Dislocated Research Articles

Clinical and Genetic Insights into Desbuquois Dysplasia: Review of 111 Case Reports.

Skeletal disorders encompass a wide array of conditions, many of which are associated with short stature. Among these, Desbuquois dysplasia is a rare but severe condition characterized by profound dwarfism, distinct facial features, joint hypermobility with multiple dislocations, and unique vertebral and metaphyseal anomalies. Desbuquois dysplasia is inherited in an autosomal recessive manner, with both the DBQD1 (MIM 251450) and DBQD2 (MIM 615777) forms resulting from biallelic mutations. Specifically, DBQD1 is associated with homozygous or compound heterozygous mutations in the CANT1 gene, while DBQD2 can result from mutations in either the CANT1 or XYLT1 genes. This review synthesizes the findings of 111 published case reports, including 54 cases of DBQD1, 39 cases of DBQD2, and 14 cases of the Kim variant (DDKV). Patients in this cohort had a median birth weight of 2505 g, a median length of 40 cm, and a median occipitofrontal circumference of 33 cm. The review highlights the phenotypic variations across Desbuquois dysplasia subtypes, particularly in facial characteristics, joint dislocations, and bone deformities. Genetic analyses revealed a considerable diversity in mutations, with over 35% of cases involving missense mutations, primarily affecting the CANT1 gene. Additionally, approximately 60% of patients had a history of parental consanguinity, indicating a potential genetic predisposition in certain populations. The identified mutations included deletions, insertions, and nucleotide substitutions, many of which resulted in premature stop codons and the production of truncated, likely nonfunctional proteins. These findings underscore the genetic and clinical complexity of Desbuquois dysplasia, highlighting the importance of early diagnosis and the potential for personalized therapeutic approaches. Continued research is essential to uncover the underlying mechanisms of this disorder and improve outcomes for affected individuals through targeted treatments.

First hip hemiarthroplasty in a Göttingen Minipig; surgical and post-mortem protocol

BackgroundProsthetic joint infections (PJI) are recalcitrant, hard-to-treat infections and severe complications of joint arthroplasty. Therefore, there is a need to develop new effective treatment strategies, and animal models of high clinical relevance are needed. This study aimed to develop a detailed surgical protocol for hip hemiarthroplasty in Göttingen minipigs and a thorough post-mortem sampling protocol to pave the way for creating a minipig PJI model.MethodsThree adult female Göttingen minipigs underwent surgery with insertion of a hip hemiarthroplasty, using the anterior approach to the hip joint. After surgery the minipigs were followed closely with daily clinical evaluation and gait scoring. Comprehensive post-mortem analyses were performed with evaluation of macroscopic lesions, microbiology, synovial fluid analysis and histology.ResultsThe study resulted in the first Göttingen minipig with hip hemiarthroplasty and identified several points of awareness when inserting a hip prosthesis in minipigs, especially the high risk of joint dislocation. A spontaneous PJI occurred in one of the minipigs, revealing an impaired ability of the immune cells to reach the bacteria at the bone-prosthesis interface.ConclusionThe present study provides a detailed description of surgical technique and post-mortem sampling and validates the suitability of the hip hemiarthroplasty minipig model for future experimental modeling of PJI.

Lisfranc Injury: A Case Report and Literature Review

Lisfranc injuries are relatively rare, accounting for only 0.2% of all injuries, and few case reports have been published on this topic. In this report, we present a case of a Lisfranc injury in a healthy 30-year-old male who fell down a staircase, landing on his left foot. The diagnosis was made using X-rays and computed tomography (CT). The X-rays showed dislocation of the tarsometatarsal joint with lateral displacement of the M4, M3, M2, and M1 metatarsals. The CT scan revealed a fracture-dislocation of the second metatarsal, with detachment of intra- and extra-articular bone fragments associated with a fracture of the medial cuneiform bone. Surgical management, in the form of open reduction and internal fixation, was performed. The patient followed an expected postoperative course and was doing well, without pain or limitation of activities, at his 3-month postoperative visit. Additionally, we provide a brief review of similar published cases and an overview of Lisfranc injuries.

The deltotrapezial fascia stabilizes the AC-Joint and its reconstruction restores the horizontal stability in AC-joint separations—a biomechanical comparison

BackgroundVarious techniques are available for the reconstruction of acromioclavicular joint (ACJ) dislocations, with the main focus being on restoration of the AC capsule or coracoclavicular (CC) ligaments. Recent research has underlined the significance of the deltotrapezial fascia (DTF) and related muscles as dynamic stabilizers of the ACJ. HypothesisReconstruction of the DTF increases the stability of the ACJ in the horizontal plane more than a complete transection of the fascia, while not restoring the stability of the native state. MethodsFive pairs of human cadaveric shoulders including the torsos were included in the study and underwent cyclic anterior-posterior loading using an electromechanical testing machine. The shoulders were put into three groups: group N (n = 10): native ACJ; group T (n = 10): ACJ with transected DTF; group R (n = 10): ACJ with reconstruction of the DTF after transection. The dislocation was recorded with an 3D optical measuring system. ResultsGroup N showed a mean horizontal displacement of 2.94 mm (± 1.26), group T showed a mean anterior displacement of 3.33 mm (± 1.37) and group R showed a mean anterior displacement of 2.95 mm (± 1.08). The mean anterior displacement for group T was significantly higher after every measured number of cycles compared with groups N and R. There was no significant difference in mean anterior displacement between groups N and R. ConclusionThe transection of the DTF results in significantly reduced stability in the horizontal plane of the ACJ. A reconstruction of the DTF restores the stability of the native ACJ in the horizontal plane. Further clinical and biomechanical investigations should focus on reconstruction techniques of the DTF.

Increased Risk of 10-Year Revision Following Total Hip Arthroplasty for Femoral Neck Fracture

BackgroundAs the incidence of femoral neck fractures (FNFs) increases with the aging population, understanding its impact on surgical outcomes is important to improving implant survival and patient satisfaction. Despite increasing use of total hip arthroplasty (THA) as management for FNF, few studies have examined long-term implant survivability. Thus, this study sought to determine the 10-years cumulative incidence of revision and indications for revision in patients undergoing THA for FNF in comparison to osteoarthritis. MethodsPatients who underwent primary THA for FNF or osteoarthritis were identified using a national administrative claims database and propensity-score matched in a 1:2 ratio based on age, gender, the Charlson Comorbidity Index (CCI), smoking, obesity, and diabetes mellitus. Kaplan-Meier and Cox proportional hazards analyses were used to observe the cumulative incidence and risk of all-cause revision, periprosthetic joint infection (PJI), dislocation, mechanical loosening, and periprosthetic fracture (PPF) within 10 years of primary THA. In total, 19,735 patients who underwent THA for FNF and 39,383 patients who underwent THA for osteoarthritis were included. ResultsThe 10-years cumulative incidences of all-cause revision (7.1 versus 4.9%), PJI (5.0 versus 3.3%), dislocation (6.8 versus 3.8%), mechanical loosening (3.1 versus 1.9%), and PPF (7.8 versus 4.0%) were significantly higher for those who underwent THA for FNF versus osteoarthritis. Femoral neck fractures were associated with higher risks of revision (hazard ratio [HR]: 1.6), PJI (HR: 1.7), dislocation (HR: 2.0), mechanical loosening (HR: 1.6), and PPF (HR: 2.2) (P < 0.001 for all). ConclusionsDespite the advantages of THA, femoral neck fractures remain a major risk factor for long-term complications. Tailored preoperative planning, surgical techniques, and postoperative bone health optimization in these patients may help minimize poor outcomes.

Simultaneous Midshaft Clavicle Fracture with Ipsilateral Acromioclavicular Joint Dislocation in Recreational Baseball Player: A Case Report

Simultaneous Midshaft Clavicle Fracture with Ipsilateral Acromioclavicular Joint Dislocation in Recreational Baseball Player: A Case Report

Superior suspensory complex of the shoulder reconstruction for acute and chronic acromioclavicular joint dislocations: the Queensland Unit for Advanced Shoulder Research 3-tunnel technique

BackgroundManagement of acromioclavicular joint (ACJ) injuries have wide variety of classification systems, surgical indications and operative techniques. Our study describes the QUASR (Queensland Unit for Advanced Shoulder Research) 3-Tunnel Technique with LARS (Ligament Augmentation and Reconstruction System; Surgical Implants and Devices, Arc sur Tille, France) artificial ligament to reconstruct the superior shoulder suspensory complex (SSSC) in acute, chronic and revision ACJ dislocations and lateral clavicle fractures. MethodsOur prospective cohort series of patients undergoing the QUASR 3-Tunnel Technique using LARS artificial ligament. This technique reconstructs the SSSC using two 4mm clavicle tunnels, one acromion tunnel, and is arthroscopically assisted to pass the artificial ligament under the coracoid. The ligament is secured with braided composite sutures and no interference screw is used. Pre and postoperative functional outcome scores were compared in patients with minimum 12-months follow-up. ResultsOf 26 patients in this series, 7 (27%) were operated within 4 weeks of injury, two (8%) were revision cases, and six (23%) were lateral clavicle fractures. Mean time to surgery was 14 weeks (2-650). Mean postoperative scores with associated 95% CI were Specific Acromioclavicular Score 87.38 (CI 75.38, 99.37), American Shoulder and Elbow Surgeons score 94.60 (87.85, 101.35), Constant 79.47 (71.87, 87.07), Simple Shoulder Test 85.44 (72.34, 98.54) and Visual Analogue Score 0.50 (-0.15, 1.15). There were two infections and one atraumatic loss of reduction, however there were no tunnel fractures. ConclusionThe QUASR 3-Tunnel Technique with LARS artificial ligament is a safe and efficient technique for both acute and chronic acromioclavicular joint reconstruction, lateral clavicle fractures with coracoclavicular ligament disruption and complex revision cases with favorable outcomes at mid-term follow-up.

Biological Fixation of AC Joint using Autologous Semitendinosus Graft in Acute Type III-VI Acromioclavicular Joint Dislocations—A Pilot Study

ABSTRACT Introduction: Injuries to the acromioclavicular (AC) joint can range from modest, transient pain to significant displacement, chronic pain, and shoulder biomechanical changes that result in long-term disability. Aim and Objective: We aimed to evaluate the functional outcome of anatomical reconstruction of ACJ using autologous semitendinosus graft in type III-VI AC joint dislocations. Materials and Methods: In this study, 20 patients with AC joint dislocation (Rockwood type III-VI) were managed by surgical fixation using autologous semitendinosus graft from November 01, 2019, to October 31, 2020, at our center. After providing written informed consent, the study enrolled patients who satisfied the inclusion criteria. Preoperative, three-month, and six-month UCLA shoulder scores were assessed. Results: Mean age of participants was 36.5 years (SD: 9.86). Radiological evaluation at each visit suggested a 100.0% success rate of this method. 95% of the participants had no complications, while 5.0% had DVT. No participants had SSI. Conclusions: Autologous semitendinosus graft fixation of type III-VI AC joint injuries is a viable surgical option with the advantages of being a biological fixation, single surgery, and having excellent functional outcomes. However, extensive multicentric comparative studies are required to draw definitive conclusions.

The classification of sacral foramina in a South African sample using cadaveric and osteological remains

Sacroiliac (SI) joint fixation is a technique used for SI joint fractures, SI joint dislocations and sacral fractures. Sacral screws can be placed either into the S1 or the S2 vertebrae if S1 is insufficient. Malpositioning of the screws is a common surgical complication as sacral variations exists amongst populations. Complications associated with the misposition of screws can lead to injury of the sacral venous plexus, iliac vessels, or sacral nerve roots. Therefore, this study aimed to evaluate sacral variations in a South African sample by determining distances between the first and second sacral foramina and classifying the common types of sacra found.A quantitative cross-sectional comparative study was conducted. One hundred and twenty (n = 120) dry human sacra and 11 formalin-fixed cadavers were measured to determine the linear distances between the first two anterior and posterior sacral foramina. Additionally, the dry human sacra were classified according to Mahato's classification system. A cadaver SI joint fixation simulation was performed by an orthopaedic surgeon.The mean sacral promontory height was found to be 31.81 mm and 37.52 mm in osteological and cadaver specimens, respectively. The mean anterior pedicle height was significantly different for the left (18.81 mm) and right (21.67 mm) side measurements. A statistically significant difference was found between cadavers and osteological samples for all measurements taken. In the osteological sample, ancestry and age mostly influenced the variations noted.Using Mahato's classification system, sacra with five sacral segments, auricular surfaces extending from the superior part of S1 to the middle of S3 and no accessory L5/S1 articulations had the highest prevalence of 59.17 %.The South African sample exhibited similarities but did not fully compare to other populations. The results in this study should be considered as a reference for surgeries involving the SI joint and sacral foramina. However, where possible, the exact anatomy with possible variations of the patient should be evaluated preoperatively using X-rays and angiograms.

Mid-Term to Long-Term Outcomes and Complications of Total Hip Arthroplasty in Patients Who Have Crowe IV Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis

BackgroundSevere forms of developmental dysplasia of the hip (DDH) in adulthood often lead to total hip arthroplasty (THA). This study aimed to evaluate the mid-term to long-term outcomes of THA in Crowe type IV DDH cases, which represent a technically challenging and complex patient group. MethodsPubMed, EMBASE, Web of Science, and Scopus were searched for observational studies and case series with over 100 months of mean follow-up on adult patients who had Crowe type IV DDH treated with THA. A total of 3,710 records were initially identified, leading to the inclusion of 24 studies in the final analysis. These studies were subjected to quality assessment using the National Institutes of Health Quality Assessment tool. Various outcomes including revision rates, leg-length discrepancy, Harris Hip Score, and complications like periprosthetic joint infections, dislocations, and nerve injuries were analyzed. A random effects model was employed for statistical analysis, with sensitivity analysis and metaregression applied in cases of high heterogeneity. ResultsThe included studies assessed 1,024 hips with a mean follow-up of 11 years, revealing improvements in Harris Hip Score and reductions in leg length discrepancy post-THA. However, notable challenges were noted, including a 10.7% rate of intraoperative fractures, a 1.8% periprosthetic joint infection rate, and a 5.8% dislocation rate. Osteolysis and aseptic loosening revisions were observed in 9.1 and 8% of cases, respectively. Heterotopic ossification occurred in 11.1% of patients. Nerve injury was reported in 4.2% of cases. With the use of metaregression, some factors for observed heterogeneity were identified. ConclusionsTotal hip arthroplasty (THA) in Crowe type IV DDH patients presents notable challenges, but can lead to substantial long-term improvements in patient-reported outcomes. Level of EvidenceIV.

THE EVALUATION OF TOTAL HIP ARTHROPLASTY IN THE MANAGEMENT OF SPASTIC PAINFUL HIP DISLOCATION IN CEREBRAL PALSY

Spasticity used to be considered a contraindication for total hip replacement (THR) procedures. Due to the development of implants as well as surgical skills, THR became an option for the treatment of painful dislocation of the hip joint in patients with spastic plegia. The aim of this study was an evaluation of mid-term results of THR in spastic CP adolescent patients with painful hips with hip joint subluxation or dislocation.In 2014–2022, 18 pts (19 hips) with CP aged 16 to 20 years underwent THR in our department. The mean follow-up was 4 years (range: 1 – 9 years). Results were evaluated using the Gross Motor Function Scale, VAS scale in accordance with the Ashworth scale, types of implants used (dual mobility cup and not dual mobility cup), and radiological assessment (Crowe scale). Complications have been thoroughly analyzed.In 10 pts there has been an improvement in the GMFSC scale average from 1 to 2 points observed after the surgery. All pts have improved in the VAS scale average of 8 points (from 10 to 7). According to the Crowe scale repositioning of preoperative dislocation to primary acetabulum was achieved in all cases. Complications occurred in 4 cases: dislocations of 2 THR with dual mobility cup and 2 THR with non-dual mobility cup requiring revision surgery with good final result. No statistical significance was noted according to the type of cup (Mann-Whitney U Test).The most important risk factor for complications is severe spasticity. We believe, that CP pts with painful hips should be treated using THR. We didn't observe any significant differences between the types of implants.These findings may serve as a basis for the prediction of outcomes of THR treatment in this specific group of pts.Level of evidence: Case-control or retrospective comparative study-Level III

Functional Results of Treatment of the Acromioclavicular Joint Dislocations Using Percutaneous Dual-Endo Button Technique

Functional Results of Treatment of the Acromioclavicular Joint Dislocations Using Percutaneous Dual-Endo Button Technique

Ankylosing spondylitis in patients undergoing total hip arthroplasty increases the risk of medical and implant-related complications: a case control analysis.

Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA. A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts. A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection, dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group. Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning.

Arthroscopic reduction and hollow screw internal fixation for Eyres Type IIIA scapular coracoid fracture: a case report

BackgroundA coracoid process fracture combined with an acromioclavicular (AC) joint dislocation is an uncommon injury that typically causes significant pain and limits shoulder movement. Open reduction and internal fixation have been the traditional treatment approach. However, arthroscopic techniques are emerging as a promising alternative for managing these injuries.Case representationA 35-year-old woman presented with right shoulder pain following an accidental fall. Imaging studies revealed a coracoid process fracture along with an AC joint dislocation. The fracture was classified as an Eyres Type IIIA, which warranted surgical intervention. Our team performed arthroscopic coracoid fracture reduction and internal fixation surgery, as well as AC joint dislocation repair using Kirschner wires. Six months after surgery, the patient demonstrated a satisfactory functional outcome with complete bone healing.ConclusionThis case report highlights the potential of arthroscopic reduction and fixation as a novel treatment option for fractures of the coracoid base.

Influence of Fractures and Dislocations in Severity of Rocker-Bottom Deformity in Patients with Charcot Foot.

The objective of this study was to identify bone fractures and joint dislocations that have greater association with the severity of arch collapse in patients with Charcot foot involving the midfoot.A retrospective study in 28 (N = 29 feet) patients who had Charcot foot deformity of the midfoot. The study included stage III of Eichenholtz classification, and Schon classification types I to III. Talar-first metatarsal and calcaneal pitch angles and cuboid height were used to evaluate the severity of the midfoot deformity in a weightbearing lateral radiograph. Two investigators evaluated the bone fracture and joint dislocation involved in weightbearing antero-posterior and lateral radiographs.There were 13 (46%) feet that showed pattern 1, 9 (31%) feet with pattern 2, and 7 (25%) feet with pattern 3 according to the Schon classification. One foot had a combination of patterns 1 and 2. Midfoot ulceration occurred in 64% (n = 19) of feet. In the multivariate analysis, plantarflexion of talar-first metatarsal angle was predicted by navicular-medial cuneiform dislocation (p = .007 [-20.620-3.683]), an increase of the negative calcaneal pitch angle by fragmentation of the cuboid (p = .003 [-15.568-3.626]), and increment of the negative cuboid height by navicular-medial cuneiform and medial cuneiform-first metatarsal dislocations (p = .040 [-12.779-0.317], p = .002 [-13.437-3.267], respectively).Bone fractures and dislocations in the sagittal plane seem to contribute to midfoot collapse, but navicular-medial cuneiform dislocation/non-union and cuboid fragmentation predict severe rocker-bottom deformity in cases of Charcot foot.

Treatment concepts for the medial clavicle and the sternoclavicular joint

Medial clavicle fractures and injuries to the sternoclavicular joint are rare injuries but can have life-threatening consequences. There are no standardized treatment algorithms or guidelines for the diagnostics and treatment. This article provides an overview of the individual topographies as well as the conservative and surgical treatment strategies.Conservative treatment is preferred for medial clavicle fractures. The indications for surgical treatment are variable but this is frequently carried out if there is a fracture displacement > 1 cm or1 shaft width and high functional demands. In the case of accompanying injuries to neurovascular structures, an open fracture or the threat of perforation of the skin, surgical treatment is mandatory. Open reduction and internal fixation using (locking) plates is currently the preferred form of treatment.In the case of posterior dislocation of the sternoclavicular joint, an immediate closed reduction must be attempted with the patient under analgosedation and with emergency treatment on standby. This temporal urgency does not exist for anterior and superior dislocations. Surgical treatment is indicated in cases of unsuccessful reduction, persistent symptomatic instability or injuries of the neurovascular bundle. From a multitude of treatment options, arthrodesis with suture cerclage has shown good results. Tendon grafts as well as special hook plates are increasingly being used due to better biomechanical qualities. The surgical treatment of combined injuries is determined by the individual injury pattern.Despite the variety of treatment strategies, the long-term outcome has consistently been positively described.

Bioprinting of osteochondral tissues: A perspective on current gaps and future trends.

Osteochondral tissue regeneration has remained a critical challenge in orthopaedic surgery, especially due to complications of arthritic degeneration arising out of mechanical dislocations of joints. The common gold standard of autografting has several limitations in presenting tissue engineering strategies to solve the unmet clinical need. However, due to the complexity of joint anatomy, and tissue heterogeneity at the interface, the conventional tissue engineering strategies have certain limitations. The advent of bioprinting has now provided new opportunities for osteochondral tissue engineering. Bioprinting can uniquely mimic the heterogeneous cellular composition and anisotropic extra-cellular matrix (ECM) organization, while allowing for targeted gene delivery to achieve heterotypic differentiation. In this perspective, we discuss the current advances made towards bioprinting of composite osteochondral tissues and present an account of challenges—in terms of tissue integration, long-term survival, and mechanical strength at the time of implantation—required to be addressed for effective clinical translation of bioprinted tissues. Finally, we highlight some of the future trends related to osteochondral bioprinting with the hope of in-clinical translation.

Comparison of the Latarjet Procedure and Iliac Crest Bone Graft Transfer in Bone Bankart Lesions in Recurrent Anterior Shoulder Dislocations.

There are various treatment modalities for bony Bankart lesions following glenohumeral joint dislocations. In this research, we aimed to compare the radiological and clinical results of patients who underwent the Latarjet procedure and iliac crest bone graft transfer. Clinical and radiological data of 15 patients were retrospectively evaluated. Inclusion criteria were a history of at least two dislocations, being between 18-65 years of age and having at least 10% glenoid bone loss. The exclusion criteria were defined as follows: patients who underwent only soft tissue procedures, patients who did not attend the follow-up, patients with other pathology in the upper extremity (fracture, cuff tear, etc.), and patients with a follow-up period of less than 12 months time. Nine patients underwent the Latarjet procedure and six underwent iliac crest bone graft transfer. Clinical evaluation, age, gender, body mass index, range of motion, Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score, Constant score, and Visual Analogue Scale (VAS) score were evaluated. Radiographic evaluation was performed with preoperative and postoperative direct radiographs and computed tomography. Mann-Whitney U test, t-test, and Fisher exact tests were used for group comparisons. The mean age of the patients was 32.6 years and the mean follow-up period was 24.9 months. When the two groups were compared, no statistical difference was found in terms of age, gender, body mass index, range of motion, Constant score, VAS score, glenoid cartilage stepping, and bone defect (p>0.05). The operation time was longer in the iliac crest bone graft transfer group compared to the Latarjet group (p<0.05). Latarjet and iliac crest bone graft transfer can be used successfully in the treatment of bony Bankart in recurrent anterior shoulder dislocations. The operation time is longer in iliac crest bone graft transfer compared to the Latarjet procedure.

Acromioclavicular joint dislocation with loop double endobutton fixation assisted by orthopaedic surgery robot positioning system

ObjectiveAcute acromioclavicular (AC) joint dislocation is a common orthopedic injury that can significantly impair shoulder function and reduce quality of life. Effective treatment methods are essential to restore function and alleviate pain. To investigate the short-term clinical efficacy of the minimally invasive closed-loop double endobutton fixation assisted by orthopaedic surgery robot positioning system (TiRobot) in the treatment of AC joint dislocation, and to evaluate its feasibility and safety.MethodsThe clinical data of 19 patients with AC joint dislocation who underwent treatment with closed-loop double Endobutton fixation assisted by TiRobot between May 2020 and December 2022 were retrospectively analyzed. Visual Analog Scale (VAS) pain scores, the Constant Murley Score (CMS), and shoulder abduction range of motion were assessed and compared preoperatively and at the last follow-up. Computed tomography (CT) parameters of the acromioclavicular joint, including acromioclavicular distance (ACD), the distance between the upper and lower Endobutton (DED), the horizontal distance between the anterior edge of the distal clavicle and the anterior edge of the acromion (DACC), the diameter of the clavicular tunnel (DCT), and coracoid tunnel diameter (DC), were compared at 2 days, and 1 month after surgery, as well as at the last follow-up, along with the evaluation of intraoperative and postoperative complications.ResultsThe postoperative VAS, CMS, and shoulder-abduction range of motion were significantly improved compared with the preoperative (all, P<0.05). The statistical analysis showed no significant difference in the CT image parameters of the acromioclavicular joint at 2 days and 1 month after surgery(all, P>0.05). Comparisons of DCT and DC revealed statistically significant differences between the last follow-up and 1 month after surgery (P<0.05), and no statistically significant difference was found in ACD, DED, and DACC(all, P>0.05). There were no complications such as infection or vascular or neurological damage, no cases of rostral or clavicle fractures, loss of reduction, heterotopic ossification, shoulder stiffness, and no loosening or breaking of internal fixations.ConclusionClosed-loop double endobutton internal fixation assisted by TiRobot is an ideal method for the treatment of acute acromioclavicular (AC) joint dislocation. This method has the advantages of relatively simple operation, more accurate localization of bone tunnel during operation, less surgical trauma, and good recovery of shoulder function.

Wrestling injuries during the 2016 Rio and 2020 Tokyo Olympic Games

ObjectivesTo evaluate and compare the injuries of Olympic wrestlers during the 2016 Rio and 2020 Tokyo Olympic Games held in August 2021 due to the COVID-19 pandemic.MethodsIn this descriptive epidemiological...