Dimitrios A Flevas, E. Pappas, S. Ristanis, G. Giakas, M. Vekris, A. Georgoulis
Introduction: Extremity dominance is one of the intrinsic factors that have been identified for ankle sprains. Electromechanical delay (EMD) is an integral part of the peroneal motor response and, therefore, substantial in preventing ankle sprains. This study aimed to investigate the effect of laterality on EMD times before and after fatigue. Methods: Fifteen healthy male volunteers participated in the study. Measurements were taken with the ankle in a neutral (0°) position, and all subjects followed an isokinetic fatigue protocol. Repeated ANOVA was used for statistical analysis, and the α level was set a priori at p ≤ 0.05. Results: No significant difference was noted in EMD times between the dominant and non-dominant legs of the volunteers (p = 0.940). Fatigue caused a significant increase in EMD by 10–15 ms (p = 0.003), while the leg × fatigue interaction was not significant (p = 0.893). Conclusions: In a non-injured athlete, both ankles seem to be under the same protection of the reactive response of the peroneal muscles. Therefore, athletes should be aware that both their extremities are equally exposed to the danger of an ankle injury. Also, fatigued ankles demonstrate longer EMD times, implying that improving resistance to fatigue may add another layer of protection that has the potential to prevent ankle sprain recurrence.
{"title":"Effect of laterality and fatigue in peroneal electromechanical delay","authors":"Dimitrios A Flevas, E. Pappas, S. Ristanis, G. Giakas, M. Vekris, A. Georgoulis","doi":"10.1051/sicotj/2022018","DOIUrl":"https://doi.org/10.1051/sicotj/2022018","url":null,"abstract":"Introduction: Extremity dominance is one of the intrinsic factors that have been identified for ankle sprains. Electromechanical delay (EMD) is an integral part of the peroneal motor response and, therefore, substantial in preventing ankle sprains. This study aimed to investigate the effect of laterality on EMD times before and after fatigue. Methods: Fifteen healthy male volunteers participated in the study. Measurements were taken with the ankle in a neutral (0°) position, and all subjects followed an isokinetic fatigue protocol. Repeated ANOVA was used for statistical analysis, and the α level was set a priori at p ≤ 0.05. Results: No significant difference was noted in EMD times between the dominant and non-dominant legs of the volunteers (p = 0.940). Fatigue caused a significant increase in EMD by 10–15 ms (p = 0.003), while the leg × fatigue interaction was not significant (p = 0.893). Conclusions: In a non-injured athlete, both ankles seem to be under the same protection of the reactive response of the peroneal muscles. Therefore, athletes should be aware that both their extremities are equally exposed to the danger of an ankle injury. Also, fatigued ankles demonstrate longer EMD times, implying that improving resistance to fatigue may add another layer of protection that has the potential to prevent ankle sprain recurrence.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41832087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Infected total elbow arthroplasty (TEA) is challenging. We evaluate the clinical and radiologic outcomes for chronic and deep infection of TEA with two-stage revision surgery. Methods: A total of 10 elbows were included in the study. The mean age was 69.1 ± 15 years (range, 34–83 years). The mean follow-up was 62 (range, 24–108) months. The clinical outcomes were assessed using a visual analog scale (VAS), range of motion (ROM) arc, and Mayo elbow performance score (MEPS). Moreover, radiographic outcomes, time to revision, pathogenic bacteria, preoperative complications, and disease period were evaluated. Results: Mean preoperative VAS score of 6.1 had improved to 3.3. Mean preoperative ROM was 68° (flexion-extension), which improved to 86.7°. Mean preoperative MEPS was 46 (range, 0–70), which improved to 75.5 (range, 35–85). The mean disease duration was 8.4 months (range, 5–20 months). The most common causative organism was methicillin-resistant Staphylococcus aureus. The second revision rate was 80% at the final follow-up. Radiographic outcome at final follow-up showed that 3 (30%) of 10 patients exhibited radiolucency evidence around the components. Three patients showed nonprogressive radiolucency around the implant interfaces without other indications of infection at the most recent follow-up. Conclusion: In patients with chronic and deep infection of TEA, two-stage revision can be an affordable option for eradication of the infection, relieving pain, and restoring joint function. However, the high second revision rate owing to bone and soft-tissue deficits remains a critical issue. Level of evidence: Level IV, Case series, Treatment study
{"title":"Staged revision still works for chronic and deep infection of total elbow arthroplasty?","authors":"Jae-Man Kwak, S. So, I. Jeon","doi":"10.1051/sicotj/2022019","DOIUrl":"https://doi.org/10.1051/sicotj/2022019","url":null,"abstract":"Purpose: Infected total elbow arthroplasty (TEA) is challenging. We evaluate the clinical and radiologic outcomes for chronic and deep infection of TEA with two-stage revision surgery. Methods: A total of 10 elbows were included in the study. The mean age was 69.1 ± 15 years (range, 34–83 years). The mean follow-up was 62 (range, 24–108) months. The clinical outcomes were assessed using a visual analog scale (VAS), range of motion (ROM) arc, and Mayo elbow performance score (MEPS). Moreover, radiographic outcomes, time to revision, pathogenic bacteria, preoperative complications, and disease period were evaluated. Results: Mean preoperative VAS score of 6.1 had improved to 3.3. Mean preoperative ROM was 68° (flexion-extension), which improved to 86.7°. Mean preoperative MEPS was 46 (range, 0–70), which improved to 75.5 (range, 35–85). The mean disease duration was 8.4 months (range, 5–20 months). The most common causative organism was methicillin-resistant Staphylococcus aureus. The second revision rate was 80% at the final follow-up. Radiographic outcome at final follow-up showed that 3 (30%) of 10 patients exhibited radiolucency evidence around the components. Three patients showed nonprogressive radiolucency around the implant interfaces without other indications of infection at the most recent follow-up. Conclusion: In patients with chronic and deep infection of TEA, two-stage revision can be an affordable option for eradication of the infection, relieving pain, and restoring joint function. However, the high second revision rate owing to bone and soft-tissue deficits remains a critical issue. Level of evidence: Level IV, Case series, Treatment study","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42787017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Factor, F. Atlan, T. Pritsch, Netta Rumack, E. Golden, S. Dadia
Objectives: To examine the clinical feasibility and results of a multidisciplinary workflow, employing rapid three-dimensional (3D) scanning and modeling software along with a high-speed printer, for in-hospital production of patient-specific 3D-printed casts, for the treatment of non-displaced wrist and hand fractures. Methods: Consenting adult patients admitted to the emergency department (ED) due to wrist or hand fractures between January and February 2021 were prospectively enrolled. The study participants underwent conversion of the standard plaster of Paris cast to a 3D-printed cast one week after the ED visit, and follow-up examinations were performed around two, six, and twelve weeks later. The primary objective was to examine the clinical feasibility in terms of complexity and length of the overall procedure. Secondary outcomes were patient-reported impressions and radiological results. Results: Twenty patients (16 males, mean age 37 ± 13.1 years) were included. The entire printing workflow took a mean of 161 ± 8 min. All patients demonstrated clinical improvement and fracture union at final follow-up, with no pressure sores or loss of reduction. Patient-reported comfort and satisfaction rates were excellent. The mean Visual Analog Scale was 0.9 ± 1.1 and 0.6 ± 1, and the mean Disabilities of the Arm, Shoulder, and Hand score was 18.7 ± 9.5 and 7.6 ± 7.6 at 2 and 6 weeks after application of the 3D-printed cast, respectively. Conclusion: The in-hospital workflow was feasible and efficient, with excellent clinical and radiographic results and high patient satisfaction and comfort rates. Our medical center now routinely provides this cast option for non-displaced wrist and hand fractures. Level of evidence: IV, Therapeutic Study
{"title":"In-hospital production of 3D-printed casts for non-displaced wrist and hand fractures","authors":"S. Factor, F. Atlan, T. Pritsch, Netta Rumack, E. Golden, S. Dadia","doi":"10.1051/sicotj/2022021","DOIUrl":"https://doi.org/10.1051/sicotj/2022021","url":null,"abstract":"Objectives: To examine the clinical feasibility and results of a multidisciplinary workflow, employing rapid three-dimensional (3D) scanning and modeling software along with a high-speed printer, for in-hospital production of patient-specific 3D-printed casts, for the treatment of non-displaced wrist and hand fractures. Methods: Consenting adult patients admitted to the emergency department (ED) due to wrist or hand fractures between January and February 2021 were prospectively enrolled. The study participants underwent conversion of the standard plaster of Paris cast to a 3D-printed cast one week after the ED visit, and follow-up examinations were performed around two, six, and twelve weeks later. The primary objective was to examine the clinical feasibility in terms of complexity and length of the overall procedure. Secondary outcomes were patient-reported impressions and radiological results. Results: Twenty patients (16 males, mean age 37 ± 13.1 years) were included. The entire printing workflow took a mean of 161 ± 8 min. All patients demonstrated clinical improvement and fracture union at final follow-up, with no pressure sores or loss of reduction. Patient-reported comfort and satisfaction rates were excellent. The mean Visual Analog Scale was 0.9 ± 1.1 and 0.6 ± 1, and the mean Disabilities of the Arm, Shoulder, and Hand score was 18.7 ± 9.5 and 7.6 ± 7.6 at 2 and 6 weeks after application of the 3D-printed cast, respectively. Conclusion: The in-hospital workflow was feasible and efficient, with excellent clinical and radiographic results and high patient satisfaction and comfort rates. Our medical center now routinely provides this cast option for non-displaced wrist and hand fractures. Level of evidence: IV, Therapeutic Study","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45616422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Shatrov, C. Batailler, E. Sappey-Marinier, S. Gunst, E. Servien, S. Lustig
{"title":"Correction Notice to: Functional Alignment Philosophy in Total Knee Arthroplasty – Rationale and technique for the varus morphotype using a CT based robotic platform and individualized planning","authors":"J. Shatrov, C. Batailler, E. Sappey-Marinier, S. Gunst, E. Servien, S. Lustig","doi":"10.1051/sicotj/2022017","DOIUrl":"https://doi.org/10.1051/sicotj/2022017","url":null,"abstract":"","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43504949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillaume Mesnard, Gaspard Fournier, Léopold Joseph, J. Shatrov, S. Lustig, E. Servien
Purpose: Meniscal lesions are commonly associated with anterior cruciate ligament (ACL) rupture. Meniscal repair, when possible, is widely accepted as the standard of care. Despite advancements in surgical and rehabilitation techniques, meniscal repair may impact muscle recovery when performed in conjunction with ACL reconstruction. The objective of this study was to explore if meniscal repairs in the context of ACL reconstruction affected muscle recovery compared to isolated ACL reconstruction. Methods: Fifty-nine patients with isolated ACL reconstruction were compared to 35 patients with ACL reconstruction with an associated meniscal repair. All ACL reconstructions were performed using hamstring grafts with screw-interference graft fixation. Isokinetic muscle testing was performed between six and eight months of follow-up. Muscle recovery between both groups was compared. A further subgroup analysis was performed to compare muscle recovery function of gender and meniscal tear location. Tegner scores were assessed at six months’ follow-up. Results: No significant differences were found between the two groups regarding muscle recovery. No difference in muscle recovery was found concerning gender. Lesion of both menisci significantly increased the deficit of hamstrings muscular strength at 60°/s compared to a lesion of one meniscus (26.7% ± 15.2 vs. 18.1% ± 13.5, p = 0.018) and in eccentric test (32.4% ± 26.2 vs. 18.1% ± 13.5, p = 0.040). No significant differences were found concerning the Tegner score. Conclusion: Meniscal repairs performed during an ACL reconstruction do not impact muscle recovery at 6–8 months post-operatively compared to an isolated ACL reconstruction. However, reparations of both menisci appear to impact hamstring muscle recovery negatively. Level of evidence: III, Retrospective cohort study
{"title":"Does meniscal repair impact muscle strength following ACL reconstruction?","authors":"Guillaume Mesnard, Gaspard Fournier, Léopold Joseph, J. Shatrov, S. Lustig, E. Servien","doi":"10.1051/sicotj/2022016","DOIUrl":"https://doi.org/10.1051/sicotj/2022016","url":null,"abstract":"Purpose: Meniscal lesions are commonly associated with anterior cruciate ligament (ACL) rupture. Meniscal repair, when possible, is widely accepted as the standard of care. Despite advancements in surgical and rehabilitation techniques, meniscal repair may impact muscle recovery when performed in conjunction with ACL reconstruction. The objective of this study was to explore if meniscal repairs in the context of ACL reconstruction affected muscle recovery compared to isolated ACL reconstruction. Methods: Fifty-nine patients with isolated ACL reconstruction were compared to 35 patients with ACL reconstruction with an associated meniscal repair. All ACL reconstructions were performed using hamstring grafts with screw-interference graft fixation. Isokinetic muscle testing was performed between six and eight months of follow-up. Muscle recovery between both groups was compared. A further subgroup analysis was performed to compare muscle recovery function of gender and meniscal tear location. Tegner scores were assessed at six months’ follow-up. Results: No significant differences were found between the two groups regarding muscle recovery. No difference in muscle recovery was found concerning gender. Lesion of both menisci significantly increased the deficit of hamstrings muscular strength at 60°/s compared to a lesion of one meniscus (26.7% ± 15.2 vs. 18.1% ± 13.5, p = 0.018) and in eccentric test (32.4% ± 26.2 vs. 18.1% ± 13.5, p = 0.040). No significant differences were found concerning the Tegner score. Conclusion: Meniscal repairs performed during an ACL reconstruction do not impact muscle recovery at 6–8 months post-operatively compared to an isolated ACL reconstruction. However, reparations of both menisci appear to impact hamstring muscle recovery negatively. Level of evidence: III, Retrospective cohort study","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48793936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To evaluate the efficacy of EXOGEN in achieving union and common pitfalls in its use within the Manchester Foundation Trust (MFT) and Salford Royal Foundation Trust (SRFT). Method: Patients receiving EXOGEN therapy between 01/01/2017 and 31/12/2019 at hospitals within MFT and SRFT were identified using EXOGEN logbooks and hospital IT systems. An equal number of patients were included from both sites. Data were retrospectively collected from clinical documents detailing clinical presentation comorbidities, and radiographic images, determining the radiological union post EXOGEN therapy. In addition, local practices were observed and compared to EXOGEN’s standardized guidance for clinicians. Results: Fifty-eight patients were included in the primary review, with 9 subsequently excluded based on insufficient clinical data. 47% of patients achieved radiological union following completion of EXOGEN therapy. Outcomes of the 23 patients with persistent non-union were as follows – 18 were referred for revision surgery, 5 were prescribed further EXOGEN therapy, 2 refused or were unfit for further intervention, and 1 did not have a plan documented. No significant baseline differences were present in both outcome groups. However, at MFT and SRFT, rates of union with EXOGEN are below that previously published in the literature. Conclusion: EXOGEN has proven successful in facilitating union in established cases of non-union without the risk and cost associated with revision surgery. Centre outcome differences may be explained by failure to educate clinicians and patients on the correct use of the EXOGEN device, failure to standardize follow-up or monitor compliance, and must be addressed to improve current services.
{"title":"Pitfalls preventing bone union with EXOGEN Low-Intensity Pulsed Ultrasound","authors":"L. Hughes, J. Khudr, Edward Gee, A. Pillai","doi":"10.1051/sicotj/2022012","DOIUrl":"https://doi.org/10.1051/sicotj/2022012","url":null,"abstract":"Objectives: To evaluate the efficacy of EXOGEN in achieving union and common pitfalls in its use within the Manchester Foundation Trust (MFT) and Salford Royal Foundation Trust (SRFT). Method: Patients receiving EXOGEN therapy between 01/01/2017 and 31/12/2019 at hospitals within MFT and SRFT were identified using EXOGEN logbooks and hospital IT systems. An equal number of patients were included from both sites. Data were retrospectively collected from clinical documents detailing clinical presentation comorbidities, and radiographic images, determining the radiological union post EXOGEN therapy. In addition, local practices were observed and compared to EXOGEN’s standardized guidance for clinicians. Results: Fifty-eight patients were included in the primary review, with 9 subsequently excluded based on insufficient clinical data. 47% of patients achieved radiological union following completion of EXOGEN therapy. Outcomes of the 23 patients with persistent non-union were as follows – 18 were referred for revision surgery, 5 were prescribed further EXOGEN therapy, 2 refused or were unfit for further intervention, and 1 did not have a plan documented. No significant baseline differences were present in both outcome groups. However, at MFT and SRFT, rates of union with EXOGEN are below that previously published in the literature. Conclusion: EXOGEN has proven successful in facilitating union in established cases of non-union without the risk and cost associated with revision surgery. Centre outcome differences may be explained by failure to educate clinicians and patients on the correct use of the EXOGEN device, failure to standardize follow-up or monitor compliance, and must be addressed to improve current services.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43208931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wynand Steenkamp, P. Rachuene, R. Dey, Nkosiphendule Lindani Mzayiya, Brian Emmanuel Ramasuvha
Introduction: Primary osteoarthritis (OA) is a common cause of knee pain. Appropriate management of knee OA is based on clinical and radiological findings. Pain, deformity, and functional impairments are major clinical factors considered along with radiological findings when making management decisions. Differences in management strategies might exist due to clinical and radiological factors. This study aims at finding possible associations between clinical and radiological observations. Methods: A prospective cross-sectional study of 52 patients with primary osteoarthritis of the knee managed conservatively at a tertiary hospital arthroplasty clinic was conducted for three months. English speaking patients with primary OA were identified and included in this study. Pain and functional impairment were assessed using Wong-Baker Faces pain scale, The Knee Society Score (KSS), and Western Ontario and McMaster Osteoarthritis Index (WOMAC). The Body Mass Index (BMI) of all participants was measured. Standard two views plain radiographs were used for radiographic grading of the OA. Anonymized radiographs were presented to two senior consultant orthopaedic surgeons who graded the OA using Kellgren and Lawrence (KL) and Ahlbäck classification systems. The severity of the functional impairment and pain score was then compared to the radiological grading. Results: The average age of our participants was 63 ± 9 years. Their average BMI was 34.9 ± 8.4 kg/m2, median self-reported pain, total WOMAC, and pain WOMAC scores were 8, 60, and 13, respectively. We observed no significant correlation between BMI and pain scores. Inter-rater reliability for KL and Ahlbäck grading was strong. There was no significant correlation between WOMAC scores and the radiological grades. Conclusion: There was no correlation between pain and functional scores, patient factors and radiological severity of OA of the knee.
{"title":"The correlation between clinical and radiological severity of osteoarthritis of the knee","authors":"Wynand Steenkamp, P. Rachuene, R. Dey, Nkosiphendule Lindani Mzayiya, Brian Emmanuel Ramasuvha","doi":"10.1051/sicotj/2022014","DOIUrl":"https://doi.org/10.1051/sicotj/2022014","url":null,"abstract":"Introduction: Primary osteoarthritis (OA) is a common cause of knee pain. Appropriate management of knee OA is based on clinical and radiological findings. Pain, deformity, and functional impairments are major clinical factors considered along with radiological findings when making management decisions. Differences in management strategies might exist due to clinical and radiological factors. This study aims at finding possible associations between clinical and radiological observations. Methods: A prospective cross-sectional study of 52 patients with primary osteoarthritis of the knee managed conservatively at a tertiary hospital arthroplasty clinic was conducted for three months. English speaking patients with primary OA were identified and included in this study. Pain and functional impairment were assessed using Wong-Baker Faces pain scale, The Knee Society Score (KSS), and Western Ontario and McMaster Osteoarthritis Index (WOMAC). The Body Mass Index (BMI) of all participants was measured. Standard two views plain radiographs were used for radiographic grading of the OA. Anonymized radiographs were presented to two senior consultant orthopaedic surgeons who graded the OA using Kellgren and Lawrence (KL) and Ahlbäck classification systems. The severity of the functional impairment and pain score was then compared to the radiological grading. Results: The average age of our participants was 63 ± 9 years. Their average BMI was 34.9 ± 8.4 kg/m2, median self-reported pain, total WOMAC, and pain WOMAC scores were 8, 60, and 13, respectively. We observed no significant correlation between BMI and pain scores. Inter-rater reliability for KL and Ahlbäck grading was strong. There was no significant correlation between WOMAC scores and the radiological grades. Conclusion: There was no correlation between pain and functional scores, patient factors and radiological severity of OA of the knee.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45691585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Anderson, Peter Vollmann, M. Weißenberger, M. Rudert
Background: As advanced age often leads to accumulating comorbidities, geriatric patients are endangered by serious events during total hip arthroplasty. This study was conducted to explore whether or not the benefit in terms of health-related quality of life (HRQoL) was comparable to younger patients. Methods: At a single academic center, 100 patients meeting the following inclusion criteria were retrospectively recruited: (1) primary arthritis of the hip leading to THA; (2) age 80 years or older at the time of surgery; (3) follow up of at least 12 months. For comparison, two further groups were recruited in the same manner, differing only in the age criterion: 100 patients aged 60–69 and 100 patients aged 70–79 at the time of hip replacement. The primary outcome was compared using the WOMAC and the EQ-5D score. The secondary outcome was determined by rates of orthopedic and non-orthopedic complications. Intragroup comparisons of the PROMS were performed by the non-parametric Wilcoxon test for paired samples. For intergroup comparisons of the PROMS, the Kruskal–Wallis-test was performed. Concerning categorial data, intergroup comparisons were performed by the Chi-Square test. The level of significance was set at 0.05. Results: Concerning the WOMAC score, neither the absolute values at 12 months after THA (p = 0.176) nor the amount of change relative to the values before surgery (p = 0.308) differed significantly between the 3 groups. Concerning the EQ-5D index the absolute values at 12 months after THA differed significantly (p = 0.008). Rates of orthopedic complications did not differ significantly (p = 0.631). Rates of non-orthopedic complications increased significantly with rising age (p = 0.033). Conclusions: Compared to younger patients, geriatric patients after THA have an equal improvement in hip-specific and general HRQoL. While rates of orthopedic complications are comparable too, non-orthopedic complications occur more frequently.
{"title":"Total hip arthroplasty in geriatric patients – a single-center experience","authors":"P. Anderson, Peter Vollmann, M. Weißenberger, M. Rudert","doi":"10.1051/sicotj/2022011","DOIUrl":"https://doi.org/10.1051/sicotj/2022011","url":null,"abstract":"Background: As advanced age often leads to accumulating comorbidities, geriatric patients are endangered by serious events during total hip arthroplasty. This study was conducted to explore whether or not the benefit in terms of health-related quality of life (HRQoL) was comparable to younger patients. Methods: At a single academic center, 100 patients meeting the following inclusion criteria were retrospectively recruited: (1) primary arthritis of the hip leading to THA; (2) age 80 years or older at the time of surgery; (3) follow up of at least 12 months. For comparison, two further groups were recruited in the same manner, differing only in the age criterion: 100 patients aged 60–69 and 100 patients aged 70–79 at the time of hip replacement. The primary outcome was compared using the WOMAC and the EQ-5D score. The secondary outcome was determined by rates of orthopedic and non-orthopedic complications. Intragroup comparisons of the PROMS were performed by the non-parametric Wilcoxon test for paired samples. For intergroup comparisons of the PROMS, the Kruskal–Wallis-test was performed. Concerning categorial data, intergroup comparisons were performed by the Chi-Square test. The level of significance was set at 0.05. Results: Concerning the WOMAC score, neither the absolute values at 12 months after THA (p = 0.176) nor the amount of change relative to the values before surgery (p = 0.308) differed significantly between the 3 groups. Concerning the EQ-5D index the absolute values at 12 months after THA differed significantly (p = 0.008). Rates of orthopedic complications did not differ significantly (p = 0.631). Rates of non-orthopedic complications increased significantly with rising age (p = 0.033). Conclusions: Compared to younger patients, geriatric patients after THA have an equal improvement in hip-specific and general HRQoL. While rates of orthopedic complications are comparable too, non-orthopedic complications occur more frequently.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43795426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. D’Ambrosi, A. Toni, J. Czubak, Jorge Guadilla, L. Lieber, I. Mariani, N. Ursino
Introduction: This multicenter prospective cohort study aimed to assess the safety and clinical and radiologic performance of the CLS® BreviusTM Stem with Kinectiv® Technology. Material and Methods: A total of 222 consecutive subjects, recruited in five different centers, qualifying for primary total hip arthroplasty (THA), were enrolled in the study. All the subjects received the CLS® BreviusTM Stem with Kinectiv® Technology. All the enrolled study subjects underwent pre-operative clinical and radiographic evaluation. Additionally, all subjects underwent post-operative clinical, functional and radiographic evaluations at 6 months and 1, 2, 3, and 5 years. These evaluations included implant survival, pain and functional performance (Harris Hip Score [HHS], University of California, Los Angeles [UCLA] Activity Score, Oxford Hip Score), subject quality-of-life (EQ-5D), radiographic parameters, complications, and concentration of metal ions (aluminum and titanium) in blood. Results: No revisions were performed during the follow-up period. Of the 222 patients, only 76 completed the 5-year follow-up. Only 7 and 5 patients had aluminum and titanium 5-year evaluations, respectively. All the clinical parameters showed an overall improvement in the overtime measured with ANOVA for repeated measures; furthermore, the clinical scores showed a statistically significant improvement at 5 years with respect to pre-operative value (p < 0.001). Aluminum and titanium showed no variation for repeated measures at different time points (p > 0.05). A total of six complications were reported, of which only two were hip-related. Conclusions: The function of the CLS® BreviusTM Stem with Kinectiv® Technology indicated that subject well-being significantly increased following THA regardless of age, gender, BMI, previous surgery, primary diagnosis, and lifestyle.
{"title":"Satisfactory clinical and radiologic outcomes with a new shorter and modular stem for end-stage hip osteoarthritis: an international prospective multicentre pilot study","authors":"R. D’Ambrosi, A. Toni, J. Czubak, Jorge Guadilla, L. Lieber, I. Mariani, N. Ursino","doi":"10.1051/sicotj/2022005","DOIUrl":"https://doi.org/10.1051/sicotj/2022005","url":null,"abstract":"Introduction: This multicenter prospective cohort study aimed to assess the safety and clinical and radiologic performance of the CLS® BreviusTM Stem with Kinectiv® Technology. Material and Methods: A total of 222 consecutive subjects, recruited in five different centers, qualifying for primary total hip arthroplasty (THA), were enrolled in the study. All the subjects received the CLS® BreviusTM Stem with Kinectiv® Technology. All the enrolled study subjects underwent pre-operative clinical and radiographic evaluation. Additionally, all subjects underwent post-operative clinical, functional and radiographic evaluations at 6 months and 1, 2, 3, and 5 years. These evaluations included implant survival, pain and functional performance (Harris Hip Score [HHS], University of California, Los Angeles [UCLA] Activity Score, Oxford Hip Score), subject quality-of-life (EQ-5D), radiographic parameters, complications, and concentration of metal ions (aluminum and titanium) in blood. Results: No revisions were performed during the follow-up period. Of the 222 patients, only 76 completed the 5-year follow-up. Only 7 and 5 patients had aluminum and titanium 5-year evaluations, respectively. All the clinical parameters showed an overall improvement in the overtime measured with ANOVA for repeated measures; furthermore, the clinical scores showed a statistically significant improvement at 5 years with respect to pre-operative value (p < 0.001). Aluminum and titanium showed no variation for repeated measures at different time points (p > 0.05). A total of six complications were reported, of which only two were hip-related. Conclusions: The function of the CLS® BreviusTM Stem with Kinectiv® Technology indicated that subject well-being significantly increased following THA regardless of age, gender, BMI, previous surgery, primary diagnosis, and lifestyle.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"67 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41331575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Shatrov, Cécile Battelier, E. Sappey-Marinier, S. Gunst, E. Servien, S. Lustig
Introduction: Alignment techniques in total knee arthroplasty (TKA) continue to evolve. Functional alignment (FA) is a novel technique that utilizes robotic tools to deliver TKA with the aim of respecting individual anatomical variations. The purpose of this paper is to describe the rationale and technique of FA in the varus morphotype with the use of a robotic platform. Rationale: FA reproduces constitutional knee anatomy within quantifiable target ranges. The principles are founded on a comprehensive assessment and understanding of individual anatomical variations with the aim of delivering personalized TKA. The principles are functional pre-operative planning, reconstitution of native coronal alignment, restoration of dynamic sagittal alignment within 5° of neutral, maintenance of joint-line-obliquity and height, implant sizing to match anatomy and a joint that is balanced in flexion and extension through manipulation of implant positioning rather than soft tissue releases. Technique: An individualized plan is created from pre-operative imaging. Next, a reproducible and quantifiable method of soft tissue laxity assessment is performed in extension and flexion that accounts for individual variation in soft tissue laxity. A dynamic virtual 3D model of the joint and implant position that can be manipulated in all three planes is modified to achieve target gap measurements while maintaining the joint line phenotype and a final limb position within a defined coronal and sagittal range. Conclusion: Functional alignment is a novel knee arthroplasty technique that aims to restore constitutional bony alignment and balance the laxity of the soft tissues by placing and sizing implants in a manner that it respects the variations in individual anatomy. This paper presents the approach for the varus morphotype.
{"title":"Functional Alignment Philosophy in Total Knee Arthroplasty – Rationale and technique for the varus morphotype using a CT based robotic platform and individualized planning","authors":"J. Shatrov, Cécile Battelier, E. Sappey-Marinier, S. Gunst, E. Servien, S. Lustig","doi":"10.1051/sicotj/2022010","DOIUrl":"https://doi.org/10.1051/sicotj/2022010","url":null,"abstract":"Introduction: Alignment techniques in total knee arthroplasty (TKA) continue to evolve. Functional alignment (FA) is a novel technique that utilizes robotic tools to deliver TKA with the aim of respecting individual anatomical variations. The purpose of this paper is to describe the rationale and technique of FA in the varus morphotype with the use of a robotic platform. Rationale: FA reproduces constitutional knee anatomy within quantifiable target ranges. The principles are founded on a comprehensive assessment and understanding of individual anatomical variations with the aim of delivering personalized TKA. The principles are functional pre-operative planning, reconstitution of native coronal alignment, restoration of dynamic sagittal alignment within 5° of neutral, maintenance of joint-line-obliquity and height, implant sizing to match anatomy and a joint that is balanced in flexion and extension through manipulation of implant positioning rather than soft tissue releases. Technique: An individualized plan is created from pre-operative imaging. Next, a reproducible and quantifiable method of soft tissue laxity assessment is performed in extension and flexion that accounts for individual variation in soft tissue laxity. A dynamic virtual 3D model of the joint and implant position that can be manipulated in all three planes is modified to achieve target gap measurements while maintaining the joint line phenotype and a final limb position within a defined coronal and sagittal range. Conclusion: Functional alignment is a novel knee arthroplasty technique that aims to restore constitutional bony alignment and balance the laxity of the soft tissues by placing and sizing implants in a manner that it respects the variations in individual anatomy. This paper presents the approach for the varus morphotype.","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46889190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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