Journal of Orthopaedic Surgery最新文献

{"title":"A randomized controlled trial comparing carbazochrome sodium sulfonate and tranexamic acid in reducing blood loss and inflammatory response after simultaneous bilateral total hip arthroplasty.","authors":"Guangtao Han, Lijun Cai, Qin Wang, Qianhao Li, Pengde Kang","doi":"10.1177/10225536241293544","DOIUrl":"10.1177/10225536241293544","url":null,"abstract":"<p><strong>Purpose: </strong>A drug known as carbazochrome sodium sulfonate (CSS) can reduce blood loss. But, it is not known how it can prevent the development of hemostatic and inflammatory conditions in patients who undergo bilateral simultaneous total hip arthroplasty (SBTHA). This study will analyze the safety and effectiveness of combining this drug with SBTHA.</p><p><strong>Methods: </strong>The study was conducted on 100 patients who underwent SBTHA with simultaneous total hip replacement. They were split into two groups: group B received TXA with CSS, group A received TXA with no CSS. The main observation of the study was the total blood loss, which is the most common indication of blood loss. Other secondary indicators of the study included hidden blood loss, postoperative blood transfusion rate, level of inflammatory reactants, hip function, pain score, venous thromboembolism (VTE) and the incidence of adverse events.</p><p><strong>Results: </strong>Group B had significantly lower TBL and HBL compared to Group A. Group B showed significant improvement in inflammatory biomarker levels, blood transfusion rate when compared to Group A (<i>p</i> < .05). No thromboembolic complications occurred in either group. There were no significant differences between the two groups in terms of postoperative swelling rate, intraoperative blood loss, visual analog scale pain score, platelet count, discharge motion and average length of stay.</p><p><strong>Conclusions: </strong>As a hemostatic agent, CSS combined with TXA can reduce postoperative blood loss in patients undergoing SBTHA, and is more effective than TXA alone in terms of blood loss and inflammation, and does not increase the incidence of thromboembolic complications.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241293544"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of changes in spinal dimensions following different correction methods in adult spinal deformity surgery.","authors":"Hoai Tp Dinh, Hiroki Ushirozako, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Tomohiro Yamada, Koichiro Ide, Kenta Kurosu, Yukihiro Matsuyama","doi":"10.1177/10225536241289313","DOIUrl":"https://doi.org/10.1177/10225536241289313","url":null,"abstract":"<p><p><b>Background:</b> Adult spinal deformity (ASD) surgery has gained popularity, with significant improvements in patient-reported outcomes. Posterior lumbar interbody fusion with multiple grade II osteotomies (PLIF + MOs) and lateral lumbar interbody fusion (LLIF) have been utilized to correct ASD; however, no studies have compared these methods with regard to the pre- and postoperative changes in length and volume of the spinal canal. This study aimed to investigate the 3-dimensional changes in the anterior vertical column length (AVCL), spinal canal length (SCL), and spinal canal volume (SCV) in patients with ASD after surgery, employing LLIF and PLIF + MOs. <b>Methods:</b> This retrospective study examined 44 patients with ASD who underwent surgery between 2010 and 2021 using two corrective surgical methods, LLIF and PLIF + MOs. Radiographic parameters and clinical outcomes were assessed, and three-dimensional models were created from computed tomography images to analyze changes in AVCL, SCL, and SCV. <b>Results:</b> We compared the effects of LLIF and PLIF + MOs on spinal canal dimensions during ASD surgery. LLIF demonstrated an increase in lumbar segment (L1-S1) AVCL and whole spine (T1-S1) SCL by 6.5 ± 8.0 mm and 13.8 ± 7.6 mm, respectively, compared with PLIF + MOs. However, PLIF + MOs exhibited a reduction in the lengths of the lumbar segment AVCL. Postoperative differences were significant for AVCL (L1-S1), SCL fusion level, and first-standing lumbar lordosis between the groups (<i>p</i> < 0.0001, 0.002, and 0.016, respectively). LLIF significantly increased the SCV at the fusion level and whole spine T1-S1 by 14.5% and 10.6%, respectively, outperforming PLIF + MOs. Despite changes in dimensions, the postoperative Oswestry disability index scores showed no significant difference between the two groups. <b>Conclusions:</b> Our study suggests that LLIF can increase spinal canal space, lumbar lordosis, and anterior column length in the lumbar spinal segment. Knowledge of these variations may be critical for enhancing surgical outcomes and preventing neurological complications.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241289313"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevation and distraction of the Tibial periosteum in the management of chronic ischemic lower limb diseases.","authors":"Meng Gan, Xiqin Xia, Yi You, Wei Xu, Xinyu Peng, Jinjun Xu, Wengao Wu, Yinkui Tang, Qiong Chen, Yun Wu, Naxin Zeng","doi":"10.1177/10225536241295483","DOIUrl":"https://doi.org/10.1177/10225536241295483","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effectiveness of tibia periosteum distraction (TPD) applied to the tibial periosteum, an innovative approach grounded in Ilizarov's tension-stress theory, for the treatment of ischemic diabetic foot and vasculitic foot conditions.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 33 patients (36 limbs) who underwent TPD between June 2019 and May 2022. The study comprised 21 males (23 limbs) and 12 females (13 limbs), aged 41 to 80 years (mean age: 63.4 years). Diabetic foot accounted for 27 cases, thromboangiitis obliterans for 2 cases, and arterial occlusive disease for 4 cases. The distribution of affected limbs included 15 left feet and 21 right feet. Periosteum traction commenced on the third postoperative day at a rate of approximately 0.75 mm/day, adjusted biweekly. The traction device was removed after two weeks. Evaluation included capillary refill and wound healing assessment, along with pre- and postoperative analysis of foot skin temperature, ankle-brachial index (ABI), visual analogue scale (VAS) pain scores, and peripheral blood oxygen saturation. CT angiography (CTA) was utilized to assess vascular conditions in both lower limbs.</p><p><strong>Results: </strong>All 33 patients were successfully followed up for a duration ranging from 4 to 24 weeks (mean: 11.03 weeks). VAS pain scores significantly decreased from preoperative (5.09 ± 1.70, range: 2-8) to postoperative two weeks (2.24 ± 0.90, range: 1-4) (t = 9.44, <i>p</i> < .001). Oxygen saturation levels increased from 83.88% ± 11.82% (range: 58%-97%) preoperatively to 91.36% ± 5.69% (range: 76%-98%) at two weeks postoperatively (t = -4.21, <i>p</i> < .001). Foot skin temperature also showed a significant increase (t = -3.98, <i>p</i> < .001). Capillary refill test at two weeks postoperatively demonstrated notable improvement. CTA revealed evident neovascularization in the operated limbs compared to preoperative conditions. Wound improvement was significant in all 33 patients within two months postoperatively.</p><p><strong>Conclusion: </strong>TPD emerges as a promising technique for chronic ischemic lower limb diseases, demonstrating favorable preliminary outcomes in wound healing promotion and amputation rate reduction. Nevertheless, large-scale randomized controlled trials are essential to further validate its efficacy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241295483"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the results of closed kinetic chain exercises applied in the conservative treatment of patellofemoral pain syndrome by means of shear wave elastography: A randomized controlled trial.","authors":"Yigit Kultur, Emir Harbiyeli, Huseyin Botanlioglu, Mahmut K Ozsahin, Sude Ozturhalli, Onder Aydingoz, Mehmet R Erginer","doi":"10.1177/10225536241280384","DOIUrl":"10.1177/10225536241280384","url":null,"abstract":"<p><strong>Purpose: </strong>Non-selective closed kinetic chain exercises (NSKCE) and or selective closed kinetic chain exercises (SCKCE) has been shown to increase Vastus medialis obliquus (VMO) muscle power in patellofemoral pain syndrome (PFPS). However, the superiority of the exercises to each other has not been shown. This study aimed to evaluating the effects of different exercises on the stiffness of the VMO and vastus lateralis (VL) muscles, pain management, functional scores, and thigh circumferences.</p><p><strong>Methods: </strong>One hundred 60 knees of 80 patients followed up in our outpatient clinic between December 2016 and February 2018 were included in the study. Patients were divided into two groups as 40 patients with single-sided PFPS (20 male and 20 female patients) and 40 healthy controls (20 male and 20 female patients). The patients in each group were divided into subgroups according to NSCKCE or SCKCE. VMO and VL muscles were measured by shear wave elastography (SWE) before and after a 6-weeks therapy.</p><p><strong>Results: </strong>There was a significant decrease in Visual Analog Scale (VAS) score while a significant increase was found in Lysholm Knee Scale (LKS), however, no statistically difference was found between the two exercise groups in PFPS patients. The effect of both exercises on pain and functional improvement was similar.</p><p><strong>Conclusion: </strong>Decrease in VAS scores, increase in LKS scores, increase in thigh circumference measurements, and increase in the stiffness of VMO and VL muscles were observed in both groups who received SCKCE and NSCKCE on PFPS patients.</p><p><strong>Trial registration: </strong>Study registered at ClinicalTrials.gov (registration number: NCT05427357).</p><p><strong>Design: </strong>Randomized controlled trial.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241280384"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding the article \"Inadequate anticoagulation and hyperuricemia cause knee pain after platelet-rich plasma injection: A retrospective study\".","authors":"Jiaxing Ding, Yanfei Yang, Jiayi Lin, Peilong Jiang","doi":"10.1177/10225536241305461","DOIUrl":"https://doi.org/10.1177/10225536241305461","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241305461"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor on \"Does high body mass index affect short-term clinical and radiologic outcomes in robotic-assisted total knee arthroplasty?\"","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/10225536241305462","DOIUrl":"https://doi.org/10.1177/10225536241305462","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241305462"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal blocking screw augmentation in ulnar intramedullary nail fixation of adult forearm diaphyseal fractures.","authors":"Yong Woo Kim, Sang Ki Lee, Young Sun An","doi":"10.1177/10225536241295520","DOIUrl":"https://doi.org/10.1177/10225536241295520","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effect of distal blocking screws on the stability and healing of ulnar diaphyseal fractures treated with intramedullary (IM) nails. The primary research question was whether the addition of distal blocking screws enhanced fracture stabilization and promoted faster healing than the standard IM nailing techniques.</p><p><strong>Methods: </strong>This retrospective study reviewed medical records of 30 patients with ulnar diaphyseal fractures treated from February 2018 to September 2023. The patients were divided into two groups: those treated using IM nails alone (<i>n</i> = 17) and those treated with using IM nails with distal blocking screws (<i>n</i> = 13). The surgical time, medullary canal space, fracture healing time, and complications were assessed. Functional outcomes were evaluated using the Grace and Eversmann rating system, the DASH scores, and the VAS scores.</p><p><strong>Results: </strong>The addition of distal blocking screws resulted in a slightly longer surgical time (56 min vs 47 min). However, the group with distal blocking screws had smaller medullary canal space and showed significantly faster fracture healing times (2.3 months vs 3.9 months; <i>p</i> = .036). There were no reported complications of nonunion, nerve injury, or infection in the distal blocking screw group, whereas the IM nail-only group had one case of nonunion (5.7%).</p><p><strong>Conclusion: </strong>The use of distal blocking screws in conjunction with IM nails for ulnar diaphyseal fractures improves fracture stability and promotes faster healing.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241295520"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative investigation to identify return to sports criteria after shoulder stabilization surgery used by professional team physicians.","authors":"Mike Szlufcik, Mario Pasurka, John Theodoropoulos, Marcel Betsch","doi":"10.1177/10225536241302219","DOIUrl":"https://doi.org/10.1177/10225536241302219","url":null,"abstract":"<p><p><b>Purpose:</b> Purpose of this study is to explore currently utilized readiness to return to sports (RTS) criteria after shoulder stabilization surgery used in elite athletes to gain novel insights into the RTS decision making process of professional team physicians.<b>Methods:</b> 19 qualitative semi-structured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after shoulder stabilization surgery. General inductive analysis and a coding process were used to identify themes and sub-themes arising from the data. A hierarchical approach in coding helped to link themes.<b>Results:</b> We were able to identify five key themes that participating physicians focused on to determine RTS decision making: external influence, objective and subjective criteria, time elapsed since surgery and type of sport. The most important RTS criteria included: range of motion and muscle strength followed by clinical joint stability, time since surgery, ability of sporting movement, psychological readiness, functional testing, absence of pain and allied team support.<b>Conclusion:</b> This study identified several main themes and subordinate minor themes as having the most influence on RTS decision after shoulder surgery. We showed that even among specialized professional team physicians, the main criteria to RTS in these categories were inconsistent necessitating the future development of specific RTS guidelines.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241302219"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of tourniquet in anterior cruciate ligament reconstruction: Is it truly necessary? A prospective randomized clinical trial.","authors":"Riccardo D'Ambrosi, Federico Valli, Fabrizio Di Feo, Pietro Marchetti, Nicola Ursino","doi":"10.1177/10225536241293538","DOIUrl":"10.1177/10225536241293538","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effects of tourniquet use in arthroscopic anterior cruciate ligament reconstruction in terms of (1) intraoperative visualization, (2) surgical time, (3) consumption of sterile saline, and (4) postoperative pain.</p><p><strong>Methods: </strong>In this prospective randomized clinical trial, patients were assigned to Tourniquet Group or No Tourniquet treatment groups. The primary outcomes were intraoperative visualization, with scores ranging from 0 to 10 (0 = no visibility; 10 = clear and perfect display), surgical time, and the consumption of sterile saline. The secondary aim was to measure postoperative pain (24 h after surgery) with the visual analog scale (VAS) for pain.</p><p><strong>Results: </strong>A total of 71 patients were included in the No Tourniquet group, and 75 were included in the Tourniquet group, with mean ages of 26.73 ± 8.05 years and 26.95 ± 10.11 years, respectively (<i>p</i> = .88). In the No Tourniquet group, 37 concomitant meniscal lesions were treated, whereas in the Tourniquet group, 38 (<i>p</i> = .99) were treated. The mean surgical times were 51.07 ± 6.90 and 50.03 ± 7.62 (<i>p</i> = .325), respectively, while the mean amount of saline consumed was 6.17 ± 1.18 L versus 5.89 ± 1.23 L (<i>p</i> = .217). Both groups achieved optimal visualization, with a sum of all surgical steps of 65.49 ± 1.86 for the no tourniquet group and 65.39 ± 1.88 for the Tourniquet group (<i>p</i> = .732). Postoperative pain was significantly lower in the No Tourniquet group (VAS score: 2.82 ± 1.33 vs 5.80 ± 1.22).</p><p><strong>Conclusions: </strong>Tourniquet use during ACL reconstruction does not improve intraoperative visualization and does not reduce surgical time but leads to greater postoperative pain with a risk of well-known tourniquet-related complications.</p><p><strong>Level of evidence: </strong>Level I - Randomized clinical trial.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241293538"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oblique sliding ulna osteotomy to treat paediatric neglected monteggia fracture dislocation.","authors":"Nik Alyani Nik Abdul Adel, Emil Fazliq Mohd, Ismail Munajat, Abdul Razak Sulaiman","doi":"10.1177/10225536241286104","DOIUrl":"https://doi.org/10.1177/10225536241286104","url":null,"abstract":"<p><strong>Introduction: </strong>There have been osteotomy methods that corrected or overcorrected the ulna deformity as part of surgical treatment for chronic radial head dislocation.</p><p><strong>Methodology: </strong>We reported surgical technique and outcome of oblique sliding ulna osteotomy that created acute lengthening, deformity correction or both to assist open reduction of radiocapitellar joint in four patients with neglected Monteggia fracture dislocation.</p><p><strong>Result: </strong>Patients aged 3-12 years old had trauma duration of 4 weeks to 3 years. Two patients had Bado type I injury, and the other two had Bado type III. There was no acute nerve injury. During the final follow-up, all patients achieved union, with the limitation of motion range in the rotation arch being less than 20°. The radial head had no recurrent dislocation.</p><p><strong>Conclusion: </strong>This case series has shown sliding osteotomy safely, providing acute correction and lengthening of the ulna without requiring bone graft to facilitate stable reduction of the neglected Monteggia lesion.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241286104"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}