Journal of orthopaedic surgery and research
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Review Meta Analysis
Is fibrin sealant effective and safe in total knee arthroplasty? A meta-analysis of randomized trials.
The objective of this study was to evaluate the efficacy and safety of fibrin sealant in patients following total knee arthroplasty (TKA). A comprehensive literature search of the electronic databases PubMed, MEDLINE, Web of Science, and Cochrane Library for published randomized controlled trials (RCTs) was undertaken. The evidence base was critically appraised using a tool from the Cochrane Bone, Joint and Muscle Trauma Group. ⋯ However, using fibrin sealant did not significantly reduced total blood loss (WMD -305.25, 95% CI -679.44 to 68.95, P = 0.11). Regarding complications, there were no significant differences in any adverse events, fever, infection, or hematoma among the study groups. In conclusion, the present meta-analysis indicates that the use of fibrin sealant was effective and safe as a hemostatic therapy for patients with TKA.
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Review Case Reports
Tandem keyhole foraminotomy in the treatment of cervical radiculopathy: retrospective review of 35 cases.
There has been no report regarding the results of two-level keyhole foraminotomy. The purpose of this study was to detail clinical outcomes following consecutive two-level cervical foraminotomy (tandem keyhole foraminotomy (TKF)) in patients with radiculopathy. ⋯ TKF is a safe and highly effective procedure for patients with cervical radiculopathy and does not require invasive preoperative examinations. Further investigation is required to determine the effects of consecutive facetectomy.
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This study investigates the safety and efficacy of anterolateral (AL) osteotomy for the treatment of lateral tibial plateau fractures merged with relatively simple and intact posterolateral (PL) corner displacement and screens applicable patients. ⋯ The AL approach is safe and effective for lateral tibial plateau fractures involving the PL corner, especially for fractures merged with simple and intact PL corner displacement (depression and/or split).
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Review Case Reports
The use of the free vascularised bone graft for nonunion of the scaphoid: a systematic review.
Fractures of the scaphoid are well known to be problematic especially when complicated by avascular necrosis, nonunion and carpal collapse. Fixation techniques have involved nonvascularised bone grafting; however, in the presence of avascular necrosis, generally poor union rates (47%) occur as identified by a meta-analysis performed by Merrell et al. The introduction of pedicled vascularised bone grafts showed further improvement; however, in the presence of carpal collapse, union rates as low as 50% have been reported by Chang et al. amongst others using the 1,2-intercompartmental supraretinacular artery pedicled graft. The difficulty lies in having a short pedicle with limited manoeuvrability to correct a humpback deformity and insert into the scaphoid cavity. Prior trauma to the soft tissues or distal radius may prohibit the use of pedicled grafts. The aim of this systematic review is to examine the published evidence for the use of free vascularised bone grafts in cases of scaphoid nonunion. ⋯ The promising data suggests that the medial femoral condylar free graft based on the descending genicular vessels can be considered in cases of proximal pole avascular necrosis and humpback deformity or in situations where other flaps are precluded or deemed unlikely to cause union.
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Randomized Controlled Trial
Effect of the knee position during wound closure after total knee arthroplasty on early knee function recovery.
This study investigated the effect of the knee position during wound closure on early knee function recovery after total knee arthroplasty (TKA). ⋯ Marking the articular capsule incision, wound closure in flexion and high flexion after wound closure can effectively decrease anterior knee pain after TKA and promote the early recovery of ROM.