The bone & joint journal
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The bone & joint journal · Jun 2020
Clinical TrialThe management of emergency spinal surgery during the COVID-19 pandemic in Italy.
The current pandemic caused by COVID-19 is the biggest challenge for national health systems for a century. While most medical resources are allocated to treat COVID-19 patients, several non-COVID-19 medical emergencies still need to be treated, including vertebral fractures and spinal cord compression. The aim of this paper is to report the early experience and an organizational protocol for emergency spinal surgery currently being used in a large metropolitan area by an integrated team of orthopaedic surgeons and neurosurgeons. ⋯ The structural organization and the management protocol we describe allowed us to reduce the time to surgery and ultimately hospital stay, thereby maximizing the already stretched medical resources available. We hope that our early experience can be of value to the medical communities that will soon be in the same emergency situation. Cite this article: Bone Joint J 2020;102-B(6):671-676.
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The bone & joint journal · Jun 2020
Comparative StudyModern full-component aseptic revision total knee arthroplasties have similar recoveries compared with primary total knee arthroplasty patients when applying an enhanced recovery anaesthetic and analgesic protocol.
Enhanced perioperative protocols have significantly improved patient recovery following primary total knee arthroplasty (TKA). Little has been investigated the effectiveness of these protocols for revision TKA (RTKA). We report on a matched group of aseptic revision and primary TKA patients treated with an identical pain and rehabilitation programmes. ⋯ An identical pain and rehabilitation protocol used for primary TKA patients can enable certain full-component aseptic RTKA patients to have a similar early functional outcome. Cite this article: Bone Joint J 2020;102-B(6 Supple A):96-100.
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The bone & joint journal · Jun 2020
A prospective study of the role of bladder scanning and post-void residual volume measurement in improving diagnostic accuracy of cauda equina syndrome.
Diagnosis of cauda equina syndrome (CES) remains difficult; clinical assessment has low accuracy in reliably predicting MRI compression of the cauda equina (CE). This prospective study tests the usefulness of ultrasound bladder scans as an adjunct for diagnosing CES. ⋯ This is the largest reported prospective evaluation of suspected CES. Use of the PVR volume ≥ 200 ml was considerably more accurate in predicting CES. It is a useful adjunct to conventional clinical assessment and allows risk-stratification in managing suspected CES. If adopted widely it is less likely incomplete CES would be missed. Cite this article: Bone Joint J 2020;102-B(6):677-682.
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The bone & joint journal · Jun 2020
Impact of chemotherapy-induced necrosis on event-free and overall survival after preoperative MAP chemotherapy in patients with primary high-grade localized osteosarcoma.
To assess the correlation between the histological response to preoperative chemotherapy and event-free survival (EFS) or overall survival (OS) in patients with high-grade localized osteosarcoma. ⋯ Chemotherapy-induced necrosis in the resected specimen showed positive correlation with EFS and OS in patients with high-grade localized osteosarcoma after MAP chemotherapy. In our analysis, optimal cut-off values of MAP chemotherapy-induced necrosis in EFS and OS were lower than the commonly used 90%, suggesting the need for re-evaluation of the optimal cut-off value through larger, international collaborative research. Cite this article: Bone Joint J 2020;102-B(6):795-803.
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The bone & joint journal · Jun 2020
Predicting implant size in total knee arthroplasty using demographic variables.
The purpose of this investigation was to determine the relationship between height, weight, and sex with implant size in total knee arthroplasty (TKA) using a multivariate linear regression model and a Bayesian model. ⋯ Implant size was correlated with basic demographic variables including height, weight, and sex. The linear regression and Bayesian models accurately predicted required implant sizes across multiple manufacturers based on height, weight, and sex alone. These types of predictive models may help improve operating room and implant supply chain efficiency. Level of Evidence: Level IV Cite this article: Bone Joint J 2020;102-B(6 Supple A):85-90.