Orthopedics
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Comparative Study
Primary ceramic-on-ceramic total hip replacement versus metal-on-metal hip resurfacing in young active patients.
The purpose of this study was to compare clinical outcomes between ceramic-on-ceramic total hip replacement and metal-on-metal hip resurfacing arthroplasty in comparable groups of young active patients at a 3- to 6-year follow-up. The first 250 patients (mean age, 49.54 years) of a series of 930 resurfacing arthroplasties were compared clinically and functionally with a series of 190 patients (mean age, 46.76 years) with ceramic-on-ceramic uncemented total hip prostheses. The total Harris hip score was 97.9 in the resurfacing group vs 92.1 in the ceramic group. In the resurfacing group, 60.71% had a strenuous activity level vs 30.43% in the ceramic group.
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Successful postoperative pain management after arthroscopic shoulder surgery allows patients to go home earlier, decreases the potential for hospital readmission, and facilitates rehabilitation. Optimal pain control considers the physiological and psychological states of the patient, the resulting alterations due to the surgery, and the technical and economic resources available during recovery. A comprehensive approach to pain control should include preoperative, intraoperative, and postoperative efforts. ⋯ Preoperative analgesia should be administered. Intraoperative efforts should include the administration of anesthetic medication intra-articularly. Postoperative management should include sleep medication, continuous cold-flow therapy, oral analgesics, and, if necessary, the use of narcotics.
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Linezolid is the first in a new group of antibiotics called oxazolidinones. As a potent antimicrobial, it has activity against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, penicillin-resistant Streptococcus pneumoniae, and macrolide-resistant streptococci. There are several documented case reports of serotonin toxicity when used with selective serotonin reuptake inhibitors. ⋯ Patients who commonly require linezolid as an antimicrobial are those with complex infections where other antibiotic treatment has failed. It is therefore important to be vigilant with linezolid use. Physicians should be aware of the nonspecific presentation of serotonin symptoms and the treatment.
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Skeletal osteochondromas or osteocartilaginous exostoses represent the most common of all benign bone tumors and 10% to 15% of all bone tumors. Osteochondromas are solitary or multiple, pedunculated or sessile exophytic outgrowths from the bone surface that are composed of cortical and medullary bone with an overlying hyaline cartilage cap. ⋯ After adolescence and skeletal maturity, osteochondromas usually exhibit no further growth. In adults, growth or imaging alterations of an osteochondroma suggest the rare diagnosis of malignant transformation; however, extensive growth of osteochondromas without histological evidence of malignancy has been reported
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Comparative Study Controlled Clinical Trial
Comparison between pointer-based and ultrasound-based navigation technique in THA using a minimally invasive approach.
The use of navigation techniques in primary total hip arthroplasty improves the position of endoprosthetic components, especially cup positioning. An intraoperative registration of the anterior pelvic plane is necessary to define the anteversion and inclination angles on the acetabular side. ⋯ Findings show more accurate postoperative radiographic anteversion with ultrasound navigation, although both manual pointer palpation and ultrasound registration techniques show a very small standard deviation in anteversion, inclination, and leg length difference. In conclusion, we recommend navigation as a very reliable tool for the positioning of implants.