Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jan 2015
Single perioperative dose of tranexamic acid in primary hip and knee arthroplasty.
Tranexamic acid (TXA) is an antifibrinolytic agent that competitively inhibits the activation of plasminogen to plasmin. It has been shown to reduce blood loss in trauma and other haemorrhagic conditions and has recently been utilised in elective orthopaedic surgery. There are various methods of administering TXA described in the literature. ⋯ This study demonstrates that a single perioperative bolus of intravenous TXA may significantly reduce operative blood loss in both primary total hip and knee arthroplasty in a cost-effective manner, in combination with meticulous perioperative haemostasis.
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Eur J Orthop Surg Tr · Jan 2015
Multicenter StudyCan preoperative CRP levels predict infections of bipolar hemiarthroplasty performed for femoral neck fracture? A retrospective, multicenter study.
Current recommendations urge us to operate quickly on femoral neck fractures to reduce the risk of comorbidity decompensation. In some cases, this leads us to operate when an underlying infection is present. In this study, we evaluated the infection rate of bipolar hemiarthroplasty after femoral neck fracture and attempted to relate it to preoperative C-reactive protein (CRP) levels. ⋯ This study could not validate the use of CRP levels, nor a 50 mg/L threshold, as predictive factors for a preexisting infection during bipolar hemiarthroplasty for femoral neck fracture. As a consequence, new infection screening tools must be developed and validated.
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Eur J Orthop Surg Tr · Jan 2015
Surgical repair of acute and chronic pectoralis major tendon rupture: clinical and ultrasound outcomes at a mean follow-up of 5 years.
Pectoralis major (PM) tendon rupture is an uncommon injury whose incidence has risen in recent decades mainly as a result of the increasing number of sports-practising individuals. This study evaluates clinical and ultrasound (US) outcomes after surgical repair of acute and chronic PM tendon rupture. ⋯ Prompt surgical repair ensures satisfactory outcomes in patients with complete PM rupture; however, delayed allograft repair provides good results with only slight strength impairment. Fresh insights are provided on the role of US in evaluating PM anatomy and tendon attachment to bone.
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Eur J Orthop Surg Tr · Jan 2015
The prevalence of knee injuries ipsilateral to tibial shaft fractures and their impact on clinical outcome.
The purpose of this prospective study was to examine the prevalence of occult knee injuries in patients with ipsilateral tibial shaft fractures and determine their impact on clinical outcome. ⋯ Ipsilateral intra-articular, extra-articular or combined knee injuries may occur at the time of injury with tibial shaft fractures. However, most of these injuries are not clinically relevant and heal without any sequel or remain asymptomatic late after fracture union. Routine use of preoperative knee MRI examination in patients with tibial shaft fractures is not necessary.