Orthopedic Reviews最新文献

{"title":"Haemodynamics, side effects and safety of the combination of continuous femoral nerve block and intravenous parecoxib for pain management after Total Knee Arthroplasty: A pilot study.","authors":"Despoina Sarridou, Anna Gkiouliava, Helena Argiriadou, Aikaterini Amaniti, Georgia Chalmouki, Athina Vadalouka","doi":"10.52965/001c.122536","DOIUrl":"https://doi.org/10.52965/001c.122536","url":null,"abstract":"<p><strong>Background: </strong>Total Knee Arthroplasty (TKA) is a well-established surgical procedure for the treatment of knee joint diseases. This operation leads to severe acute and chronic pain, and intravenous administration of parecoxib could provide significant pain relief.</p><p><strong>Objective: </strong>The aim of the study was to compare the hemodynamic data and safety profile of patients who received parecoxib compared to placebo following TKA.</p><p><strong>Methods: </strong>Ninety patients were followed during this study and were randomly assigned into two equal groups. Group P received parecoxib and Group C received the placebo. Exclusion criteria included age < 40 or > 80 years, ASA III or higher, obesity (>140 kg), allergy to local anaesthetics, opioid dependence, contraindications for subarachnoid anaesthesia, femoral block or the administration of parecoxib.The haemodynamic data collected were Systolic Arterial Pressure (SAP), Diastolic Arterial Pressure (DAP), Heart Rate (HR), Oxygen Saturation (Ox-Sat), blood transfusion requirements and side effects. Recordings were performed every hour for up to 10 hours and at 15min, 4, 8, 12, 24, 36 hours postoperatively.</p><p><strong>Results: </strong>The postoperative SAP and DAP data presented similar findings among groups (p>0.05) within the aforementioned time intervals. The postoperative HR data for both groups displayed no statistically significant difference between the two cohorts (p>0.05). Regarding the occurrence of transfusion, there is no statistically significant difference between the parecoxib and placebo cohorts. The frequency of side effects was negligible and could not be correlated with either group.</p><p><strong>Conclusion: </strong>Therefore, parecoxib did not render any noticeable impact on the hemodynamic profile of the patients.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122536"},"PeriodicalIF":1.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Patterns of Physicians who Perform Caudal Epidural Steroid Injections.","authors":"Ashlyn Brown, Jason Parmar, Suma Ganji-Angirekula, Christopher L Robinson, Rana Al-Jumah, Jatinder Gill, Jamal Hasoon","doi":"10.52965/001c.123283","DOIUrl":"https://doi.org/10.52965/001c.123283","url":null,"abstract":"<p><strong>Introduction: </strong>Caudal epidural steroid injections (ESIs) are commonly employed in the management of low back pain and radiculopathy. Despite their widespread use, practice patterns among physicians performing caudal ESIs can vary significantly. This study aims to identify variability in injection techniques utilized by physicians during caudal ESIs, focusing on steroid use, needle selection, and catheter use. This study also looks at major permanent neurological injuries related to caudal ESIs.</p><p><strong>Methods: </strong>A survey was distributed to a cohort of physicians who regularly perform ESIs. The survey comprised questions regarding the type of needle primarily used, steroid selection, the use of catheters, and major neurological injuries from caudal ESIs. The respondents included a diverse group of pain management physicians from various specialties and practice settings.</p><p><strong>Results: </strong>The results revealed a predominant preference for the use of particulate steroids (72.41%) when performing caudal ESIs. Additionally, physicians primarily prefer to use spinal needles (72.41%) compared to other needle types. A majority of physicians (65.12%) reported that they never use a catheter when performing caudal ESIs to access higher pathology. Finally, all physician responders (100%) reported that they have never caused a permanent neurological injury when performing a caudal ESI.</p><p><strong>Conclusion: </strong>This survey provides initial data among physicians who perform caudal ESIs. Our results demonstrate the majority of physicians favor using particulate steroids and a spinal needle, with fewer opting to use a catheter during these procedures. There were no reported major permanent neurological injuries, demonstrating that caudal ESIs are a safe interventional option for managing lumbosacral pain complaints.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"123283"},"PeriodicalIF":1.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral ligament reconstruction and additive medial ligament reconstruction in chronic ankle instability: a retrospective study.","authors":"Moritz Kleinevoß, Daiwei Yao, Christian Plaass, Christina Stukenborg-Colsman, Kiriakos Daniilidis, Sarah Ettinger, Leif Claassen","doi":"10.52965/001c.120051","DOIUrl":"https://doi.org/10.52965/001c.120051","url":null,"abstract":"<p><strong>Background: </strong>Ligamentous lesions of the ankle joint are common. Isolated medial ligament injuries are rare but are often associated with lateral ligament injuries, isolated medial ligament lesions are often overlooked. The present study aimed to evaluate the clinical and functional differences in the outcomes of isolated lateral and combined medial and lateral ligament reconstruction. The study is based on patient-reported outcome measurements and motion sensor technology to assess these outcomes.</p><p><strong>Objective: </strong>The purpose of this study was to compare the clinical and functional outcomes of isolated lateral and combined lateral and medial ankle ligament reconstruction.</p><p><strong>Methods: </strong>From December 2014 to August 2018, 111 patients underwent either isolated lateral ligament (LG) or medial and lateral ligament (MLG) reconstruction. Of the 104 patients meeting the inclusion criteria, 49 had LG and 55 had MLG reconstruction. Outcome measures included the Short Form-36 Health Survey SF-36, Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAMG), Tegner Activity Scale, the European Foot and Ankle Society (EFAS), American Orthopaedic Foot and Ancle Society (AOFAS) hindfoot score, and the Karlsson Peterson Score. Mobility and stability were assessed using the Ortheligent™ motion sensor for both healthy and treated ankles.</p><p><strong>Results: </strong>While there were no significant differences in outcome scores between the groups, overall scores improved after treatment (p >0.00). Notably LG showed improved movement, with better dorsal extension measured by the Sensor (p ÷ 0.02). The sensor's results correlated significantly with FAOS subscales for pain (p ÷0.05), stiffness (p ÷ 0.01), ADL (p ÷0.02), and sports (p >0.00).</p><p><strong>Conclusion: </strong>Postoperative results, regardless of LG or MLG, showed significant subjective well-being improvement. LG's advantages were highlighted by a significant improvement in dorsal extension, supported by correlated results from a portable motion sensor assessing ankle stability.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"120051"},"PeriodicalIF":1.4,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11386540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of bone cement implantation syndrome in cemented bipolar hemiarthroplasty: impact in patients with and without preexisting heart disease.","authors":"Varah Yuenyongviwat, Jiranuwat Janejaturanon, Theerawit Hongnaparak, Khanin Iamthanaporn","doi":"10.52965/001c.122320","DOIUrl":"10.52965/001c.122320","url":null,"abstract":"<p><strong>Background: </strong>With the increasing incidence of hip fractures in older adults, hip replacement with a cemented femoral stem has become a viable treatment option. However, concerns regarding potential complications, particularly bone cement implantation syndrome (BCIS), especially in patients with preexisting medical conditions, have prompted orthopedic surgeons to explore alternative approaches.</p><p><strong>Objective: </strong>The research question of this retrospective study is whether BCIS incidence in patients with preexisting heart disease undergoing cemented bipolar hemiarthroplasty is higher than that of patients without preexisting heart disease.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 311 patients undergoing cemented bipolar hemiarthroplasty, including 188 without preexisting heart disease and 123 with heart disease. Anesthetic records were reviewed to assess parameters related to BCIS. BCIS severity was graded systematically, emphasizing key metrics, such as hypotension, arterial desaturation, and the loss of consciousness.</p><p><strong>Results: </strong>Among the patients, no perioperative deaths occurred. Grade 1 BCIS was observed in 13 patients (4.18 %), without instances of grade 2 or 3. Notably, grade 1 BCIS was observed in only 2 patients with preexisting heart disease (1.63%) and 11 patients (5.85%) without preexisting heart disease.</p><p><strong>Conclusion: </strong>BCIS incidence after cemented bipolar hemiarthroplasty was minimal, with a predominantly low severity. Importantly, preexisting heart disease did not pose a significant increase in the risk of BCIS. This finding confirms the safety of cemented bipolar hemiarthroplasty in older adults.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122320"},"PeriodicalIF":1.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic Management of a Patient with Renal Cell Carcinoma-Associated Venous Thrombosis and Massive Transfusion.","authors":"Gary Zhang, Ryan Palacios, Jamal Hasoon, Christopher L Robinson, Anvinh Nguyen","doi":"10.52965/001c.122538","DOIUrl":"10.52965/001c.122538","url":null,"abstract":"<p><p>A 53-year-old male with a history of multiple deep venous thromboses (DVTs) underwent a right open radical nephrectomy with inferior vena cava (IVC) thrombectomy in the context of renal cell carcinoma (RCC)-associated venous thrombosis. Imaging and renal biopsy revealed a diagnosis of RCC with non-occlusive thrombosis of the left renal vein and occlusive thrombosis of the infrarenal IVC. The major risks of concern for the procedure included thrombus embolization from surgical manipulation and massive bleeding. Intraoperatively, the patient experienced significant hemorrhage requiring massive transfusion protocol. The purpose of this case report is to emphasize the importance of multidisciplinary involvement, intraoperative thrombus monitoring, and principles of massive transfusion in the management of similar cases.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122538"},"PeriodicalIF":1.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of long term outcomes and innovations in Total Knee Arthroplasty: KINEMATIC, PERSONALIZED KNEE vs. CONVENTIONAL.","authors":"Zaki Alhifzi","doi":"10.52965/001c.122318","DOIUrl":"10.52965/001c.122318","url":null,"abstract":"<p><strong>Background: </strong>Kinematic alignment is an emerging approach for total knee arthroplasty, with the aim to restore patient's individual pre-arthritic joint kinematics. In this systematic review and meta-analysis, we compared the kinematic alignment with the conventional mechanical alignment for total knee arthroplasty.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Cochrane Library, and Scopus on June 2, 2024. We screened the retrieved studies for eligibility. Then extracted the data from the included studies, and then pooled the data as mean difference (MD) or odds ratio (OR) with a 95% confidence interval using Review Manager Software (ver. 3.5).</p><p><strong>Results: </strong>There was no significant difference between KA and MA in the different reported scores: combined KSS score at 6 months (<i>P</i> = 0.23) and 1 years (<i>P</i> = 0.60), KSS Patient satisfaction (<i>P</i> = 0.33), KSS function score (<i>P</i> = 0.07), Oxford score at 6 months (<i>P</i> = 0.45) and 2 years (<i>P</i> = 0.41), KOOS score (<i>P</i> = 0.26). Moreover, there was statistically significant difference in range of motion for flexion and extension at 1 and 2 years, incision length, the length of hospital stay, or the duration of surgery.</p><p><strong>Conclusion: </strong>Although kinematic alignment showed slightly better clinical outcomes than mechanical alignment, the difference between the two techniques is not statistically significant.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122318"},"PeriodicalIF":1.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Radius Fracture with Dislocation of the Radioulnar Joint.","authors":"Ishani Anand, Benjamin Jamal, Latha Ganti, Kevin Sherin","doi":"10.52965/001c.122125","DOIUrl":"10.52965/001c.122125","url":null,"abstract":"<p><p>The authors report on the case of a 30-year-old male who sustained a wrist injury following a motorcycle accident. Emergency department evaluation revealed a left open distal radius fracture with distal radioulnar joint dislocation. The patient underwent surgical fixation to restore full mobility of his wrist.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122125"},"PeriodicalIF":1.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of therapeutic methods for Legg-Calvé-Perthes disease according to staging, limits of conservative treatment: a systematic review with meta-analysis.","authors":"Marco Aurelio Santos Santana, Lucas Bahiense Guimarães, Ludmila Correia Mendes, Lucas Leal Varjao","doi":"10.52965/001c.122123","DOIUrl":"10.52965/001c.122123","url":null,"abstract":"<p><p>Legg-Calvé-Perthes disease (LCPD) is known as a self-limiting pediatric orthopedic pathology that affects the hip due to ischemia with consequent aseptic avascular necrosis of the femoral head. This is a systematic literature review carried out in the databases indexed in the Medical Literature Analysis and Retrieval System Online (MEDLINE) in accordance with the precepts established by the PRISMA methodology (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The aim was to compare the effectiveness of treatment for Legg-Calvé-Perthes disease in relation to its staging: the limits of conservative treatment. Conservative treatment was used in four studies, and most patients under the age of 6.5 had Stulberg I and II results. Older patients, between eight and ten years old, had a relatively better classification when they underwent surgical treatment. In this context, the data collected did not show significant variations; however, it was possible to observe that conservative treatment was more effective in this population, while surgical treatment is better recommended at older ages.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122123"},"PeriodicalIF":1.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating the Risks of Lower Extremity Injuries in Soccer: A Comprehensive Analysis of Lower Extremity Injury Rates in Soccer Between 2014 and 2023.","authors":"Anish Amirneni, Jasra Elahi, Nofel Iftikhar, Latha Ganti","doi":"10.52965/001c.122315","DOIUrl":"10.52965/001c.122315","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;With events such as the Copa America 2024, the 2026 World Cup, and the arrival of European stars in Major League Soccer (MLS), the already observed and forecasted rise of soccer in the United States (US) seems to be an inevitable outcome. Although regular participation in soccer features several benefits, including increasing cardiovascular health, decreasing stress, and promoting interpersonal relationships, the risk of injury, as is the case in any sport, is ever present. Although many sports that are popular in America feature high rates of concussion, rotator cuff injuries, and general upper extremity injuries, soccer, being more strenuous on the lower-half of the body, features a disproportionate rate of lower extremity injuries. An analysis of the frequencies of these injuries, relative to factors such as year of injury, age, gender, location of injury, and diagnosis of injury, may help organizational bodies and soccer leagues implement new regulations regarding the usage of protective equipment and rules regarding gameplay. This study aims to illuminate these takeaways in an effort to better patient care outcomes in soccer-related injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This paper utilized the National Electronic Injury Surveillance System Database (NEISS) to compile data on lower extremity soccer-related injuries within the defined study period, 2014-2023. Inclusion criteria for the study involved all patients presenting to the emergency department (ED) within the study period and within the defined age range of 0 to 69 years old, with injuries sustained from or related to soccer. Using NEISS, trends were elucidated discriminating based on year of injury, sex, age group, location of injury, and diagnosis group of injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Within the defined study period of 10 years, from 2014-2023, there were approximately 843,063 total soccer-related lower extremity injuries which presented to various EDs across the US. Regarding majorities, the most injuries were sustained in 2014 (12.84% of total injuries), most patients sustaining injuries were male (66.6% of all patients), and within the age range of 10-19 years old (63.24% of all patients), with the most instances occurring at age 15. Lower extremity injuries were most reported to be affecting the ankle with 306,797 incidences (36.39% of total injuries seen) and the most frequent diagnosis group was reported to be strains/sprains with 396,420 (47.02% of total injuries seen) total occurrences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study analyzes the incidents of lower extremity injuries while participating in soccer for the last 10 years, 2014-2023. The study provides new data regarding the frequency of injuries and their relative rate with respect to year of injury, age group, sex, location of injury, and diagnosis. The results of this study show injury majorities and trends which can be used to dictate changes in regulation regarding ","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122315"},"PeriodicalIF":1.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patella Baja with Complete Quadriceps Tendon Rupture.","authors":"Liyana Ahmed, Sanjana Konda, Latha Ganti, Darren McAuley","doi":"10.52965/001c.122121","DOIUrl":"10.52965/001c.122121","url":null,"abstract":"<p><p>Patella baja is an uncommon yet dangerous condition primarily found in patients who have received knee surgery, but can occur in anyone, more commonly in overweight, middle-aged males. The case presented outlines an instance in which a man with no previous history of knee injury or surgery, yet with other high-risk factors, develops patella baja after a minor injury. The case highlights the importance of testing and awareness of such conditions. The case report outlines the cause, diagnosis, and treatment of the patient's condition.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"16 ","pages":"122121"},"PeriodicalIF":1.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}