (Followers: 11)
International Journal of Orthopaedic Surgery     Open Access   (Followers: 5)
International Journal of Orthopaedics     Open Access   (Followers: 2)
International Journal of Research in Orthopaedics     Open Access  
International Musculoskeletal Medicine     Hybrid Journal   (Followers: 7)
International Orthopaedics     Hybrid Journal   (Followers: 18)
JAAOS : Global Research & Reviews     Open Access   (Followers: 1)
JBJS Journal of Orthopaedics for Physician Assistants     Hybrid Journal  
JBJS Reviews     Full-text available via subscription   (Followers: 11)
JOR Spine     Open Access   (Followers: 3)
Journal de Traumatologie du Sport     Full-text available via subscription   (Followers: 2)
Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen     Hybrid Journal  
Journal of Bone and Joint Diseases     Open Access   (Followers: 4)
Journal of Bone and Joint Infection     Open Access   (Followers: 1)
Journal of Brachial Plexus and Peripheral Nerve Injury     Open Access   (Followers: 4)
Journal of Cachexia, Sarcopenia and Muscle     Open Access   (Followers: 2)
Journal of Children's Orthopaedics     Open Access   (Followers: 10)
Journal of Clinical Orthopaedics and Trauma     Hybrid Journal   (Followers: 5)
Journal of Experimental Orthopaedics     Open Access   (Followers: 8)
Journal of Hand Surgery (European Volume)     Hybrid Journal   (Followers: 44)
Journal of Head Trauma Rehabilitation     Hybrid Journal   (Followers: 17)
Journal of Musculoskeletal Research     Hybrid Journal   (Followers: 9)
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal  
Journal of Orthodontic Science     Open Access   (Followers: 2)
Journal of Orthopaedic & Sports Physical Therapy     Full-text available via subscription   (Followers: 70)
Journal of Orthopaedic Association of South Indian States     Open Access   (Followers: 5)
Journal of Orthopaedic Diseases and Traumatology     Open Access   (Followers: 5)
Journal of Orthopaedic Reports     Full-text available via subscription   (Followers: 12)
Journal of Orthopaedic Research     Hybrid Journal   (Followers: 29)
Journal of Orthopaedic Science     Hybrid Journal   (Followers: 4)
Journal of Orthopaedic Surgery     Open Access   (Followers: 1)
Journal of Orthopaedic Surgery and Research     Open Access   (Followers: 8)
Journal of Orthopaedic Translation     Open Access  
Journal of Orthopaedic Trauma     Hybrid Journal   (Followers: 15)
Journal of Orthopaedics     Full-text available via subscription   (Followers: 3)
Journal of Orthopaedics and Allied Sciences     Open Access   (Followers: 9)
Journal of Orthopaedics and Spine     Open Access   (Followers: 3)
Journal of Orthopaedics and Traumatology     Open Access   (Followers: 16)
Journal of Orthopaedics, Trauma and Rehabilitation     Open Access   (Followers: 6)
Journal of Orthopedics & Rheumatology     Open Access  
Journal of Orthopedics, Traumatology and Rehabilitation     Open Access   (Followers: 6)
Journal of Pediatric Orthopaedics     Hybrid Journal   (Followers: 15)
Journal of Prosthetics and Orthotics     Hybrid Journal   (Followers: 14)
Journal of Scleroderma and Related Disorders     Hybrid Journal  
Journal of the American Academy of Orthopaedic Surgeons     Hybrid Journal   (Followers: 12)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 8)
Journal of Traumatic Stress     Hybrid Journal   (Followers: 25)
Knee Surgery, Sports Traumatology, Arthroscopy     Hybrid Journal   (Followers: 27)
Multiple Sclerosis and Related Disorders     Hybrid Journal   (Followers: 8)
Musculoskeletal Care     Hybrid Journal   (Followers: 19)
Musculoskeletal Science and Practice     Hybrid Journal   (Followers: 3)
Nigerian Journal of Orthopaedics and Trauma     Open Access  
North American Spine Society Journal (NASSJ)     Open Access   (Followers: 3)
OA Orthopaedics     Open Access   (Followers: 7)
Obere Extremität     Hybrid Journal   (Followers: 1)
Open Journal of Orthopedics     Open Access   (Followers: 3)
Open Journal of Orthopedics and Rheumatology     Open Access  
Open Journal of Trauma     Open Access  
Open Orthopaedics Journal     Open Access  
Operative Orthopädie und Traumatologie     Hybrid Journal  
Operative Techniques in Orthopaedics     Full-text available via subscription   (Followers: 6)
Orthopädie & Rheuma     Full-text available via subscription  
Orthopädie und Unfallchirurgie up2date     Hybrid Journal  
Orthopaedic Journal of Sports Medicine     Open Access   (Followers: 14)
Orthopaedic Nursing     Hybrid Journal   (Followers: 11)
Orthopaedic Proceedings     Partially Free  
Orthopaedic Surgery     Open Access   (Followers: 1)
Orthopaedics & Traumatology: Surgery & Research     Full-text available via subscription   (Followers: 6)
Orthopaedics and Trauma     Full-text available via subscription   (Followers: 28)
Orthopedic Clinics of North America     Full-text available via subscription   (Followers: 5)
Orthopedic Research and Reviews     Open Access   (Followers: 6)
Orthopedic Reviews     Open Access   (Followers: 7)
Orthopedics     Full-text available via subscription   (Followers: 6)
Orthoplastic Surgery     Open Access  
Osteoarthritis and Cartilage     Full-text available via subscription   (Followers: 20)
Osteoarthritis and Cartilage Open     Open Access  
Osteologie     Hybrid Journal  
Osteoporosis and Sarcopenia     Open Access  
OTA International     Open Access  
Paediatric Orthopaedics and Related Sciences     Open Access   (Followers: 3)
Pain Management in General Practice     Full-text available via subscription   (Followers: 12)
Prosthetics and Orthotics International     Hybrid Journal   (Followers: 8)
Revista Brasileira de Ortopedia     Hybrid Journal  
Revista Chilena de Ortopedia y Traumatología / Chilean Journal of Orthopaedics and Traumatology     Open Access  
Revista Colombiana de Ortopedia y Traumatología     Full-text available via subscription  
Revista Cubana de Ortopedia y Traumatologí­a     Open Access  
Revista de la Asociación Argentina de Ortopedia y Traumatología     Open Access  
Revista Española de Cirugía Ortopédica y Traumatología     Full-text available via subscription   (Followers: 1)
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revue de Chirurgie Orthopédique et Traumatologique     Full-text available via subscription   (Followers: 3)
Romanian Journal of Orthopaedic Surgery and Traumatology     Open Access  
SA Orthopaedic Journal     Open Access   (Followers: 2)
SICOT-J     Open Access   (Followers: 1)
Spine     Hybrid Journal   (Followers: 73)
Spine Journal     Hybrid Journal   (Followers: 26)
Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology     Full-text available via subscription   (Followers: 3)
Strategies in Trauma and Limb Reconstruction     Open Access   (Followers: 1)
Techniques in Orthopaedics     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 5)
Trauma     Hybrid Journal   (Followers: 5)
Trauma (Travma)     Open Access  
Trauma und Berufskrankheit     Hybrid Journal  
Traumatology     Full-text available via subscription   (Followers: 1)
Traumatology and Orthopedics of Russia     Open Access  
Zeitschrift für Orthopädie und Unfallchirurgie     Hybrid Journal   (Followers: 2)
Ортопедия, травматология и протезирование     Open Access  


Similar Journals
Journal Cover
Advances in Orthopedics
Journal Prestige (SJR): 0.922
Citation Impact (citeScore): 2
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2090-3464 - ISSN (Online) 2090-3472
Published by Hindawi Homepage  [339 journals]
  • Opioid Sparing Analgesics in Spine Surgery

    • Abstract: Combinations of various nonopioid analgesics have been used to decrease pain and opioid consumption postoperatively allowing for faster recovery, improved patient satisfaction, and decreased morbidity. These opioid alternatives include acetaminophen, NSAIDs, COX-2 specific inhibitors, gabapentinoids, local anesthetics, dexamethasone, and ketamine. Each of these drugs presents its own advantages and disadvantages which can make it difficult to implement universally. In addition, ambiguous administration guidelines for these nonopioid analgesics lead to a difficult implementation of standardization protocols in spine surgery. A focus on the efficacy of different pain modalities specifically within spine surgery was implemented to assist with this standardized protocol endeavor and to educate surgeons on limiting opioid prescribing in the postoperative period. The purpose of this review article is to investigate the various opioid sparing medications that have been used to decrease morbidity in spine surgery and better assist surgeons in managing postoperative pain. Methods. A narrative review of published literature was conducted using the search function in Google scholar and PubMed was used to narrow down search criteria. The keywords “analgesics,” “spine,” and “pain” were used.
      PubDate: Sat, 30 Jul 2022 06:35:02 +000
  • Femoral Head Coverage Assessment in Healthy Children Younger than 6 Years

    • Abstract: Introduction. Developmental dysplasia of the hip (DDH) is one of the commonest hip joint pathologies in children; to treat it properly, hip surgeons should know the normal femoral head (FH) coverage by the acetabulum. This paper aims to assess the femoral head coverage in healthy children younger than 6 years. Methods. 270 hip joint CT scans were selected, and digital pelvic models were created according to these scans. FH coverage by the five acetabular regions was assessed according to patient’s age and sex. Results. Normal reference values of FH coverage by different acetabular regions were obtained. It was found that the growth process of different acetabular regions occurs nonlinearly with the periods of acceleration. Anterior and superior-anterior acetabular regions grow more intensively in boys up to 3 years old and between 4 and 5 years old both in boys and girls; superior-posterior, posterior-superior, and posterior-inferior acetabular regions grow more intensively in boys and girls up to 3 years old and between 4 and 5 years old (). The following sex differences in FH coverage by the acetabulum were found: more superior-anterior FH coverage was found in boys and posterior FH coverage in girls ().
      PubDate: Fri, 22 Jul 2022 07:05:02 +000
  • The Feasibility of Using the Direct Anterior Approach for Total Hip
           Arthroplasty or Bipolar Hemiarthroplasty to Treat Femoral Neck Fractures
           among the Elderly

    • Abstract: Purpose. Femoral neck fractures (FNFs) are a significant cause of mortality and disability among the elderly. Total hip arthroplasty (THA) is the preferred treatment method in active, cognitively intact patients. In less active or cognitively impaired patients, bipolar hemiarthroplasty (BHA) is the practical option in Japan. Even with the direct anterior approach (DAA), clinical concerns about conducting THA in elderly patients include possible dislocations, critical complications, and medical cost-effectiveness. This study is aimed at rethinking the practical surgical indications for FNFs. Methods. Between April 2019 and March 2021, BHA patients with displaced FNF (n = 21) performed through the DAA were compared with THA patients with displaced FNF (n = 19). The perioperative complications, clinical and radiologic outcomes, and mortality were compared between groups retrospectively at six months. Results. THA patients had an increased average operation time (103.3 min vs. 89.1 min, ) and similar amounts of bleeding (183.16 ml. vs. 121.1 ml.). The percentages of patients who received biological transfusion showed no difference, with low rates of perioperative complications (4% vs. 0%) and similar mortality rates compared to BHA patients. One THA patient experienced posterior dislocation during a state of postoperative delirium. Conclusion. THA through the DAA might be a credible and safe option for FNF patients, with excellent functional outcomes and fewer surgery-related complications. Early posterior dislocation might be related to optimized offset distance and not related to leg discrepancy or other radiographic items. Hence, orthopedic surgeons should reconsider their options before conducting BPH for elderly and cognitively intact FNF patients.
      PubDate: Wed, 20 Jul 2022 09:35:01 +000
  • Total Knee Arthroplasty, All-in-One versus Four-in-One Femoral Cutting Jig
           System: A Comparison Study

    • Abstract: Background. Total knee arthroplasty (TKA) is often indicated for end-stage knee osteoarthritis management. The posterior-stabilized (PS) implant is one of the TKA implants with various component designs, including femoral component cutting jigs. However, little is known about how the differences in cutting jig designs affect the outcomes. This study aims to compare the radiographic and functional outcomes of the patients who underwent cemented TKA using all-in-one and four-in-one femoral component PS implants. Methods. A retrospective comparative study assessed patients who underwent cemented TKA using PS implants from 2018 to 2019. The patients were divided into all-in-one and four-in-one groups. Demographic data, surgery duration, postoperative radiological findings after one week, and functional outcomes after two years were collected and compared. Results. A total of 96 patients were included in the study, 55 patients were in all-in-one sample, and 41 patients were in four-in-one sample. The majority of the patients in both groups were female, aged>60 years old, overweight (BMI ≥ 25), and presented with an ASA score of II. We found significantly shorter surgery duration in the all-in-one group compared to the four-in-one group (128.00 ± 36.24 vs. 210.61 ± 57.54, ). The four-in-one group and the all-in-one group showed the insignificant difference in α, β, δ, and γ angles (, 0.273, 0.594, and 0.818). The functional outcomes (SF-12, KSS, and KOOS) showed insignificant differences. Conclusion. There is no differentiation for the postsurgery functional and radiological outcomes between all-in-one and four-in-one implants.
      PubDate: Mon, 11 Jul 2022 11:35:03 +000
  • Microbiological Profile and Drug Resistance Analysis of Postoperative
           Infections following Orthopedic Surgery: A 5-Year Retrospective Review

    • Abstract: Background. The distribution of postoperative orthopedic infection and their susceptibility pattern to antibiotics vary regionally and change over time. The incidence of methicillin-resistant Staphylococcus aureus infection is rising worldwide. Therefore, knowledge of the frequency of the causative microorganisms and their susceptibility to antibiotics are necessary for an improved therapeutic outcome. This study aims to study the frequency and distribution of postoperative orthopedic infection and their resistance pattern to antibiotics. Methods. The study utilized a retrospective design that took place over a period of 5 years from 2016 and 2020 at a tertiary care hospital. The bacterial culture testing was performed by a recommended method. Descriptive statistics were used to analyze the data. Results. A total of 158 patients (100 males and 58 females) with positive cultures of postoperative orthopedic infection were included. The most common infective organism was Staphylococcus aureus, 64 patients (38.1%); coagulase-negative staphylococci, 40 patients (23.8%); Klebsiella species, 14 patients (8.3%); and Enterococcus species, Escherichia coli, and Pseudomonas aeruginosa in 10 patients (6%). Data also showed that gram-positive bacteria were detected in 118 patients (70.8%), while gram-negative microorganisms were found in 50 patients (29.8%). Among Staphylococcus aureus, 79.7% were MRSA, and vancomycin was the most effective antibiotic in staphylococcus infections. The antibiotics with the greatest sensitivity to gram-positive bacteria were vancomycin, linezolid, tigecycline, moxifloxacin, and nitrofurantoin, while the antibiotics for gram-negative bacteria with greater sensitivity were tigecycline, amikacin, ertapenem, imipenem, and cefotaxime. Conclusion. Staphylococcus aureus is the most common postoperative orthopedic infection, which was predominantly MRSA with vancomycin being the most effective antibiotic. In addition, the results showed a high resistance pattern to the commonly used antibiotics, leaving few choices. Antibiotic agents should be carefully selected according to specific drug sensitivity through routine monitoring of drug resistance patterns and to help formulate hospital antibiotic policy.
      PubDate: Mon, 04 Jul 2022 10:50:04 +000
  • The Health-Related Quality of Life of Patients Waiting for Anterior
           Cruciate Ligament Reconstruction Is Worse Than an Age- and Sex-Matched
           Population: Increasing Time on Waiting List for Surgery Was Independently
           Associated with a Worse Quality of Life

    • Abstract: Background. The aims of this study were to assess the health-related quality of life (HRQoL) of patients awaiting anterior cruciate ligament (ACL) reconstruction compared to the population at risk: whether knee-specific function was predictive of HRQoL and to identify factors associated with a worse HRQoL. Methods. Sixty-seven patients (male, n = 50; female, n = 17; mean age, 29) identified from the surgical waiting list completed a questionnaire that included demographics, BMI, time of injury, EuroQol 5-dimension (EQ-5D), Short-Form (SF-36), and International Knee Documentation Committee (IKDC) scores. Age- and sex-matched HRQoL data were obtained from population level data. Results. The mean EQ-5D score for the study cohort was significantly worse than the matched score (difference, 0.367; ), and the same trend was observed for all eight dimensions of the SF-36 score. Thirty-three (49%) patients felt their health, in general, was somewhat or much worse compared to one year ago. There was a correlation between IKDC and EQ-5D scores (r = 0.540, ). Linear regression was used to formulate the EQ-5D score: EQ-5D = (IKDCx0.013)–0.015 (constant). The SF-36 physical component and length of time on the waiting list were independently associated with the HRQoL, with each 14-point drop or for every 200 days, a clinically significant deterioration in patients’ HRQoL occurred, respectively. Conclusions. Patients had a significantly worse HRQoL when compared to the age- and sex-matched population, which deteriorates with worsening physical function and increasing length of time on the waiting list. The knee-specific IKDC correlated with HRQoL and could be used to estimate the EQ-5D score.
      PubDate: Fri, 24 Jun 2022 09:50:01 +000
  • A Bibliometric Analysis of the 50 Most Commonly Cited Studies of the
           Direct Anterior Approach in Total Hip Arthroplasty

    • Abstract: Introduction. The direct anterior approach (DAA) has garnered a lot of attention and surgical popularity for total hip arthroplasty in recent years. Some of the postulated advantages for the increase in popularity of this approach include better pain control and earlier recovery in the immediate postoperative period. The amount of literature available on this topic has rapidly increased over the last 10 years requiring the need for an updated guide to best navigate the topic. Methods. The ISI Web of Knowledge database was used to search for research articles regarding the DAA surgical technique. The Boolean operative that yielded the largest search results was ([direct anterior approach hip] OR [anterior hip] OR [anterior hip arthroplasty] NOT [spine]). Results. 92% of the highest cited articles on the DAA were published within the past two decades. One author, Keggi K, published 4 or more articles, with the highest citation average (110.5 citations). Recent articles were more strongly correlated with higher citation counts (R2 = 0.21 . 0.19). Conclusion. This review clearly outlines the increasing trend in the most influential publications regarding DAA being published in the past two decades. This review allows interested surgeons to understand the historic literature pertaining to this topic. This review can assist future researchers in identifying trends in UKA as well as help clinicians navigate this body of literature.
      PubDate: Fri, 17 Jun 2022 09:35:02 +000
  • The Role of Virtual Clinics in Postoperative Total Knee Replacement
           Surgery Follow-Up during COVID-19 Pandemic

    • Abstract: Background. The purpose of this study was to evaluate the feasibility of the virtual clinic for outpatient follow-up care after TKR surgery. Methods. A total of 546 TKR surgeries were performed from January 2017 to December 2019. 30 patients were not able to go the hospital for routine follow-up. The data collections were taken for age, gender, year of surgery, functional score (Oxford Knee Score (OKS)), and active range of motion (ROM). The virtual clinic was conducted with the physician assistant and the operating surgeon via WhatsApp video call (WhatsApp Inc., Mountain View, California, USA) or Zoom (Zoom Video Communications, Inc., San Jose, California, USA). Result. The average follow-up period was 39.1 months. The earliest follow-up was 20 months, while the longest follow-up was 97 months. The average OKS score was 45. The average consultation time for the virtual clinic is 9 minutes 21 seconds. Most of the patients were satisfied with the online consultation, with only two patients having a satisfaction score below 80%. Conclusion. The virtual clinic for TKR surgery showed a high satisfaction rate during the COVID-19 pandemic, which has the potential to extend to the postpandemic era.
      PubDate: Thu, 16 Jun 2022 10:05:02 +000
  • Caregivers’ Knowledge, Attitude, and Practice towards Pressure Injuries
           in Spinal Cord Injury at Rehabilitation Center in Bangladesh

    • Abstract: The purpose of this study was to determine caregivers’ knowledge, attitude, and practice (KAP) on the prevention and care of pressure injuries (PIs) in individuals with spinal cord injury. A quantitative cross-sectional study with descriptive correlation design was used to implement a modified semistructured questionnaire using a convenient sampling method. McDonald’s standard of learning outcome measurement criteria was used to categorize caregivers’ KAP. A Pearson product-moment correlation coefficient (r) was utilized to assess the relationships between caregivers’ KAP, with a value of 0.05 or less considered statistically significant. The study findings indicate that caregivers had a moderate level of knowledge (M = 73.68%, SD = 6.43), a neutral attitude (M = 70.32%, SD = 6.89), and a moderate level of practice (M = 74.77%, SD = 9.08). A positive correlation existed between caregivers’ knowledge and attitude (r = 0.30, ), as well as between knowledge and practice (r = 0.37, ). Nevertheless, there was no correlation between attitude and practice (r = 0.12, ). The study findings suggest that caregivers need to develop a positive attitude and expand their knowledge in order to improve their practice. The KAP factors that require higher priority were positioning and turning the patient, preventing skin breakdown, assessing weight changes over time, interest in patient care, additional care for PIs, frequently changing the individual’s position, priority to PI care, interest in other types of care other than PIs, using special cushions, consulting doctors on a regular basis, being aware of clothing and fabrics, proper transfer technique, pressure relief, and skin inspection, among others.
      PubDate: Tue, 14 Jun 2022 11:35:02 +000
  • 3D-Printed Models versus CT Scan and X-Rays Imaging in the Diagnostic
           Evaluation of Proximal Humerus Fractures: A Triple-Blind Interobserver
           Reliability Comparison Study

    • Abstract: Background. Proximal humerus fractures (PHFs) are one of the most frequent fractures in the elderly and are the third most fractures after those of the hip and wrist. PHFs are assessed clinically through conventionally standard imaging (X-ray and computed tomography (CT) scans). The present study aims to conduct the diagnostic evaluation and therapeutic efficacy of the 3D-printed models (3DPMs) for the PHFs, compared with the standard imaging. Objectives. In terms of fracture classification and surgical indication, PHFs have poor interobserver agreement between orthopedic surgeons using traditional imaging such as X-rays and CT scan. Our objective is to compare interobserver reliability in diagnostic evaluation of PHFs using 3DPMs compared to traditional imaging. Methods. The inclusion criteria were elders aged >65 years, fracture classification AO/OTA 11 B and 11 C, and no pathological fractures or polytrauma. In addition, 9 PHFs were assessed by 6 evaluators through a questionnaire and double-blinded administered for each imaging (X-ray and CT scan) and 3DPMs for each fracture. The questionnaire for each method regarded Neer classification, Hertel classification, treatment indication (IT), and surgical technique (ST). Interobserver reliability was calculated through the intraclass correlation coefficient (ICC). Results. Nine patients with PHF were included in the study (66% female). The Neer and Hertel classifications between imaging types had similar ICC values between raters with no statistical differences. IT reliability using CT scan and 3DPMs (ICC = 1; ) assessed better agreement compared with X-rays IT. The ST reliability using 3DPMs (ICC = 0.755; ) was statistically superior to traditional imaging (ST-RX ICC = -0.004 (); ST-CT ICC = 0.429 ).Conclusion. Classification systems like Neer and Hertel offer poor reliability between operators. The 3DPMs for evaluating diagnostics are comparable to CT images but superior to the surgical technique agreement. The application of 3DPMs is effective for preoperative fracture planning and the modeling of patient-specific hardware.
      PubDate: Mon, 13 Jun 2022 08:35:02 +000
  • Efficacy of Red Cell Salvage Systems in Open Acetabular Surgery

    • Abstract: Over the past 50 years, treatment of displaced acetabular fractures has moved away from conservative treatment with bedrest to operative intervention to achieve anatomic reduction, stable fixation, and allow early range of motion of the hip. However, operative fixation is not without complications. Internal fixation of traumatic acetabular fractures has been coupled with large volume of blood loss both at the time of injury and surgery. This often results in the need for allogenic blood products, which has been linked to increase morbidity (Vamvakas and Blajchman, 2009). In an attempt to avoid the risk associated with allogenic blood transfusion numerous techniques and methods have been devised. Red blood cell salvage (CS) is an intraoperative blood salvage tool where blood is harvested from the operative field. It is washed to remove the plasma, white blood cells, and platelets. The red cells are resuspended in a crystalloid solution. If the hematocrit of the resuspended red blood cells is sufficient, it is transfused to the patient intravenously. The benefits of CS in major spine surgery, bilateral knee replacement, and revision hip surgery are well established (Goulet et al. 1989, Gee et al. 2011, Canan et al. 2013). However, literature reviewing the use of cell saver in orthopedic trauma surgery, specifically acetabular surgery is limited. Our institute performed a retrospective review of 63 consecutive operative acetabular fractures at a level one trauma center. Our study revealed that patients with blood loss of less than 400 mL were 13 times less likely to receive autologous blood, and patients with hemoglobin less than 10.5 were 5 times less likely to receive autologous transfusion (). We also found that no patients with a hemoglobin level less than 10.5 and EBL less than 400 mL received autologous blood return. Autologous blood transfusion had no effect on volume or rate of allogenic blood transfusion. We believed that if a patient’s preoperative hemoglobin is less than 10.5 or expected blood loss is less than 400 mL, then CS should have a very limited role, if any, in the preoperative blood conservation strategy. We found ASA greater than 2, BMI greater than 24 and associated fracture type to be a risk factor for high blood loss.
      PubDate: Thu, 02 Jun 2022 10:35:02 +000
  • Revision Surgery Using Retrograde Nail versus Replating in Nonunion Distal
           Femur Fracture Treated with Plate

    • Abstract: Articular distal femur fractures represent 4% to 6% of femur fractures. Locking compression plates (LCPs) are the main treatment option. Nevertheless, a reoperation rate of 12.9% has been reported; nonunion is reported at 4.8%, delayed union at 1.6%, and malunion at 0.6%. Treatment of nonunions can be challenging as no unanimous consensus regarding the best surgical technique has been reached. The aim of this study was to evaluate and compare two types of revision surgery as treatment of LCP-treated articular distal femoral fracture nonunion: retrograde nail or replating. A retrospective cohort study of patients admitted from January 2015 to February 2017 for nonunion of AO/OTA 33C2 fractures previously treated with a lateral LCP was conducted. Patients were treated either with intramedullary nailing (Group A) or with replating (Group B). One independent observer performed clinically and radiographically followed up at 1, 3, 6, 9, 12, 24, and 36 months after surgery. The nonunion scoring system (NUSS) was used. Nine patients were included in our study. The mean follow-up was 2 years. Five patients were treated with intramedullary nailing and four with replating. The NUSS score was 24.2 ± 6.8 in the nailing group and 37.3 ± 3 in the replating group (). In the nailing group, radiographic consolidation was obtained in all cases. In the replating group, nonunion was found in 3 patients and failure of osteosynthesis in one patient. Therefore, four patients (Group B) underwent implant removal and retrograde femoral nailing, obtaining radiological healing. The union time was 7.6 months in the nailing group. Retrograde intramedullary nailing can be used as an effective treatment of aseptic AO-33C distal femoral nonunion following primary locking plating.
      PubDate: Thu, 02 Jun 2022 07:50:02 +000
  • Evaluation of Safety and Efficacy of Traction, Closed Reduction, and
           Subsequent Hip Fixation in Hilgenreiner Brace in Patients with Severe
           Forms of Hip Developmental Dysplasia

    • Abstract: Background. Hilgenreiner brace (Hb) was developed to improve hip reduction rate and reduce the incidence of femoral head avascular necrosis (AVN). In children under the age of 18 months with unstable hip joints or a dislocated hip joint, the treatment method involves nonsurgical treatment in most cases. Objectives. To evaluate the effectiveness and safety of traction, closed reduction, and hip fixation in Hb in patients with severe forms of hip developmental dysplasia (DDH) in follow-up. Materials and Methods. Prospective, clinical, cohort observation and retrospective matched-pair analysis. Analysis of medical records was conducted to evaluate the effectiveness of using Hb for treatment of dislocated hip joints in
      PubDate: Sun, 29 May 2022 11:50:03 +000
  • Kinematic and Radiographic Evaluation of Acromioclavicular Reconstruction
           with a Synthetic Ligament

    • Abstract: Purpose. The optimal surgical technique for unstable acromioclavicular (AC) and coracoclavicular (CC) joint injuries has not yet been established. The biomechanical and radiographic effect of the LockDown device, a synthetic ligament for AC joint reconstruction, was evaluated to assess the optimal surgical technique for unstable AC and CC joint injuries. It was hypothesized that the LockDown device would restore AC joint kinematics and radiographic stability to near native values. Methods. Three fresh frozen cadaveric torsos (6 shoulders) modelled CC joint motion in their “native,” “severed,” and “reconstructed” states. The effects of stressed and unstressed native, severed, and reconstructed conditions on AC separation and CC distances in anteroposterior, mediolateral, and inferosuperior directions during shoulder abduction, flexion, and scaption were assessed. The analysis of variance (, 0.05) was used to compare CC distance and peak AC distance in anteroposterior, mediolateral, and inferosuperior directions during shoulder flexion, abduction, and scaption measurements among native, severed, and reconstructed states with unstressed and stressed Zanca radiographic views. Results. From radiographic analyses, the CC distance was significantly greater () across the surgical state in stressed versus unstressed views. Mean difference between stressed and unstressed views was 1.8 mm in native state, 4.1 mm in severed state, and 0.9 mm in reconstructed state. The CC distance was significantly greater in the “severed” state (10.4 mm unstressed; 14.5 mm stressed) compared to the “native” state () (6.5 mm unstressed; 8.3 mm stressed) and compared to the “reconstructed” state () (3.1 mm unstressed; 4.0 mm stressed) and significantly less () in the “reconstructed” state compared to the “native” state. CC distances decreased from native to reconstructed, an average of 3.3 mm for unstressed and 4.3 mm for stressed. On average, peak AC joint separation distance in anteroposterior, mediolateral, and inferosuperior directions during shoulder-abduction, flexion, and scaption was shown to be restored to 11.5 mm of native values after reconstruction with LockDown device. Conclusion. Reconstruction of AC joint with LockDown synthetic ligament restores motion of clavicle and acromion to near native values, thereby decreasing scapular dyskinesis and enhancing AC joint stability.
      PubDate: Sat, 28 May 2022 07:35:02 +000
  • Evaluation of Crossover Sign in Pelvis Models Made with a
           Three-Dimensional Printer

    • Abstract: Introduction. Investigation of the crossover sign (COS) in different degrees of tilt in pelvises made by three-dimensional printing of CT scans among patients with normal hip versions was carried out. Methods. Radiology CT scans of 8 normal pelvises reconstructed in 3D and the effect of sequential tilting on the presence of the false-positive COS in 48 radiographs were investigated. Results. The COS was seen in 77% of the AP radiographs during tilt changes. The average distance between the tip of the coccyx and the symphysis pubis was 32.06 ± 10.99 mm. Also, COSs were present in all radiographs from 6 degrees tilt and above. Conclusion. Minor tilting of the pelvis can result in a false-positive crossover sign on AP plain radiographs.
      PubDate: Thu, 26 May 2022 09:35:01 +000
  • Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells in
           Association with Arthroscopic Microfracture of Knee Articular Cartilage
           Defects: A Pilot Randomized Controlled Trial

    • Abstract: Background. This study aims to compare the effects of platelet-rich plasma (PRP) alone or in combination with adipose-derived mesenchymal stem cells (AD-MSCs) in patients affected by cartilage defects, undergoing knee arthroscopic microfracture. Methods. Thirty-eight patients diagnosed with a knee monocompartmental cartilage defect (Outerbridge grade IV) on the MRI, underwent an arthroscopic procedure. After the confirmation of the lesion, they all received the same bone marrow stimulation technique (microfracture) and were randomized into two groups: the first one had additional PRP injection (group A), while the second received PRP and AD-MSC injection (group B). Knee assessment and pain score were documented with Knee Injury Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Short-Form (SF) 12, and Visual Analogue Scale (VAS) before the treatment and at 1, 3, 6, and 12 months of follow-up postoperatively. An additional arthroscopic procedure, performed in four patients for a subsequent meniscal lesion, let us evaluate cartilage evolution by performing a macro/microscopical assessment on cartilage biopsy specimens. Results. At the 12-month follow-up, both groups showed a comparable functional improvement. The scores on the IKDC form, KOOS, pain VAS, and SF-12 significantly improved from baseline () to 12 months postoperatively in both treatment groups. The four second-look arthroscopies showed a complete repair of the articular defects by smooth solid cartilage layer, with a good chondrocytic population, in both groups. A thick smooth hyaline-like cartilage with a predominantly viable cell population and normal mineralization (a form closely resembling native tissue) was observed in group B. Conclusions Modern regenerative medicine techniques, such as PRP and AD-MSC, associated with traditional arthroscopic bone marrow stimulating techniques, seem to enhance cartilage restoration ability. The preliminary results of this pilot study encourage the synergic use of these regenerative modulating systems to improve the quality of the regenerated cartilage.
      PubDate: Thu, 28 Apr 2022 14:35:01 +000
  • Recent Biomimetic Approaches for Articular Cartilage Tissue Engineering
           and Their Clinical Applications: Narrative Review of the Literature

    • Abstract: Since articular cartilage is lacking blood vessels and nerves, its capacity to heal is extremely limited. This means that ruptured cartilage affects the joint as a whole. A health issue known as osteoarthritis can develop as a result of injury and deterioration. Osteoarthritis development can be speeded up by the widespread deterioration of articular cartilage, which ranks third on the list of musculoskeletal disorders requiring rehabilitation, behind only low back pain and broken bones. The current treatments for cartilage repair are ineffective and rarely restore full function or tissue normalcy. A promising new technology in tissue engineering may help create functional cartilage tissue substitutes. Ensuring that the cell source is loaded with bioactive molecules that promote cellular differentiation and/or maturation is the general approach. This review summarizes recent advances in cartilage tissue engineering, and recent clinical trials have been conducted to provide a comprehensive overview of the most recent research developments and clinical applications in the framework of degenerated articular cartilage and osteoarthritis.
      PubDate: Fri, 22 Apr 2022 12:20:02 +000
  • Clinical Outcomes and Predictors of Patients with Fracture in Debre Markos
           Comprehensive Specialized Hospital, North West Ethiopia: A Prospective
           Cohort Study

    • Abstract: Background. Fracture continues to be a major public health concern in many parts of the developing world that results in several consequences and complications including lifelong morbidity and mortality. This study aimed to assess clinical outcomes of patients following fracture in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia. Methods. An institution-based prospective cohort study was conducted from November 2020 to July 2021 among 207 fracture patients (69 visited traditional bone setter and 138 did not visit traditional bone setter). Data were collected through face-to-face interviews, physical examinations, and radiological investigations. Data were entered using Epi-Data version 3.1 and analysis was done using STATA 14 statistical software. Descriptive statistics were summarized using mean, median, standard deviation, and percentage and presented in tables and figures. The generalized linear model was fitted to identify the risks of the outcome variable. Risk Ratio with its 95% confidence interval was used and factors with a P-value less than 0.05 were considered as a statistically significant association. Result. The mean age of the participants was 37.5 ± 13.6 years and two-thirds of the participants were males. Nearly half of the patients 92 (44%), 50 (54%) from the exposed and 42 (46%) from the nonexposed group, were delayed getting treatment from the hospital. The majority of the patients had been treated with Plaster of Paris immobilization (55%) followed by fixation (15%) and a combination of both (12%). Nearly half of the participants (48%), 74% from the exposed and 35% from the nonexposed group, developed complications during the follow-up period. The commonest complication was joint stiffness (45%) followed by osteoarthritis (21%). The risk of fracture-related complications among patients who did not visit traditional bone setter was decreased by 54% as compared to visitors (RR 0.46; 95% CI: (0.35, 0.60)) Conclusion. The magnitude of complications following the fracture is found to be high and the risk of complications among patients who visited traditional bone setters increased significantly. Therefore, prevention measures should be strengthened and integration between hospitals and traditional bone setters should be made so that basic training on fractures management will be given.
      PubDate: Fri, 22 Apr 2022 12:20:01 +000
  • Patellofemoral Pain Syndrome in Young Female Athletes: A Case-Control

    • Abstract: Background. Patellofemoral pain syndrome (PFPS) is the most common cause of anterior knee pain in children and adolescents, and it is characterized by highly limiting, recurrent, frontal pain. Objectives. The purpose of the study is to assess the incidence and onset of PFPS in the young female athletes and to compare it to healthy individuals. Methods. Between 2017 and 2019, 51 subjects were reviewed and divided in three groups: rhythmic gymnastics athletes (RG; 21 individuals, mean age: 13.8 ± 3.6 years), basketball athletes (BG; 17 individuals, mean age: 14.2 ± 3.1 years), and control group (CG; 13 individuals, mean age: 14.5 ± 4.3 years). All patients underwent physical examination including patellar glide, tilt, grind and apprehension tests, tiptoe and jack tests, Coleman block, and navicular drop tests. The clinical and functional outcomes of the subjects were assessed using the Kujala patellofemoral score (KPS). Results. In RG patients were recorded 66.7% of normal footprint (NF), 9.5% of cavus feet (FCF), and 23.8% of flatfeet (FFF); 14.8% patellar positive tests, KS = 98.6 ± 13.7. BG patients had 70.6% of NF, 11.8% FCF, and 17.6% of FFF; 23.5% patellar positive tests, KS = 98.3 ± 12.4. CG patients had 61.5% of NF, 7.7% of FCF and 30.8% of FFF; 15.4% patellar positive tests, KPS = 98,9 ± 15.3. No statistically significance was found between the three cohorts of patients. Conclusions. PFPS is a common pathology; muscular imbalance and overuse could exacerbate pain and discomfort in young female athletes. Our findings show high type and level of sport activity are not related to increase frequency of clinical symptoms related to PFPS.
      PubDate: Fri, 15 Apr 2022 10:05:00 +000
  • Fixator-Assisted Nailing for Femur Neck Fracture Nonunion: A Case Series

    • Abstract: Background. Femoral neck fractures in young adults tend to be a result of high-energy trauma with a common pattern of Pauwels type III fracture, and they require timely and meticulous diagnosis and management. The objective of this study was to assess the clinical and radiological outcomes of the fixator-assisted nailing technique for managing femur neck fracture nonunion. Methods. This was a case series study of 16 patients with nonunion femoral neck fractures treated via a fixator-assisted nailing technique. Our inclusion criteria comprised the inclusion of any patient between the ages of 14 and 60 years old with a neglected neck of femur fracture or nonunion of the femur neck. In addition, we only included patients without further posttreatment trauma and without known metabolic diseases. The conditions that were excluded from this study included hip joints with preexisting osteoarthritis, radiographic evidence of avascular necrosis of the femoral head, and associated ipsilateral acetabulum fracture or fracture-dislocation. The fracture characteristics that were selected for the fixator-assisted nailing (FAN) technique were clear signs of pseudoarthrosis (such as sclerosis, clear fracture line defects, and failure of implants), in addition to evidence of varus malalignment. All fractures were Pauwels type III. Radiographs of the pelvis with both hips and a posteroanterior (PA) view of the injured hip were taken. Full weight bearing was allowed in all the patients from the first day postoperatively. Physical therapy was started for pain reduction modalities, stretching, and abductor strengthening. Results. Union of the femur neck fracture and osteotomy site was achieved in all patients. An excellent functional status after four months of follow-up was found based on a modified Harris hip score questionnaire. At follow-up, no patient was suffering from pain or flexion contracture. Preoperative limb length discrepancy (LLD) (cm) was 1.8 ± 0.8 cm and postoperative was 0 ± 0.1 cm, . Preoperative neck-shaft angle (NSA) (o) was 85.6 ± 4.4 and postoperative was 126.9 ± 2.5, . Preoperative Pauwels angle (o) was an average of 50.4 ± 5.9 and postoperative was 31.3 ± 2.5, .Conclusion. Our study indicates that FAN has a high success rate in young patients with nonunited femoral neck fractures.
      PubDate: Thu, 14 Apr 2022 10:50:01 +000
  • Satisfactory Functional Outcome and Significant Correlation with the
           Length of Haglund’s Deformity after Endoscopic Calcaneoplasty: A Minimum
           4-Year Follow-Up Study

    • Abstract: Background. Haglund’s syndrome is a posterosuperior calcaneal prominence with posterior heel pain causing functional disability to the patient. Operative treatment is indicated after failure of conservative measures and includes resection of the bony hump along with retrocalcaneal bursectomy. This study aimed to evaluate the functional outcome and degree of patient satisfaction after endoscopic resection of Haglund’s deformity with assessment of correlation with the length of bony exostosis. Methods. Seventeen patients (21 feet) with a mean age of 44.7 ± 5.1 years were included in this study. Six females and 11 males underwent endoscopic calcaneoplasty. Clinical outcome evaluation included the assessment of the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). The preoperative and postoperative lengths of bony exostosis were measured radiologically. The paired t test and the Wilcoxon signed-rank test compared the preoperative and final postoperative means. was considered statistically significant. Results. The mean follow-up period was 56.4 ± 5.1 months. Statistically significant improvements in the preoperative mean of AOFAS (from 55.7 ± 9.3 to 94.3 ± 7.1) and VAS (from 8.1 ± 1.4 to 0.7 ± 1.04) at the final follow-up were noted . There was a statistically significant correlation between clinical scores (AOFAS and VAS) and the final postoperative length of the bone above parallel pitch lines (PPLs). The patients were satisfied and returned to their previous activities without reporting major morbidities except one patient who had mild pain with exertion. Conclusion. Endoscopic calcaneoplasty is a safe, less invasive surgical procedure for the management of Haglund’s syndrome after failure of conservative treatment. It provided a satisfactory clinical result without serious complications at a minimum 4-year follow-up.
      PubDate: Wed, 13 Apr 2022 10:05:01 +000
  • Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by
           Open Reduction and Internal Fixation with Bioabsorbable Nails

    • Abstract: Purpose. The purpose of our study was to evaluate the clinical outcome following open reduction and internal fixation of humeral capitellum fractures in adolescents and to assess the usefulness of bioresorbable implants in that procedure. Due to the rarity of these fractures, there are not many studies dealing with the problem in the literature. Methods. We retrospectively evaluated a group of 6 skeletally immature patients aged 10.6–15.3 treated at our department from January 2015 to December 2021. Four type I and two type IV were diagnosed based on the Bryan and Morrey classification. Our patients underwent an open reduction and internal fixation of coronal shear fractures with the use of SmartNail®. Results. All patients were satisfied with the treatment outcome and had full pronation and flexion after surgery. Two patients presented minor deficits of extension and supination compared with the contralateral elbow. At the one-year follow-up, all patients scored 100 on the Mayo Elbow Performance Score. Conclusions. Correct diagnosis and early surgical intervention in humeral capitellum fractures are crucial. That fractures should be anatomically reduced with no articular cartilage damage in order to prevent osteoarthritis. Based on our experience, SmartNail® implant is accurate for the osteochondral fragment fixation.
      PubDate: Mon, 11 Apr 2022 05:50:03 +000
  • Proximal Junction Kyphosis in Adult Scoliosis: Best Postoperative
           Radiological Predictors—A Retrospective Cohort Study

    • Abstract: Background. Proximal junction kyphosis (PJK) is the postsurgical radiographic event seen in the surgical plane after the fusion of a spinal deformity. Unfavorable health outcomes have been reported in symptomatic PJK patients compared to non-PJK patients. Methods. The data for adult scoliosis patients who underwent curve correction were extracted from the hospital database. Pelvic and spinal parameters were measured and calculated to compare four predictive formulae for occurrences of PJK. Formula 1. Restoration of hypothetical values of lumbar lordosis (LL) and thoracic kyphosis (TK) according to pelvic incidence (PI). Formula 2. Evaluation of global sagittal alignment. Formula 3. Restoration of the apex of LL to its hypothetical position according to the spine shape. Formula 4. Evaluation of positive-sum and negative-sum of (LL + TK). Results. A total number of cases were 52. There were 14 cases of PJK. The incidence of PJK was 26.9%, and the mean age for PJK cases was 63.2 ± 5.2. The excellent predictor for occurrences of PJK was formula 3. Postsurgical sagittal apexes of lumbar lordosis were located in their hypothetical position in 24 cases, and 12.5% of these cases developed PJK. While sagittal apexes were not located in their hypothetical position in 28 patients, PJK occurred in 39.3% of them (, OR: 4.53, (95% CI: 1.09–18.9)). The second good predictor for occurrences of PJK was formula 2 (GSA>45° versus GSA
      PubDate: Wed, 23 Mar 2022 08:35:01 +000
  • The Clinical History and Basic Science Origins of Transcutaneous
           Osseointegration for Amputees

    • Abstract: Transcutaneous osseointegration for amputees (TOFA) refers to an intramedullary metal endoprosthesis which passes transcutaneously to connect with a limb exoprosthesis. The first recognizably modern experiments and attempts occurred in the 1940s. Multiple researchers using a plethora of materials and techniques over the following 50 years identified principles and obstacles which informed the first long-term successful surgery in 1990. Unfortunately, the current mainstream TOFA literature presents almost exclusively subsequent developments, generally omitting prior research, leading to some historical mistakes being repeated. Given the increasing interest and surgical volume of TOFA, this literature review was performed to delineate TOFA’s basic science and surgical origins and to integrate these early efforts within the contemporary understanding. Studying this research could protect and benefit future patients, surgeons, and implant developers as TOFA is entering a phase of increased attention and innovation. The aim of this article is to provide a focused reference of foundational research, much of which is difficult to identify and retrieve, for clinicians and researchers.
      PubDate: Fri, 18 Mar 2022 12:20:03 +000
  • A Cost-Utility Analysis of Robotic Arm-Assisted Total Hip Arthroplasty:
           Using Robotic Data from the Private Sector and Manual Data from the
           National Health Service

    • Abstract: Purpose. The aim was to assess the cost-effectiveness of robotic arm-assisted total hip arthroplasty (rTHA) compared with manual total hip arthroplasty (mTHA) and to assess the influence of annual volume on the relative cost-effectiveness of rTHA. Methods. A database of both rTHA (n = 48 performed in a private centre) and mTHA (n = 512 performed in the National Health Service) was used. Patient demographics, preoperative Oxford hip score, forgotten joint score, EuroQol 5-dimensional 3-level (EQ-5D), and postoperative EQ-5D were recorded. Two models for incremental cost-effectiveness ratios using cost per quality-adjusted life year (QALY) for rTHA were calculated based on a unit performing 100 rTHAs per year: 10-year follow-up and a lifetime time horizon (remaining life expectancy of a 69-year-old patient). Results. When adjusting for confounding factors, rTHA was independently associated with a 0.091 () greater improvement in the EQ-5D compared to mTHA. This resulted in a 10-year time horizon cost per QALY for rTHA of £1,910 relative to mTHA, which increased to £2,349 per QALY when discounted (5%/year). When using the 10-year time horizon cost per QALY was approximately £3,000 for a centre undertaking 50 rTHAs per year and decreased to £1,000 for centre undertaking 200 rTHAs per year. Using a lifetime horizon, the incremental unadjusted cost per QALY gained was £980 and £1432 when discounted (5%/year) for rTHA compared with mTHA. Conclusions. Despite the increased cost associated with rTHA, it was a cost-effective intervention relative to mTHA due to the associated greater health-related quality of health gain, according to the EQ-5D outcome measure.
      PubDate: Sun, 27 Feb 2022 12:50:02 +000
  • Multiple Venous Thromboembolism Pharmacologic Agents Are Associated with
           an Increased Risk for Early Postoperative Complications following a Total
           Joint Arthroplasty

    • Abstract: The purpose of this study was to determine the effect that concurrent venous thromboembolism (VTE) medications had on early outcomes following primary total joint arthroplasty (TJA). 2653 total knee and hip arthroplasties were reviewed at a tertiary medical center. The study performed a multivariable comparison of outcomes in patients on 2 or more VTE medications, as well as a logistic regression on outcomes following each addition of a VTE medication postoperatively (number of VTE medications was 1–4). Controlling for gender, age, body mass index, and preoperative American Society of Anesthesiologists score throughout the analysis, patients who received 2 or more VTE prophylaxis medications had increased LOS (), transfusions (), emergency department visits (), readmissions (), 90dPOE (), and PE (). Every additional postoperative VTE medication incrementally increased the risk for longer LOS (), transfusions (), 90dPOE (), deep vein thrombosis (), PE (), emergency department visits (), and readmission (). Patients on multiple VTE medications following TJA demonstrate significantly poorer outcomes. The current study’s findings caution the use of multiple VTE medications whenever possible immediately following a TJA.
      PubDate: Mon, 07 Feb 2022 11:20:01 +000
  • A Balanced Arthroscopic Debridement of the Inner Layer of the Knee
           Retinaculum Increases the Tibiofemoral Joint Space Width

    • Abstract: Introduction. Traditional techniques can enlarge the medial tibiofemoral joint space width (JSW) for meniscal repairs, but a remnant ligament laxity may be developed. Alternatively, the debridement of the inner retinaculum layer may result in a balanced JSW without causing extra-ligament damage (retinaculum layers II and collateral ligament). Purpose. The purpose of this study was to determine whether a concentric arthroscopic debridement of the inner retinaculum layer increases the tibiofemoral JSW in patients with meniscal injuries. Secondarily, we determine whether the increase in JSW is symmetrical between compartments and describe the rate of complications and patient satisfaction. Method. Twenty middle-aged (15 male and five female) patients diagnosed with acute meniscal injury aged 36 ± 12 years were enrolled. The patients were submitted to an arthroscopic debridement of the inner layer of the knee retinaculum for both the medial and lateral compartments. The tibiofemoral JSW was measured intra-articularly using a custom instrument. A two-way ANOVA for repeated measures was used to compare the JSW. A Bland–Altman analysis and test-retest analysis were performed. Results. The JSW increased following the debridement of the inner retinaculum layer, for both the medial and lateral compartments . No complications were identified, and the patients were satisfied with the intervention. The minimal detectable change and bias of the custom instrument were 0.06 mm and 0.02 mm, respectively. Conclusion. The debridement allows a clinically important (>1 mm) symmetric tibiofemoral JSW enlargement. The technique suggests favoring the diagnosis of meniscus injuries and manipulating arthroscopic instruments without secondary complications after one year.
      PubDate: Sat, 29 Jan 2022 11:20:03 +000
  • Cruciate Substituting Implants in Primary Total Knee Arthroplasty

    • Abstract: The use of cruciate substituting (CS) total knee replacement has been increasing in popularity. There are numerous factors that have likely contributed to this expansion. The CS philosophy incorporates the ease of use commonly cited by advocates of the posterior stabilized (PS) total knee design with the bone preservation associated with a cruciate retaining (CR) design. The ultra-congruent highly cross-linked polyethylene liner increases stability without an appreciable change in wear. Furthermore, balancing the flexion and extension gaps does not require “titrating” the posterior cruciate ligament, improving the user-friendliness. This paper reviews the nuances of this implant design compared to PS and CR designs as well as provides surgical technique recommendations/considerations.
      PubDate: Mon, 24 Jan 2022 11:50:00 +000
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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