Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Sep 2019
Randomized Controlled TrialComparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy.
This study aimed to compare clinical efficacy and safety of chloroprocaine and lidocaine in epidural anesthesia for outpatient knee arthroscopy. Eighty patients undergoing knee arthroscopy were randomly allocated to receive 3% 2-chloroprocaine (group C, n = 40) or 2% lidocaine (group L, n = 40) for epidural block. Latency to anesthesia onset, highest block level, time to achieve peak effect, time to complete sensory and motor block regression, vital signs including respiration and hemodynamics, and complications during follow-up were recorded. ⋯ No adverse effects or neurologic complications were found in both groups. In conclusion, epidural chloroprocaine elicits rapid anesthetic effects, fast sensor and motor block, and faster recovery of motor function compared to lidocaine. These characteristics make chloroprocaine better than lidocaine as the choice of epidural anesthesia in short clinical operations such as knee arthroscopy.
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J Orthop Surg (Hong Kong) · Sep 2019
ReviewCurrent status of the magnetically controlled growing rod in treatment of early-onset scoliosis: What we know after a decade of experience.
The magnetically controlled growing rod (MCGR) has had approximately 10 years of clinical experience worldwide. Clinical effectiveness to control early-onset scoliosis is consistent even at final surgery. MCGRs have significantly lower relative percentage of infection or wound complications as compared to traditional growing rods. ⋯ Unique complications of MCGR include clunking, temporary diminishing distraction gains, and metallosis. Temporary reductions in distraction gains are observed as the MCGR lengthens but return to normal baseline distraction gains after rod exchange. Lack of standardization for rod configuration, distraction strategies and decisions of whether to keep the rods in situ, remove without fusion surgery or to perform spinal fusion at skeletal maturity will require further study.
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J Orthop Surg (Hong Kong) · Sep 2019
Multicenter StudyThe acceptance of CIRS among orthopedic and trauma surgeons in Germany-Significant gap between positive perception and actual implementation in daily routine.
Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. ⋯ The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.
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J Orthop Surg (Hong Kong) · Sep 2019
Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type.
Hydroxyapatite (HA)-coated stem has been introduced to decrease complications and eventually achieve quicker implant ingrowth and long-term stability. The aim of this study was to determine subsidence rate and incidence of perioperative periprosthetic fracture (PPF) of uncemented collarless Corail stem for displaced femoral neck fractures according to Dorr type. ⋯ Dorr type C had higher risk of subsidence when using uncemented collarless HA-coated stem. Dorr canal type had no bearing on risk of PPFs. Women did not have significantly higher risk of both subsidence and PPFs compared to men. A collarless fully HA-coated Corail stem had 3.6% of radiological subsidence and 5.0% of PPF risk.
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J Orthop Surg (Hong Kong) · Sep 2019
Sharp systolic blood pressure elevation at extubation is a risk factor for symptomatic epidural hematoma after spine surgery.
The present study is a single-center retrospective cohort study. ⋯ The risk for symptomatic epidural hematoma is significant in patients with SBP at extubation that is more than 1.3 times that of SBP at rest.