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Surgical indications for anterior cruciate ligament reconstruction combined with extra-articular lateral tenodesis or anterolateral ligament reconstruction 前交叉韧带重建术联合关节外外侧肌腱固定术或前外侧韧带重建术的手术指征
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2018.09.007
Diego Ariel de Lima , Camilo Partezani Helito , Fábio Roberto Alves de Lima , José Alberto Dias Leite

Recently described in the medical literature, the anterolateral ligament of the knee is already considered an important stabilizer against the anterolateral tibial rotation, affecting the pivot shift in the failure of the anterior cruciate ligament and behaving as an important secondary rotational stabilizer. The mechanism of anterolateral ligament injury combined with anterior cruciate ligament injury is similar to the mechanism of anterior cruciate ligament injury alone. Thus, the main objective of the joint reconstruction of anterior cruciate ligament and anterolateral ligament would be increased rotational control and prevention of anterior cruciate ligament re-rupture. In view of this importance, the aim of the present study is to summarize the evidence on the main surgical indications described for anterior cruciate ligament reconstruction combined with lateral extra-articular tenodesis or anterolateral ligament reconstruction. A review of the literature was conducted in April 2017, through a search of the PubMed, MEDLINE, Cochrane, and Google Scholar databases, with no date limits. After reviewing the main articles in the subject, it was concluded that the main surgical indications described for anterior cruciate reconstruction combined with extra-articular lateral tenodesis or anterolateral ligament reconstruction are: anterior cruciate ligament revision, physical examination with pivotal shift grade 2 or 3, practice of sport with pivot mechanism and/or high level mechanism, ligament laxity and Segond fracture; Secondly, the following may also be indications: chronic anterior cruciate ligament injury, age less than 25 years old, and radiological sign of lateral femoral condyle depression. However, it is worth mentioning that more studies are still needed to prove these trends.

最近在医学文献中描述,膝关节前外侧韧带已经被认为是胫骨前外侧旋转的重要稳定剂,影响前交叉韧带失效时的枢轴移位,并作为重要的次要旋转稳定剂。前外侧韧带损伤合并前交叉韧带损伤的机制与单独前交叉韧带损伤的机制相似。因此,前交叉韧带与前外侧韧带联合重建的主要目的是加强旋转控制,防止前交叉韧带再次断裂。鉴于这一重要性,本研究的目的是总结前交叉韧带重建联合外侧关节外肌腱固定术或前外侧韧带重建的主要手术指征的证据。2017年4月,通过检索PubMed、MEDLINE、Cochrane和Google Scholar数据库,对文献进行了回顾,没有日期限制。回顾本课题主要文献,认为前交叉韧带重建术联合关节外外侧肌腱固定术或前外侧韧带重建术的主要手术指征为:前交叉韧带翻修、2级或3级枢轴移位体检、支点机制和/或高位机制运动练习、韧带松弛和第二次骨折;其次,以下也可能是指征:慢性前交叉韧带损伤,年龄小于25岁,有股外侧髁凹陷的影像学征象。然而,值得一提的是,这些趋势还需要更多的研究来证明。
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引用次数: 13
Intra-individual evaluation of results between open and endoscopic release in bilateral carpal tunnel syndrome 双侧腕管综合征开放与内窥镜释放治疗效果的个体内评价
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.09.010
Carlos Henrique Fernandes, Lia Miyamoto Meirelles, Marcela Fernandes, Luis Renato Nakachima, João Baptista Gomes dos Santos, Flavio Fallopa

Objective

The authors performed an intra-individual comparison of surgical results between the open and endoscopic surgical techniques in patients with bilateral carpal tunnel syndrome. Each hand was submitted to surgery using one of these techniques.

Methods

Fifteen patients (30 hands) were evaluated by the Boston Questionnaire, visual analogue pain scale, palmar grip strength, and for tip, key, and tripod pinch strengths. These measurements were taken before surgery and at two weeks, one month, three months, and six months after the procedure. Scores for each evaluation tool in each evaluation time period were compared.

Results

In comparison to the group submitted to open surgery, the group submitted to endoscopic surgery had worse scores in the evaluation of the 1st and 6th postoperative months regarding the severity of the symptoms. The authors found no differences in the functional status of the hand. Regarding the intensity of pain evaluated by the visual analogue pain scale, no difference was found between the averages in all time periods evaluated. No differences in palmar grip strength and in fingertip, key (lateral), and tripod pinch strengths were found in all time periods. There were no differences between averages in the preoperative period at two weeks, one month, and three months after surgery. After six months, the group of patients submitted to open surgery presented greater tripod force than the group of patients who underwent endoscopic surgery.

Conclusion

No differences were observed by using the intra-individual evaluation in the results between open and endoscopic techniques for the treatment of carpal tunnel syndrome.

目的对双侧腕管综合征患者的切开与内窥镜手术进行个体内比较。每只手都使用其中一种技术进行手术。方法采用波士顿问卷、视觉模拟疼痛量表、手掌握力、指尖、键和三脚架握力对15例患者(30只手)进行评估。这些测量是在手术前、手术后两周、一个月、三个月和六个月进行的。比较各评估工具在各评估时段的得分。结果与开放手术组相比,内镜手术组在术后1个月和6个月的症状严重程度评分较差。作者发现手的功能状态没有差异。关于视觉模拟疼痛量表评估的疼痛强度,在所有评估时间段的平均值之间没有发现差异。手掌握力、指尖、键(侧)和三脚架夹紧力在所有时期均无差异。术前2周、1个月和术后3个月的平均值无差异。六个月后,接受开放手术的患者比接受内窥镜手术的患者表现出更大的三脚架力。结论应用个体内评价方法对开放技术与内镜技术治疗腕管综合征的疗效无差异。
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引用次数: 4
Clinical and radiographic outcomes of hip resurfacing arthroplasty after eight years – a retrospective study 髋关节置换术8年后临床和影像学结果的回顾性研究
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.09.008
Felipe Spinelli Bessa, Ronald Delgadillo Fuentes, Helder de Souza Miyahara, Alberto Tesconi Croci, Leandro Ejnisman, José Ricardo Negreiros Vicente

Objective

To assess the clinical and radiographic outcomes of hip resurfacing arthroplasty for the treatment of hip osteoarthritis.

Methods

This study retrospectively assessed 30 patients with hip osteoarthritis who underwent hip resurfacing arthroplasty between 2005 and 2014. Patients of both genders suffering from advanced primary and secondary hip osteoarthritis were included in the study. Data were collected about postoperative complications and the need for revision of the arthroplasty. Antero-posterior pelvis and lateral hip x-rays were performed in order to classify osteolysis according to the Amstutz criteria; the Lequèsne index of severity for osteoarthritis of the hip and the UCLA activity level questionnaires were answered pre- and postoperatively.

Results

After a mean follow-up of eight years, a statistically significant improvement was observed between the mean of the outcomes of both scores, when compared pre- and postoperatively (p < 0.001). Nevertheless, there was a high incidence of arthroplasty revision (20%), related to the size of the femoral stem and errors in surgical technique.

Conclusion

Using the appropriate technique, hip resurfacing arthroplasty can present good results in well-selected patients.

目的评价髋关节置换术治疗髋关节骨性关节炎的临床和影像学效果。方法回顾性分析2005年至2014年间30例髋关节置换术患者的髋关节骨性关节炎。患有晚期原发性和继发性髋关节骨关节炎的男女患者均被纳入研究。收集有关术后并发症和需要翻修关节置换术的数据。根据Amstutz标准进行骨盆前后位和髋侧位x线检查,对骨溶解进行分类;术前和术后分别填写髋关节骨关节炎严重程度lequ指数和UCLA活动水平问卷。结果平均随访8年后,与术前和术后比较,两种评分结果的平均值有统计学意义上的显著改善(p <0.001)。然而,关节置换术翻修的发生率很高(20%),这与股骨干的大小和手术技术错误有关。结论选择合适的人工髋关节置换术,采用适当的技术,可取得良好的效果。
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引用次数: 1
The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity 微骨折胫骨截骨术治疗膝内翻畸形骨关节炎的作用
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.08.023
Leonardo Antunes Bellot de Souza, Vinícius Magno da Rocha, Max Rogerio Freitas Ramos

Objective

To evaluate the microfracture intervention with tibial valgus osteotomy associated in the treatment of varus gonarthrosis.

Methods

From November 2005 to May 2013, 129 patients with medial gonarthrosis, varus deformity (8°–12°), and range of movement greater than 90° were evaluated. Patients with advanced gonarthrosis (Alhbäck 3, 4, and 5), Outerbridge lesion inferior to IV, previous knee surgery, body mass index greater than 35 kg/m2, and/or cruciate ligament injuries were not included. All patients were treated with videoarthroscopy followed by tibial valgus osteotomy. In the group osteotomy associated with microfracture (n = 56, mean age = 39.3), tibial valgus osteotomy and microfracture techniques to address chondral defects were used. In the isolated osteotomy group (n = 73, mean age = 41.4), only this procedure was performed. Post-surgical follow-up was 24 months, with four evaluations in the first 6 months, proceeding to biannual twice-a-year evaluation in the subsequent period. The Lysholm scale was used for functional monitoring.

Results

There was a significant improvement in the pain, limping, and squatting domains of the Lysholm scale but only in the isolated osteotomy group. A greater variance of results was observed in the osteotomy group associated to microfracture, in addition to an increased risk of functional deterioration (OR = 8.64).

Conclusion

The association of microfractures and tibial valgus osteotomy was correlated to lower functional outcomes than tibial valgus osteotomy alone, and may be related to the risk of worsening in the first two postoperative years.

目的探讨胫骨外翻截骨联合微骨折介入治疗关节内翻症的疗效。方法对2005年11月至2013年5月129例内侧关节畸形,内翻畸形(8°-12°),活动范围大于90°的患者进行评估。晚期关节病(Alhbäck 3,4,5)、低于IV级的Outerbridge病变、既往膝关节手术、体重指数大于35 kg/m2和/或十字韧带损伤的患者不包括在内。所有患者均行关节镜下胫外翻截骨术。截骨联合微骨折组(56例,平均年龄39.3岁)采用胫骨外翻截骨联合微骨折技术治疗软骨缺损。在孤立截骨组(n = 73,平均年龄= 41.4)中,仅行该手术。术后随访24个月,前6个月进行4次评估,随后进行一年两次的评估。功能监测采用Lysholm量表。结果Lysholm量表疼痛、跛行和下蹲症状均有显著改善,但仅在孤立截骨组。除功能恶化的风险增加外,截骨组与微骨折相关的结果差异更大(OR = 8.64)。结论微骨折联合胫骨外翻截骨术与单纯胫骨外翻截骨术相比,其功能预后较低,且可能与术后前两年病情恶化的风险有关。
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引用次数: 2
Evaluation of intra- and interobserver reliability of the AO classification for wrist fractures 腕部骨折AO分类的观察者内部和观察者之间可靠性评价
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.08.024
Pedro Henrique de Magalhães Tenório, Marcelo Marques Vieira, Abner Alberti, Marcos Felipe Marcatto de Abreu, João Carlos Nakamoto, Alberto Cliquet Júnior

Objective

This study evaluated the intraobserver and interobserver reliability of the AO classification for standard radiographs of wrist fractures.

Methods

Thirty observers, divided into three groups (orthopedic surgery senior residents, orthopedic surgeons, and hand surgeons) classified 52 wrist fractures, using only simple radiographs. After a period of four weeks, the same observers evaluated the initial 52 radiographs, in a randomized order. The agreement among the observers, the groups, and intraobserver was obtained using the Kappa index. Kappa-values were interpreted as proposed by Landis and Koch.

Results

The global interobserver agreement level of the AO classification was considered fair (0.30). The three groups presented fair global interobserver agreement (residents, 0.27; orthopedic surgeons, 0.30; hand surgeons, 0.33). The global intraobserver agreement level was moderated. The hand surgeon group obtained the higher intraobserver agreement level, although only moderate (0.50). The residents group obtained fair levels (0.30), as did the orthopedics surgeon group (0.33).

Conclusion

The data obtained suggests fair levels of interobserver agreement and moderate levels of intraobserver agreement for the AO classification for wrist fractures.

目的评价腕关节骨折标准x线片AO分型在观察者内和观察者间的可靠性。方法采用单纯x线片对52例腕部骨折进行分类,观察对象30人,分为骨科高级住院医师、骨科医生和手外科医生3组。四周后,同样的观察人员以随机顺序评估最初的52张x光片。使用Kappa指数获得观察者,小组和内部观察者之间的协议。kappa值由Landis和Koch提出。结果AO分类的整体观察者间一致性水平为公平(0.30)。三个组呈现公平的全球观察者间协议(居民,0.27;骨科,0.30;手外科医生,0.33)。全球观察者内部的共识水平有所缓和。手外科医生组获得了更高的观察者内一致性水平,尽管只有中等水平(0.50)。住院医师组获得了相当的水平(0.30),骨科医生组也获得了相当的水平(0.33)。结论所获得的数据表明,对于腕关节骨折的AO分类,观察者之间的一致程度一般,观察者内部的一致程度中等。
{"title":"Evaluation of intra- and interobserver reliability of the AO classification for wrist fractures","authors":"Pedro Henrique de Magalhães Tenório,&nbsp;Marcelo Marques Vieira,&nbsp;Abner Alberti,&nbsp;Marcos Felipe Marcatto de Abreu,&nbsp;João Carlos Nakamoto,&nbsp;Alberto Cliquet Júnior","doi":"10.1016/j.rboe.2017.08.024","DOIUrl":"10.1016/j.rboe.2017.08.024","url":null,"abstract":"<div><h3>Objective</h3><p>This study evaluated the intraobserver and interobserver reliability of the AO classification for standard radiographs of wrist fractures.</p></div><div><h3>Methods</h3><p>Thirty observers, divided into three groups (orthopedic surgery senior residents, orthopedic surgeons, and hand surgeons) classified 52 wrist fractures, using only simple radiographs. After a period of four weeks, the same observers evaluated the initial 52 radiographs, in a randomized order. The agreement among the observers, the groups, and intraobserver was obtained using the Kappa index. Kappa-values were interpreted as proposed by Landis and Koch.</p></div><div><h3>Results</h3><p>The global interobserver agreement level of the AO classification was considered fair (0.30). The three groups presented fair global interobserver agreement (residents, 0.27; orthopedic surgeons, 0.30; hand surgeons, 0.33). The global intraobserver agreement level was moderated. The hand surgeon group obtained the higher intraobserver agreement level, although only moderate (0.50). The residents group obtained fair levels (0.30), as did the orthopedics surgeon group (0.33).</p></div><div><h3>Conclusion</h3><p>The data obtained suggests fair levels of interobserver agreement and moderate levels of intraobserver agreement for the AO classification for wrist fractures.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 6","pages":"Pages 703-706"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2017.08.024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36631845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Radiographic evaluation and pain symptomatology of the knee in severely obese individuals – controlled transversal study 严重肥胖者膝关节疼痛的影像学评价和症状——对照横向研究
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2018.09.006
Glaucus Cajaty Martins , Luiz Felippe Martins Filho , Andre Heringer Raposo , Raphael Barbosa Gamallo , Zartur Menegassi , Antônio Vítor de Abreu

Objective

To evaluate the prevalence of pain and radiographic degenerative arthritis in a group of severe obese patients (body mass index [BMI] > 35).

Methods

41 patients with an indication of bariatric surgery were studied. The group of severely obese patients was subdivided into two subgroups: those with BMI < 50 and those with BMI > 50 (n = 14). They were compared to control group (n = 39). The following parameters were analyzed and correlated: radiographic arthritis by Kellgren-Lawrence's classification, tibiofemoral axis, gender, age, and knee pain (visual analog scale [VAS]). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate in 21 severe obese patients and IN 19 controls.

Results

A higher incidence of knee pain was observed in the severely obese group when compared with the control group (p < 0.0001, odds ratio: 2.96). In the severely obese group, increasing levels of pain with aging were observed (p = 0.047). A positive correlation was observed between the incidence of radiographic arthritis and increasing age in the severely obese (p = 0.001) and control (p = 0.037) groups. The WOMAC index results were worse in the severely obese group when compared with the control group (p = 0.001, odds ratio: 18.2).

Conclusion

A higher incidence of knee pain was observed in the severely obese group when compared with the control group. In the severely obese group, there increasing levels of pain with aging. A positive relation between the incidence of arthritis and increasing age was observed in the severely obese and control groups. The WOMAC index results were worse in the severely obese group.

目的评价重度肥胖患者(体重指数[BMI] >35)。方法对41例有减肥手术指征的患者进行分析。重度肥胖患者组再分为两个亚组:BMI和lt组;50和BMI >50 (n = 14)。与对照组(n = 39)进行比较。对以下参数进行分析和相关性分析:Kellgren-Lawrence关节炎影像学分类、胫股轴、性别、年龄、膝关节疼痛(视觉模拟量表[VAS])。采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)对21例重度肥胖患者和19例对照组进行评估。结果重度肥胖组膝关节疼痛发生率高于对照组(p <0.0001,优势比:2.96)。在严重肥胖组中,疼痛水平随年龄增长而增加(p = 0.047)。在严重肥胖组(p = 0.001)和对照组(p = 0.037)中,x线关节炎的发病率与年龄增长呈正相关。重度肥胖组的WOMAC指数结果较对照组差(p = 0.001,优势比:18.2)。结论重度肥胖组膝关节疼痛发生率高于对照组。在严重肥胖的人群中,疼痛程度随着年龄的增长而增加。在严重肥胖组和对照组中,关节炎的发病率与年龄增长呈正相关。重度肥胖组的WOMAC指数结果更差。
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引用次数: 2
Percutaneous autogenous bone marrow injection for delayed union or non-union of long bone fractures after internal fixation 经皮自体骨髓注射治疗长骨骨折内固定后延迟愈合或不愈合
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.09.004
Ramji Lal Sahu

Objectives

The aim of this study was to assess the results of percutaneous injection of autologous bone marrow in the treatment of fractures presenting with delayed union or non-union after internal fixation.

Methods

This prospective study was carried out at the Orthopeedics Department from June 2005 to June 2010. A total of 93 patients with delayed union and non-union (56 delayed unions and 37 non-unions) of the long bone were recruited from the Emergency and Outpatient Departments and treated with percutaneous autologous bone marrow injections. The clinical results of this study were rated on the basis of the criteria of union. All patients were followed for 24 months.

Results

All the fractures (delayed union and non-union) were united within 12 weeks. Most of the patients had discomfort at the donor site for few days; none had problems of persistent pain. The results were excellent in 68.81% (64/93) of cases, good in 19.35% (18/93) of cases, and poor in 11.82% (11/93) of cases.

Conclusion

Percutaneous autologous bone marrow injection is an effective and safe method for the treatment of diaphyseal non-union and delayed union. Thus, it is concluded that with an adequate amount of autologous bone marrow injection, successful union in delayed union and non-union of fractures of long bones can be achieved.

目的评价经皮自体骨髓注射治疗骨折内固定后延迟愈合或不愈合的效果。方法本前瞻性研究于2005年6月至2010年6月在骨科进行。我们从急诊科和门诊部招募了93例长骨延迟愈合和不愈合的患者(56例延迟愈合,37例不愈合),并采用经皮自体骨髓注射治疗。本研究的临床结果以愈合标准为基础进行评分。所有患者随访24个月。结果所有骨折(延迟愈合和不愈合)均在12周内愈合。大多数患者在供体部位有几天的不适;没有人有持续疼痛的问题。优良率为68.81%(64/93),良率为19.35%(18/93),差率为11.82%(11/93)。结论经皮自体骨髓注射治疗骨干骨不愈合和延迟愈合是一种安全有效的方法。由此可见,在注入适量的自体骨髓后,长骨骨折延迟愈合和不愈合均可成功愈合。
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引用次数: 14
Accuracy of the kissing sign on lumbar spine MRI in cases of axillary disc herniation and the surgical correlation: an Indian multi-center study 吻征在腋窝椎间盘突出症腰椎MRI上的准确性及其手术相关性:一项印度多中心研究
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.10.011
Jitendra Parmar , Yash Gulati , Maulik Vora , Bhupesh Patel , Chander Mohan

Objectives

Magnetic resonance imaging has proven to be a valuable tool in the assessment of disc abnormalities. Two types of disc extrusion can be described according to the direction of herniated disc material: shoulder type and axillary type. Axillary disc herniation is described when the extruded disc fragment lies in the recess between the lateral border of cauda equina and medial to the nerve roots, while in the shoulder type the disc lies lateral to the nerve roots. It is very important to describe the type of disc herniation, as the surgical approach differs in each type. To the best of the authors’ knowledge, no definite signs have been described in literature to date. This study aimed to address the accuracy of the kissing sign on MRI for he diagnosis of axillary disc herniation.

Methods

The MRIs of 72 patients undergoing spinal surgery were prospectively evaluated for axillary disc herniation by a senior radiologist and experienced spinal surgeon using the kissing sign on MRI. The kissing sign was considered positive when the herniated disc material was in direct contact with the lamina and/or ligamentum flavum on axial images. Subsequently, all surgeries were performed by two independent surgeons and the actual type of disc herniation was documented. The accuracy of the results was statistically assessed.

Results

The kissing sign on MRI was found to be 66.66% sensitive, 92.59% specific, and 76.38% accurate in detecting axillary disc herniation with significant correlation with the surgical findings.

Conclusion

The type of disc herniation is an important parameter for patient selection in different surgical approaches. The kissing sign on MRI can be considered as an important tool for diagnosing axillary disc herniation due to its high specificity and accuracy.

目的磁共振成像已被证明是评估椎间盘异常的一种有价值的工具。根据椎间盘材料突出的方向可分为肩胛型和腋窝型两种椎间盘突出类型。当突出的椎间盘碎片位于马尾外侧边界和神经根内侧之间的隐窝时,描述腋窝椎间盘突出,而肩关节型椎间盘位于神经根外侧。描述椎间盘突出的类型是非常重要的,因为每种类型的手术入路不同。据作者所知,到目前为止,文献中没有明确的迹象。本研究旨在探讨接吻征在MRI诊断腋窝椎间盘突出的准确性。方法由资深放射科医师和经验丰富的脊柱外科医师对72例脊柱外科手术患者的腋窝椎间盘突出症MRI进行前瞻性评价。在轴向图像上,当椎间盘突出物与椎板和/或黄韧带直接接触时,接吻征被认为是阳性的。随后,所有手术均由两名独立的外科医生进行,并记录了椎间盘突出的实际类型。对结果的准确性进行了统计评估。结果MRI接吻征对腋窝椎间盘突出症的诊断敏感性为66.66%,特异性为92.59%,准确率为76.38%,与手术表现有显著相关性。结论椎间盘突出的类型是选择不同手术入路的重要参数。MRI接吻征具有较高的特异性和准确性,可作为诊断腋窝椎间盘突出症的重要工具。
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引用次数: 2
Evaluation of the use of tranexamic acid in total knee arthroplasty 氨甲环酸在全膝关节置换术中的应用评价
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2018.09.008
Mariana Diana Chaves de Almeida , Rodrigo Pires e Albuquerque , Guilherme Mathias Palhares , Juliana Patrícia Chaves de Almeida , João Mauricio Barretto , Naasson Cavanellas

Objective

Evaluate the efficacy of tranexamic acid in reducing bleeding in patients undergoing total knee arthroplasty.

Methods

101 patients were randomized into two groups: the tranexamic acid group (n = 51) and the placebo group (n = 50). Patients were compared regarding the following parameters: reduction of hemoglobin, total estimated blood loss, drain output, and postoperative blood transfusion rate.

Results

Comparing the groups, there were statistically significant differences (p < 0.05) in the following parameters: reduction of hemoglobin, decreased hematocrit, estimated blood loss, and drain output. All values were lower in the tranexamic acid group. Only placebo group patients required blood transfusion.

Conclusion

The use of intravenous tranexamic acid is effective to reduce bleeding in patients undergoing total knee arthroplasty.

目的评价氨甲环酸在全膝关节置换术中减少出血的疗效。方法101例患者随机分为氨甲环酸组(n = 51)和安慰剂组(n = 50)。比较患者的以下参数:血红蛋白降低、估计总失血量、排液量和术后输血率。结果两组比较,差异有统计学意义(p <0.05)以下参数:血红蛋白降低,红细胞压积降低,估计失血量和排血量。氨甲环酸组各项指标均较低。只有安慰剂组患者需要输血。结论静脉注射氨甲环酸可有效减少全膝关节置换术患者出血。
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引用次数: 3
Snapping scapula syndrome: arthroscopic surgical treatment 肩胛骨折断综合征:关节镜手术治疗
Pub Date : 2018-11-01 DOI: 10.1016/j.rboe.2017.09.012
Alexandre Tadeu do Nascimento , Gustavo Kogake Claudio

Objectives

To evaluate the results of patients undergoing arthroscopic surgical treatment for snapping scapula syndrome.

Methods

This is a retrospective study of 11 patients undergoing scapulothoracic arthroscopy for the treatment of snapping scapula syndrome. The study included patients with clinical diagnosis of snapping scapula syndrome who did not show pain improvement after at least six months of physical therapy. Patients were assessed using the DASH, UCLA, visual analogue pain assessment (VAS), and Short-Form 36 (SF36) scores.

Results

The mean age at surgery was 38.4 years (21–48). The mean duration of symptoms before surgery was 2.8 years (range 6 months to 6 years). The mean follow-up duration was 12 months (range: 6.4–28). The mean postoperative scores were: DASH, 7.8 points; VAS, 1.5 points, being ten cases (90%) of mild pain and one case (10%) of moderate pain; UCLA, 32; and SF-36, 79.47.

Conclusions

The arthroscopic approach for the treatment of snapping scapula syndrome presents excellent functional results.

目的评价关节镜下手术治疗肩胛骨折断综合征的疗效。方法对11例经肩胛骨镜治疗肩胛骨折断综合征的患者进行回顾性研究。该研究包括临床诊断为肩胛骨断裂综合征的患者,他们在至少六个月的物理治疗后没有表现出疼痛的改善。采用DASH、UCLA、视觉模拟疼痛评估(VAS)和简易36 (SF36)评分对患者进行评估。结果平均手术年龄为38.4岁(21-48岁)。手术前症状的平均持续时间为2.8年(6个月至6年)。平均随访时间为12个月(6.4-28个月)。术后平均评分为:DASH, 7.8分;VAS评分1.5分,轻度疼痛10例(90%),中度疼痛1例(10%);加州大学洛杉矶分校,32;SF-36, 79.47。结论关节镜下入路治疗肩胛骨折断综合征具有良好的功能效果。
{"title":"Snapping scapula syndrome: arthroscopic surgical treatment","authors":"Alexandre Tadeu do Nascimento ,&nbsp;Gustavo Kogake Claudio","doi":"10.1016/j.rboe.2017.09.012","DOIUrl":"10.1016/j.rboe.2017.09.012","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the results of patients undergoing arthroscopic surgical treatment for snapping scapula syndrome.</p></div><div><h3>Methods</h3><p>This is a retrospective study of 11 patients undergoing scapulothoracic arthroscopy for the treatment of snapping scapula syndrome. The study included patients with clinical diagnosis of snapping scapula syndrome who did not show pain improvement after at least six months of physical therapy. Patients were assessed using the DASH, UCLA, visual analogue pain assessment (VAS), and Short-Form 36 (SF36) scores.</p></div><div><h3>Results</h3><p>The mean age at surgery was 38.4 years (21–48). The mean duration of symptoms before surgery was 2.8 years (range 6 months to 6 years). The mean follow-up duration was 12 months (range: 6.4–28). The mean postoperative scores were: DASH, 7.8 points; VAS, 1.5 points, being ten cases (90%) of mild pain and one case (10%) of moderate pain; UCLA, 32; and SF-36, 79.47.</p></div><div><h3>Conclusions</h3><p>The arthroscopic approach for the treatment of snapping scapula syndrome presents excellent functional results.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 6","pages":"Pages 728-732"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2017.09.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36631850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Revista Brasileira de Ortopedia (English Edition)
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