International orthopaedics
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Propionibacterium acnes (P. acnes), an important opportunistic anaerobic Gram-positive bacterium, causes bone and joint infections, discitis and spondylodiscitis. Accumulated evidence suggested that this microbe can colonise inside intervertebral discs without causing symptoms of discitis. Epidemiological investigation shows that the prevalence ranges from 13 % to 44 %. ⋯ However, until now, there were hypotheses only to explain problems such as how P. acnes access intervertebral discs and what the exact pathological mechanism it employs during its latent infection period. In addition, research regarding diagnostic procedures and treatment strategies were also rare. Overall, the prevalence and possible pathological role that P. acnes plays inside nonpyogenic intervertebral discs is summarised in this paper.
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Review Meta Analysis
Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.
The methods for pain control after total knee arthroplasty (TKA) vary and have been extensively studied in recent years. Femoral nerve block (FNB) is used as the standard method due to its effective pain control following TKA, but it may weaken the quadriceps strength. Adductor canal block (ACB) is a newly developing analgesic protocol with fast functional recovery and good pain control after TKA. A meta-analysis was conducted to try to find out if ACB is better than FNB in pain treatment and joint functional recovery after TKA. ⋯ ACB provide better ambulation ability, faster functional recovery and better pain control at rest after TKA compared to FNB. The use of ACB post TKA is worthy of being recommended to replace FNB as a standard analgesic protocol for pain treatment after TKA.
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Review Meta Analysis
Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.
The methods for pain control after total knee arthroplasty (TKA) vary and have been extensively studied in recent years. Femoral nerve block (FNB) is used as the standard method due to its effective pain control following TKA, but it may weaken the quadriceps strength. Adductor canal block (ACB) is a newly developing analgesic protocol with fast functional recovery and good pain control after TKA. A meta-analysis was conducted to try to find out if ACB is better than FNB in pain treatment and joint functional recovery after TKA. ⋯ ACB provide better ambulation ability, faster functional recovery and better pain control at rest after TKA compared to FNB. The use of ACB post TKA is worthy of being recommended to replace FNB as a standard analgesic protocol for pain treatment after TKA.
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Periprosthetic fractures (PPFs) after total knee arthroplasty (TKA), especially in patients with multiple revisions, remain challenging mainly due to bone quality and loss of bone stock. Megaprostheses, although providing immediate stability and weight bearing, are rarely used in this indication. The aim of the study was to provide a description of the surgical technique and evaluate the outcome of this technique with respectable published data. ⋯ Megaprostheses represent a valuable option in distal femoral PPFs type 3 according to Su et al., as well as proximal tibia PPFs type 1B according to Felix et al., with loose tibial components. Infection remains the most frequent nonmechanical complication. Prospective clinical studies are required to exactly define the outcome of this technique in PPFs; use of the Henderson classification system would allow comparison between megaprostheses in oncological and nononcological indications.
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Periprosthetic fractures (PPFs) after total knee arthroplasty (TKA), especially in patients with multiple revisions, remain challenging mainly due to bone quality and loss of bone stock. Megaprostheses, although providing immediate stability and weight bearing, are rarely used in this indication. The aim of the study was to provide a description of the surgical technique and evaluate the outcome of this technique with respectable published data. ⋯ Megaprostheses represent a valuable option in distal femoral PPFs type 3 according to Su et al., as well as proximal tibia PPFs type 1B according to Felix et al., with loose tibial components. Infection remains the most frequent nonmechanical complication. Prospective clinical studies are required to exactly define the outcome of this technique in PPFs; use of the Henderson classification system would allow comparison between megaprostheses in oncological and nononcological indications.