Open Journal of Orthopedics and Rheumatology最新文献

{"title":"A Young Lady with ANA negative SLE with Secondary Anti Phospholipid Syndrome","authors":"Gomes Richmond Ronald, Khan Saiful Bahar","doi":"10.17352/ojor.000026","DOIUrl":"https://doi.org/10.17352/ojor.000026","url":null,"abstract":"Systemic Lupus Erythematosus (SLE) is a chronic, inflammatory, autoimmune, multisystem connective tissue disease characterized by various autoantibodies to nuclear and cytoplasmic antigens and commonly affects the joints and a variety of organs due to an over activation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 24-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, oral ulcer and proteinuria. The serum autoantibodies were all negative except anti ribosomal P. She was also positive for lupus anti-coagulant. She was treated with oral prednisolone, hydroxychloroquine with topical tacrolimus and improved significantly. Three months after, repeat ANA and anti-ds DNA showed persistent negativity but lupus anti-coagulant remained positive. This case suggests that ANA may not be required in the pathogenesis of SLE.","PeriodicalId":245794,"journal":{"name":"Open Journal of Orthopedics and Rheumatology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117111660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic requirement in first 24 hours following Total Knee Arthroplasty with or without Peri-articular Levobupivacaine Infiltration","authors":"Memon Ar, R. Gul","doi":"10.17352/OJOR.000017","DOIUrl":"https://doi.org/10.17352/OJOR.000017","url":null,"abstract":"Introduction: Post-operative analgesia is an important part of Total Knee Arthroplasty (TKA) to facilitate early mobilization and patient satisfaction. We investigated the effect of periarticular infiltration of the joint with levobupivacaine local anesthetic (LA) on the requirement of analgesics in the first 24 hours period post operatively. \u0000Methods: 28 patients who underwent TKA were analysed retrospectively. They were divided into two groups of 14 each; who did and did not receive the LA infiltration respectively. Analgesic requirement was assessed in terms of the amount of paracetamol, morphine, diclofenac, oxynorm and tramadol administered in 24hrs post operatively. Visual analogue scale was used to record the subjective pain intensity.","PeriodicalId":245794,"journal":{"name":"Open Journal of Orthopedics and Rheumatology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127794934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Management of large and massive rotator cuff tears- Current trends amongst UK shoulder surgeons","authors":"Hackney Rg, Cowling Paul, I. M, Javed M, Conaghan Pg, Kingsbury Sr","doi":"10.17352/pjor.000014","DOIUrl":"https://doi.org/10.17352/pjor.000014","url":null,"abstract":"Background: Management of large and massive rotator cuff tears remains controversial. Such tears are often irreparable, and results of treatment are unpredictable. This study documents the current practice of orthopaedic surgeons in the British Elbow and Shoulder Society. Methods: A questionnaire was prepared pertaining to the management of large and massive rotator cuff tears with minimal degenerative changes in three age groups: Patients of 50 years (young), 65 years (still active), aged 75 years (elderly) were considered. Various risk factors for failure of repair were considered. Results: Physiotherapy and arthroscopic debridement were the most commonly selected management options in young and middle groups in cases of a large/massive rotator cuff tear. Patch repairs were offered by 30% of respondents overall. Latissimus dorsi transfer was utilised by 30%, 8% and 2% respectively in each age group. Reverse shoulder replacement was indicated by 8%, 36% and 76% respectively. Discussion: There was a marked inconsistency in the pre-op planning and number and choice of options between respondents. Most surgeons offered non-augmented repairs in a scenario where they admitted failure was likely. The need for a multicenter trial is widely recognised and 87% of respondents were willing to participate in such a trial.","PeriodicalId":245794,"journal":{"name":"Open Journal of Orthopedics and Rheumatology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123620804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IV. Bisphosphonates promote healing of complicated stress fractures in the foot","authors":"F. E., Ianssen T, Husebye Ee","doi":"10.17352/ojor.000039","DOIUrl":"https://doi.org/10.17352/ojor.000039","url":null,"abstract":"Delayed healing of stress fractures constitutes a signifi cant clinical problem causing pain and disability for the patients affected. The vast majority heal after immobilization of the extremity affected, but a certain small number of patients display delayed union despite standard treatment, resulting in prolonged disability and usually end up needing orthopedic procedures to get symptomatic relief. All stress fractures exhibit Bone Marrow Edema or Bone Marrow Lesions (BMLs) with and without fracture lines on MRI, and in cases of delayed union these lesions persist. Thus, it is conceivable that BML formation might contribute to non-union. Previous studies on transient osteoporosis and osteoarthritis have demonstrated that bisphosphonates can reduce BMLs. We therefore wanted to test, whether treatment with IV. Bisphosphonates could promote healing of such fractures. In this study we report our clinical experience and the results obtained after treating 8 patients exhibiting delayed healing an off label protocol using two Zoledronic acid infusions (given 3 months apart). Seven female and one male patient (aged 30-72) were enrolled. All had signs of non-union for more than 12 months (defi ned as continued pain, disability and persistent BMLs on MRI). Pain was monitored using VAS (1-10) and MRI was performed in six of the patients at baseline, 3, 6 and 12 months after the fi rst infusion. All patients received Ca (0.5-1 g Ca per day) and vitamin D supplementation (800-1000 IE per day). All patients experienced clinical healing with signifi cant reduction of pain at the fracture site and improvement of ambulation within 1-3 months after the fi rst infusion. 4 patients experienced further reducgtion of pain after the second infusion. At 6 months, ambulatory functions were completely restored in all patients and a highly signifi cant reduction of VAS scores from an average of 7.3 before treatment to 1.1 at 6 months and 0,9 at 12 months (P<0,0001) could be demonstrated. The alleviation of pain was accompanied by reduction or total resolution of BMLs on MRI. Except for 2 cases of fl u-like symptoms after the fi rst infusion, no adverse effects were recorded. In conclusion, In conclusion, 2 infusions of zoledronic acid (5 mg) given 3 months apart, may emerge as a possible treatment modality of stress fractures in the foot showing delayed union, and could potentially reduce the need for more extensive surgical intervention in such complicated cases. This small observational pilot study needs to be corroborated in a larger randomized, controlled trial. Research Article IV. Bisphosphonates promote healing of complicated stress fractures in the foot E Fink-Eriksen1*, T Ianssen2 and EE Husebye2 1Departments of Odontology, Oslo University Hospital Spesialistsenteret Pilestredet Park, Norway 2Departments of Orthopedic Surgery, Oslo University Hospital Spesialistsenteret Pilestredet Park, Norway Received: 01 July, 2021 Accepted: 14 July, 2021 Published: 16 July,","PeriodicalId":245794,"journal":{"name":"Open Journal of Orthopedics and Rheumatology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127081460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}