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Percutaneous femoral de-rotational varus osteotomy for the treatment of acetabular dysplasia: surgical technique. 经皮股骨去旋转内翻截骨术治疗髋臼发育不良:外科技术。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023003
Rami Jahmani, Ziad Ali Audat, Abdualaziz Z Alanazi, Giovanni Lovisetti

Pediatric acetabular dysplasia is common in orthopedic practice. Femoral de-rotational varus osteotomy (FDVO) is one of the surgical options suggested for treatment. In this article, we describe a simplified surgical technique of performing FDVO percutaneously using a pediatric Limb Reconstruction System external fixator, and we discuss the advantages and disadvantages of the technique.

小儿髋臼发育不良在骨科实践中很常见。股骨去旋转内翻截骨术(FDVO)是建议治疗的手术选择之一。在本文中,我们描述了一种使用儿童肢体重建系统外固定架经皮进行FDVO的简化手术技术,并讨论了该技术的优点和缺点。
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引用次数: 0
Double lag-screw compression for optimal fixation of intertrochanteric fractures with large fragment gap: A technical note. 双拉力螺钉加压固定大碎片间隙转子间骨折的最佳方法:技术注意事项。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023005
Panagiotis Karampinas, Athanasios Galanis, Eftychios Papagrigorakis, Michail Vavourakis, Anastasia Krexi, Spiros Pneumaticos, John Vlamis

Cephalomedullary nailing of unstable intertrochanteric fractures has been established as a fruitful surgical approach with relatively limited complications. Anatomic fracture reduction and proper implant positioning are vital to attaining a favorable long-term surgical outcome. Appropriate intraoperative fracture compression augments stability and invigorates healing. The amount of compression permitted by cephalomedullary nails cannot always adequately reduce large fragment gaps. This paper presents a novel technical trick of double compression of the fracture site, in order to achieve the essential extra compression and reduction when required, thus decreasing the risk of postoperative implant cut-out. The technique was used in 14 out of 277 peritrochanteric fractures treated with cephalomedullary nailing in our trauma center for 12 months, with satisfactory outcomes regarding both fracture site union and postoperative functional capacity.

颅髓内钉治疗不稳定粗隆间骨折是一种有效的手术方法,并发症相对较少。解剖骨折复位和正确的植入物定位对于获得良好的长期手术结果至关重要。术中适当的骨折压迫可增加稳定性并促进愈合。头髓钉允许的压缩量不能总是充分减少大碎片间隙。本文提出了一种新的技术手法,即对骨折部位进行双重压迫,以便在需要时进行必要的额外压迫和复位,从而降低术后种植体切出的风险。我们创伤中心对277例股骨粗隆周围骨折进行了为期12个月的头髓内钉治疗,其中14例采用了该技术,在骨折部位愈合和术后功能恢复方面均取得了令人满意的结果。
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引用次数: 0
Tibial tubercule osteotomy during the revision of total knee arthroplasty: The technique of a referral center with 10 years of experience. 全膝关节置换术翻修时胫骨结核截骨术:一个有10年经验的转诊中心的技术。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023016
Nicolas Cance, Cecile Batailler, Robin Canetti, Elvire Servien, Sébastien Lustig

Introduction: The Tibial Tubercle Osteotomy (TTO) technique, by lifting the distal bony attachment of the extensor mechanism, allows efficient knee exposure while preserving soft tissues and tendinous attachments. The surgical technique seems essential to obtain satisfying outcomes with a low rate of specific complications. Several tip sand tricks can be used to improve this procedure during the revision of total knee arthroplasty (RTKA).

Technique: The osteotomy should be at least: 60 mm in length and 20 mm in width to allow fixation with 2 screws; and 10-15 mm thick to resist to screw compression. The proximal cut of the osteotomy must keep a proximal buttress spur of 10 mm to get primary stability and avoid the tubercle ascension. A smooth end of the TTO distally reduces the risk of a tibial shaft fracture. The strongest fixation is obtained using two bicortical 4.5 mm screws slightly ascendant.

Results: From January 2010 to September 2020, 135 patients received an RTKA with concomitant TTO and a mean follow-up of 51 ± 26 months [24-121]. The osteotomy was healed in 95% of patients (n = 128) with a mean delay of 3.4 ± 2.7 months [1.5-24]. However, there are some specific and significant complications related to the TTO. Twenty complications (15%) related to the TTO were recorded, with 8 (6%) requiring surgery.

Conclusion: Tibial tubercle osteotomy in RTKA is an efficient procedure to improve knee exposure. To avoid tibial tubercle fracture or non-union, a rigorous surgical technique is primordial with a sufficient length and thickness of the tibial tubercle, a smooth end, a proximal step, a final good bone contact, and a strong fixation.

胫骨结节截骨术(TTO)技术,通过解除伸肌机制的远端骨附着,允许有效的膝关节暴露,同时保留软组织和肌腱附着。手术技术似乎是获得令人满意的结果和低特定并发症率的必要条件。在全膝关节置换术(RTKA)翻修期间,可以使用一些提示和技巧来改善这一过程。技术:截骨长度至少为60mm,宽度至少为20mm,以便用2枚螺钉固定;并且10- 15mm厚以抵抗螺杆压缩。截骨的近端切口必须保持10 mm的近端支突,以获得初步稳定,避免结节上升。TTO远端平滑的末端可降低胫骨干骨折的风险。最强的固定是使用两个双皮质4.5 mm螺钉,螺钉略上升。结果:2010年1月至2020年9月,135例患者接受RTKA合并TTO,平均随访51±26个月[24-121]。95%的患者(n = 128)截骨愈合,平均延迟3.4±2.7个月[1.5-24]。然而,有一些特定的和显著的并发症与TTO有关。记录了20例(15%)与TTO相关的并发症,其中8例(6%)需要手术。结论:胫骨结节截骨术是改善膝关节暴露的有效方法。为了避免胫骨结节骨折或不愈合,严格的手术技术是最基本的,包括胫骨结节足够的长度和厚度,光滑的末端,近端步骤,最后良好的骨接触和牢固的固定。
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引用次数: 0
Bilateral spontaneous quadriceps tendon rupture: a case report and literature review. 双侧自发性股四头肌肌腱断裂1例报告并文献复习。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 Epub Date: 2023-11-03 DOI: 10.1051/sicotj/2023031
Mohammad Alkhatatba, Yazan Anaqreh, Suhaib Bani Essa, Ala'a Alma'aiteh, Hamzeh Ziad Audat, Naser Obeidat, Marwan Ahmed
Bilateral spontaneous quadriceps tendon rupture is a rare condition characterized by the simultaneous tear of the fibrous tissue connecting the quadriceps muscle to the patella bone. Prompt diagnosis is crucial for appropriate treatment and optimal outcomes. We present a case of a 70-year-old male with bilateral knee pain and an inability to walk, resulting from a trivial fall. Despite initial misdiagnosis, a thorough evaluation, including physical examination and imaging, revealed bilateral quadriceps tendon rupture. Surgical repair was performed, followed by a comprehensive rehabilitation program. At the four-month follow-up, the patient showed significant improvement in pain and function. This article provides a comprehensive review of the existing literature on bilateral quadriceps tendon rupture, emphasizing the challenges in the diagnosis and management of this rare condition. Early diagnosis, prompt surgical intervention, and a tailored rehabilitation program are crucial for successful outcomes.
双侧自发性股四头肌肌腱断裂是一种罕见的情况,其特征是连接股四头肌肉和髌骨的纤维组织同时撕裂。及时诊断对于适当的治疗和最佳结果至关重要。我们报告一例70岁男性,因轻微跌倒导致双侧膝盖疼痛,无法行走。尽管最初有误诊,但包括体检和影像学在内的全面评估显示双侧股四头肌肌腱断裂。进行了手术修复,随后进行了全面的康复计划。在四个月的随访中,患者的疼痛和功能明显改善。本文对双侧股四头肌肌腱断裂的现有文献进行了全面回顾,强调了这种罕见疾病的诊断和治疗面临的挑战。早期诊断、及时的手术干预和量身定制的康复计划对成功的结果至关重要。
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引用次数: 0
Estimated diameter increase from a 4S to a 6S hamstring graft configuration - A cadaveric study. 估计直径从4S到6S腿筋移植配置增加-尸体研究。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 Epub Date: 2023-11-30 DOI: 10.1051/sicotj/2023033
Yoan Bourgeault-Gagnon, Alexandre Keith Leang, Sonia Bédard, Karina Lebel, Frédéric Balg, François Vézina

Purpose: Graft diameter in anterior cruciate ligament reconstructions has been shown to influence the risk of failure. It is therefore important to be able to adjust the graft configuration to modify the diameter. To measure the impact of a 6-strand (6S) hamstring autograft configuration on graft diameter compared to the standard 4-strand (4S) configuration.

Methods: Cadaveric study on 33 knees, using the usual hamstring graft harvesting technique. Semitendinosus and gracilis tendons were harvested and their length, width, and diameter were measured in 4S and 6S configurations separately by three evaluators.

Results: 6S configuration leads to a median increase of 1.5 (range: 0.0-2.0) mm in diameter compared to 4S (p < 0.001). A graft diameter of more than 8 mm is attained in less than a third of 4S grafts within this population in comparison to 84% when the 6S configuration is used.

Discussion: The 6S hamstring graft configuration increases the graft diameter by a median of 1.5 millimeters compared to the traditional 4S configuration. It can reliably be used to obtain an 8.5 mm graft diameter or more in cases where the semitendinosus measures at least 270.5 mm and the 4S configuration has a diameter of 7.5 mm or 8 mm. This information helps to better delineate the impact of a 6S configuration in a pre-operative or intra-operative setting to optimize the decisional process and surgical flow and to easily adapt the graft diameter.

Level of evidence: V (cadaveric study).

目的:研究前交叉韧带重建中移植物直径对失败风险的影响。因此,能够调整接枝结构以改变直径是很重要的。测量6股(6S)腘绳肌腱自体移植与标准4股(4S)肌腱移植对移植直径的影响。方法:采用常规腘绳肌移植技术,对33例膝关节进行尸体研究。取半腱肌和股薄肌肌腱,分别由3名评估者在4S和6S构型下测量其长度、宽度和直径。结果:与4S配置相比,6S配置可使移植物直径中位数增加1.5 mm(范围:0.0-2.0)(p)。讨论:6S配置可使移植物直径中位数比传统4S配置增加1.5 mm。它可以可靠地用于获得8.5 mm或更大直径的移植物,在半腱肌测量至少270.5 mm和4S配置的直径为7.5 mm或8 mm的情况下。该信息有助于更好地描述6S配置在术前或术中设置中的影响,以优化决策过程和手术流程,并轻松调整移植物直径。证据等级:V级(尸体研究)。
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引用次数: 0
Treatment of failed scaphoid nonunion fixation using free medial femoral condyle vascularized bone grafting. 游离股骨内侧髁带血管骨移植治疗舟状骨不连固定失败。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023004
Islam Koriem, Aly Abdalla Agina, Ahmed K El Ghazawy

Background: Nonunion in scaphoid fractures may be considered a devastating problem. Union failure results in scaphoid deformity, resorption, and bone loss. Failed previous fixation decreases remaining bone stock and makes it more difficult to achieve union. Free vascularized graft represents a good option to achieve scaphoid union with revision fixation. Our study aims at the assessment of the management of scaphoid fractures non-union after failed previous fixation with the use of a free vascularized graft from the medial femoral condyle.

Methods: This is a retrospective study including 16 cases with persistent scaphoid nonunion after previous fixation managed by vascularized medial femoral condyle grafts. The mean follow-up was 24 months. Previous surgical attempts and nonunion duration were noted. We evaluated the union rate, together with ROM, Scapholunate angles and pain scores.

Results: the union was achieved in 13 of 16 cases. Pain improved in all patients (10/16 complete relief). Wrist ROM at follow-up was an average of 50° flexion 48° extension. There was no change in the relationship between lunate and scaphoid with an average angle of 37.5° preoperative and 38° postoperative.

Conclusion: Free vascularized MFC grafts are considered a reliable method to treat persistent nonunion of scaphoid fractures after failed previous operations. Short-term follow-up data showed considerable union rates with adequate pain relief and satisfactory ROM.

背景:舟状骨骨折不愈合可能被认为是一个毁灭性的问题。愈合失败导致舟状骨畸形、骨吸收和骨丢失。先前固定失败会减少剩余骨存量,使骨愈合更加困难。带血管的游离移植物是一个很好的选择,以实现舟骨愈合翻修固定。我们的研究目的是评估使用股骨内侧髁带血管的游离移植物对先前固定失败后舟状骨骨折不愈合的处理。方法:回顾性分析16例经带血管的股内侧髁移植物固定后舟骨不愈合的病例。平均随访时间为24个月。记录以前的手术尝试和不愈合持续时间。我们评估愈合率、关节活动度、舟月角和疼痛评分。结果:16例患者中13例成功愈合。所有患者的疼痛均有所改善(10/16完全缓解)。随访时腕关节活动度平均为屈曲50°48°。月骨与舟骨的关系没有变化,术前和术后的平均角度分别为37.5°和38°。结论:游离带血管的MFC移植是治疗舟状骨骨折术后持续不愈合的可靠方法。短期随访数据显示相当高的愈合率,足够的疼痛缓解和满意的ROM。
{"title":"Treatment of failed scaphoid nonunion fixation using free medial femoral condyle vascularized bone grafting.","authors":"Islam Koriem,&nbsp;Aly Abdalla Agina,&nbsp;Ahmed K El Ghazawy","doi":"10.1051/sicotj/2023004","DOIUrl":"https://doi.org/10.1051/sicotj/2023004","url":null,"abstract":"<p><strong>Background: </strong>Nonunion in scaphoid fractures may be considered a devastating problem. Union failure results in scaphoid deformity, resorption, and bone loss. Failed previous fixation decreases remaining bone stock and makes it more difficult to achieve union. Free vascularized graft represents a good option to achieve scaphoid union with revision fixation. Our study aims at the assessment of the management of scaphoid fractures non-union after failed previous fixation with the use of a free vascularized graft from the medial femoral condyle.</p><p><strong>Methods: </strong>This is a retrospective study including 16 cases with persistent scaphoid nonunion after previous fixation managed by vascularized medial femoral condyle grafts. The mean follow-up was 24 months. Previous surgical attempts and nonunion duration were noted. We evaluated the union rate, together with ROM, Scapholunate angles and pain scores.</p><p><strong>Results: </strong>the union was achieved in 13 of 16 cases. Pain improved in all patients (10/16 complete relief). Wrist ROM at follow-up was an average of 50° flexion 48° extension. There was no change in the relationship between lunate and scaphoid with an average angle of 37.5° preoperative and 38° postoperative.</p><p><strong>Conclusion: </strong>Free vascularized MFC grafts are considered a reliable method to treat persistent nonunion of scaphoid fractures after failed previous operations. Short-term follow-up data showed considerable union rates with adequate pain relief and satisfactory ROM.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9336705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study. 与标准的直接上入路(DSA)相比,上横无创重建(STAR)入路提供了更好的结果:一项匹配的前瞻性单外科医生比较研究。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023008
Eustathios Kenanidis, Nikolaos Milonakis, Foukarakis Georgios, Michael Potoupnis, Eleftherios Tsiridis

Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon.

Methods: Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016-2017 and 2020-2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up.

Results: The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months.

Conclusions: The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure.

简介:直接上入路(DSA)是一种保留肌肉的髋关节入路,不保护梨状肌和其他短外旋肌。我们提出了一种DSA改良方法,我们命名为STAR(优越横向无创伤重建),它具有DSA优势,但总是保留梨状肌。我们的研究比较了通过STAR入路接受原发性全髋关节置换术(THA)的患者与由资深外科医生进行匹配的DSA组的早期术后、放射学和功能结果。方法:每组,DSA和STAR分别包括2016-2017年和2020-2021年期间由外科医生进行的200例选择性原发性单侧tha手术。两组患者采用相同的纳入标准。两组人的年龄和性别都是匹配的。两组均采用相同的术后疼痛管理、化学预防和物理治疗方案。两位独立的骨科医生进行了临床和放射学随访。结果:STAR组平均切口长度(p = 0.042)和住院时间(p = 0.002)明显低于DSA组。STAR组平均术中出血量(p = 0.085)和输血需要量(p = 0.228)均低于DSA组。术后第一个月和第三个月结束时,STAR组术后功能评分的平均改善明显高于DSA组。结论:与DSA相比,STAR方法可以更早地改善原发性THA患者的功能,缩短住院时间,减少输血需求。两种入路并发症风险均有限,且髋臼和股骨通路良好。
{"title":"Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study.","authors":"Eustathios Kenanidis,&nbsp;Nikolaos Milonakis,&nbsp;Foukarakis Georgios,&nbsp;Michael Potoupnis,&nbsp;Eleftherios Tsiridis","doi":"10.1051/sicotj/2023008","DOIUrl":"https://doi.org/10.1051/sicotj/2023008","url":null,"abstract":"<p><strong>Introduction: </strong>The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon.</p><p><strong>Methods: </strong>Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016-2017 and 2020-2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up.</p><p><strong>Results: </strong>The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months.</p><p><strong>Conclusions: </strong>The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
No clinical difference at mid-term follow-up between TiN-coated versus uncoated cemented mobile-bearing total knee arthroplasty: a matched cohort study. 中期随访中,tin包覆与未包覆的骨水泥可移动全膝关节置换术无临床差异:一项匹配队列研究。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023001
Etienne Deroche, Cécile Batailler, Jobe Shatrov, Stanislas Gunst, Elvire Servien, Sébastien Lustig

Introduction: Nitride-based ceramic coating was introduced into surgical implants to improve hardness, reduce abrasion, and decrease the risk of metal-induced adverse reactions, especially for patients with suspected or identified metal hypersensitivity. The study aimed to evaluate the effectiveness and safety of a titanium nitride (TiN) coated prosthesis with a mobile bearing design.

Methods: This was a retrospective matched-cohort study from a single center, comparing clinical outcomes between patients receiving either a TiN-coated versus an uncoated cobalt-chromium-molybdenum (CoCrMo) prostheses for primary total knee replacement. Seventeen patients received the TiN prosthesis between 2015 and 2019. These were matched 1:2 with patients receiving uncoated mobile-bearing knee prostheses with the same design manufacturer.

Results: Fourteen patients in the TiN group had complete 5-year follow-up data and were compared with 34 patients from the CoCrMo group. The Knee Society Score was 170.6 ± 28.0 (Function subscore 83.7 ± 17.5 and Knee subscore 86.9 ± 13.8) in the TiN group and 180.7 ± 49.4 (Function subscore 87.5 ± 14.3 and Knee subscore 93.2 ± 9.6) in CoCrMo group, with no statistically significant difference (p = 0.19). One patient underwent a revision for instability requiring the removal of the implant in the TiN group and none in the CoCrMo group. The survival rates were 92.9% (CI95% 77.3-100.0) and 100.0% in the TiN group and CoCrMo group respectively (p = 1.0).

Discussion: TiN-coated TKA with mobile bearing resulted in satisfactory clinical outcomes, and a low revision rate, and there was no complication related to the coated implant. The use of TiN-coated prostheses in case of confirmed or suspected metal allergy provides satisfactory short-term clinic outcomes.

导论:氮基陶瓷涂层被引入到外科植入物中,以提高硬度,减少磨损,降低金属诱发不良反应的风险,特别是对于怀疑或确定金属过敏的患者。本研究旨在评估氮化钛(TiN)涂层具有移动轴承设计的假体的有效性和安全性。方法:这是一项来自单中心的回顾性匹配队列研究,比较接受tin涂层和未涂层钴铬钼(CoCrMo)假体进行原发性全膝关节置换术的患者的临床结果。2015年至2019年期间,17名患者接受了TiN假体。这些患者与接受相同设计制造商的无涂层可移动膝关节假体的患者的比例为1:2。结果:TiN组14例患者有完整的5年随访数据,与CoCrMo组34例患者相比。TiN组膝关节社会评分为170.6±28.0分(功能评分83.7±17.5分,膝关节评分86.9±13.8分),CoCrMo组膝关节社会评分为180.7±49.4分(功能评分87.5±14.3分,膝关节评分93.2±9.6分),差异无统计学意义(p = 0.19)。TiN组有1例患者因不稳定需要移除植入物而进行了翻修,而CoCrMo组没有患者。TiN组和CoCrMo组的生存率分别为92.9% (CI95% 77.3 ~ 100.0)和100.0% (p = 1.0)。讨论:锡包覆可移动承载TKA临床效果满意,修复率低,无与包覆种植体相关的并发症。在确认或怀疑金属过敏的情况下,使用锡涂层假体提供了令人满意的短期临床结果。
{"title":"No clinical difference at mid-term follow-up between TiN-coated versus uncoated cemented mobile-bearing total knee arthroplasty: a matched cohort study.","authors":"Etienne Deroche,&nbsp;Cécile Batailler,&nbsp;Jobe Shatrov,&nbsp;Stanislas Gunst,&nbsp;Elvire Servien,&nbsp;Sébastien Lustig","doi":"10.1051/sicotj/2023001","DOIUrl":"https://doi.org/10.1051/sicotj/2023001","url":null,"abstract":"<p><strong>Introduction: </strong>Nitride-based ceramic coating was introduced into surgical implants to improve hardness, reduce abrasion, and decrease the risk of metal-induced adverse reactions, especially for patients with suspected or identified metal hypersensitivity. The study aimed to evaluate the effectiveness and safety of a titanium nitride (TiN) coated prosthesis with a mobile bearing design.</p><p><strong>Methods: </strong>This was a retrospective matched-cohort study from a single center, comparing clinical outcomes between patients receiving either a TiN-coated versus an uncoated cobalt-chromium-molybdenum (CoCrMo) prostheses for primary total knee replacement. Seventeen patients received the TiN prosthesis between 2015 and 2019. These were matched 1:2 with patients receiving uncoated mobile-bearing knee prostheses with the same design manufacturer.</p><p><strong>Results: </strong>Fourteen patients in the TiN group had complete 5-year follow-up data and were compared with 34 patients from the CoCrMo group. The Knee Society Score was 170.6 ± 28.0 (Function subscore 83.7 ± 17.5 and Knee subscore 86.9 ± 13.8) in the TiN group and 180.7 ± 49.4 (Function subscore 87.5 ± 14.3 and Knee subscore 93.2 ± 9.6) in CoCrMo group, with no statistically significant difference (p = 0.19). One patient underwent a revision for instability requiring the removal of the implant in the TiN group and none in the CoCrMo group. The survival rates were 92.9% (CI95% 77.3-100.0) and 100.0% in the TiN group and CoCrMo group respectively (p = 1.0).</p><p><strong>Discussion: </strong>TiN-coated TKA with mobile bearing resulted in satisfactory clinical outcomes, and a low revision rate, and there was no complication related to the coated implant. The use of TiN-coated prostheses in case of confirmed or suspected metal allergy provides satisfactory short-term clinic outcomes.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10760528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Partial versus total knee arthroplasty for isolated antero-medial osteoarthritis - An analysis of PROMs and satisfaction. 局部与全膝关节置换术治疗孤立性前内侧骨关节炎- PROMs和满意度分析。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023006
Adarsh Annapareddy, Praharsha Mulpur, Mrinal Prakash, A B Suhas Masilamani, Krishna Kiran Eachempati, A V Gurava Reddy

Aim: This study aimed to compare the patient-reported functional outcomes and patient satisfaction after medial Unicompartmental Knee Arthroplasty (UKA) versus Total Knee Arthroplasty (TKA), performed for anteromedial osteoarthritis (AMOA) of the knee in patients from an Indian population, at a minimum 3-year follow-up.

Methods: This is a prospective matched cohort study (1:2 ratio). One hundred and one UKA cases were matched to 206 TKA cases by propensity score matching for age, body mass index (BMI), gender distribution, and the Charlson Comorbidity Index (CCI). The primary outcome (Oxford knee score, OKS) was assessed at a 3-year follow-up, along with secondary outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Score, Forgotten Joint Score (FJS), Anterior Knee Pain (Kujala) score, patient satisfaction, and revision rate at the final follow-up).

Results: The UKA group was superior to the TKA group in patient-reported functional outcomes based on the OKS (p = 0.004). Using the FJS score, UKA was more likely to be a forgotten joint compared to TKA (p < 0.001). However, differences in the OKS and FJS did not meet the reported minimal clinically important difference (MCID) thresholds. Quality of life (EuroQol-5D VAS scale) was found to be significantly higher in the UKA group (p < 0.001). Patients in the UKA group were more likely to be very satisfied (75.2%) versus the TKA group (62.1%, p = 0.023).

Conclusion: For AMOA, UKA was associated with improved patient satisfaction compared to TKA. Although patient-reported outcome measures were statistically in favour of UKA over TKA, the differences were not clinically significant. Multicenter and randomized studies comparing the two procedures are warranted.

Evidence: Level-II Therapeutic.

目的:本研究旨在比较来自印度人群的治疗膝关节前内侧骨关节炎(AMOA)的单室膝关节置换术(UKA)和全膝关节置换术(TKA)后患者报告的功能结果和患者满意度,随访至少3年。方法:这是一项前瞻性匹配队列研究(1:2)。通过年龄、体质指数(BMI)、性别分布、Charlson共病指数(CCI)的倾向评分匹配,将101例UKA与206例TKA进行匹配。主要结局(牛津膝关节评分,OKS)在3年随访中进行评估,次要结局(西安大略省和麦克马斯特大学骨关节炎指数[WOMAC]评分,遗忘关节评分(FJS),膝关节前侧疼痛(Kujala)评分,患者满意度和最终随访时的翻修率)一起进行评估。结果:基于OKS, UKA组在患者报告的功能结局方面优于TKA组(p = 0.004)。使用FJS评分,与TKA相比,UKA更有可能成为遗忘关节(p结论:对于AMOA,与TKA相比,UKA与提高患者满意度相关。虽然患者报告的结果测量在统计学上支持UKA优于TKA,但差异无临床意义。多中心和随机研究比较这两种方法是有必要的。证据:ii级治疗。
{"title":"Partial versus total knee arthroplasty for isolated antero-medial osteoarthritis - An analysis of PROMs and satisfaction.","authors":"Adarsh Annapareddy,&nbsp;Praharsha Mulpur,&nbsp;Mrinal Prakash,&nbsp;A B Suhas Masilamani,&nbsp;Krishna Kiran Eachempati,&nbsp;A V Gurava Reddy","doi":"10.1051/sicotj/2023006","DOIUrl":"https://doi.org/10.1051/sicotj/2023006","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to compare the patient-reported functional outcomes and patient satisfaction after medial Unicompartmental Knee Arthroplasty (UKA) versus Total Knee Arthroplasty (TKA), performed for anteromedial osteoarthritis (AMOA) of the knee in patients from an Indian population, at a minimum 3-year follow-up.</p><p><strong>Methods: </strong>This is a prospective matched cohort study (1:2 ratio). One hundred and one UKA cases were matched to 206 TKA cases by propensity score matching for age, body mass index (BMI), gender distribution, and the Charlson Comorbidity Index (CCI). The primary outcome (Oxford knee score, OKS) was assessed at a 3-year follow-up, along with secondary outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Score, Forgotten Joint Score (FJS), Anterior Knee Pain (Kujala) score, patient satisfaction, and revision rate at the final follow-up).</p><p><strong>Results: </strong>The UKA group was superior to the TKA group in patient-reported functional outcomes based on the OKS (p = 0.004). Using the FJS score, UKA was more likely to be a forgotten joint compared to TKA (p < 0.001). However, differences in the OKS and FJS did not meet the reported minimal clinically important difference (MCID) thresholds. Quality of life (EuroQol-5D VAS scale) was found to be significantly higher in the UKA group (p < 0.001). Patients in the UKA group were more likely to be very satisfied (75.2%) versus the TKA group (62.1%, p = 0.023).</p><p><strong>Conclusion: </strong>For AMOA, UKA was associated with improved patient satisfaction compared to TKA. Although patient-reported outcome measures were statistically in favour of UKA over TKA, the differences were not clinically significant. Multicenter and randomized studies comparing the two procedures are warranted.</p><p><strong>Evidence: </strong>Level-II Therapeutic.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Characteristics and clinical features of cauda equina syndrome: insights from a study on 256 patients. 马尾综合征的特点和临床特征:来自256例患者的研究。
IF 1.6 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1051/sicotj/2023019
Junaid Zeb, Jehan Zaib, Arshad Khan, Mehreen Farid, Seemab Ambreen, Syed Hussaini Shah

Objective: To determine the frequency, clinical presentation, and etiological factors of cauda equina syndrome (CES).

Materials and method: This retrospective study was done on 256 participants, and aimed to analyze the frequency and patterns of clinical presentation in suspected cases of CES. The inclusion criteria included participants aged 18 or older with medical records available for review and having red-flagged symptoms for CES. The study collected information on various factors such as age, gender, confirmation of CES on MRI, neurological deficits, etiological factors, duration of symptoms, and more. The data collected was analyzed using descriptive statistics and logistic regression to identify significant variables between MRI-proven CES and suspected CES.

Results: The mean age was 58.05 ± 19.26 years, with 151 females (58.98%) and 105 males (41.02%). The majority (50.78%) had a neurological deficit, while other symptoms included difficulty initiating micturition or impaired sensation of urinary flow (17.58%), loss of sensation of rectal fullness (3.12%), urinary or faecal incontinence (35.16%), bilateral sciatica (21.88%), neurological symptoms in the lower limbs (25.00%), anaesthesia or any leg weakness (24.22%), and bilateral sciatica as the predominant symptom (21.88%). Symptoms were chronic in 47.27% and acute in 21.88%. The odds of MRI-proven CES increase by 3% per year of age. Neurological deficit was strongly associated with MRI-proven CES (OR = 14.97), while loss of sensation of rectal fullness increased the odds by 10-fold (OR = 10.62).

Conclusion: CES can present with various symptoms, including the bilateral neurological deficit, urinary and faecal incontinence, and bilateral sciatica, with age, severe bilateral neurological deficit, and loss of sensation of rectal fullness being associated with MRI-proven CES. Early diagnosis and treatment are crucial for better outcomes.

目的:了解马尾综合征(CES)的发病频率、临床表现及病因。材料与方法:本研究对256名受试者进行回顾性研究,旨在分析疑似CES病例的临床表现的频率和模式。纳入标准包括年龄在18岁或以上、有可供审查的医疗记录且有CES危险症状的参与者。该研究收集了各种因素的信息,如年龄、性别、MRI上确认的CES、神经功能障碍、病因因素、症状持续时间等。采用描述性统计和逻辑回归分析收集的数据,以确定mri证实的CES和疑似CES之间的显著变量。结果:平均年龄58.05±19.26岁,其中女性151例(58.98%),男性105例(41.02%)。大多数患者(50.78%)有神经功能障碍,其他症状包括排尿困难或尿流感觉受损(17.58%),直肠饱足感丧失(3.12%),尿失禁或粪失禁(35.16%),双侧坐骨神经痛(21.88%),下肢神经症状(25.00%),麻醉或任何腿部无力(24.22%),双侧坐骨神经痛为主要症状(21.88%)。慢性症状占47.27%,急性症状占21.88%。mri证实的CES的几率每年增加3%。神经功能障碍与mri证实的CES密切相关(OR = 14.97),而直肠充盈感丧失使可能性增加了10倍(OR = 10.62)。结论:mri证实的CES可表现为多种症状,包括双侧神经功能缺损、尿便失禁、双侧坐骨神经痛,年龄、严重的双侧神经功能缺损、直肠饱足感丧失与CES相关。早期诊断和治疗对于获得更好的结果至关重要。
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