Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees / Hany Elbardesy in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680 Titre : Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees Type de document : texte imprimé Auteurs : Hany Elbardesy ; Hazem M. Salamah ; André McLeod Année de publication : 2021 Article en page(s) : p. 665-680 Note générale : https://doi.org/10.52628/87.7.12 Langues : Anglais (eng) Mots-clés : Medial pivot  posterior stabilised  total knee arthroplasty  meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted this study following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017 [article] Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees [texte imprimé] / Hany Elbardesy ; Hazem M. Salamah ; André McLeod . - 2021 . - p. 665-680. https://doi.org/10.52628/87.7.12 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680 Mots-clés : Medial pivot  posterior stabilised  total knee arthroplasty  meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted this study following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017

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Subcuticular sutures versus staples for skin closure after primary hip arthroplasty / Hany Elbardesy in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64 Titre : Subcuticular sutures versus staples for skin closure after primary hip arthroplasty Type de document : texte imprimé Auteurs : Hany Elbardesy ; Rehan Gul ; Shane Guerin Année de publication : 2021 Article en page(s) : p. 55-64 Note générale : https://doi.org/10.52628/87.1.08 Langues : Anglais (eng) Mots-clés : total hip arthroplasty  total joint arthroplasty  skin closure  meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined. Permalink : ./index.php?lvl=notice_display&id=96577 [article] Subcuticular sutures versus staples for skin closure after primary hip arthroplasty [texte imprimé] / Hany Elbardesy ; Rehan Gul ; Shane Guerin . - 2021 . - p. 55-64. https://doi.org/10.52628/87.1.08 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64 Mots-clés : total hip arthroplasty  total joint arthroplasty  skin closure  meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined. Permalink : ./index.php?lvl=notice_display&id=96577

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The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis / Hany Elbardesy in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 93-102 Titre : The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis Type de document : texte imprimé Auteurs : Hany Elbardesy ; Matthew Nagle ; Lydia Simmons ; James Harty Année de publication : 2021 Article en page(s) : p. 93-102 Note générale : https://doi.org/10.52628/87.1.12 Langues : Anglais (eng) Mots-clés : knee focal metallic implant  HemiCAP  UniCAP  Wave prosthesis  inlay design Résumé : Knee osteochondral defects are a common problem among people, especially young and active patients. So effective joint preserving surgeries is essential to prevent or even delay the onset of osteoarthritis for these group of patients. This study aims to critically appraise and evaluate the evidence for the results and effectiveness of femoral condyle resurfacing (HemiCAP/ UniCAP) in treatment of patients with focal femoral condyle cartilage defect. Using the search terms : HemiCAP, UniCAP, Episurf, focal, femoral, condyle, inlay and resur-facing, we reviewed the PubMed and EMBASE and the Cochrane Database of Systematic Reviews (CDSR) to find any articles published up to March 2020. The short term follow-up of the HemiCAP shows (6.74 %) revision rate. However, 29.13 % loss of follow up let us consider these results with caution especially if the revision rate progressively increased with time to 19.3 % in 5-7 years with no enough evidence for the long term results except the data from the Australian Joint Registry 2018, where the cumulative revision rate was 40.6 % (33.5, 48.4) at ten years. The UniCAP that used for defect more than 4 cm 2 has a high revision rate (53.66 %) which is considered unacceptable revision rate in com-parison to another similar prosthesis such as Uni-Knee Arthroplasty (UKA). The evidence from published studies and our meta- analysis suggests that partial resurfacing of the femoral condyle (HemiCAP) doesn’t support its usage as a tool to treat the focal cartilage defect in middle- aged patients. The UniCAP as femoral condyle resurfacing has very high revision rate at 5-7 years (53.66 %) which make us recommend against its usage. Permalink : ./index.php?lvl=notice_display&id=96591 [article] The partial femoral condyle focal resurfacing (HemiCAP-UniCAP) for treatment of full-thickness cartilage defects, systematic review and meta-analysis [texte imprimé] / Hany Elbardesy ; Matthew Nagle ; Lydia Simmons ; James Harty . - 2021 . - p. 93-102. https://doi.org/10.52628/87.1.12 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 93-102 Mots-clés : knee focal metallic implant  HemiCAP  UniCAP  Wave prosthesis  inlay design Résumé : Knee osteochondral defects are a common problem among people, especially young and active patients. So effective joint preserving surgeries is essential to prevent or even delay the onset of osteoarthritis for these group of patients. This study aims to critically appraise and evaluate the evidence for the results and effectiveness of femoral condyle resurfacing (HemiCAP/ UniCAP) in treatment of patients with focal femoral condyle cartilage defect. Using the search terms : HemiCAP, UniCAP, Episurf, focal, femoral, condyle, inlay and resur-facing, we reviewed the PubMed and EMBASE and the Cochrane Database of Systematic Reviews (CDSR) to find any articles published up to March 2020. The short term follow-up of the HemiCAP shows (6.74 %) revision rate. However, 29.13 % loss of follow up let us consider these results with caution especially if the revision rate progressively increased with time to 19.3 % in 5-7 years with no enough evidence for the long term results except the data from the Australian Joint Registry 2018, where the cumulative revision rate was 40.6 % (33.5, 48.4) at ten years. The UniCAP that used for defect more than 4 cm 2 has a high revision rate (53.66 %) which is considered unacceptable revision rate in com-parison to another similar prosthesis such as Uni-Knee Arthroplasty (UKA). The evidence from published studies and our meta- analysis suggests that partial resurfacing of the femoral condyle (HemiCAP) doesn’t support its usage as a tool to treat the focal cartilage defect in middle- aged patients. The UniCAP as femoral condyle resurfacing has very high revision rate at 5-7 years (53.66 %) which make us recommend against its usage. Permalink : ./index.php?lvl=notice_display&id=96591

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