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Leopold VJ, Hipfl C, Zahn RK, Pumberger M, Perka C, Hardt S. Periacetabular Osteotomy with a Modified Fixation Technique Using K-Wires Shows Clinical Results Comparable to Screw Fixation at Mid-Term Follow-Up. J Clin Med 2023; 12:6204. [PMID: 37834848 PMCID: PMC10573708 DOI: 10.3390/jcm12196204] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The optimal fixation technique in periacetabular osteotomy (PAO) remains controversial. Modified fixation with Kirschner wires (K-wires) was described as a feasible and safe alternative. However, clinical follow-up of patients treated with this technique is lacking. AIMS To assess patient-reported outcomes (PROMs) in patients treated with PAO with the K-wire fixation technique and to compare it with the screw fixation technique. METHODS We conducted an analysis of 202 consecutive PAOs at a single university center between January 2015 and June 2017. A total of 120 cases with complete datasets were included in the final analysis. PAOs with K-wire fixation (n = 63) were compared with screw fixation (n = 57). Mean follow-up was 63 ± 10 months. PROMs assessed included the International Hip Outcome Tool (iHOT 12), Subjective Hip Value (SHV), and UCLA activity score (UCLA). Pain and patient satisfaction (NRS) were evaluated. Joint preservation was defined as non-conversion to total hip arthroplasty (THA). RESULTS Preoperative baseline PROMs in both fixation groups were similar. In both groups, PROMs (p = <0.001) and pain (p = <0.001) improved significantly. Postoperative functional outcome was similar in both groups: iHOT 12 (71.8 ± 25.1 vs. 73 ± 21.1; p = 0.789), SHV (77.9 ± 21.2 vs. 82.4 ± 13.1; p = 0.192), UCLA (6.9 ± 1.6 vs. 6.9 ± 1.9; p = 0.909), and pain (2.4 ± 2.1 vs. 2.0 ± 2.1; p = 0.302). Patient satisfaction did not differ significantly (7.6 ± 2.6 vs. 8.2 ± 2.2; p = 0.170). Conversion to THA was low in both groups (two vs. none; p = 0.497). CONCLUSION Periacetabular osteotomy with K-wire fixation provided good clinical results at mid-term follow-up, comparable to those of screw fixation. The technique can therefore be considered a viable option when deciding on the fixation technique in PAO.
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Affiliation(s)
- Vincent Justus Leopold
- Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Kaiser PB, Cronin P, Stenquist DS, Miller CP, Velasco BT, Kwon JY. Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries. Foot Ankle Spec 2020; 13:351-355. [PMID: 32306750 DOI: 10.1177/1938640020914679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/18/2022]
Abstract
The use of suture button (SB) devices in the treatment of syndesmotic ankle injuries is increasing. These constructs have demonstrated better syndesmotic reduction, improved clinical outcomes, and lower rates of hardware removal compared with screw fixation. However, placing a SB device without a fibular plate can be technically challenging. In this technique tip, we use an illustrative case to demonstrate a technique tip that minimizes the risk of anterior or posterior cortical breach of the fibula and helps facilitate more accurate placement of a SB device.Levels of Evidence: Level V: Expert opinion.
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Affiliation(s)
- Philip B Kaiser
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
| | - Patrick Cronin
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
| | - Derek S Stenquist
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
| | - Christopher P Miller
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
| | - Brian T Velasco
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
| | - John Y Kwon
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Orthopaedics Residency Program, Boston, Massachusetts (PBK, PC, DSS).,Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts (CPM).,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (BTV).,Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (JYK)
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