Acta orthopaedica Scandinavica
-
Randomized Controlled Trial Clinical Trial
Preventive effects of ibuprofen on periarticular heterotopic ossification after total hip arthroplasty. A randomized double-blind prospective study of treatment time.
We determined the efficacy and the minimum treatment time necessary for prophylaxis with nonsteroidal anti-inflammatory drugs (NSAIDs) for periarticular heterotopic ossification (HO) after total hip arthroplasty (THA). Using a double-blind placebo controlled design, 144 patients operated on with total hip arthroplasty for primary arthrosis were treated postoperatively with (1) ibuprofen for 3 weeks, (2) ibuprofen for 1 week and placebo for the next 2 weeks or (3) placebo for 3 weeks. Radiographic occurrence of periarticular heterotopic ossification and complications of the treatment were recorded for the first year. ⋯ There was no difference in HO between the patients treated for 8 or 21 days postoperatively. Both 8 and 21 days of treatment with ibuprofen following THA effectively prevents clinically significant degrees of HO. No serious short-term complications of the treatment were noted.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Postoperative blood salvage in hip and knee arthroplasty. A prospective study on cost effectiveness in 161 patients.
We conducted a prospective controlled study on 161 patients who underwent primary or revision total hip or knee arthroplasty to assess the efficacy and limitations of postoperative blood salvage. The actual quantity of blood salvaged after washing, the theoretical increase in hemoglobin concentration caused by its reinfusion and the cost of this procedure were studied. ⋯ One third of the devices used were discarded as not effective enough and, in order to obtain an increase of 1 g/dL in the hemoglobin concentration, an average of 3.4 postoperative Solcotrans Plus Orthopaedic devices were used. To obtain the same increase in hemoglobin concentration as that given by an allogeneic blood transfusion, the overall cost of materials alone was more than five times the price of a single blood unit transfusion.
-
The epidemiology of ankle fractures is changing. Increasing longevity has resulted in the highest age-specific incidence of ankle fractures being in women between 75 and 84 years of age. ⋯ Isolated malleolar fractures accounted for two thirds of the series, with bimalleolar fractures occurring in one fourth of the patients and trimalleolar fractures in the remaining 7%. Open fractures occurred in 2%.
-
In a prospective study, 94 consecutive patients with unstable intertrochanteric fractures were treated by 16 surgeons, using a modified 4-hole Medoff sliding plate and followed clinically and radiographically for 1 year. Weight bearing after surgery was allowed as tolerated. This new device is smaller and uses a simpler technique of insertion than the original 6-hole Medoff sliding plate. ⋯ All fractures united and no postoperative lag screw penetration occurred. The use of a shorter side-plate with 4 cortical bone screws was sufficient for fixation and no plate loosening or breakage was observed. On the basis of this experience, biaxial dynamization seems to facilitate fracture impaction and stability, and the simplified 4-hole Medoff sliding plate appears to be a suitable method for the treatment of unstable intertrochanteric fractures.