International orthopaedics
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Nonunion and large bone defects present a therapeutic challenge to the surgeon and are often associated with significant morbidity. These defects are expensive to both the health care system and society. ⋯ It has been shown that a combination of neo-osteogenesis and neovascularisation will restore tissue deficits, and that the optimal approach includes a biomaterial scaffold, cell biology techniques, a growth factor and optimisation of the mechanical environment. Further prospective, controlled, randomised clinical studies will determine the effectiveness and economic benefits of treatment with mesenchymal stem cells, not in comparison to other conventional surgical approaches but in direct conjunction with them.
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In septic joint surgery, the most frequently used antiseptics are polyhexanide, hydrogen peroxide and taurolidine. The aim of this study was to examine the effects of these antiseptics on viability of human chondrocytes. Our hypothesis was that antiseptics and supplemental irrigation with sodium chloride lavage are less toxic on human chondrocytes than treatment with antiseptics only. ⋯ After treatment with antiseptics followed by sodium chloride solution a significant increase of vital and total cell numbers resulted in comparison with the chondrocytes that were only treated with antiseptics. The data show that treatment with polyhexanid, hydrogen peroxide or taurolidine induces cell death of human chondroctes in vitro. The application of sodium chloride solution after the treatment with polyhexanide and hydrogen peroxide possibly has a protective effect on chondrocyte viability.
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Randomized Controlled Trial
Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty.
This is a randomised controlled trial to examine whether intra-articular injection of tranexamic acid (TXA) decreases blood loss, as well as reducing leg swelling after total knee arthroplasty (TKA). ⋯ The results revealed intra-articular administration of TXA decreased not only blood loss, but also knee joint swelling after TKA.
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Comparative Study
Arthroplasty versus arthrodesis for end-stage ankle arthritis: decision analysis using Markov model.
Total ankle arthroplasty and arthrodesis are the two mainstreams of treatment for end-stage ankle arthritis. This study was performed to determine which is a better choice for ankle arthritis, using a decision analysis and Markov model to reflect the repetitive nature of revision arthroplasty. ⋯ Based on current evidence, total ankle arthroplasty was found to be a better treatment than arthrodesis for ankle arthritis. Future development in the implant materials, improved understanding of ankle biomechanics, and surgical techniques will further enhance the clinical outcome of total ankle arthroplasty.
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Clinical Trial
The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up.
The purpose of this study was to evaluate longer-term efficacy over a two-year follow-up of coblation nucleoplasty treatment for protruded lumbar intervertebral disc. ⋯ Coblation nucleoplasty may have satisfactory clinical outcomes for treatment of protruded lumbar intervertebral disc for as long as two-year follow-up, but longer-term benefit still needs verification.