Total knee arthroplasty （TKA） can contribute to significant pain for the patient. Continuous peripheral nerve blocks （CPNBs） have been shown to be efficacious in treating post-surgical pain. The objective of this ...Total knee arthroplasty （TKA） can contribute to significant pain for the patient. Continuous peripheral nerve blocks （CPNBs） have been shown to be efficacious in treating post-surgical pain. The objective of this study is to determine the efficacy of a bupivacaine 0.2% solution administered via CPNB plus standard of care （SOC） compared to SOC alone. SOC for this institution includes the use of opioid analgesics, non-opioid analgesics, regional anesthesia, and other adjuncts. The primary outcome is the overall use of post-operative pain medication. Secondary outcomes include the average length of stay and average pain scores. Methods： A data surveillance system was used to retrospectively identify all patients who underwent TKA with and without the use of CPNB. To be included, patients must have been male or female ≥ 18 years of age who underwent TKA from September 2016 through September 2017. And 70 patients were included in both the CPNB and SOC groups. A retrospective chart review determined the following data： The types and amounts of pain medications used, the length of stay, and patient-reported pain scores. Results： There was an increase in the amount of as needed pain medication use in the CPNB ＋ SOC vs. SOC group with 12.97 administrations vs. 12.67 administrations respectively. Length of stay was increased in the CPNB ＋ SOC vs. SOC group with 3.65 days in the CPNB ＋ SOC group vs. 3.5 days in the SOC group. Pain scores were increased in the CPNB ＋ SOC group with a patient average pain score of 4.5 vs. the SOC groups average pain score of 4.4. Conclusions： The use of a 0.2% bupivacaine solution administered via CPNB in addition to SOC resulted in increased utilization of as needed pain medication administration, increased average length of stay, and increased average pain scores when compared to SOC alone.展开更多
Objective:To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament (ACL)and posterior cruciate ligament(PCL) simultaneously by using allograft patellar tendon under arthroscopy. Meth...Objective:To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament (ACL)and posterior cruciate ligament(PCL) simultaneously by using allograft patellar tendon under arthroscopy. Methods:From May 2003 to November 2005,10 cases of ruptured ACL and PCL were fixated with compressed screws and reconstructed under arthroscopy with allograft patellar tendon simultaneously.The clinical results were evaluated according to IKDC,Lysholm,and Tegner clinical rating scales. Results:All patients were followed up for 12-30 months(mean:18 months).At the last follow-up,there was no knee extension limitation and knee flexion was between 120°and 135°,with an average of 128.38°.The Lysholm score of the 10 cases was 66.5±5.6 before operation and 89.8±3.4 at last follow up.The difference was statistically significant(P<0.01).The average Tegner activity score decreased from 6.9±1.7(range.4-9)before injury to 5.5±1.6(rang:2-9)at the follow-up (P=0.53).At the end of follow-up,IKDC score was graded as A in 4 cases(40.0%),B in 5(50.0%),and C in 1(10.0%).Of the 10 patients,8 returned to the same sports level as before injury and 2 were under the level. Conclusion:Arthroscopic combined reconstruction of ACL and PCL with allograft patellar tendon has the advantages of minimal trauma in surgery and reliable satisfactory outcome.展开更多
Objective： To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat varus knee in young and active patients. Methods： Between June 2001 to July 2008, 18 patients...Objective： To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat varus knee in young and active patients. Methods： Between June 2001 to July 2008, 18 patients with monocompartmental degeneration of the knee combined with a varus malalignment of the leg had the modified biplanar opening high tibial osteotomy and the osteotomy was fixed with the locking plates （Locking Compression Plate System）. The mean varus deformity before operation was 11.5° （5°- 19°） and no degenerative changes were found in other departments. Stability of the knee was normal in 15 patients, but ruptures in anterior cruciate ligaments or lateral collateral ligament were presented in the remaining 3 patients. Preoperative symptom was mainly limited in the pain of medial compartment. The preoperative and follow-up data for the range of motion and Lysholm score were determined. Subjective satisfactory examination was also applied to the patients for the operation they selected. Results： All of the patients were followed up with an average of 32.5 months （12-82 months）. There was no ununion or delayed union in this group during the follow-up period. No complications like broken plate, nerve injury, or blood vessel injury occurred. The postoperative average corrected degree was 9.5° （5.5°-18°）. No degenerations developed in the three departments of the knee. The Lysholm scores before and after surgery were 42.5 and 77.5, respectively （P〈0.01）. The overall fineness rate was 83.3%. The subjective satisfactory survey demonstrated that about 83.3% patients showed satisfactory on the operation. There was no obvious difference in the range of motion before and after operation, but significant changes were found in the Lysholm score and varus degree from preoperative to follow-up. Conclusion： Proximal opening high tibial osteotomy performed in conjunction with the special rigid locking plate yielded good results for symptomatic genu varum. This new classic technique can be effectively applied to the medial compartment degeneration of the knee in active young patients.展开更多
OBJECTIVE: To analyze the component law of Chinese medicines in fuming-washing therapy for knee osteoarthritis(KOA), and develop new fuming-washing prescriptions for KOA through unsupervised data mining methods.METHOD...OBJECTIVE: To analyze the component law of Chinese medicines in fuming-washing therapy for knee osteoarthritis(KOA), and develop new fuming-washing prescriptions for KOA through unsupervised data mining methods.METHODS: Chinese medicine recipes for fuming-washing therapy for KOA were collected and recorded in a database. The correlation coefficient among herbs, core combinations of herbs, andnew prescriptions were analyzed using modified mutual information, complex system entropy cluster, and unsupervised hierarchical clustering, respectively.RESULTS: Based on analysis of 345 Chinese medicine recipes for fuming-washing therapy, 68 herbs occurred frequently, 33 herb pairs occurred frequently, and 12 core combinations were found.Five new fuming-washing recipes for KOA were developed.CONCLUSION: Chinese medicines for fuming-washing therapy of KOA mainly consist of wind-dampness-dispelling and cold-dispersing herbs, blood-activating and stasis-resolving herbs,and wind-dampness-dispelling and heat-clearing herbs. The treatment of fuming-washing therapy for KOA also includes dispelling wind-dampness and dispersing cold, activating blood and resolving stasis, and dispelling wind-dampness and clearing heat. Zhenzhutougucao(Herba Speranskiae Tuberculatae), Honghua(Flos Carthami), Niuxi(Radix Achyranthis Bidentatae), Shenjincao(Herba Lycopodii Japonici), Weilingxian(Radix et Rhizoma Clematidis Chinensis), Chuanwu(Radix Aconiti), Haitongpi(Cortex Erythrinae Variegatae), Ruxiang(Olibanum),Danggui(Radix Angelicae Sinensis), Caowu(Radix Aconiti Kusnezoffii), Moyao(Myrrha), and Aiye(Folium Artemisiae Argyi) are the main herbs used in the fuming-washing treatment for KOA.展开更多
文摘Total knee arthroplasty （TKA） can contribute to significant pain for the patient. Continuous peripheral nerve blocks （CPNBs） have been shown to be efficacious in treating post-surgical pain. The objective of this study is to determine the efficacy of a bupivacaine 0.2% solution administered via CPNB plus standard of care （SOC） compared to SOC alone. SOC for this institution includes the use of opioid analgesics, non-opioid analgesics, regional anesthesia, and other adjuncts. The primary outcome is the overall use of post-operative pain medication. Secondary outcomes include the average length of stay and average pain scores. Methods： A data surveillance system was used to retrospectively identify all patients who underwent TKA with and without the use of CPNB. To be included, patients must have been male or female ≥ 18 years of age who underwent TKA from September 2016 through September 2017. And 70 patients were included in both the CPNB and SOC groups. A retrospective chart review determined the following data： The types and amounts of pain medications used, the length of stay, and patient-reported pain scores. Results： There was an increase in the amount of as needed pain medication use in the CPNB ＋ SOC vs. SOC group with 12.97 administrations vs. 12.67 administrations respectively. Length of stay was increased in the CPNB ＋ SOC vs. SOC group with 3.65 days in the CPNB ＋ SOC group vs. 3.5 days in the SOC group. Pain scores were increased in the CPNB ＋ SOC group with a patient average pain score of 4.5 vs. the SOC groups average pain score of 4.4. Conclusions： The use of a 0.2% bupivacaine solution administered via CPNB in addition to SOC resulted in increased utilization of as needed pain medication administration, increased average length of stay, and increased average pain scores when compared to SOC alone.
文摘Objective:To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament (ACL)and posterior cruciate ligament(PCL) simultaneously by using allograft patellar tendon under arthroscopy. Methods:From May 2003 to November 2005,10 cases of ruptured ACL and PCL were fixated with compressed screws and reconstructed under arthroscopy with allograft patellar tendon simultaneously.The clinical results were evaluated according to IKDC,Lysholm,and Tegner clinical rating scales. Results:All patients were followed up for 12-30 months(mean:18 months).At the last follow-up,there was no knee extension limitation and knee flexion was between 120°and 135°,with an average of 128.38°.The Lysholm score of the 10 cases was 66.5±5.6 before operation and 89.8±3.4 at last follow up.The difference was statistically significant(P<0.01).The average Tegner activity score decreased from 6.9±1.7(range.4-9)before injury to 5.5±1.6(rang:2-9)at the follow-up (P=0.53).At the end of follow-up,IKDC score was graded as A in 4 cases(40.0%),B in 5(50.0%),and C in 1(10.0%).Of the 10 patients,8 returned to the same sports level as before injury and 2 were under the level. Conclusion:Arthroscopic combined reconstruction of ACL and PCL with allograft patellar tendon has the advantages of minimal trauma in surgery and reliable satisfactory outcome.
基金Project (No. 30801167) supported by the National Natural Science Foundation of China
文摘Objective： To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat varus knee in young and active patients. Methods： Between June 2001 to July 2008, 18 patients with monocompartmental degeneration of the knee combined with a varus malalignment of the leg had the modified biplanar opening high tibial osteotomy and the osteotomy was fixed with the locking plates （Locking Compression Plate System）. The mean varus deformity before operation was 11.5° （5°- 19°） and no degenerative changes were found in other departments. Stability of the knee was normal in 15 patients, but ruptures in anterior cruciate ligaments or lateral collateral ligament were presented in the remaining 3 patients. Preoperative symptom was mainly limited in the pain of medial compartment. The preoperative and follow-up data for the range of motion and Lysholm score were determined. Subjective satisfactory examination was also applied to the patients for the operation they selected. Results： All of the patients were followed up with an average of 32.5 months （12-82 months）. There was no ununion or delayed union in this group during the follow-up period. No complications like broken plate, nerve injury, or blood vessel injury occurred. The postoperative average corrected degree was 9.5° （5.5°-18°）. No degenerations developed in the three departments of the knee. The Lysholm scores before and after surgery were 42.5 and 77.5, respectively （P〈0.01）. The overall fineness rate was 83.3%. The subjective satisfactory survey demonstrated that about 83.3% patients showed satisfactory on the operation. There was no obvious difference in the range of motion before and after operation, but significant changes were found in the Lysholm score and varus degree from preoperative to follow-up. Conclusion： Proximal opening high tibial osteotomy performed in conjunction with the special rigid locking plate yielded good results for symptomatic genu varum. This new classic technique can be effectively applied to the medial compartment degeneration of the knee in active young patients.
基金Supported by Grant from the Administration of Traditional Chinese Medicine of Guangdong Province in China(No.20131161)the Specialized Research Fund for the Doctoral Program of Higher Education of China(No.20124425110004)
文摘OBJECTIVE: To analyze the component law of Chinese medicines in fuming-washing therapy for knee osteoarthritis(KOA), and develop new fuming-washing prescriptions for KOA through unsupervised data mining methods.METHODS: Chinese medicine recipes for fuming-washing therapy for KOA were collected and recorded in a database. The correlation coefficient among herbs, core combinations of herbs, andnew prescriptions were analyzed using modified mutual information, complex system entropy cluster, and unsupervised hierarchical clustering, respectively.RESULTS: Based on analysis of 345 Chinese medicine recipes for fuming-washing therapy, 68 herbs occurred frequently, 33 herb pairs occurred frequently, and 12 core combinations were found.Five new fuming-washing recipes for KOA were developed.CONCLUSION: Chinese medicines for fuming-washing therapy of KOA mainly consist of wind-dampness-dispelling and cold-dispersing herbs, blood-activating and stasis-resolving herbs,and wind-dampness-dispelling and heat-clearing herbs. The treatment of fuming-washing therapy for KOA also includes dispelling wind-dampness and dispersing cold, activating blood and resolving stasis, and dispelling wind-dampness and clearing heat. Zhenzhutougucao(Herba Speranskiae Tuberculatae), Honghua(Flos Carthami), Niuxi(Radix Achyranthis Bidentatae), Shenjincao(Herba Lycopodii Japonici), Weilingxian(Radix et Rhizoma Clematidis Chinensis), Chuanwu(Radix Aconiti), Haitongpi(Cortex Erythrinae Variegatae), Ruxiang(Olibanum),Danggui(Radix Angelicae Sinensis), Caowu(Radix Aconiti Kusnezoffii), Moyao(Myrrha), and Aiye(Folium Artemisiae Argyi) are the main herbs used in the fuming-washing treatment for KOA.
