Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2014
Meta Analysis Comparative StudyComparison between autologous blood transfusion drainage and no drainage/closed-suction drainage in primary total hip arthroplasty: a meta-analysis.
Primary aim of this meta-analysis of randomized controlled trials (RCTs) was to compare blood loss, transfusion rate and postoperative hemoglobin levels at 24-48 h after primary total hip arthroplasty (THA) between autologous blood transfusion (ABT) drainage and no drainage/closed-suction drainage and to obtain a powerful conclusion which way of drainage had the best clinical efficacy. Secondary aim was to compare the postoperative complication rates during the first year to indentify which way of drainage was safest. ⋯ Autologous blood transfusion drainage and no drainage/closed-suction drainage have similar clinical efficacy and safety in primary THA with regard to clinical outcomes and complication rates.
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Tears of the anterior cruciate ligament (ACL) are very frequent injuries, particularly in young and active people. Arthroscopic reconstruction using tendon auto- or allograft represents the gold-standard for the management of ACL tears. ⋯ Understanding the mechanisms of this regeneration process and the cells involved may pave the way for novel, less invasive and biology-based strategies for ACL repair. This review aims to focus on the current knowledge on the mechanisms of ACL healing, the nature and potential of ligament derived stem/progenitor cells as well as on the potential and the limitations of using mesenchymal stem cells (MSCs) for treating injured ACL.
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The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. ⋯ Therapeutic IV.
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Arch Orthop Trauma Surg · Nov 2014
Multicenter StudyHip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors.
Retrospective review of prospectively collected data. ⋯ Patients ≥75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.
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Arch Orthop Trauma Surg · Nov 2014
Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty.
Blood transfusion is often required in total knee replacement (TKR); several methods of blood preservation are commonly used but the ideal solution is to reduce the blood loss during and after surgery. Aim of the study was to evaluate the hemostatic efficacy and safety of intravenous use of tranexamic acid in patients receiving TKR (cemented). ⋯ Tranexamic acid reduced blood loss in TKR and significantly reduced the blood transfusion need also when compared to fibrin tissue adhesive. The use of tranexamic acid is safe and in future may avoid preparation of autologous blood unit before surgery with a decrease of cost and medical figures involved.