Comparison of prostaglandin E1 and epidural anesthesia for mastectomy.

Hypotensive anesthesia has been used in an attempt to reduce intraoperative blood loss. Although both epidural anesthesia and vasodilators have been used to establish the controlled hypotensive anesthesia, little is known about the differences between the two method. We compared epidural anesthesia and prostaglandin (PG) El in patients scheduled for total mastectomy.

Usefulness of interposition arthroplasty in the Sauvé-Kapandji procedure for rheumatoid wrist.

The aim of synovectomy combined with the Sauvé-Kapandji (S-K) procedure for the treatment of a rheumatoid wrist is to obtain a stable painless wrist that retains sufficient mobility for function. However, loss of motion occurs postoperatively in most cases. In our study of 59 rheumatoid patients, the results of the transposition of distal strips of retinaculum into the radiocarpal and ulnocarpal joints for interposition arthroplasty to maintain wrist motion (interposition group), and transposition below the extensors to provide a gliding surface (SK group) were evaluated.

Examination of the risk of continuous leflunomide treatment on the incidence of infectious complications after joint arthroplasty in patients with rheumatoid arthritis.

To determine whether the risk of infectious complications after total joint arthroplasty is increased in rheumatoid arthritis patients who are treated continuously with leflunomide, the incidences of infectious complications in 41 rheumatoid arthritis patients who received continuous leflunomide treatment (leflunomide group) and in 41 patients who did not receive leflunomide within 4 weeks of surgery (nonleflunomide group) were compared. The incidence (6.1%) of local infection after surgery in the leflunomide group (82 procedures) was slightly lower than that (6.

Arthroscopic and open synovectomy of the elbow in rheumatoid arthritis.

Background: Synovectomy has been advocated for early treatment of the rheumatoid elbow. It has not been determined whether arthroscopic or open synovectomy is better and whether a preoperative arc of flexion of >90 degrees is an important prognostic factor.

Methods: Arthroscopic or open synovectomy was performed in fifty-eight elbows in fifty-three patients with rheumatoid arthritis and radiographic changes in the joint of Larsen grade 2 or less.

Augmented subscapularis muscle transposition for rotator cuff repair during shoulder arthroplasty in patients with rheumatoid arthritis.

The effectiveness of rotator cuff repair by augmented subscapularis transposition via the Leeds-Keio artificial ligament was evaluated in patients with rheumatoid arthritis undergoing total shoulder arthroplasty. The minimum follow-up period was 2 years. Final clinical scores (Hospital for Special Surgery scoring system) and the incidence of radiolucency and upward migration of shoulder components in 20 shoulders with rotator cuff repair by augmented subscapularis transposition were superior to those of 19 shoulders with cuff repair by subscapularis transposition alone and similar to those of 22 shoulders with intact rotator cuffs.

Volume of a wash and the other conditions for maximum therapeutic effect of arthroscopic lavage in rheumatoid knees.

The objective of this study was to determine the appropriate volume of saline to obtain a beneficial effect of arthroscopic lavage and the prognostic factors related to the clinical effect in a refractory rheumatoid knee. Arthroscopic lavage or arthrocentesis was performed in a random manner in 142 patients with relapsing rheumatoid arthritis. All patients were followed up for 24 months.

Usefulness of bioabsorbable thread pins after resection arthroplasty for rheumatoid forefoot reconstruction.

Background: Bioabsorbable thread pin has been used for internal fixation of bone. The results of resection arthroplasty of the lesser metatarsophalangeal (MTP) joints using internal intramedullary fixation with bioabsorbable pins have not been reported.

Methods: Resection arthroplasty of the MTP joints of the lesser toes with poly-L-lactic acid (PLLA) thread pins or Kirschner wires was performed at random in reconstruction of the 87 rheumatoid forefeet (62 patients) with a grommet-protected silicone-rubber implant insertion of the first MTP joint.

Synovial membrane enhancement and bone erosion by magnetic resonance imaging for prediction of radiologic progression in patients with early rheumatoid arthritis.

Objective: The aim of this study was to determine the prognostic factors related to radiographic progression in patients with early rheumatoid arthritis (RA) (less than 1 year after onset) undergoing enhanced MRI at entry.

Methods: Demographic characteristics, disease duration, and enhanced MRI of the dominant wrists were recorded at entry. Duration of morning stiffness, number of swollen joints, serum rheumatoid factor (RF), erythrocyte sedimentation rate, C-reactive protein (CRP) level, and radiographs of hands and feet (Sharp/van der Heijde score) were assessed at each follow-up.

Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as treatment for rheumatoid knees with joint effusion.

Objective: The aim of this study was to find if a complete synovial fluid aspiration before injection of intra-articular high molecular weight hyaluronan influences the treatment result for knees with rheumatoid arthritis (RA), including joint effusion and the prognostic factors related to clinical effect.

Methods: The arthritic knees including effusion were randomized to arthrocentesis or no arthrocentesis before the hyaluronan (1.9-2.