Does postoperative low-dose duloxetine provide analgesic effect and lower morphine consumption after primary total knee arthroplasty? A prospective, double-blind, randomized controlled trial.

Introduction: Duloxetine as an adjunct analgesic has shown effective results in trials of patients undergoing total knee arthroplasty (TKA). However, the regimen has not been standardized. We, therefore, evaluated the analgesic efficacy of low-dose duloxetine after TKA.

Comparison of Functional Recovery Between Unicompartmental and Total Knee Arthroplasty: A Randomized Controlled Trial.

Background: Comparisons of functional recovery between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) using performance-based tests are lacking. Therefore, this study aimed to compare 2-minute walk test (2MWT) and Timed Up-and-Go test (TUG) results between UKA and TKA for isolated medial knee osteoarthritis (OA). We hypothesized that UKA yields faster functional recovery than TKA as measured with the 2MWT and TUG.

Novel molded antibiotic cement spacer: is it better than handmade cement spacer for treatment of chronically infected total hip arthroplasty?

Purpose: A handmade antibiotic cement spacer is the easiest method for producing a spacer for treating chronic periprosthetic joint infection after total hip arthroplasty (THA). However, a molded spacer offers more head and stem sizes to match the patient's anatomy. The purpose of this study was to evaluate the functional outcomes and complications between handmade and molded spacers.

Does Nefopam Provide Analgesic Effect and Reduce Morphine Consumption After Primary Total Knee Arthroplasty? A Prospective, Double-Blind, Randomized Controlled Trial.

Background: One of the most undesirable results after total knee arthroplasty (TKA) is severe immediate postoperative pain, resulting in patient dissatisfaction. We aimed to evaluate nefopam's analgesic efficacy after primary TKA along with related outcomes, including morphine consumption and adverse events.

Methods: We conducted a double-blind, randomized controlled trial of patients undergoing unilateral primary TKA, comparing 24 hours of 80 mg of continuous intravenous nefopam to placebo infusion.

Efficacy and Systemic Absorption of Peri-articular Versus Intra-articular Administration of Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.

Background: Tranexamic acid (TXA) is widely accepted as an effective method for reducing blood loss after total knee arthroplasty (TKA). As different routes of local TXA administration have been proposed to minimize systemic complications, we aimed to investigate the effectiveness and systemic absorption of peri-articular (PA) and intra-articular (IA) administration of TXA after primary TKA.

Methods: In a randomized controlled trial of patients scheduled for unilateral primary TKA, 108 were assigned to receive PA-TXA (15 mg/kg), IA-TXA (2 g), or no TXA injection.

Modified Kerboul Angle Predicts Outcome of Core Decompression With or Without Additional Cell Therapy.

Background: Core decompression is the most common procedure for early-stage osteonecrosis of the femoral head (ONFH). This study investigated outcomes of core decompression with/without bone marrow aspirate concentrate (BMAC), based on the Kerboul combined necrotic angles using magnetic resonance imaging.

Methods: We reviewed 66 patients (83 hips) with early ONFH, Association Research Circulation Osseous stages I-IIIa, who underwent core decompression alone (26 patients, 33 hips) or in combination with BMAC (40 patients, 50 hips).

Effect of Different Tourniquet Pressure on Postoperative Pain and Complications After Total Knee Arthroplasty: A Prospective, Randomized Controlled Trial.

Background: Tourniquet pressure inflation is commonly selected between 100 and 150 mm Hg above the systolic blood pressure (SBP). Given the lack of evidence to support a given inflation pressure, our study aimed to ascertain the lowest tourniquet pressure that facilitated total knee arthroplasty (TKA) and resulted in the least postoperative pain and complications.

Methods: In a double-blind, randomized controlled trial of patients scheduled for unilateral primary TKA, 150 were assigned to use tourniquet pressures of SBP + 75 mm Hg (group I), SBP + 100 mm Hg (group II), and SBP + 150 mm Hg (group III).

The effect of immediate post-operative knee range of motion photographs on post-operative range of motion after total knee arthroplasty : An assessor-blinded randomized controlled clinical trial in sixty patients.

Purpose: We attempted to determine the effect of immediate post-operative knee range of motion (ROM) photographs on improving ROM after total knee arthroplasty (TKA).

Methods: Sixty patients, scheduled for unilateral primary TKA, were randomized into two groups. The photo group (n = 30) were immediately shown post-TKA knee ROM photographs as motivation for rehabilitation.

Outcomes of Cemented Total Knee Arthroplasty for Secondary Osteonecrosis of the Knee.

Background: Secondary osteonecrosis of the knee (SOK) generally occurs in relatively young patients; at advanced stages of SOK, the only viable surgical option is total knee arthroplasty (TKA). We conducted a retrospective study to investigate implant survivorship, clinical and radiographic outcomes, and complications of contemporary cemented bicompartmental TKA with/without patellar resurfacing for SOK.

Methods: Thirty-eight cemented TKAs in 27 patients with atraumatic SOK, mean age 43 years (17 to 65), were retrospectively reviewed.

Initial Presentation and Progression of Secondary Osteonecrosis of the Knee.

Background: Early detection and intervention are critical to maintaining the native articular cartilage before collapse in secondary osteonecrosis of the knee (SOK). We conducted a retrospective study documenting the initial stage of presentation and the progression of SOK.

Methods: Our database was reviewed for patients younger than 65 years of age diagnosed with atraumatic SOK between 2002 and 2018.

Diagnosis of Osteonecrosis of the Femoral Head: Too Little, Too Late, and Independent of Etiology.

Background: Joint preservation is more effective in early-stage osteonecrosis of the femoral head (ONFH); thus, prompt diagnosis when the femoral head is still salvageable is important. We report a 20-year retrospective study that summarizes age at presentation, etiology, and Association Research Circulation Osseous stage at diagnosis.

Methods: Our database was reviewed to identify patients younger than 65 years of age who were diagnosed with atraumatic ONFH between 1998 and 2018.

A new method for measurement of the size of subacromial spurs of the shoulder by cassette tilt view.

Objective: Subacromial impingement syndrome is one of the most common causes of pain in the shoulder. To this date, there is no specific radiographic view that can be used to evaluate the size of a subacromial spur. This study aims to examine a cassette tilt view can be used to evaluate the size of a subacromial spur.

Outcomes of mobile bearing unicompartmental knee arthroplasty in medial osteoarthritis knee with and without preoperative genu recurvatum.

Aim: To compare clinical outcomes of patients with and without preoperative genu recurvatum (GR) following mobile bearing unicompartmental knee arthroplasty (UKA).

Methods: We prospectively followed 176 patients for at least 24 mo who had been treated by unilateral, minimally invasive, Oxford UKA. Patients with medial osteoarthritis (OA) knee and preoperative GR (Group I) accounted for 18% ( = 32) and patients without preoperative GR (Group II) accounted for the remaining 82% ( = 144).

Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis.

Background: Theoretically, potential errors in femoral component (FC) sizing can affect postoperative functional outcomes after total knee arthroplasty (TKA), including range of motion (ROM), anterior knee pain, and flexion stability. Incidences of asymmetrical femoral components (AFC) in bilateral TKA have been reported; however; there is a lack of data on exactly why AFC size selection may differ in patients who have had posterior referencing system bilateral TKA. Therefore, this study was conducted to determine risk factors of AFC size selection in patients specifically undergoing posterior referencing bilateral TKA and to compare clinical outcomes between those with AFC or symmetrical femoral component (SFC) sizes.

Is Regular Knee Radiograph Reliable Enough to Assess the Knee Prosthesis Position?

Background: Proper knee alignment and prosthesis position may theoretically provide better surgical results and increase longevity of total knee arthroplasty. The 3-feet standing long radiograph (LR) is the gold standard for assessment of these parameters. However, the conventional standing regular knee radiograph (RR) is still being used because of convenience and lower cost.

Effectiveness Testing of Combined Innovative Pressurized Carbon Dioxide Lavage and Pulsatile Normal Saline Irrigation to Enhance Bone Cement Penetration in Total Knee Replacement: A Cadaveric Study.

Background: The cementing technique in total knee arthroplasty (TKA) is essential for a successful outcome. Previous studies have shown that deeper cement penetration results in greater tensile and shear strength between the bony part and the prosthetic parts. Objective:

Objective: To investigate the effectiveness of combined innovative pressurized carbon dioxide lavage and pulsatile normal saline irrigation for enhancing cement penetration into cancellous bone, as compared with standard pulsatile normal irrigation alone.

Vertical pelvic ring displacement in pelvic ring injury: Measurements in pelvic outlet radiograph and in cadavers.

Background: Vertical pelvic ring displacement (VPRD) is a serious injury and needs assessment. Pelvic outlet radiographs are routinely taken. However, relationship of radiographic and actual VPRD is still in question.

Sterility verification of innovative pressurized carbon dioxide lavage for bone surface preparation in cemented knee arthroplasty.

Objective: To verify sterility of innovative pressurized carbon dioxide (CO) lavage for bone surface preparation in cemented knee arthroplasty.

Material And Method: Twenty-five 500 L. air samples from the innovative pressurized CO, lavage were laboratory tested to verify the presence or absence of either bacteria or fungi in microbial air samplings taken in a biological safety cabinet.

The comparative study of reliability and reproducibility of distal radius' fracture classification among: AO frykman and Fernandez classification systems.

Objective: To study the reliability and reproducibility ofdistal radius fracture classification in plain radiographs.

Material And Method: Ninety-eight displaced distal radius fractures radiographs were classified in four groups ofobservers. The first group consisted of one senior orthopedics staff and two hand-orthopedic surgeons (with experience ranging from ten to thirty years).