Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2014
Characteristics and significance of fever during 4 weeks after primary total knee arthroplasty.
Most previous studies on postoperative fever (POF; ≥38 °C) after total knee arthroplasty (TKA) have reported findings from only the immediate postoperative days (PODs). The hypothesis of the current study is that 4 weeks of follow-up may reveal differences in the characteristics of POF and fever-related factors between a normal inflammatory response and an early acute infection-related response. ⋯ The occurrence of POF and MT along with elevated C-reactive protein and local symptomatic findings at 2-4 weeks postoperatively may indicate the need for a positive fever workup to recognize early acute periprosthetic infection.
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Arch Orthop Trauma Surg · May 2014
Randomized Controlled Trial Comparative StudyTreatment of postoperative pain after total hip arthroplasty: comparison between metamizol and paracetamol as adjunctive to opioid analgesics-prospective, double-blind, randomised study.
Metamizole use has been limited because of its risk of agranulocytosis. However, more recent literature seems to support its safety. This prospective, randomised, double-blind study was conducted to compare the analgesic effects of intravenous metamizole or intravenous paracetamol in combination with morphine PCA during the first 24 h following total hip arthroplasty. ⋯ In this study, we have also shown excellent efficacy of paracetamol and metamizole combined with opioids, but metamizole proved to be a better analgesic than paracetamol. It is also necessary to mention the financial aspect considering that intravenous paracetamol is about ten times more expensive than an equivalent analgesic doses of intravenous metamizole.
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Arch Orthop Trauma Surg · May 2014
Comparative Study Clinical TrialPostural stability in relation to anthropometric and functional characteristics in women with knee osteoarthritis following total knee arthroplasty.
Due to the controversial information about postural stability in patients with lower limb joints osteoarthritis (OA), the following main questions are raised: how serious is the postural stability disturbance and which factors have an impact on postural stability before and after total knee arthroplasty (TKA). ⋯ Prospective comparative study, Level II.
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Arch Orthop Trauma Surg · May 2014
Randomized Controlled Trial Comparative StudyLaser method for intraoperative evaluation of lower extremity alignment: comparison of a novel technique to CT and a conventional method.
Accurate restoration of mechanical alignment is an important factor in reconstructive surgery of the lower extremity. Conventional intraoperative methods, such as using an electrocautery cable, provide only a momentary evaluation of alignment. In this study, we evaluated a novel technique using a laser emitter, which projected the mechanical axis of the lower extremity, providing continuous intraoperative information on alignment. ⋯ Determination of the mechanical axis during surgery remains a difficult clinical problem. Restoration of alignment is an important prognostic factor for surgical outcome. Based on these data, the laser method represents a simple, yet effective tool for continuous intraoperative evaluation of lower extremity alignment.
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Arch Orthop Trauma Surg · May 2014
Randomized Controlled TrialThe intraoperative use of ultrasound facilitates significantly the arthroscopic debridement of calcific rotator cuff tendinitis.
During arthroscopy, the localization of calcific deposit in patients suffering from calcifying tendinitis can be demanding and time consuming, frequently using ionizing radiation. Intraoperative ultrasound has been recently promoted, facilitating deposit localization and reducing radiation dose. ⋯ Intraoperative US significantly facilitates the detection of calcific deposits during arthroscopic debridement by speeding up surgery and reducing the number of needle punctures. Hence, we have changed our method of detecting calcific deposits intraoperatively from fluoroscopy to ultrasound.