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A retrospective study to compare early outcomes of bilateral total knee replacement done in single sitting versus double sitting 一项回顾性研究比较单坐与双坐双侧全膝关节置换术的早期结果
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_78_21
J. Wadhwani, R. Siwach, Ravi Sihag, P. Kamboj, Karan Siwach
Aim: We aimed to conduct a study comparing early outcomes of bilateral total knee replacement (BTKR) done in single sitting versus double sitting. Materials and Methods: The study included 58 patients who were already operated case of BTKR done in single sitting (sequential BTKR) – Group I (n = 30) and double sitting (staged BTKR) – Group II (n = 27), during time period April 2016 to May 2019. At follow-up, functional outcome in both the groups was assessed by Knee Injury and Osteoarthritis (OA) Outcome Score, Western Ontario and McMaster Universities OA Index score, and Visual Analog Scale scores. Results: The mean age in Group I was 64.5 ± 10.52 years and in Group II was 63.92 ± 5.76 years. The mean body mass index (BMI) in Group I was 28.42 ± 1.365 kg/m2, whereas the mean BMI in Group II was 29.19 ± 1.898 kg/m2. The mean length of hospital stay in Group I was 15.23 ± 2.921 days as compared to 23.69 ± 5.259 days in Group II. There was no mortality in both the groups within 90 days after operation in both the groups. There was significantly less requirement of hospital stay in Group I as compared to Group II (P = 0.001, Mann–Whitney U-test). Conclusion: We found that the single sitting BTKR is cost-effective and a relatively safe surgery. There was significantly lower length of hospital stay in single sitting BTKR along with no major complication in our study. Thus we advocate BTKR as a single sitting surgery with proper patient selection and preanesthetic workup.
目的:我们旨在进行一项研究,比较单坐与双坐双侧全膝关节置换术(BTKR)的早期结果。材料与方法:本研究纳入58例已行单坐位(顺序式BTKR) - I组(n = 30)和双坐位(分期式BTKR) - II组(n = 27)手术的患者,时间为2016年4月至2019年5月。在随访中,两组的功能结局通过膝关节损伤和骨关节炎(OA)结局评分、西安大略大学和麦克马斯特大学OA指数评分和视觉模拟量表评分进行评估。结果:ⅰ组患者平均年龄64.5±10.52岁,ⅱ组患者平均年龄63.92±5.76岁。组平均体重指数(BMI)为28.42±1.365 kg/m2,组平均BMI为29.19±1.898 kg/m2。组患者平均住院时间15.23±2.921天,组患者平均住院时间23.69±5.259天。术后90 d内两组患者均无死亡。I组住院时间要求显著低于II组(P = 0.001, Mann-Whitney u检验)。结论:单坐位BTKR是一种经济、安全的手术。在我们的研究中,单坐式BTKR的住院时间明显较短,且无重大并发症。因此,我们提倡BTKR作为单坐式手术,适当的患者选择和麻醉前检查。
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引用次数: 0
Spinal tuberculosis and neurological deficit: A 10-year study in rural tertiary care center of central India 脊柱结核和神经功能缺损:印度中部农村三级保健中心的10年研究
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_29_21
R. Patil, G. Mote, A. Wankhede, K. Wandile, C. Badole
Background: India is a home for 27% of the world's tuberculosis (TB) cases. When compared, extrapulmonary TB (EPTB) cases have a lower incidence than pulmonary TB (PTB), but there is no significant reduction in the incidence of EPTB than PTB. Spinal TB is most common of skeletal TB. Aims: We aimed to study and to identify the clinical-radiological features in spinal TB and the incidence of neurological involvement along with factors associated with it. Settings and Design: This was a retrospective study in a tertiary care center of Central India. Subjects and Methods: A total of 114 cases with spinal TB were included in the study. Data collected retrospectively from January 2008 to December 2018 using a picture archiving and picture archiving and communication system of the hospital. Radiographs, magnetic resonance imaging scan, computed tomography, and ultrasound findings were studied. History and clinical examination findings were thoroughly analyzed. Statistical Analysis Used: Data were analyzed using Epi Info Software. Results: There were 74 (64.9%) male cases and 40 (35.1%) female cases. Most of the cases belong to rural 85 (74.5%) than urban 29 (24.5%) area. After neurological evaluation, paraparesis/paraplegia was observed in 52 (45.6%) cases and tetraplegia in 2 (1.7%) cases. Sensory deficit was observed in 10 (10.5%) cases. Bowel/bladder involvement was present in 5 (4.4% cases). Most of the cases with neurodeficit had dorsal vertebral involvement 30 (61.1%). Conclusions: The pattern of spinal TB is varied and is difficult to get diagnosed. We observed a high proportion of cases with neurodeficit. Most of them were with late-onset TB. This highlights that early diagnosis and complete treatment are very important in the treatment of TB of the spine.
背景:印度是世界上27%结核病病例的发源地。相比之下,肺外结核(EPTB)病例的发病率低于肺结核(PTB),但EPTB的发病率没有显著降低。脊柱结核是最常见的骨骼结核。目的:我们的目的是研究和确定脊柱结核的临床放射学特征和神经系统受累的发生率以及与之相关的因素。背景和设计:这是一项在印度中部三级保健中心进行的回顾性研究。研究对象和方法:共纳入114例脊柱结核患者。数据回顾性收集自2008年1月至2018年12月,使用图片存档和医院图片存档和通信系统。研究了x线片、磁共振成像扫描、计算机断层扫描和超声检查结果。对病史和临床检查结果进行全面分析。使用统计分析:数据分析使用Epi Info软件。结果:男性74例(64.9%),女性40例(35.1%)。农村85例(74.5%)高于城市29例(24.5%)。经神经学评估,52例(45.6%)出现截瘫/截瘫,2例(1.7%)出现四肢瘫痪。感觉障碍10例(10.5%)。5例(4.4%)出现肠/膀胱受累。大多数神经缺损病例累及背椎体30(61.1%)。结论:脊柱结核类型多样,诊断困难。我们观察到高比例的病例有神经功能障碍。其中大多数为迟发性结核病。这突出了早期诊断和彻底治疗在脊柱结核的治疗中非常重要。
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引用次数: 0
Bilateral floating knee: A rare case report 双侧浮动膝1例
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_50_21
Jayachandran Ganesh, Sabari Selvam
Ipsilateral fractures of the femur and tibia have been called “floating knee” injuries and may include combinations of diaphyseal, metaphyseal, and intra-articular fractures. These are often high-energy injuries and most frequently occur in the polytrauma patient. Many of these fractures are open, with associated vascular injuries. Surgical stabilization of both fractures and early mobilization of the patient and the extremity produce the best clinical outcomes. This rare case report is of 43-year-old female from an urban setup in Chennai who underwent an Road Traffic Accident (RTA) and sustained injuries that lead to a bilateral floating knee. She was initially managed as per principles of damage control orthopedics and stabilized with knee spanning external fixators on either side. On further stabilization of the patient, bilateral definitive fixation was done in a staged manner. The patient finally regained full functional range of motions on either limb and was completely rehabilitated within 3 months.
股骨和胫骨的同侧骨折被称为“浮动膝”损伤,可能包括干骺端、干骺端和关节内骨折的组合。这些通常是高能损伤,最常见于多发伤患者。许多骨折是开放性的,并伴有血管损伤。手术稳定骨折和早期活动患者和四肢产生最佳的临床结果。这个罕见的病例报告是来自金奈城市的43岁女性,她经历了一次道路交通事故(RTA)并持续受伤,导致双侧浮动膝盖。患者最初按照损伤控制骨科的原则进行治疗,并在两侧使用跨膝外固定架进行稳定。在进一步稳定患者后,分阶段进行双侧最终固定。患者最终在3个月内恢复了四肢的全部功能活动范围,并完全康复。
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引用次数: 0
Prevalence of osteoporosis in Eastern Odisha – A cross-sectional study of bone mineral density 东奥里萨邦骨质疏松症的流行-骨密度的横断面研究
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_60_21
Madhuchhanda Pattnaik, Tanmoy Mohanty, S. Jena
Introduction: Osteoporosis is a common metabolic disease of the bone characterized by decreased bone mass and micro-architectural deterioration in bone tissues that results in increased susceptibility to fractures. Osteoporosis is a significant public health problem in many parts of the world, also in India. The primary purpose of the article is to find out the prevalence of osteoporosis in Eastern Odisha through the cross-sectional study of bone mineral density (BMD). Materials and Methods: Two thousand and one hundred individuals within the age range of 20–82 years were included in the study. It was conducted between February 2016 and August 2017. The instrument to measure BMD was the Achilles Express Bone Ultradensitometer. Their average BMD was calculated according to T score by using the World Health Organization guidelines for the classification into normal, osteopenic, and osteoporotic. The findings were statistically analyzed. The results were compared with the results of other authors. Statistical analysis was performed using the SPSS software version 16 (IBM Corporation, Armonk, New York USA). Results: Prevalence of osteoporosis was found to be 22.4% and osteopenia 37.9%. There was a significant difference in the prevalence of osteoporosis between premenopausal and postmenopausal women. Conclusion: In India, no centralized data are available to show the prevalence of osteoporosis. This study was an effort to find out the prevalence of osteoporosis in Eastern part of Odisha, India. Ultrasonic heel densitometry is a safe and noninvasive method for the assessment of BMD to diagnose and assess the osteoporotic individuals so that adequate steps can be taken in them to prevent fracture and other complications of osteoporosis.
骨质疏松症是一种常见的骨代谢性疾病,其特征是骨量减少,骨组织微结构恶化,导致骨折易感性增加。骨质疏松症在世界许多地区是一个重大的公共卫生问题,在印度也是如此。本文的主要目的是通过骨密度(BMD)的横断面研究来了解奥里萨邦东部骨质疏松症的患病率。材料与方法:研究纳入年龄在20-82岁之间的2,100名个体。该调查于2016年2月至2017年8月进行。测量骨密度的仪器为阿基里斯快速骨超强度计。他们的平均骨密度是根据T评分计算的,按照世界卫生组织的指南分为正常、骨质减少和骨质疏松。对调查结果进行统计分析。结果与其他作者的结果进行了比较。采用SPSS软件16版(IBM Corporation, Armonk, New York USA)进行统计分析。结果:骨质疏松率为22.4%,骨质减少率为37.9%。绝经前和绝经后妇女的骨质疏松患病率有显著差异。结论:在印度,没有集中的数据显示骨质疏松症的患病率。本研究旨在了解印度奥里萨邦东部地区骨质疏松症的患病率。超声足跟密度测量是一种安全、无创的评估骨密度的方法,用于诊断和评估骨质疏松症患者,以便采取适当的措施预防骨折和骨质疏松症的其他并发症。
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引用次数: 1
Comparative analysis of functional and radiological outcome of proximal femoral nail versus dynamic hip screw in treatment of intertrochanteric fractures 股骨近端钉与动力髋螺钉治疗股骨粗隆间骨折的功能及影像学效果比较分析
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_73_21
R. Shukla, Prateek Pathak, Arpit Choyal
Background: Intertrochanteric fracture is one of the most common fractures of the hip, especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. This study was done to compare the functional and radiological outcome of PFN with dynamic hip screw (DHS) in treatment of type 31-A2, intertrochanteric fractures. Materials and Methods: From June 2019 to June 2021, prospective randomized and comparative study was conducted on the 162 patients of type 31-A2 intertrochanteric fractures of hip who were operated using PFN or DHS. Intraoperative complications were noted. Functional outcome was assessed using Harris hip score (HHS) and radiological findings were compared at 6, 12, and 24 months postoperatively. Results: In our study, out of 162 patients, 77 patients are managed with DHS, while 85 patients are managed with PFN. The average age group of the patients was 61–70 years. In our series, we found that patients with DHS had longer duration of surgery (111 min) and required longer time for mobilization, while patients who underwent PFN had shorter duration of surgery (97 min) and allowed early mobilization. In addition, complications such as DVT, lag screw cutout, shortening, and superficial infection are more in DHS group as compared to PFN group. The patients treated with PFN started early ambulation as they had better HHS in the early postoperative period as well as late postoperative period. Conclusion: PFN is better than DHS in type 31-A2 intertrochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight-bearing and mobilization, reduced hospital stay, decreased risk of infection, and decreased complications.
背景:股骨粗隆间骨折是髋部最常见的骨折之一,尤其是在骨质疏松的老年人中,通常是由于简单跌倒等低能量创伤所致。本研究旨在比较PFN与动力髋螺钉(DHS)治疗31-A2型转子间骨折的功能和影像学结果。材料与方法:2019年6月- 2021年6月,对采用PFN或DHS手术治疗31-A2型髋粗隆间骨折的162例患者进行前瞻性随机对照研究。注意术中并发症。使用Harris髋关节评分(HHS)评估功能结果,并比较术后6、12和24个月的影像学结果。结果:在我们的研究中,162例患者中,77例患者采用DHS治疗,85例患者采用PFN治疗。患者平均年龄61 ~ 70岁。在我们的研究中,我们发现DHS患者的手术时间更长(111分钟),需要更长的活动时间,而PFN患者的手术时间更短(97分钟),可以早期活动。DHS组DVT、lag screw cutout、缩短、表表感染等并发症发生率高于PFN组。患者术后早期和后期HHS较好,采用PFN治疗的患者较早下床。结论:PFN治疗31-A2型转子间骨折在减少失血量、缩短手术时间、早期负重和活动、缩短住院时间、降低感染风险和减少并发症等方面优于DHS。
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引用次数: 1
The safety and efficacy of biceps tenodesis performed using a novel suture anchor 使用新型缝合锚钉进行二头肌肌腱固定术的安全性和有效性
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_83_21
Andrea Johnson, M. Fowler, Michaline West, Justin J. Turcotte, Daniel E. Redziniak
Introduction: Biceps tendon degeneration or tearing is a significant cause of shoulder discomfort and dysfunction. Biceps tenodesis is commonly performed to treat symptomatic biceps tendon pathology. A variety of fixation techniques can be used including screw fixation, endobutton, or suture anchor techniques. This study examines the patient outcomes when the FOOTPRINT™ Ultra suture anchor system is used for biceps tenodesis. Materials and Methods: Retrospective review of consecutive patients undergoing biceps tenodesis was conducted. All patients underwent biceps tenodesis using the FOOTPRINT™ Ultra suture anchor. The primary endpoint was any device-related complication during the intraoperative or postoperative period. Descriptive and inferential statistics were performed to assess patient characteristics and outcomes. Results: Twenty-nine patients were included in this study; 20 (69.0%) underwent arthroscopic biceps tenodesis and the remainder underwent open surgery. The mean follow-up time was 8.51 ± 5.28 months postoperatively. One patient experienced a postoperative infection within the first 30 days requiring a return to the operating room. Two patients experienced a complication within the first 6 months postoperatively. No patients experienced a device-related complication. No patients experienced a retear of their biceps tendon; two patients experienced a retear to their rotator cuff repair. The mean pain Numeric Rating Scale improved from 5.88 ± 2.58 on a scale of 0–10 preoperatively to 1.94 ± 2.32 postoperatively (P < 0.001). Conclusion: The FOOTPRINT™ Ultra suture anchor appears to be safe for the use in patients undergoing arthroscopic or open biceps tenodesis.
简介:二头肌肌腱退变或撕裂是引起肩部不适和功能障碍的重要原因。二头肌肌腱固定术通常用于治疗症状性二头肌肌腱病变。可使用多种固定技术,包括螺钉固定、内扣或缝合锚钉技术。本研究检查了使用FOOTPRINT™Ultra缝合锚定系统进行二头肌肌腱固定术的患者结果。材料与方法:对连续接受二头肌肌腱固定术的患者进行回顾性分析。所有患者均使用FOOTPRINT™Ultra缝合锚钉进行二头肌肌腱固定术。主要终点是术中或术后任何与器械相关的并发症。采用描述性和推断性统计来评估患者的特征和结果。结果:29例患者纳入本研究;20例(69.0%)行关节镜肱二头肌肌腱固定术,其余行开放手术。平均随访时间为8.51±5.28个月。一名患者在前30天内发生术后感染,需要返回手术室。2例患者术后6个月内出现并发症。没有患者出现器械相关并发症。没有患者出现肱二头肌肌腱撕裂;两名患者经历了肩袖修复的复发。平均疼痛数值评定量表从术前的5.88±2.58(0-10)改善到术后的1.94±2.32 (P < 0.001)。结论:对于接受关节镜或开放式二头肌肌腱固定术的患者,FOOTPRINT™Ultra缝合锚钉似乎是安全的。
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引用次数: 0
Predicting short-term outcome of Metal-on-Metal Hip Resurfacing (MOMHR): A multivariate analysis using 14 independent variables 金属对金属髋关节表面置换(MOMHR)的短期预后预测:一项使用14个自变量的多变量分析
Pub Date : 2022-01-01 DOI: 10.4103/jotr.jotr_18_21
Amrit Goyal, W. Macaulay, J. Geller, Wenbao Wang, Jonathon Nyce
Introduction: The aim of this study was to research factors affecting the short-term outcome of metal-on-metal hip resurfacing (MOMHR) and develop a multivariate regression model that may predict outcome. Materials and Methods: This was a prospective study of 154 patients who underwent MOMHR and were followed for a minimum of 1 year. Fourteen independent variables (age, gender, diagnosis, co-morbidities, body mass index (BMI), pr-operative Western Ontario and McMaster Universities Osteoarthritis (WOMAC) physical component/stiffness (S)/pain (P), short form 12 (SF-12) physical (SP), SF-12 mental (SM), acetabular and femoral component sizes, operative time, and estimated blood loss) were analyzed using correlation and multivariate regression analyses. Multivariate regression model was tested by using an independent cohort for validation. Results: Correlation analyses found four variables that significantly influence short term MOMHR outcome. These include comorbidities (C, P = 0.0001), preoperative SF-12 mental (SM, P = 0.0004), BMI (P = 0.0006), and gender (G, P = 0.0454). By multivariate analysis, the subsequent regression model was obtained with an R2 value of 0.3816: Outcome = G*4.72 ‒ BMI*0.70 ‒ C*0.11 + SM*0.31 + 87.44. The average predicted outcome using this equation did not differ significantly from the observed WOMAC physical function outcome at a minimum of 1 year postoperatively. Conclusion: To the best of our knowledge, this study is the first reported multivariate analysis of factors affecting MOMHR and confirms the correlation of some of the previously proposed factors such as gender, BMI, comorbidities, and preoperative function. The multivariate regression equation can be used to predict the short-term outcome of MOMHR.
本研究的目的是研究影响金属对金属髋关节表面置换(MOMHR)短期预后的因素,并建立一个可能预测预后的多元回归模型。材料和方法:这是一项前瞻性研究,154例患者接受了MOMHR,随访至少1年。14个独立变量(年龄、性别、诊断、合并症、体重指数(BMI)、手术前西安大略和麦克马斯特大学骨关节炎(WOMAC)物理成分/僵硬度(S)/疼痛(P)、短形式12 (SF-12)物理(SP)、SF-12精神(SM)、髋臼和股骨成分大小、手术时间和估计失血量)采用相关和多变量回归分析进行分析。采用独立队列对多元回归模型进行验证。结果:相关分析发现四个变量显著影响短期MOMHR结果。这些包括合并症(C, P = 0.0001),术前SF-12精神(SM, P = 0.0004), BMI (P = 0.0006)和性别(G, P = 0.0454)。经多因素分析,得到后续回归模型,R2值为0.3816:Outcome = G*4.72 - BMI*0.70 - C*0.11 + SM*0.31 + 87.44。使用该方程的平均预测结果与术后至少1年观察到的WOMAC身体功能结果没有显著差异。结论:据我们所知,本研究首次报道了影响MOMHR因素的多变量分析,并证实了先前提出的一些因素(如性别、BMI、合并症和术前功能)之间的相关性。多元回归方程可用于预测MOMHR的短期预后。
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引用次数: 0
一本の馬尾に蔓状に発生した長大な神経鞘腫の一例 在一根马尾上呈蔓状生长的大型神经鞘瘤的一个例子
Pub Date : 2021-09-25 DOI: 10.5035/nishiseisai.70.721
達也 柴田, 秀樹 大田, 佳之 松本, 吉城 木田, 洋平 井口, 政人 巽, 健一 田原, 京一 眞田, 秀祐 萩原, 浩隆 木田, 義治 竹光
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引用次数: 0
高校空手選手における貧血調査 高中空手道选手贫血调查
Pub Date : 2021-09-25 DOI: 10.5035/nishiseisai.70.703
義隆 木戸, 卓也 田島, 奈美 山口, 誠 長澤, 智美 大田, 雄大 森田, 琢示 横江, 秀一 川越, 悦男 帖佐
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引用次数: 0
高度関節水腫を呈した両膝樹枝状脂肪腫の1例 呈高度关节水肿的双膝树枝状脂肪瘤一例
Pub Date : 2021-09-25 DOI: 10.5035/nishiseisai.70.653
彰 小畑, 雅士 平川, 昌悟 松田, 弘 津村
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引用次数: 0
期刊
Journal of Orthopedics Traumatology and Rehabilitation
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