2021 innovations in orthopedic surgery and traumatology

Maïte Van Cauter, Pierre Pirlot, Pierre-Philippe Guilmot, Loïc Thoreau, Maxime Bonnelance, Gautier Beckers, Hervé Poilvache, Daniel Morcillo, Vincent Druez, Jean-Emile Dubuc, Nadia Irda, Ludovic Kaminski, Simon Vandergugten, Alin Sirbu, Karim Tribak, Dan Published in the journal : February 2022 Category : Chirurgie orthopédique et traumatologie

Summary :

The year 2021 enabled us to shed light on the impact of minimally-invasive techniques in hip arthroplasty surgery, continued progress in knee arthroplasty, place of unconventional strategies in the control of implant infections, and interest of a new surgical positioning for performing shoulder arthroscopy techniques.

The optimization of surgical techniques in hip arthroplasty renders it now possible to identify those patients for whom a postoperative blood control proves necessary but also, therefore, for optimizing the patients before the intervention in order to reduce the risk of postoperative anemia and transfusion requirement. The benefit of knee replacement surgery has so far not matched that of hip replacement. Nevertheless, the development of resurfacing strategies respecting the individual anatomy of the patient, supported by modern technology and particularly robotization and using custom-made implants, augurs well for significant progress. Infection is a serious complication of arthroplasty surgery. To the classic strategies were added new therapeutic approaches, such as two-stage surgery in one stage and a better definition of the place of long-term suppressive antibiotic therapy.

Finally, an optimal position for patients benefitting from shoulder arthroscopy is that in the supine position, avoiding the disadvantages of semi-sitting and lateral decubitus positions, with the first associated with increased anesthetic risks and the second with surgical difficulties in the event of conversion to an open approach, with a risk of injury to the brachial plexus.

Key Words

Hip arthroplasty, blood testing, anemia, transfusion, knee arthroplasty, robotization, custom implants, prosthesis infection, one-stage surgery, suppressive antibiotic therapy, shoulder arthroscopy, supine position, rotator cuff suture