Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Randomized Controlled Trial Clinical TrialArthroscopic cartilage debridement by excimer laser in chondromalacia of the knee joint. A prospective randomized clinical study.
A new operative technique in arthroscopic treatment of chondromalacia using ultraviolet laser systems is introduced. The postoperative results are evaluated in a prospective and randomized clinical trial. One hundred and forty patients stage II or III chondromalacia according to Outerbridge were randomly assigned to arthroscopic operation using either laser or mechanical instruments. ⋯ In the short-term follow-up laser surgery gave superior results in regard to reducing pain (P less than 0.05) and leading to a lower incidence of reactive synovitis (P less than 0.01). No difference was found in respect of disability and functional impairment. Our results lead to the conclusion that arthroscopic laser application seems to be a successful procedure in the treatment of degenerative cartilage disorders, providing precise ablation of tissue without significant thermal damage to the remaining cartilage.
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Arch Orthop Trauma Surg · Jan 1990
Randomized Controlled Trial Clinical TrialAntibiotic prophylaxis in lower-extremity amputations due to ischemia. A prospective, randomized trial of cephalothin versus methicillin.
The efficiency of prophylactic antibiotic therapy in amputation surgery was studied in a prospective, randomized trial of a first-generation cephalosporin (cephalothin) compared with a narrow-spectrum beta-lactam stable penicillin (methicillin). Eighty-eight patients received cephalothin 2 g X 4 on the day of operation, while 86 patients received methicillin 1 g X 4. The patients were followed up for 21 days. ⋯ The reamputation frequency was 18.2% in the cephalothin group compared with 12.8% in the methicillin group; the frequency of below-knee reamputation was 18.4% versus 7.7% (P = 0.1469). No clostridial infections were found. The study did not demonstrate any significant difference between cephalothin and methicillin in the prophylaxis for lower-extremity amputations, although the latter drug tended to be the best choice.
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Arch Orthop Trauma Surg · Jan 1984
Randomized Controlled Trial Clinical TrialEarly results after Colles' fracture: functional bracing in supination vs dorsal plaster immobilization.
A randomized clinical study of functional bracing in supination (FUSU) versus dorsal plaster immobilization (DPI) was conducted in 145 patients with Colles' fracture. A dynamic wrist unit was developed and used in 68 patients allocated for FUSU. The anatomical end result after FUSU was excellent or good in 80% of the patients versus 64% after DPI (P less than 0.05), in particular due to less dorsal angulation (P less than 0.001) and less radial shortening. ⋯ At 6 months, 92% satisfactory results were achieved after FUSU versus 86% after DPI (P less than 0.05). Both anatomical and functional benefits were recorded in Frykman type V, VI, and VIII fractures and in the group of displaced intra-articular fractures. The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation.