Pub Date : 2024-07-25DOI: 10.1177/22104917241258237
Aytan Safarli, Berkay Kırnaz, Derin Kumcuoglu, Vusal Mahmudov, Ziya Karimov, A. Berdeli
Knee osteoarthritis (KOA) is the most common degenerative joint disease. Adipose-derived stromal vascular fraction cell therapy slows the progression of knee osteoarthritis and prevents hyaline cartilage degeneration without serious side effects. This study aims to present retrospectively the effectiveness of stromal vascular fraction cells isolated from adipose tissue by the non-enzymatic method applied to 55 osteoarthritis patients of different age groups and Kellgren-Lawrence grades on the recovery of the disease. Fifty-five patients with knee osteoarthritis, treated with stromal vascular fraction cells at the International Medical Centre (Azerbaijan) between 2020 and 2021, were included in the study to be evaluated retrospectively. Patients aged 32–67 years, Grades I–IV according to Kellgren-Lawrence classification, were included in this study. Pain and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires before treatment, at the 5th month, and 12th month after stromal vascular fraction injection. At the fifth and 12th months post-treatment, it was observed that the WOMAC scores were significantly improved compared with pre-treatment scores. It was also observed that stromal vascular fraction therapy was effective for Kellgren-Lawrence Grades I and II at 12 months. The most significant decrease in the WOMAC score after stromal vascular fraction treatment was observed in patients aged 45–60 years, and it was also found that there was no meaningful relationship between stromal vascular fraction efficiency and gender. According to our results, non-enzymatically stromal vascular fraction treatment is more effective for longer in osteoarthritis patients with early age and low Kellgren-Lawrence grades (I and II). Moreover, our finding is that the stromal vascular fraction cells could be used safely in osteoarthritis treatments and significantly benefit patients’ quality of life.
膝关节骨关节炎（KOA）是最常见的退行性关节疾病。脂肪基质血管成分细胞疗法可减缓膝关节骨性关节炎的进展，防止透明软骨退化，且无严重副作用。本研究旨在回顾性地展示用非酶法从脂肪组织中分离出的基质血管成分细胞对55名不同年龄段和Kellgren-Lawrence分级的骨关节炎患者的疾病恢复效果。这项研究对2020年至2021年期间在国际医疗中心（阿塞拜疆）接受基质血管分化细胞治疗的55名膝关节骨关节炎患者进行了回顾性评估。根据凯尔格伦-劳伦斯（Kellgren-Lawrence）分类法，患者年龄在32-67岁之间，属于I-IV级。在治疗前、基质血管成分注射后第5个月和第12个月，使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）问卷对疼痛和功能限制进行评估。据观察，治疗后第5个月和第12个月的WOMAC评分与治疗前相比有明显改善。此外，还观察到基质血管分数疗法在12个月后对凯尔格伦-劳伦斯分级I级和II级有效。基质血管分数治疗后，45-60 岁患者的 WOMAC 评分下降最为明显，同时还发现基质血管分数的有效率与性别之间没有明显的关系。根据我们的研究结果，对于年龄较小、Kellgren-Lawrence 分级较低（I 级和 II 级）的骨关节炎患者，非酶切基质血管分数治疗的有效时间更长。此外，我们还发现基质血管成分细胞可安全地用于骨关节炎治疗，并显著提高患者的生活质量。
{"title":"Retrospective evaluation of the short-term effectiveness of non-enzymatically isolated stromal vascular fraction cells in patients with knee osteoarthritis","authors":"Aytan Safarli, Berkay Kırnaz, Derin Kumcuoglu, Vusal Mahmudov, Ziya Karimov, A. Berdeli","doi":"10.1177/22104917241258237","DOIUrl":"https://doi.org/10.1177/22104917241258237","url":null,"abstract":"Knee osteoarthritis (KOA) is the most common degenerative joint disease. Adipose-derived stromal vascular fraction cell therapy slows the progression of knee osteoarthritis and prevents hyaline cartilage degeneration without serious side effects. This study aims to present retrospectively the effectiveness of stromal vascular fraction cells isolated from adipose tissue by the non-enzymatic method applied to 55 osteoarthritis patients of different age groups and Kellgren-Lawrence grades on the recovery of the disease. Fifty-five patients with knee osteoarthritis, treated with stromal vascular fraction cells at the International Medical Centre (Azerbaijan) between 2020 and 2021, were included in the study to be evaluated retrospectively. Patients aged 32–67 years, Grades I–IV according to Kellgren-Lawrence classification, were included in this study. Pain and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires before treatment, at the 5th month, and 12th month after stromal vascular fraction injection. At the fifth and 12th months post-treatment, it was observed that the WOMAC scores were significantly improved compared with pre-treatment scores. It was also observed that stromal vascular fraction therapy was effective for Kellgren-Lawrence Grades I and II at 12 months. The most significant decrease in the WOMAC score after stromal vascular fraction treatment was observed in patients aged 45–60 years, and it was also found that there was no meaningful relationship between stromal vascular fraction efficiency and gender. According to our results, non-enzymatically stromal vascular fraction treatment is more effective for longer in osteoarthritis patients with early age and low Kellgren-Lawrence grades (I and II). Moreover, our finding is that the stromal vascular fraction cells could be used safely in osteoarthritis treatments and significantly benefit patients’ quality of life.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"7 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1177/22104917241256658
See Lok Douglas Ho, Ching San Esther Chow
Background: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patients who underwent the conventional Kleinert protocol versus the Saint John protocol. Methods: 20 fingers in the Kleinert group and 18 fingers in the Saint John group were included in this retrospective study. Pain score, range of movement, grip strength, and complications were studied at 6 and 12 weeks postoperatively. Results: The Saint John protocol showed significantly less pain at 6 week (0.167 vs 1.08, P = 0.032) and less flexion contracture at the PIPJ at 6 weeks (3.33 vs 12.25, P = 0.032). Both groups showed similar rerupture rates (5.5% vs 5%). Conclusions: Saint John protocol demonstrated better clinical outcomes while not sacrificing the integrity of repair.
背景：目前还没有具体证据来确定 I/II 区屈肌腱修复后的最佳活动策略。圣约翰方案是一种积极的运动机制，它利用腕部运动来促进更好的临床效果。我们的目的是比较接受传统克莱因特方案和圣约翰方案的患者的疗效。方法：这项回顾性研究包括克莱因特组的 20 个手指和圣约翰组的 18 个手指。对术后 6 周和 12 周的疼痛评分、活动范围、握力和并发症进行了研究。结果显示圣约翰方案在 6 周时疼痛明显减轻（0.167 vs 1.08，P = 0.032），6 周时 PIPJ 屈曲挛缩明显减轻（3.33 vs 12.25，P = 0.032）。两组的再骨折率相似（5.5% vs 5%）。结论圣约翰方案在不牺牲修复完整性的同时，显示出更好的临床效果。
{"title":"Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study","authors":"See Lok Douglas Ho, Ching San Esther Chow","doi":"10.1177/22104917241256658","DOIUrl":"https://doi.org/10.1177/22104917241256658","url":null,"abstract":"Background: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patients who underwent the conventional Kleinert protocol versus the Saint John protocol. Methods: 20 fingers in the Kleinert group and 18 fingers in the Saint John group were included in this retrospective study. Pain score, range of movement, grip strength, and complications were studied at 6 and 12 weeks postoperatively. Results: The Saint John protocol showed significantly less pain at 6 week (0.167 vs 1.08, P = 0.032) and less flexion contracture at the PIPJ at 6 weeks (3.33 vs 12.25, P = 0.032). Both groups showed similar rerupture rates (5.5% vs 5%). Conclusions: Saint John protocol demonstrated better clinical outcomes while not sacrificing the integrity of repair.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"94 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1177/22104917231214804
Y. Kokubo, Hideaki Nakajima, Yuya Izubuchi, Akihiko Matsumine
Background: The clinical results of conservative treatment in correctly selected patients with fragility fracture of the pelvis are acceptable. However, there is a loss of social and physical independence and autonomy. This study aimed to evaluate factors associated with decreased walking ability in patients with conservatively treated fragility fractures of the pelvis. Methods: Overall, 124 patients aged >70 years were included. Fragility fracture of the pelvis was classified according to the Rommens classification. Walking ability before and 1 year after injury was assessed using the Functional Ambulation Category. Results: The overall recovery rate of walking ability of conservatively treated patients to the preinjury state was 73%, one year after injury. The presence of cancer and > four-week bed rest were determinants of decreased walking ability one year after injury. Conclusions: The presence of cancer and more than four-week bed rest were risk factors for a significant decrease in walking ability.
{"title":"Factors affecting decreased walking ability in patients with conservatively treated fragility fracture of the pelvic ring","authors":"Y. Kokubo, Hideaki Nakajima, Yuya Izubuchi, Akihiko Matsumine","doi":"10.1177/22104917231214804","DOIUrl":"https://doi.org/10.1177/22104917231214804","url":null,"abstract":"Background: The clinical results of conservative treatment in correctly selected patients with fragility fracture of the pelvis are acceptable. However, there is a loss of social and physical independence and autonomy. This study aimed to evaluate factors associated with decreased walking ability in patients with conservatively treated fragility fractures of the pelvis. Methods: Overall, 124 patients aged >70 years were included. Fragility fracture of the pelvis was classified according to the Rommens classification. Walking ability before and 1 year after injury was assessed using the Functional Ambulation Category. Results: The overall recovery rate of walking ability of conservatively treated patients to the preinjury state was 73%, one year after injury. The presence of cancer and > four-week bed rest were determinants of decreased walking ability one year after injury. Conclusions: The presence of cancer and more than four-week bed rest were risk factors for a significant decrease in walking ability.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"35 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-09DOI: 10.1177/22104917241232087
Chun Lok Chow, Y. Siu, C. Ma, T. Lui
The technique of ultrasound-guided regional anesthesia has demonstrated satisfactory efficacy and safety in fixation of various fractures. There are limited studies performed concerning the applicability of a surgeon self-performed ultrasound-guided regional anesthesia. This study aimed to evaluate the efficacy of a self-performed ultrasound-guided regional anesthesia by surgeon for distal radius fracture fixation in terms of intraoperative and post-operative characteristics. Material and Methods: Patients with distal radius fracture who underwent surgery under the surgeon-performed ultrasound-guided regional anesthesia were evaluated in this retrospective study. A total of 12 patients (2 male/10 female) with a mean age of 60.6 were evaluated for the type of injury by AO classification, American Society of Anesthesiologists Classification (ASA), intraoperative visual analog scale pain (VAS) scores, duration of operation, post-operative pain control, complications and duration of hospitalisation. Result: Average age of the study population was 60.6, of which four of them were of ASA I, six of them ASA II and two of them ASA III. We provided complete pain control during the operation with all of the patient experience no pain (VAS = 0) throughout the operation. Average operative time was 77.5 min. Average blood loss was 7.7 mL. Early post-operative pain control at 6 h after operation was well with majority of patients experience pain of VAS 1. Average post-operative hospital length of stay is 2.08 days. There was no complication arising from the application of regional anesthesia. Conclusion: Ultrasound-guided regional anesthesia can provide excellent efficacy and pain control during and after operation. Occurrence of complication was well avoided. Distal radius fracture fixation can be performed safely by orthopaedic surgeons under this technique.
超声引导下区域麻醉技术在各种骨折的固定中表现出令人满意的疗效和安全性。关于外科医生自行实施超声引导下区域麻醉的适用性研究有限。本研究旨在从术中和术后特征方面评估外科医生自行实施超声引导区域麻醉用于桡骨远端骨折固定术的疗效。材料与方法：这项回顾性研究评估了在外科医生超声引导下进行区域麻醉的桡骨远端骨折患者。共对 12 名患者（2 男/10 女）（平均年龄 60.6 岁）进行了评估，评估内容包括 AO 分类、美国麻醉医师协会分类（ASA）、术中视觉模拟评分疼痛（VAS）评分、手术时间、术后疼痛控制、并发症和住院时间。研究结果研究对象的平均年龄为 60.6 岁，其中 4 人为 ASA I 级，6 人为 ASA II 级，2 人为 ASA III 级。我们在手术过程中完全控制了疼痛，所有患者在整个手术过程中均无疼痛感（VAS = 0）。平均手术时间为 77.5 分钟。平均失血量为 7.7 毫升。术后 6 小时的早期疼痛控制良好，大多数患者的疼痛程度为 VAS 1。术后平均住院时间为 2.08 天。应用区域麻醉时未出现并发症。结论超声引导下区域麻醉可在手术过程中和手术后提供出色的疗效和疼痛控制。很好地避免了并发症的发生。骨科外科医生可以使用这种技术安全地进行桡骨远端骨折固定术。
{"title":"Ultrasound-guided regional anesthesia by orthopaedic surgeons in fixation of distal radius fracture","authors":"Chun Lok Chow, Y. Siu, C. Ma, T. Lui","doi":"10.1177/22104917241232087","DOIUrl":"https://doi.org/10.1177/22104917241232087","url":null,"abstract":"The technique of ultrasound-guided regional anesthesia has demonstrated satisfactory efficacy and safety in fixation of various fractures. There are limited studies performed concerning the applicability of a surgeon self-performed ultrasound-guided regional anesthesia. This study aimed to evaluate the efficacy of a self-performed ultrasound-guided regional anesthesia by surgeon for distal radius fracture fixation in terms of intraoperative and post-operative characteristics. Material and Methods: Patients with distal radius fracture who underwent surgery under the surgeon-performed ultrasound-guided regional anesthesia were evaluated in this retrospective study. A total of 12 patients (2 male/10 female) with a mean age of 60.6 were evaluated for the type of injury by AO classification, American Society of Anesthesiologists Classification (ASA), intraoperative visual analog scale pain (VAS) scores, duration of operation, post-operative pain control, complications and duration of hospitalisation. Result: Average age of the study population was 60.6, of which four of them were of ASA I, six of them ASA II and two of them ASA III. We provided complete pain control during the operation with all of the patient experience no pain (VAS = 0) throughout the operation. Average operative time was 77.5 min. Average blood loss was 7.7 mL. Early post-operative pain control at 6 h after operation was well with majority of patients experience pain of VAS 1. Average post-operative hospital length of stay is 2.08 days. There was no complication arising from the application of regional anesthesia. Conclusion: Ultrasound-guided regional anesthesia can provide excellent efficacy and pain control during and after operation. Occurrence of complication was well avoided. Distal radius fracture fixation can be performed safely by orthopaedic surgeons under this technique.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1177/22104917241256656
Sebastian Husi, Werner Vach, Dieter Cadosch, Marcel Jakob, F. Saxer, H. Eckardt
Acetabular fractures are challenging injuries in the heterogeneous population of elderly patients. In patients able to partially bear weight, open reduction and internal fixation (ORIF) is indicated. In frail patients, ORIF combined with primary total hip arthroplasty (THA) allows early weight-bearing to preserve independence. This article systematically analyses a treatment algorithm that separates fractures into stable fractures treated conservatively and fractures needing surgical stabilization with osteosynthesis or osteosynthesis plus arthroplasty, dependent on patient characteristics but less on the fracture classification or energetic impact of the trauma. Data on patients ≥50 years of age treated for acetabular fractures (2009–2019) were retrospectively analyzed. The primary outcome was loss of independence. In-hospital complications, length of stay, re-operations, the need for walking aids, and pain were analyzed as secondary outcomes. Out of 207 patients, 135 were male, average age was 70 years. Eighty-five patients were treated conservatively, 89 ORIF, and 33 ORIF plus arthroplasty in one operation. The initial morbidity of patients treated with the combined operation was higher than osteosynthesis alone, but the long-term outcome was favorable with less pain and fewer secondary interventions. Age and female gender were associated with the decision to treat the fracture with the combination of osteosynthesis and arthroplasty. The results suggest that aged and potentially frail patients with acetabular fracture have better long-term outcome after ORIF combined with arthroplasty at the price of an initially higher risk of adverse outcomes. Females were more frequently treated with the combined operation independent of other risk factors
{"title":"Comparative outcome of different treatment options for acetabulum fractures in elderly individuals—a retrospective analysis of 207 patients","authors":"Sebastian Husi, Werner Vach, Dieter Cadosch, Marcel Jakob, F. Saxer, H. Eckardt","doi":"10.1177/22104917241256656","DOIUrl":"https://doi.org/10.1177/22104917241256656","url":null,"abstract":"Acetabular fractures are challenging injuries in the heterogeneous population of elderly patients. In patients able to partially bear weight, open reduction and internal fixation (ORIF) is indicated. In frail patients, ORIF combined with primary total hip arthroplasty (THA) allows early weight-bearing to preserve independence. This article systematically analyses a treatment algorithm that separates fractures into stable fractures treated conservatively and fractures needing surgical stabilization with osteosynthesis or osteosynthesis plus arthroplasty, dependent on patient characteristics but less on the fracture classification or energetic impact of the trauma. Data on patients ≥50 years of age treated for acetabular fractures (2009–2019) were retrospectively analyzed. The primary outcome was loss of independence. In-hospital complications, length of stay, re-operations, the need for walking aids, and pain were analyzed as secondary outcomes. Out of 207 patients, 135 were male, average age was 70 years. Eighty-five patients were treated conservatively, 89 ORIF, and 33 ORIF plus arthroplasty in one operation. The initial morbidity of patients treated with the combined operation was higher than osteosynthesis alone, but the long-term outcome was favorable with less pain and fewer secondary interventions. Age and female gender were associated with the decision to treat the fracture with the combination of osteosynthesis and arthroplasty. The results suggest that aged and potentially frail patients with acetabular fracture have better long-term outcome after ORIF combined with arthroplasty at the price of an initially higher risk of adverse outcomes. Females were more frequently treated with the combined operation independent of other risk factors","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"8 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-29DOI: 10.1177/22104917231225969
Kieron Phillips, Jun Xiang Ng, Tarek Abdelkader, Alex Wirianski
Objective: The Singapore Institute of Technology Shoulder Assessment Battery (SIT-SAB) is a novel shoulder test battery involving six different tests. It is created to aid clinicians in the return-to-play decision-making process. This study aims to establish the normative score for the SIT-SAB and assess the reliability of its scoring criteria. Methods: This cross-sectional observational study looked at healthy adults aged 18 or older with asymptomatic shoulders and normal shoulder mobility were recruited for the study. The participants performed all the tests in the SIT-SAB, and the measurements and scores obtained were recorded. Nineteen participants returned for two additional sessions on separate days to analyse the SIT-SAB's reliability. The inter-rater, intra-rater and test–retest reliability was calculated using a two-way mixed effect International Consensus Criteria (ICC) model. The ICC coefficient and the 95% confidence interval were used to determine the reliability of the SIT-SAB. Results: The SIT-SAB demonstrated good inter-rater, intra-rater and inter-day reliability (ICC = 0.81 (0.51–0.93), 0.97 (0.92–0.99), 0.89 (0.78–0.96), respectively) and has a mean score of 87.3 ± 10.3. The SIT-SAB scores were not correlated with any demographic, anthropometric characteristics or other factors. Conclusion: The findings provided the normative score to be expected of a healthy Singaporean adult and showed that the scoring criteria used were stable and demonstrated good reliability. Further research is needed to establish the cut-off score required for a safe return-to-play.
{"title":"A novel return-to-play battery for shoulder injury/surgery: Normative values and psychometric properties","authors":"Kieron Phillips, Jun Xiang Ng, Tarek Abdelkader, Alex Wirianski","doi":"10.1177/22104917231225969","DOIUrl":"https://doi.org/10.1177/22104917231225969","url":null,"abstract":"Objective: The Singapore Institute of Technology Shoulder Assessment Battery (SIT-SAB) is a novel shoulder test battery involving six different tests. It is created to aid clinicians in the return-to-play decision-making process. This study aims to establish the normative score for the SIT-SAB and assess the reliability of its scoring criteria. Methods: This cross-sectional observational study looked at healthy adults aged 18 or older with asymptomatic shoulders and normal shoulder mobility were recruited for the study. The participants performed all the tests in the SIT-SAB, and the measurements and scores obtained were recorded. Nineteen participants returned for two additional sessions on separate days to analyse the SIT-SAB's reliability. The inter-rater, intra-rater and test–retest reliability was calculated using a two-way mixed effect International Consensus Criteria (ICC) model. The ICC coefficient and the 95% confidence interval were used to determine the reliability of the SIT-SAB. Results: The SIT-SAB demonstrated good inter-rater, intra-rater and inter-day reliability (ICC = 0.81 (0.51–0.93), 0.97 (0.92–0.99), 0.89 (0.78–0.96), respectively) and has a mean score of 87.3 ± 10.3. The SIT-SAB scores were not correlated with any demographic, anthropometric characteristics or other factors. Conclusion: The findings provided the normative score to be expected of a healthy Singaporean adult and showed that the scoring criteria used were stable and demonstrated good reliability. Further research is needed to establish the cut-off score required for a safe return-to-play.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"67 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140366279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1177/22104917241227621
Wan Tze-Kit, H. Yung-Chak, Lam Kwok-Hang, Chu Kwok-Keung, Leung Lok-Ming, Tse Chi-Chung, Wong Chun-Kwan
While most geriatric patients with hip fracture benefit from definitive operative treatment, pre-operative pain management is often overlooked. Conventional oral analgesics may provide suboptimal pain control, resulting in poor morbidity outcomes. Fascia iliaca compartment block (FICB) provides a more consistent analgesic effect. This study aims to provide high level local evidence on the effect of FICB in pre-operative pain control for these patients in Hong Kong. This study was a double-blinded randomized controlled trial. Mentally competent geriatric patients with acute fracture hip, admitted to United Christian Hospital, were recruited to receive pre-operative FICB. The procedure was carried out by landmark approach with addition of ultrasonography-guidance. They were randomized into intervention group (receiving 0.25% levobupivacaine), and control group (receiving normal saline as placebo). Numeric Rating Scale of pain score (at rest, and on gentle movement) at different time intervals, timing of injection, systemic analgesic use, complications, and demographics were compared. Total 80 patients were recruited from July 2019 to September 2021 and randomized into intervention and control groups. Two patients in intervention group and 1 in control group were withdrawn due to development of delirium. Demographics of both groups were comparable. Pain score at rest was significantly lower at 12 h after injection in intervention group (41.4% reduction, p = 0.03). Pain score upon gentle movement was significantly lower in intervention group at 1 h (p = 0.01), 12 h (28.9% reduction, p = 0.003) and 24 h after injection (p = 0.01). There was no complication from the procedure documented. Total systemic analgesic use was similar in both groups. FICB is an effective choice of pre-operative analgesia for geriatric hip fracture patients with good safety profile, especially in controlling pain induced by movement. It shall be considered as a routine practice for suitable patients.
{"title":"Randomized controlled trial on analgesic effect of pre-operative fascia iliaca compartment block in geriatric patients with hip fracture","authors":"Wan Tze-Kit, H. Yung-Chak, Lam Kwok-Hang, Chu Kwok-Keung, Leung Lok-Ming, Tse Chi-Chung, Wong Chun-Kwan","doi":"10.1177/22104917241227621","DOIUrl":"https://doi.org/10.1177/22104917241227621","url":null,"abstract":"While most geriatric patients with hip fracture benefit from definitive operative treatment, pre-operative pain management is often overlooked. Conventional oral analgesics may provide suboptimal pain control, resulting in poor morbidity outcomes. Fascia iliaca compartment block (FICB) provides a more consistent analgesic effect. This study aims to provide high level local evidence on the effect of FICB in pre-operative pain control for these patients in Hong Kong. This study was a double-blinded randomized controlled trial. Mentally competent geriatric patients with acute fracture hip, admitted to United Christian Hospital, were recruited to receive pre-operative FICB. The procedure was carried out by landmark approach with addition of ultrasonography-guidance. They were randomized into intervention group (receiving 0.25% levobupivacaine), and control group (receiving normal saline as placebo). Numeric Rating Scale of pain score (at rest, and on gentle movement) at different time intervals, timing of injection, systemic analgesic use, complications, and demographics were compared. Total 80 patients were recruited from July 2019 to September 2021 and randomized into intervention and control groups. Two patients in intervention group and 1 in control group were withdrawn due to development of delirium. Demographics of both groups were comparable. Pain score at rest was significantly lower at 12 h after injection in intervention group (41.4% reduction, p = 0.03). Pain score upon gentle movement was significantly lower in intervention group at 1 h (p = 0.01), 12 h (28.9% reduction, p = 0.003) and 24 h after injection (p = 0.01). There was no complication from the procedure documented. Total systemic analgesic use was similar in both groups. FICB is an effective choice of pre-operative analgesia for geriatric hip fracture patients with good safety profile, especially in controlling pain induced by movement. It shall be considered as a routine practice for suitable patients.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"22 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.1177/22104917231225970
A. Mahmoud, Jarrod Younger, Emily Morris, Matthew Hope
Background: This retrospective study aimed to assess whether delaying flap coverage in open midshaft tibia fractures leads to higher infection rates. Methods: Patients were recruited retrospectively from a tertiary trauma database between 2012 and 2020. Patients included were over 18-years old and had an open tibia fracture that required flap coverage with at least 6 months follow-up. The collected complications were deep infections, aseptic non-union, flap failure and revision surgery. Results: Group-A ( n = 18) and Group-B ( n = 37) were analysed. Deep infections rate was 6% in Group-A and 38% in Group-B which was significantly different, χ2(1, N = 55) = 6.4, p = 0.01. The rate of revision surgery was 17% in Group-A and 54% in Group-B and was significant, χ2(1, N = 55) = 7, p = 0.008. Binary logistic regression showed that Group-B were 10 times more likely to develop a deep infection (95% confidence interval 1.2–83, p = 0.034). Conclusion: Delaying soft tissue coverage of open tibia fractures for over a week increases the risk of deep infection and revision surgery.
背景：这项回顾性研究旨在评估在开放性胫骨中段骨折中延迟皮瓣覆盖是否会导致更高的感染率。研究方法从2012年至2020年期间的三级创伤数据库中回顾性招募患者。纳入的患者年龄在18岁以上，胫骨开放性骨折需要皮瓣覆盖，随访至少6个月。收集的并发症包括深部感染、无菌性不愈合、皮瓣失败和翻修手术。结果对 A 组（18 人）和 B 组（37 人）进行了分析。A组深度感染率为6%，B组为38%，差异显著，χ2（1，N = 55）= 6.4，P = 0.01。A组的翻修手术率为17%，B组为54%，差异显著，χ2（1，N = 55）= 7，P = 0.008。二元逻辑回归显示，B 组发生深度感染的几率是 A 组的 10 倍（95% 置信区间 1.2-83, p = 0.034）。结论开放性胫骨骨折软组织覆盖延迟一周以上会增加深部感染和翻修手术的风险。
{"title":"A delay in flap coverage of open midshaft tibia fractures increases complications: A retrospective study","authors":"A. Mahmoud, Jarrod Younger, Emily Morris, Matthew Hope","doi":"10.1177/22104917231225970","DOIUrl":"https://doi.org/10.1177/22104917231225970","url":null,"abstract":"Background: This retrospective study aimed to assess whether delaying flap coverage in open midshaft tibia fractures leads to higher infection rates. Methods: Patients were recruited retrospectively from a tertiary trauma database between 2012 and 2020. Patients included were over 18-years old and had an open tibia fracture that required flap coverage with at least 6 months follow-up. The collected complications were deep infections, aseptic non-union, flap failure and revision surgery. Results: Group-A ( n = 18) and Group-B ( n = 37) were analysed. Deep infections rate was 6% in Group-A and 38% in Group-B which was significantly different, χ2(1, N = 55) = 6.4, p = 0.01. The rate of revision surgery was 17% in Group-A and 54% in Group-B and was significant, χ2(1, N = 55) = 7, p = 0.008. Binary logistic regression showed that Group-B were 10 times more likely to develop a deep infection (95% confidence interval 1.2–83, p = 0.034). Conclusion: Delaying soft tissue coverage of open tibia fractures for over a week increases the risk of deep infection and revision surgery.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139964084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-13DOI: 10.1177/22104917231225971
Wong Chi Kuen, L. Kay, Shen Wan Yiu
Background and Literature Review: The Reamer-Irrigator-Aspirator (RIA) and RIA2 system have been gaining popularity for their application in autologous bone graft harvest, followed by intramedullary canal clearance and nail fixation in the past two decades. However, there have been only few studies on the use of newer RIA2 system. Current literature suggests that the prevalence of complications associated with RIA system varied from 0.7% to 11.9%. Among those complications, cortex perforation is the most commonly reported, followed by cardiopulmonary complications, wound infection, low energy fracture, and RIA device failure. In this study, we also illustrated a rare complication of device failure—breakage of reamer head with metallic debris retention in RIA2. Illustrative Case: The RIA2 system was used for autologous bone graft harvest in a young overweight man with significant tibial bone defect. During the harvest procedure, the reamer head broke in the femoral canal. There were retained metallic prongs inside the canal, which were retrieved and removed by different devices. Conclusion: The usage, efficacy, and safety of RIA and RIA2 system are deemed promising with proper indication, patient selection, and judicious surgical technique. Broken reamer head with retained metal debris is a rarely reported complication in RIA2 system. Mechanical, implant and patient factors possibly contribute to this complication. Preventive recommendations are also discussed in this study.
{"title":"A review on application and complications associated with Reamer Irrigator Aspirator (RIA) and RIA2 in autologous bone graft harvest","authors":"Wong Chi Kuen, L. Kay, Shen Wan Yiu","doi":"10.1177/22104917231225971","DOIUrl":"https://doi.org/10.1177/22104917231225971","url":null,"abstract":"Background and Literature Review: The Reamer-Irrigator-Aspirator (RIA) and RIA2 system have been gaining popularity for their application in autologous bone graft harvest, followed by intramedullary canal clearance and nail fixation in the past two decades. However, there have been only few studies on the use of newer RIA2 system. Current literature suggests that the prevalence of complications associated with RIA system varied from 0.7% to 11.9%. Among those complications, cortex perforation is the most commonly reported, followed by cardiopulmonary complications, wound infection, low energy fracture, and RIA device failure. In this study, we also illustrated a rare complication of device failure—breakage of reamer head with metallic debris retention in RIA2. Illustrative Case: The RIA2 system was used for autologous bone graft harvest in a young overweight man with significant tibial bone defect. During the harvest procedure, the reamer head broke in the femoral canal. There were retained metallic prongs inside the canal, which were retrieved and removed by different devices. Conclusion: The usage, efficacy, and safety of RIA and RIA2 system are deemed promising with proper indication, patient selection, and judicious surgical technique. Broken reamer head with retained metal debris is a rarely reported complication in RIA2 system. Mechanical, implant and patient factors possibly contribute to this complication. Preventive recommendations are also discussed in this study.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"18 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139964563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-11DOI: 10.1177/22104917231225968
Jittima Saengsuwan, P. Sirasaporn
To examine shoulder ultrasound imaging in both tetraplegic and paraplegic spinal cord injury (SCI) patients with shoulder pain. All 28 individuals with SCI with shoulder pain were enrolled in this study. Fifty-six shoulders were evaluated by ultrasound (US) imaging. Fourteen tetraplegics and 14 paraplegics were enrolled (age 45.4 ± 13.8 years [mean ± SD]). Median time post-SCI was 8.6 years. Twenty-three individuals (82.1%) were independent in transfer and four individuals (14.3%) were partially independent in transfer. The prevalence of shoulder pain was 78.6% in manual wheelchair ambulators, 10.7% in gait aids users, 7.1% in wheelchair sitters, and 3.6% in no assistive device individuals. Abnormal US imaging was found in 24/28 (85.7%) individuals. Total shoulder US abnormalities were 38 units. Most common abnormal US imaging was supraspinatous tendinosis (42.1%), biceps tendon effusion (23.7%), positive dynamic supraspinatus impingement (21.1%), and subdeltoid bursitis (18.4%). Shoulder ultrasonographic abnormalities were common in the patients with SCI with shoulder pain. The supraspinatus tendinosis is the most common abnormal US imaging in patients with SCI with shoulder pain.
{"title":"Ultrasound imaging in spinal cord injury patients with shoulder pain","authors":"Jittima Saengsuwan, P. Sirasaporn","doi":"10.1177/22104917231225968","DOIUrl":"https://doi.org/10.1177/22104917231225968","url":null,"abstract":"To examine shoulder ultrasound imaging in both tetraplegic and paraplegic spinal cord injury (SCI) patients with shoulder pain. All 28 individuals with SCI with shoulder pain were enrolled in this study. Fifty-six shoulders were evaluated by ultrasound (US) imaging. Fourteen tetraplegics and 14 paraplegics were enrolled (age 45.4 ± 13.8 years [mean ± SD]). Median time post-SCI was 8.6 years. Twenty-three individuals (82.1%) were independent in transfer and four individuals (14.3%) were partially independent in transfer. The prevalence of shoulder pain was 78.6% in manual wheelchair ambulators, 10.7% in gait aids users, 7.1% in wheelchair sitters, and 3.6% in no assistive device individuals. Abnormal US imaging was found in 24/28 (85.7%) individuals. Total shoulder US abnormalities were 38 units. Most common abnormal US imaging was supraspinatous tendinosis (42.1%), biceps tendon effusion (23.7%), positive dynamic supraspinatus impingement (21.1%), and subdeltoid bursitis (18.4%). Shoulder ultrasonographic abnormalities were common in the patients with SCI with shoulder pain. The supraspinatus tendinosis is the most common abnormal US imaging in patients with SCI with shoulder pain.","PeriodicalId":517288,"journal":{"name":"Journal of Orthopaedics, Trauma and Rehabilitation","volume":"41 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139895133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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