Is Stem Revision Necessary for Vancouver B2 Periprosthetic Hip Fractures? Analysis of Osteosynthesis Results from 39 Cases

Although stem revision is recommended for Vancouver B2 periprosthetic hip fractures (PPHFs), there has recently been a debate whether, under certain conditions, they could be treated by osteosynthesis alone. This study aimed to describe the medium-term clinical and radiological results of several patients with V-B2 fractures treated via osteosynthesis. A retrospective study of patients with V-B2 PPHF treated by osteosynthesis without stem revision, operated on between 2009 and 2019, was performed. The type of arthroplasty, type of stem, ASA, Charlson Comorbidity Index (CCI), medical and implant complications, reoperation rate, first-year mortality, radiological results (consolidation time), and functional results were analyzed. Thirty-nine patients were included. Their average age was 78.82 years. Most of the patients presented ASA ≥ 3 (35/39) and CCI ≥ 5 (32/39). Radiological consolidation was achieved in 93.5% of patients, with an average consolidation time of 92.93 days. The average Parker test score before admission was 5.84 while the current one was 4.92 (5.16 years follow-up). Osteosynthesis without stem revision is a valid surgical alternative in certain types of patients with V-B2 PPHF, depending on previous mobility, fracture pattern (anatomical reconstruction possible), anesthetic risk, comorbidities, and previous hip pain.

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Pyrocarbon Implant for Trapeziometacarpal Arthritis: Mid-term Clinical and Radiological Results

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0041-1729998 ◽

2021 ◽

Vol 49 (01) ◽

pp. 037-045

Author(s):

Elisabete Ribeiro ◽

Melanie Ribau ◽

Juvenália Ribeiro ◽

Pedro Varanda ◽

Luis Filipe Rodrigues

Keyword(s):

Clinical Symptoms ◽

Pyrolytic Carbon ◽

Functional Results ◽

Contralateral Side ◽

Average Score ◽

Radiological Results ◽

Asymptomatic Patients ◽

Clinical And Radiological Results ◽

Mid Term Results

AbstractPyrolytic carbon implants for trapeziometacarpal (TMC) arthritis have been extensively studied, but there is still discrepancy in the literature concerning the mid-term functional results. Our group describes the clinical and radiological results after five years of surgical management of TMC arthritis with Pyrodisk (Integra Life Sciences, Plainsboro, NJ, US). A total of 19 patients (2 males and 17 females) aged 56.45 ± 5.95 (range: 44 to 67) years were reviewed with a mean follow-up of 74.05 ± 14.43 (range: 60.00 to 105.83) months. At the final follow-up, the score on the Visual Analogue Scale (VAS) for pain was of 1.76 ± 2.05, the average score on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire was of 22.73 ± 22.33, and all functional parameters were above the 90% barrier of the contralateral side. The progression of radiolucency was 89% at 1 year and 11% at 5 years of follow-up respectively, but it was not related to the clinical outcomes. The prevalence of subluxation (around one-fourth of the center of the implant) was of 24% in asymptomatic patients, and dislocation was not observed. The overall survival of the implant was of 89%. Revision took place in 11% of the cases due to persistent pain and implant breakage after direct impact. More than 75% of the patients were very or highly satisfied with the treatment. In conclusion, Pyrodisk enabled us to obtain good functional mid-term results, with an acceptable survival of the implant and low risk of dislocation. Radiological findings do not necessarily translate into clinical symptoms.

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InSafeLOCK® humeral nailing for humeral nonunions: Clinical and radiological results

Joint Diseases and Related Surgery ◽

10.52312/jdrs.2021.81535 ◽

2021 ◽

Vol 32 (2) ◽

pp. 446-453

Author(s):

Oktay Polat ◽

Serdar Toy ◽

Birkan Kibar

Keyword(s):

External Rotation ◽

Operation Time ◽

Functional Results ◽

Dash Score ◽

Radiological Results ◽

Iliac Bone Graft ◽

Loss Of Reduction ◽

The Mean ◽

Clinical And Radiological Results

Objectives: This study aims to evaluate the clinical and functional results of patients treated with InSafeLOCK® humeral nail and iliac crest autograft for humeral nonunion. Patients and methods: A total of 15 patients (11 males, 4 females; mean age: 52.1±15.3 years; range, 31 to 78 years) who were followed conservatively for humeral fractures and operated with the InSafeLOCK® humeral nail and iliac bone graft in our center between June 2018 and January 2020 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, operative data, and pre- and postoperative Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Constant-Murley Scores (CMS) were recorded. Results: The mean time from injury to nonunion treatment was 10.9±1.6 months. Five patients had atrophic, eight patients had oligotrophic, and two patients had hypertrophic nonunion. Preoperatively, the mean DASH was 37.7±9.1, the mean CMS was 69.7±6.3, and the mean VAS was 3.8±0.7. In all patients, union was achieved. The mean operation time was 59.0±16.2 min. The mean postoperative DASH score was 16.1±8.7, CMS 87.4±3.4, and VAS score 0.8±0.7. Regarding the shoulder joint, the mean abduction was 164.7±11.3 degrees, the mean internal rotation was 82.0±6.8 degrees, the mean external rotation was 81.3±8.3 degrees, and the mean flexion was 162.0±12.1 degrees. During follow-up, complications such as vascular-nerve injury, reflex sympathetic dystrophy, screw migration or loosening, implant failure, and loss of reduction did not occur in any of our patients. Conclusion: Considering the satisfactory functional and radiological results, the InSafeLOCK® humeral nail can be used safely in humeral nonunions.

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Medium-term clinical and radiological results of surgically treated stage 3A Kienböck’s disease

Hand Surgery and Rehabilitation ◽

10.1016/j.hansur.2021.07.002 ◽

2021 ◽

Author(s):

Kazim Onur Unal ◽

Olgun Bingol ◽

Alperen Korucu ◽

Enver Kilic ◽

Guzelali Ozdemir ◽

...

Keyword(s):

Medium Term ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Radiological Results ◽

Clinical And Radiological Results ◽

Kienbock’S Disease

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Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

The Scientific World JOURNAL ◽

10.1155/2014/148592 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Nicola Piolanti ◽

Lorenzo Andreani ◽

Paolo Domenico Parchi ◽

Enrico Bonicoli ◽

Francesco Niccolai ◽

...

Keyword(s):

Groin Pain ◽

Large Diameter ◽

Acetabular Revision ◽

Acetabular Cup ◽

Medium Term ◽

Retrospective Design ◽

Radiological Results ◽

Functional Scores ◽

Clinical And Radiological Results

Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60) of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32). 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1%) showed thigh pain and only 4 hips (12.11%) presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

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