Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Sep 2017
Randomized Controlled TrialRandomized controlled trial comparing efficacy of conventional and new single larger dose of intra-articular viscosupplementation in management of knee osteoarthritis.
Intra-articular hyaluronic acid (HA) injection is used in management of knee, hand and hip osteoarthritis. While HA injection is included in the list of evaluated therapies, its efficacy and optimum dosing still have no consensus. This study was conducted to explore the possibility of using single injection HA to increase patient convenience while maintaining the therapeutic efficacy. ⋯ The study shows single 5 ml dose regime comparing well with conventional three doses of 2.5 ml of intra-articular GO-ON HA injected at weekly intervals and confirms good efficacy, tolerability and safety of single larger dose of GO-ON knee intra-articular injection.
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J Orthop Surg (Hong Kong) · Sep 2017
Comparative StudyThe optimal protocol to reduce blood loss and blood transfusion after unilateral total knee replacement: Low-dose IA-TXA plus 30-min drain clamping versus drainage clamping for the first 3 h without IA-TXA.
Although intraarticular tranexamic acid (IA-TXA) administration or drainage clamping are popular methods used to reduce blood loss after total knee replacement (TKR), the protocol remains controversial. We aimed (1) to establish new protocols through investigating whether two methods, that is, low-dose (500 mg) IA-TXA plus 30-min drain clamping and drainage clamping for the first 3 h without IA-TXA, can reduce blood loss and blood transfusion after unilateral TKR and (2) to make recommendations related to clinical application. ⋯ The drainage clamping method can be safer than IA-TXA administration in patients with risk factor of venous thromboembolic complication. Furthermore, the IA-TXA administration can be more optimal than drainage clamping in patients with high bleeding tendency or lateral retinacular release during TKR, who would be concerned about postoperative wound complication.
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J Orthop Surg (Hong Kong) · Sep 2017
Manual preoperative tracheal retraction exercise decreases the occurrence of postoperative oropharyngeal dysphagia after anterior cervical discectomy and fusion.
Preoperative tracheal retraction exercise (TRE) to minimize the occurrence of postoperative oropharyngeal dysphagia after anterior cervical spine surgery. ⋯ Preoperative TRE can significantly reduce the occurrence of postoperative dysphagia after ACDF surgery. During follow-up, the incidence of postoperative dysphagia was significantly lower and had resolved at 3 months in all patients.
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J Orthop Surg (Hong Kong) · Sep 2017
Decreased postoperative gluteus medius muscle cross-sectional area measured by computed tomography scan in patients with intertrochanteric fractures nailing.
In patients with femoral intertrochanteric fractures treated by cephalomedullary (CM) nailing, abduction force reportedly decreased by 25-30% during the postoperative follow-up period. The purpose of the current study is to evaluate the cross-sectional area (CSA) and adipose tissue ratio (ATR) of the gluteus medius muscle on the postoperative computed tomography (CT) view, expecting this graphic study will support clinical results. ⋯ Our image findings documented that gluteus medius is significantly changed in CSA and ATR. The damage possibly triggers decrease in muscular strength of hip abduction in the postoperative follow-up period. This measurement is objective, and needed no patient's endurance and cooperation.
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J Orthop Surg (Hong Kong) · Sep 2017
Median nerve movement in the carpal tunnel before and after carpal tunnel release using transverse ultrasound.
We aimed to compare the movement of the median nerve within the carpal tunnel during wrist and finger motions between before and after carpal tunnel release (CTR) using transverse ultrasound in carpal tunnel syndrome (CTS) patients and to evaluate the biomechanical efficacy of CTR for CTS. ⋯ The current study demonstrated the movement patterns of the median nerve in the carpal tunnel during wrist and finger motions compared before and after CTR using transverse ultrasound in CTS patients. The findings suggested that as the median nerve shifted greatly palmarly away from the tendons after CTR, the nerve avoids compression or shearing stress from the tendons. This ultrasound information could offer further understanding of the pathomechanics of CTS and provide a more accurate diagnosis of CTS and better treatment by CTR.