Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 5 Articles
Background. Among coracoclavicular (CC) fixation techniques, the use of flip button device was demonstrated to have successful\noutcomes with the advantage of being able to accommodate an arthroscopic procedure. Purpose. This study was conducted to\ninvestigate the factors associated with loss of fixation after arthroscopically assisted CC fixation using a single flip button device\nfor acromioclavicular (AC) joint dislocations. Materials and Methods. We enrolled a total of 47 patients (35 men and 12 women).\nPlain radiography was performed at a mean of 24 months postoperatively to evaluate the final radiological outcome. The primary\noutcome measure was a long-term reduction of the AC joint for at least 24 months. Results. We found that 29 patients had a\nhigh quality reduction (61.7%) and 18 patients had a low quality reduction (38.3%) in initial postoperative CT findings. Our study\nshowed that the duration (5 days) from injury to treatment and the quality of initial postoperative reduction were significantly\nassociated with the maintenance of reduction at final follow-up. Conclusion. Our study showed that maintaining stable reduction\nafter arthroscopically assisted CC fixation using a single flip button device technique is difficult especially in patients who received\ndelayed treatment or whose initial reduction quality was poor....
Objective: There are two monocyte populations in human blood: CD14+CD16âË?â??\nclassical monocytes and CD14+CD16+ inflammatory monocytes. CD14+CD16+\ninflammatory monocytes, account for approximately 10% of the total monocytes,\nmay be expanded in various types of inflammatory conditions. The\npurpose of this study was to investigate whether the expansion of the\nCD14+CD16+ monocyte population represents a risk factor of aseptic loosening\n(AL). Methods: Peripheral monocytes subsets were measured in revision\npatients with AL (n = 35) and in patients with stable implants (SI, n = 56).\nThe gene profiles of TNFÃ?±, IL-1Ã?², CD16, CD68 and TRAP5B from collected\nloosening periprosthetic tissues were analyzed. Results: There were no significant\ndifferences in the CD14+CD16+ monocyte populations between the SI\nand AL patients. The CD14+CD16+ monocytes were marginally higher in revision\npatients with osteolysis (n = 30), compared to patients without osteolysis\n(n = 5) though no statistically difference was found. There was an association\nbetween the CD14+CD16+ monocyte subpopulation and the tissue gene profiles,\nincluding IL-1Ã?² (p = 0.063), CD68 (p = 0.036), and TRAP5B (p = 0.073).\nConclusion: It was demonstrated that the expansion of CD14+CD16+ monocytes\nreflects, to some extent, the inflammatory status of the loosening periprosthetic\ntissues. It is unclear if some of those SI patients (no pain and negative\nradiograph) who have a higher frequency of CD14+CD16+ monocytes\nmay be at the early stage of AL. Further evaluation of CD14+CD16+ monocyte\npopulation, independently or combined with other factors, will be useful to\ndesign a risk profile for AL incidence and progression....
Background: This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral\nneck fractures.\nMethods: Meta-analysis was performed on the difference in revision rate and overall mortality between participants\nundergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA.\nResults: Pooled direct and indirect results indicated no significant difference in mortality between THA and\nHA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17,\n95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74;\nP = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA\nand HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.\n34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA\nthan osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition\nin inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA,\nHA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and\nTHA had significantly lower revision rates compared with osteosynthesis.\nConclusions: There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA\nand THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide\nsupport for the use of hip arthroplasty to treat displaced fractures of the femoral neck....
Background: This meta-analysis aims to illustrate the efficacy and safety of intrathecal morphine (ITM) versus\nfemoral nerve block (FNB) for pain control after total knee arthroplasty (TKA).\nMethods: In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science,\nCochrane Database of Systematic Reviews, Cami Info. Inc., Casalini databases, EBSCO databases, Verlag database and\nGoogle database. Data on patients prepared for TKA surgery in studies that compared ITM versus FNB for pain control\nafter TKA were collected. The main outcomes were the visual analogue scale (VAS) at 6, 12, 24, 48 and 72 and total\nmorphine consumption at 12, 24 and 48 h. The secondary outcomes were complications that included postoperative\nnausea and vomiting (PONV) and itching. Stata 12.0 was used for pooling the data.\nResults: Five clinical studies with a total of 225 patients (ITM group = 114, FNB group = 111) were ultimately included in\nthe meta-analysis. The results revealed that the ITM group was associated with a reduction of VAS at 6, 12, 24, 48 and\n72 h and total morphine consumption at 12, 24 and 48 h. There was no significant difference between the occurrences\nof PONV. However, the ITM group was associated with an increased occurrence of itching after TKA.\nConclusions: Some immediate analgesic efficacy and opioid-sparing effects were obtained with the administration of\nITM when compared with FNB. The complications of itching in the ITM group were greater than in the FNB group. The\nsample size and the quality of the included studies were limited. A multi-centre RCT is needed to identify the optimal\nmethod for reaching maximum pain control after TKA....
Objective: To study the influence of patellar resurfacing on quality of life under\na standardised score. The chosen score was the Knee Society Score (KSS), which\nconsiders range of motion, pain, contractors, alignment and stability. Methods:\nRetrospective review of 60 patients submitted to total knee arthroplasty (TKA)\nwas divided into two groups: with patellar resurfacing (PR) and without patellar\nresurfacing (NPR). We reviewed data from these patients containing the KSS,\nwhich are routinely used in our service. Data were analysed from 2013 to 2014,\nwith a minimal patient follow-up of 18 months. Results: There were no unsatisfactory\nscores in our study. Total scores (KSS) were similar between the\ngroups (mean KSS: PR = 88.36 Ã?± 9.64; NPR = 84.26 Ã?± 9.44 [p = 0.1]). While\nstratifying into groups (poor, fair, good, excellent), we found excellent results in\n84.8% of PR versus 59.3% NPR (p = 0.056). These data did not reach statistical\nsignificance and can therefore be considered a coincidental result. Conclusion:\nAlthough these results did not show statistical significance (p = 0.056), patellar\nresurfacing patients tend to get more ââ?¬Å?excellentââ?¬Â results after 18 months of follow-\nup in quality of life when evaluated by KSS. Perhaps a larger amount of patients\nwould suffice to acquire statistical significance in a future study....
Loading....