Introduction: Platelet-rich plasma (PRP) has gained increasing popularity in the orthopedic field. There has been still no consensus on PRP preparation technique, thus providing a variety of final PRP products. Different preparation techniques lead to different compositions of PRP, which include platelet concentration, the number of leukocytes, and their subtypes.
View Article and Find Full Text PDFIntroduction: Knee osteoarthritis (KOA) is a musculoskeletal disease that leads to pain, stiffness, and deformity of the load-bearing knee joints. Biologic products including platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are now in the spotlight for the treatment of KOA owing to their role of disease-modifying potential effect. There are still limited studies on the survival rate of KOA treated with biological intervention.
View Article and Find Full Text PDFOsteoarthritis (OA) tends to occur in older individuals frequently burdened with comorbidities and diverse pharmacological interactions. As articular cartilage has low regenerative power, potent local tissue engineering approaches are needed to support chondrogenic differentiation. Acellular preparation methods as well as approaches to coax endogenous reparative cells into the joint space appear to have limited success.
View Article and Find Full Text PDFStem Cells Int
September 2017
In this randomized controlled trial, in early osteoarthritis (OA) that failed conservative intervention, the need for total knee arthroplasty (TKA) and WOMAC scores were evaluated, following a combination of arthroscopic microdrilling mesenchymal cell stimulation (MCS) and repeated intra-articular (IA) autologous activated peripheral blood stem cells (AAPBSCs) with growth factor addition (GFA) and hyaluronic acid (HA) versus IA-HA alone. Leukapheresis-harvested AAPBSCs were administered as three weekly IA injections combined with HA and GFA (platelet-rich plasma [PRP] and granulocyte colony-stimulating factor [hG-CSF]) and MCS in group 1 and in group 2 but without hG-CSF while group 3 received IA-HA alone. Each group of 20 patients was evaluated at baseline and at 1, 6, and, 12 months.
View Article and Find Full Text PDFBackground: Trauma or osteoarthritis (OA) create articular cartilage defects that cannot efficiently heal, thus leading to significant long-term disability. Failed conservative treatment in cartilage diseases is a known condition that necessitates repair attempts but current methods are inadequate. Recent studies in OA animal models and humans, showed articular cartilage regeneration following combinations of drilling, adult stem cells, and intra-articular hyaluronic acid.
View Article and Find Full Text PDFBackground: Non-steroidal anti-inflammatory drug (tNSAIDs) or selective COX-II inhibitor (COXIBs) are generally used as the first-line intervention of knee osteoarthritis (OA). Total knee arthroplasty (TKA) is suggested for those who dissatisfy from non-surgical treatment. However the long-term usage of tNSAIDs may lead to articular cartilage and resulted in higher rate of TKA.
View Article and Find Full Text PDFObjective: The primary aim of the present study is to comparison between using narrow and wide saw blade of proximal tibial bone cut in close slot cutting block guide verified by computer navigation system.
Material And Method: The authors evaluated 80 knees in 80 patients. After cutting the proximal tibia, the cutting surface was validated using the navigated cutting block adapter, and the angular difference between the cutting surface and that preoperatively planned in the sagittal and coronal planes was recorded.
Background: Rationale perioperative antibiotic for prevent infection in total knee arthroplasty is well established. The recommendation are preoperative antibiotic should be administered within 1 h before skin incision and prophylactic antibiotics should be administered within 1 h before skin incision, if prolong surgery more than 4-6 hours need addition doses and duration of prophylactic antibiotic administration should not exceed the 24-hour postoperative period then not need for additional antibiotic. If there is evidences of infection, intravenous antibiotic and follow by oral antibiotic is mandatory in acute infection in conjuction with scrub and debridement.
View Article and Find Full Text PDFBackground: A vast amount of literature describes the incidence of fracture as a risk for recurrent osteoporotic fractures in western and Asian countries. Osteoporosis evaluation and treatment after a low-trauma fracture, however, has not been well characterized in postmenopausal women in Asia. The purpose of this study was to characterize patient and health system characteristics associated with the diagnosis and management of osteoporosis among postmenopausal women hospitalized with a fragility fracture in Asia.
View Article and Find Full Text PDFBackground & Aims: We established a working group to examine the burden of atherothrombotic and musculoskeletal diseases in Asia and made recommendations for safer prescribing of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin.
Methods: By using a modified Delphi process, consensus was reached among 12 multidisciplinary experts from Asia. Statements were developed by the steering committee after a literature review, modified, and then approved through 3 rounds of anonymous voting by using a 6-point scale from A+ (strongly agree) to D+ (strongly disagree).
Objective: To evaluate the incidence and risk profiles for gastrointestinal (GI) events and cardiovascular (CV) events in elderly patients (aged > or =60 years) with knee osteoarthritis using tNSAIDs (traditional non-steroidal anti-inflammatory drugs) or coxibs users in patients with knee osteoarthritis aged > or =60 years.
Material And Method: A hospital-based retrospective cohort study was applied. Data on prescription drug (NSAIDs, celecoxib, etoricoxib) was obtained from hospital database.
Background: Modern metal-on-metal total hip resurfacing show improvement outcome as a viable alternative arthroplasty in the young, but in Thailand it remains controversial whether this procedure is appropriate by Thai surgeon. Some in doubt this procedure may need high technical demand and may not valuable in Thailand.
Objective: To analyze the early clinical and radiographic outcomes of Birmingham Hip Resurfacing (BHR) by Thai surgeon in Thailand.
Background: Modern total hip resurfacing has been associated with excellent intermediate outcome in patients with osteonecrosis hip who are under 60 years., Up to 30-50% necrosis area in X-ray and MRI are theoretically acceptable to perform total hip resurfacing. However, both of plain X-ray and MRI still are uncertain information to precisely support decision making for either hip resurfacing or hip arthroplasty.
View Article and Find Full Text PDFObjective: To examine the clinical outcome of minisubvastus approach, a true quadriceps-sparing approach for minimally invasive knee arthroplasty.
Material And Method: Between January 2005 and January 2008, 398 knees were included in this study. We evaluated the results of primary total knee arthroplasties performed with minisubvastus approach in patients at a minimum 1-year follow-up period.
Background: Treatment with repeated cycles of Intra-Articular Sodium Hyaluronate (IA-HA), from previous study, can improve symptoms and delay surgical interventions in knee osteoarthritis patients who failed conservative treatment within minimum 2-years follow-up. This is a continued study to follow-up responded patients in the mentioned study whether continuing treatment with IA-HA could prolong time to surgery until the end of follow-up.
Objective: To evaluate the incidence of total knee replacement (TKR) in patients receiving repeated cycles of IA-HA during a 54-month follow-up period.
Background: Mini-incision subvastus approach is soft tissue preservation of the knee. Advantages of the mini-incision subvastus approach included reduced blood loss, reduced pain, self rehabilitation and faster recovery. However, the improved visualization, component alignment, and more blood preservation have been debatable to achieve the better outcome and preventing early failure of the Total Knee Arthroplasty (TKA).
View Article and Find Full Text PDFBackground: Intra-articular injection of hyaluronic acid has become an intervention step between conservative and operative treatment of knee osteoarthritis. This is recommended by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR). However, the expected outcomes and the selection criteria are undetermined and controversial.
View Article and Find Full Text PDFBackground: Failed conservative treatments of knee osteoarthritis (OA) in the elderly have traditionally been treated with TKA (Total Knee Arthroplasty). Although TKA is a gold standard and cost-effective treatment in elderly patients, it should be considered as the last resource for patients with pain that cannot be controlled by the usual conservative therapeutic approaches. Numerous studies showed that intra-articular Sodium Hyaluronate (IA-HA) (Hyalgan) is effective for treatment in various stages of knee OA.
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