Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Mar 2015
Randomized Controlled TrialComparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial.
Poor postoperative pain control is frequently associated with complications and delayed discharge from a hospital. Preemptive analgesia is one of the methods suggested for reducing postoperative pain. Opioids are effective for pain control, but there known addictive properties make physicians cautious about using them. Parecoxib and ketorolac are potent non-opioid NSAIDs that are attractive alternative drugs to opioids to avoid opioid-related side effects. However, there are no good head-to-head comparisons between these two drugs in the aspect of preemptive analgesic effects in lumbar spinal fusion surgery. This study aimed to compare the efficacy in terms of postoperative pain control and safety of parecoxib with ketorolac as preemptive analgesia in posterior lumbar spinal fusion patients. ⋯ Preemptive analgesia using both ketorolac and parecoxib showed a significantly better early postoperative pain control in the PACU than the control group in patients undergoing lumbar spinal fusion.
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Bmc Musculoskel Dis · Mar 2015
Multicenter Study Observational StudyPsychological predictors of recovery from low back pain: a prospective study.
Recovery from low back pain (LBP) is an important outcome for patients and clinicians. Psychological factors are known to impact the course of LBP but have not been extensively investigated for predicting recovery. The purposes of this study were to: 1) describe LBP recovery rates at 6 months following 4 weeks of physical therapy; 2) identify psychological factors predictive of 6 month recovery status; and 3) identify psychological factors that co-occur with 6 month recovery status. ⋯ Our findings indicated that psychological risk status, depressive symptoms, and pain intensity were predictive of 6 month recovery status. Furthermore elevated fear-avoidance, kinesiophobia, and depressive symptoms co-occurred with non-recovery at 6 months. Future studies should investigate whether stratified psychologically informed treatment options have the potential to improve recovery rates for those most at risk for non-recovery.
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Bmc Musculoskel Dis · Mar 2015
Does integrity of the lesser trochanter influence the surgical outcome of intertrochanteric fracture in elderly patients?
Most surgeons do not fix the lesser trochanter when managing femoral intertrochanteric fractures with intramedullary nails. We have not found any published clinical studies on the relationship between the integrity of the lesser trochanter and surgical outcomes of intertrochanteric fractures treated with intramedullary nails. The purpose of this study was to evaluate the impact of the integrity of the lesser trochanter on the surgical outcome of intertrochanteric fractures. ⋯ The integrity of the lesser trochanter has no significant influence on the surgical outcome of intramedullary nail internal fixation of femoral intertrochanteric fractures.
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Bmc Musculoskel Dis · Mar 2015
Comparative StudyA cohort study of 4,190 patients treated with low-intensity pulsed ultrasound (LIPUS): findings in the elderly versus all patients.
Patient age is one of many potential risk factors for fracture nonunion. Our hypothesis is that older patients (≥ 60) with fracture risk factors treated with low-intensity pulsed ultrasound (LIPUS) have similar heal rate (HR) to the population as a whole. We evaluate the impact of age in conjunction with other risk factors on HR in LIPUS-treated patients with fresh fracture (≤ 90 days old). ⋯ Comorbid conditions in conjunction with aging can reduce fracture HR. Patients with fracture who used LIPUS had a 96% HR, whereas the expected HR averages 93%. Time to treatment was significantly shorter among patients who healed (p < 0.0001), suggesting that it is beneficial to begin LIPUS treatment early. Older patients (≥ 60) with fracture risk factors treated with LIPUS exhibit similar heal rates to the population as a whole.
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Bmc Musculoskel Dis · Feb 2015
Comparative StudyRevision TKA with a condylar constrained prosthesis using metaphyseal and surface cementation: a minimum 6-year follow-up analysis.
The increasing number of revision knee arthroplasty result in the more frequently use of a constraint implant but results from previous reports are difficult to interpret. The purpose of this study was to compare the long-term outcomes of superficial cemented versus metaphyseal cemented in revision total knee arthroplasty with a condylar constrained arthroplasty. ⋯ Radiologic outcome was better in revision total knee arthroplasty using metaphyseal cemented revision and components with press-fit cementless stems than in the surface cementation-based approach; however, the difference was not clinically relevant.