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Rovere G, Bosco F, Miceli A, Ratano S, Freddo G, D'Itri L, Ferruzza M, Maccauro G, Farsetti P, Camarda L. Adoption of blockchain as a step forward in orthopedic practice. Eur J Transl Myol 2024. [PMID: 38785351 DOI: 10.4081/ejtm.2024.12197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/25/2024] [Indexed: 05/25/2024] Open
Abstract
Blockchain technology has gained popularity since the invention of Bitcoin in 2008. It offers a decentralized and secure system for managing and protecting data. In the healthcare sector, where data protection and patient privacy are crucial, blockchain has the potential to revolutionize various aspects, including patient data management, orthopedic registries, medical imaging, research data, and the integration of Internet of Things (IoT) devices. This manuscript explores the applications of blockchain in orthopedics and highlights its benefits. Furthermore, the combination of blockchain with artificial intelligence (AI), machine learning, and deep learning can enable more accurate diagnoses and treatment recommendations. AI algorithms can learn from large datasets stored on the blockchain, leading to advancements in automated clinical decision-making. Overall, blockchain technology has the potential to enhance data security, interoperability, and collaboration in orthopedics. While there are challenges to overcome, such as adoption barriers and data sharing willingness, the benefits offered by blockchain make it a promising innovation for the field.
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Affiliation(s)
- Giuseppe Rovere
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome.
| | - Francesco Bosco
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Angelo Miceli
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Salvatore Ratano
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Giuseppe Freddo
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Lorenzo D'Itri
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Massimo Ferruzza
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
| | - Giulio Maccauro
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome.
| | - Pasquale Farsetti
- Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome.
| | - Lawrence Camarda
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (ME.PRE.C.C.), University of Palermo, Palermo.
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Bucci G, Ratano S, McGovern RP, Singleton SB, Christoforetti JJ. Endoscopic Repair of Hip Abductor Tendon Tears: A Case Report. J Orthop Case Rep 2024; 14:18-24. [PMID: 38560327 PMCID: PMC10976531 DOI: 10.13107/jocr.2024.v14.i03.4272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/02/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Greater trochanteric pain syndrome is a common incapacitating hip condition characterized by chronic lateral hip pain. This condition includes a range of pathologies ranging from trochanteric bursitis, hip abductor pathology involving the gluteus medius and minimum, external coxa saltans (snapping hip syndrome), or combinations of these. Hip abductor tendon tears have gained recognition as a main contributor to this condition. This pathology is often misdiagnosed and left untreated because of the frequency of partial-thickness undersurface tears. Once this challenging diagnosis is confirmed, non-operative treatments are considered the first therapeutic approach. Despite the availability and effectiveness of multiple non-operative therapies, a considerable percentage of patients will present with chronic disabling pain and refractory symptoms. Many health-care providers are unaware of accessible advanced surgical techniques that benefit patients unresponsive to conservative management. Case Report We present the case of a 51-year-old female patient with chronic lateral hip pain refractory to conservative treatment for more than two years, treated successfully with endoscopic abductor tendon repair. The patient returned to the desired activities six months following surgery without any reported complications. Patient's pre-operative reported outcomes utilizing the MHOT-14 and Vail hip scores improved from 27 to 79 points (on a scale of 0-100) and from 30 to 56 points (on a scale of 0-100), respectively, at eight months follow-up. Conclusion This case report is illustrative of endoscopic surgical repair of the hip abductor tendons in the setting of a chronic full-thickness abductor tendon tear in a female patient after failure of conservative management. The multiple advantages of the technique include performance in an ambulatory day surgery center, soft-tissue preservation, and fewer complications compared to other open techniques. Knowledge of this pathology and its state-of-the-art available treatments is relevant for orthopedic surgeons and a wide range of health providers who encounter patients with chronic lateral hip pain.
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Affiliation(s)
- Gabriella Bucci
- Department of Orthopedics. Texas Health Research Foundation, Dallas/Ft Worth Texas, USA
- Department of Family Medicine. LSU Health Family Medicine Residency Program, Shreveport, LA, USA
| | - Salvatore Ratano
- Department of Orthopaedic Surgery, Cardinale Panico Hospital Tricase, Italy
| | - Ryan P. McGovern
- Department of Orthopedics, PatientIQ Customer Success Manager. 350 W. Ontario St. 300, Chicago, USA
| | - Steven B. Singleton
- UT Southwestern, Department of Orthopaedic Surgery, Section Chief: Sports Medicine, DFW, Texas, USA
| | - John J. Christoforetti
- Department of Orthopedics. Texas Health Research Foundation, Dallas/Ft Worth Texas, USA
- Department of Orthopedics. Maryland Orthopedic Specialists: Centers for Advanced Orthopedics Bethesda, Maryland, USA
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Ratano S, Jovanovic B, Ouabo EC. Effects of the Percutaneous Carbon Dioxide Therapy on Post-surgical and Post-traumatic Hematoma, Edema and Pain. J Orthop Case Rep 2023; 13:11-17. [PMID: 38162355 PMCID: PMC10753674 DOI: 10.13107/jocr.2023.v13.i12.4058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/08/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Carbon dioxide therapy (CDT) has been used since the Roman Empire to improve the microcirculation and oxygenation of tissues altered. The classical indications are vasculopathies and ischemic diseases. Hypothesis The CDT could be effective in favoring joint mobility recovery and pain reduction in patients with post-surgical or post-traumatic hematoma, edema, and pain. Study Design Case report. Material and Methods Eight patients were treated once a day for 5-10 days; a single session lasted 50 min. For post-surgical cases, the treatment began the day or the day after they were discharged from the hospital. Result For all patients in this series, the CDT has brought clinical benefits in terms of decreasing pain and improving of joint mobility. Conclusion The CDT is a safe and effective treatment to provide a greater amount of oxygen to the injured tissues. It favors the healing of post-surgical and post-traumatic hematoma and edema, promoting the mobility recovery of patients.
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Affiliation(s)
- Salvatore Ratano
- Department of Orthopaedic Surgery, University of Palermo, Palermo, Italy
| | - Biljana Jovanovic
- Private Practice, Center of Orthopedic Surgery, Clinique Bois-Cerf, 1006 Lausanne, Switzerland
| | - Eric Choudja Ouabo
- Private Practice, Center of Orthopedic Surgery, Clinique Bois-Cerf, 1006 Lausanne, Switzerland
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Ratano S, Ponzio EM, Camarda L. Tibial tubercle osteotomy: effect of different osteotomy planes on contact surface area and tubercle anteriorization. Musculoskelet Surg 2023; 107:361-366. [PMID: 36580268 DOI: 10.1007/s12306-022-00770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
In 1983, Fulkerson introduced a technique of tibial tubercle osteotomy performed according to an inclined plane with respect to frontal plane. Due to obliquity of the osteotomy plane, this procedure allows both anterior and medial transfer of the tibial tubercle. The purpose of the study was to investigate the influence of the different degrees of the oblique plane of osteotomy on anterior displacement and the contact surface area of tibial tubercle. Synthetic bones were used for the study. An osteotomy of the tibial tubercle (TT) was performed in each specimen. Specifically, 3 different degrees of osteotomy planes relative to the reference frontal plane were examined: 20°, 30° and 40°. On each sample, tibial tubercle medial transposition of 5 mm, 10 mm and 15 mm was performed. Anterior displacement was measured with a caliper. Further, the bone contact surface was calculated for each sample and each transposition. Finally, the measured data were statistically compared with a geometric model. At 5 mm of medial TT transposition, the anterior displacement (AD) was 0.1 mm when the osteotomy was performed at 20°. It increased of 1.5 mm and 2.7 mm, respectively at 30° and 40°. At 15 mm of TT transposition, the AD was 3.4 mm at 20°, 7.6 mm at 30° and 10.0 mm at 40°. Concerning the amount of medialization, it was observed a decrease in the overall contact surface passing from 5 to 15 mm of TT transposition. In addition, regarding the oblique plane of the osteotomy, it was observed an increase in the contact surface area passing from 20° to 40°. The main result of the present study is that the amount of anteriorization and medialization of the tibial tubercle could be predicted by the degrees of oblique plane of osteotomy. An increase in medialization significantly reduces the contact surface area at low degrees of osteotomy plane, potentially increasing the risk of non-union.
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Affiliation(s)
- Salvatore Ratano
- Department of Orthopaedics and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy
- Department of Orthopaedic Surgery (DICHIRINOS), University of Palermo, Via del Vespro, 127, 90100, Palermo, Italy
| | - Elena Maria Ponzio
- Department of Orthopaedics and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy
- Department of Orthopaedic Surgery (DICHIRINOS), University of Palermo, Via del Vespro, 127, 90100, Palermo, Italy
| | - Lawrence Camarda
- Department of Orthopaedics and Traumatology (DICHIRONS), University of Palermo, Palermo, Italy.
- Department of Orthopaedic Surgery (DICHIRINOS), University of Palermo, Via del Vespro, 127, 90100, Palermo, Italy.
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Cassaro S, Ratano S, Cobisi DC, Salomone G, Ferruzza M, Camarda L. Bilateral Bennett's fracture: A case report. Trauma Case Rep 2023; 44:100786. [PMID: 36851906 PMCID: PMC9958504 DOI: 10.1016/j.tcr.2023.100786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 02/10/2023] Open
Abstract
Bennet's fracture represents one of the most common injuries of the hand district, involving the base of the thumb, and it is affects children and elderly patients the most. The fracture is caused by direct axial trauma to a partially flexed first metacarpal and it is always intra-articular: the fracture line separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal. The fracture pattern is such that the first metacarpal shaft moves dorsally, proximally, and radially due to the pull of the abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and the adductor pollicis brevis, which remain attached to the fracture fragment. The surgical treatment consists of closed reduction with percutaneous pinning or open reduction with either pins or interfragmentary screws. The decision to treat these fractures with either open reduction or closed reduction is still a matter of debate. To the best of our knowledge, there are no cases of bilateral Bennett's fracture reported in literature. The aim of this paper is to present a rare case of bilateral Bennet's fracture, the decision of two different treatments, and the good clinical outcomes.
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Affiliation(s)
- Salvatore Cassaro
- Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy
| | - Salvatore Ratano
- Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy
| | | | - Gabriele Salomone
- Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy
| | - Massimo Ferruzza
- Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy
| | - Lawrence Camarda
- Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy
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Gousopoulos L, Dobbelaere A, Ratano S, Bondoux L, Tibesku CO, Aït-Si-Selmi T, Bonnin MP. Custom total knee arthroplasty combined with personalised alignment grants 94% patient satisfaction at minimum follow-up of 2 years. Knee Surg Sports Traumatol Arthrosc 2023; 31:1276-1283. [PMID: 36656348 DOI: 10.1007/s00167-023-07318-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE The purpose was to report detailed patient-reported outcome measures (PROMs) and satisfaction rates for computed tomography (CT)-based custom TKA at minimum follow-up of 2 years. The hypothesis was that custom TKA combined with 'personalised alignment' would yield equivalent or better PROMs compared to values reported in systematic reviews and meta-analyses on off-the-shelf (OTS) TKA. METHODS Of an initial cohort of 150 custom TKAs, four died (unrelated to surgery), one required a revision, and five refused participation, leaving 140 patients for analysis. Patients completed pre- and post-operative PROMs (Oxford Knee Score (OKS), Forgotten Joint Score (FJS), Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster osteoarthritis index (WOMAC)) as well as overall level of satisfaction. Proportions that attained a patient acceptable symptom state (PASS) were calculated for OKS and FJS. Clinical findings were compared to the average scores reported for PROMs in recent systematic reviews and/or meta-analyses on OTS TKA. Descriptive statistics were used to summarise the clinical findings as means, standard deviations (SD) and ranges, or numbers and percentages. RESULTS At mean follow-up 33.5 ± 4.5 months, 94% (135/143) were either satisfied or very satisfied. Proportions that achieved PASS were 89% for OKS (120/135), and 85% for FJS (118/139). Median OKS, WOMAC and KOOS Symptoms and Pain scores were all within the 4th quartile of medians reported in systematic reviews and/or meta-analyses. CONCLUSIONS At a minimum follow-up of two years following custom TKA combined with 'personalised alignment', 94% of patients were either satisfied or very satisfied, and the PASS criteria were achieved in 89% for OKS and 85% for FJS, all of which compare favourably to published outcomes of OTS TKA. Direct comparisons to the literature may not be appropriate, however, considering the heterogeneity of patient demographics and alignment techniques. Randomised controlled trials with sufficient statistical power are needed to corroborate these findings and generalise them to unselected TKA patients. LEVEL OF EVIDENCE IV, retrospective cohort study.
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Affiliation(s)
- Lampros Gousopoulos
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Andreas Dobbelaere
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Salvatore Ratano
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Louka Bondoux
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | | | - Tarik Aït-Si-Selmi
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Michel P Bonnin
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
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Beckers L, Müller JH, Daxhelet J, Ratano S, Saffarini M, Aït-Si-Selmi T, Bonnin MP. Considerable inter-individual variability of tibial geometric ratios renders bone-implant mismatch unavoidable using off-the-shelf total knee arthroplasty: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 31:1284-1298. [PMID: 34075491 DOI: 10.1007/s00167-021-06623-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/21/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis was to investigate the variability in tibial geometric ratios among knees of different sexes and races to determine whether commercially-available tibial baseplates accommodate the morphologic diversity. The hypothesis was that anthropometric studies report considerable variability of tibial geometric ratios among sexes and races. METHODS This systematic review and meta-analysis was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria. Two authors independently conducted an electronic search using MEDLINE® and Embase® on 28 January 2021 for clinical studies reporting on tibial geometric ratios. Tibial geometric ratios, as reported by the clinical studies, were represented by plotting their means and two standard deviations for comparison to two symmetric and two asymmetric commercially-available tibial baseplates. RESULTS A total of 27 articles that reported on a combined total of 20,944 knees were eligible for data extraction. Variation in tibial aspect ratios was equal among sexes. The greatest variation in aspect ratio was observed among East Asians, followed by Caucasians, African-Americans, Indian and Middle Easterns. The variation in tibial asymmetry ratio was larger among men compared to women. The greatest variation in asymmetry ratio was observed among African-Americans, followed by Caucasians, East Asians, Indian and Middle Easterns. Bone-implant mismatch of > 3 mm overhang or > 4 mm under-coverage with four commercially-available tibial baseplates occurred in large proportions of knees due to variations in aspect ratio (in 17-100% of knees) and asymmetry ratio (in 7-100% of knees). CONCLUSION Anthropometric studies reported considerable inter-individual variability of tibial geometric ratios, which exceeded effects of sexual dimorphism and racial diversity. Bone-implant mismatch may be unavoidable in a large proportion of knees, when considering that a surgeon generally only uses one or a few TKA brands. These findings support the drive towards patient-specific implants to potentially achieve accurate bone-implant fit by implant customisation. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Lucas Beckers
- Centre Orthopédique Santy, Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France
| | | | - Jeremy Daxhelet
- Centre Orthopédique Santy, Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France
| | - Salvatore Ratano
- Centre Orthopédique Santy, Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France
| | - Mo Saffarini
- ReSurg SA, Rue Saint-Jean 22, 1260, Nyon, Switzerland.
| | - Tarik Aït-Si-Selmi
- Centre Orthopédique Santy, Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France
| | - Michel P Bonnin
- Centre Orthopédique Santy, Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France
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Daxhelet J, Aït-Si-Selmi T, Müller JH, Saffarini M, Ratano S, Bondoux L, Mihov K, Bonnin MP. Custom TKA enables adequate realignment with minimal ligament release and grants satisfactory outcomes in knees that had prior osteotomies or extra-articular fracture sequelae. Knee Surg Sports Traumatol Arthrosc 2021; 31:1212-1219. [PMID: 34041553 DOI: 10.1007/s00167-021-06619-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To report the early clinical and radiographic outcomes of custom total knee arthroplasty (TKA) in knees that had prior osteotomies and/or extra-articular fracture sequelae. METHODS The authors retrospectively analysed a consecutive series of 444 knees that received custom TKA between 2016 and 2019 and identified 41 knees that had prior extra-articular events (osteotomies or fracture sequelae). Patients responded to pre- and post-operative (> 12 months) questionnaires, including Knee Society Score (KSS), Oxford Knee Score (OKS), Forgotten Joint Score (FJS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Net improvements were calculated by subtracting pre- from post-operative scores. In addition to a preoperative CT scan, pre- and post-operative long-leg weight-bearing radiographs were obtained, on which the hip-knee-ankle (HKA) angle, femoral mechanical angle (FMA, between femoral mechanical axis and joint line) and tibial mechanical angle (TMA, between tibial mechanical axis and joint line) angles were measured, and alignment was planned within a 'target zone' of FMA and TMA within 85°-95° and HKA angle within 175°-183°. Agreements between preoperative, planned and post-operative angles were calculated using intra-class correlation coefficients (ICC). RESULTS From the initial 41 knees, 3 had incomplete post-operative data and 1 was revised for painful stiffness due to uncorrected rotational malunion, leaving 37 knees for analysis. Twenty had prior osteotomies (tibia, n = 18, femur, n = 2), 8 had isolated fractures (tibial, n = 3; femoral, n = 5), and 9 had both osteotomies and fractures. Postoperative coronal alignments were 90.4° ± 2.4° for FMA, 89.3° ± 2.6° for TMA and 179.9° ± 3.0° for HKA angle. Agreements between planned and achieved alignments were fair to excellent, and 29 (78%) knees were within the 'target zone'. At a mean follow-up of 15 ± 5 months, all clinical scores had improved significantly (p < 0.001). CONCLUSIONS Custom TKA granted satisfactory clinical outcomes and a low complication rate in knees that had prior osteotomies and/or extra-articular fracture sequelae. Using custom implants and strategies for coronal alignment, 29 (78%) of the 37 knees were successfully aligned within the 'target zone', and 35 (95%) of the 41 knees did not require ligament release. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Jeremy Daxhelet
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Tarik Aït-Si-Selmi
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | | | - Mo Saffarini
- ReSurg SA, Rue Saint-Jean 22, 1260, Nyon, Switzerland.
| | - Salvatore Ratano
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Louka Bondoux
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | - Kalin Mihov
- University Hospital "Saint Marina", Varna, Bulgaria
| | - Michel P Bonnin
- Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
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Stramazzo L, Ratano S, Monachino F, Pavan D, Rovere G, Camarda L. Cement augmentation for trochanteric fracture in elderly: A systematic review. J Clin Orthop Trauma 2020; 15:65-70. [PMID: 33717919 PMCID: PMC7920012 DOI: 10.1016/j.jcot.2020.10.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cement augmentation of internal fixation of hip fracture has reported to improve fracture stability in osteoporotic hip fractures, reducing the risk of cut-out of the sliding screw through the femoral head. The purpose of present study was to perform a systematic literature review on the effects of augmentation technique in patients with osteoporotic hip fractures. MATERIAL AND METHODS A comprehensive literature search was systematically performed to evaluate all papers published in English language included in the literature between January 2010 and July 2020, according to the PRISMA 2009 guidelines. In vivo and in vitro studies, case reports, review articles, cadaveric studies, biomechanical studies, histological studies, oncological studies, technical notes, studies dealing with radiological classifications and studies on revision surgery were excluded. RESULTS A total of 5 studies involving 301 patients were included. Patients had a mean age of 84.6 years and were followed up for a mean period of 11 months. The proximal femoral fractures were stabilized with implantation of the PFNA or Gamma nail and augmentation was performed with two different cements: polymethylmethacrylate (PMMA) in 4 studies and calcium phosphate (CP) in one study. Overall, 57.5% of patients reached the same or greater preoperative mobility, and postoperative Parker Mobility Score and Harris Hip Score were acceptable. No significantly complications were observed, and no additional surgery related to the implant was required. CONCLUSION The results of this systematic review show that cement augmentation is a safe and effectiveness method of fixation to treat trochanteric fractures.
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Affiliation(s)
- Leonardo Stramazzo
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Palermo, Italy
| | - Salvatore Ratano
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Palermo, Italy
| | - Francesco Monachino
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Palermo, Italy
| | - Davide Pavan
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Palermo, Italy
| | - Giuseppe Rovere
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Lawrence Camarda
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Palermo, Italy
- Corresponding author. Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Via del Vespro, 90100, Palermo, Italy.
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