Analgesic effects of low -dose trama dol after arthroscopic knee surgery

Objective To investigate analgesic effect of i ntra -articular low -dose tramadol a fter arthroscopic knee surgery.Methods60patients undergoing arthroscopic k nee surgery under lumbar anesthesia were randomly divided into intra -ar ticular injection of tramadol(TJ group),mulscle injection of tramadol(TM)and saline control group.Vision analog scoring was conducted under exte nsion of knee joint 8h and24h after drugs administration.Follow -up was done to observe unwanted e ffects 48h after surgery.Results Score of TJ group was significantly lower than those of other groups(P <0.05).No unwanted effects were found.Conclusion Intra -articular tramadol in low -dose could relieve operative pain.

Safety and outcomes of hip and knee replacement surgery in liver transplant recipients

BACKGROUND Liver transplant(LT)is becoming increasingly common with improved life expectancy.Joint replacement is usually a safe procedure;however,its safety in LT recipients remains understudied.AIM To evaluate the mortality,outcome,and 90-d readmission rate in LT patients undergoing hip and knee replacement surgery.METHODS Patients with history of LT who underwent hip and knee replacement surgery between 2016 and 2019 were identified using the National Readmission Database.RESULTS A total of 5046119 hip and knee replacement surgeries were identified.3219 patients had prior LT.Mean age of patients with no history of LT was 67.51[95%confidence interval(CI):67.44-67.58],while it was 64.05(95%CI:63.55-64.54)in patients with LT.Patients with history of LT were more likely to have prolonged length of hospital stay(17.1%vs 8.4%,P<0.001).The mortality rate for patients with no history of LT was 0.22%,while it was 0.24%for patients with LT(P=0.792).Patients with history of LT were more likely to have re-admissions within 90 d of initial hospitalization:11.4%as compared to 6.2%in patients without history of LT(P<0.001).The mortality rate between both groups during readmission was not statistically different(1.9%vs 2%,P=0.871)respectively.CONCLUSION Hip and knee replacements in patients with history of LT are not associated with increased mortality;increased readmissions were more frequent in this cohort of patients.Chronic kidney disease and congestive heart failure appear to predict higher risk of readmission.

Injuries Requiring Surgery in Folk Dancers： A Retrospective Cohort Study of 9 Years

Background： In this study, we examined professional folk dancer injuries which required surgery and if there are any associated factors like age, gender, dexterity, dance style and to evaluate the return to their full capacity. Materials and Methods： Seventy five members of the Fire of Anatolia dance group （mean age： 26.8 ± 5.2; 18-38 years） performers were evaluated. The dancers suffered 14 orthopedic injuries requiring surgery （3 meniscus tears, 2 anterior cruciate ligament tears one of which is with posterolateral corner tear, 1 posterior cruciate ligament tear, 1 patellar dislocation, 1 scaphoid fracture, 1 extensor tendon cut in hand, 1 infrapatellar bursitis, 2 Hoffa’s fat pad syndromes, 2 symptomatic medial plicaes） during a nine-year period. Follow-up time was 51 ± 41.9 （29.5-92） months. Results： Following surgeries, the dancers could restart rehearsals in 12.7 ± 9 （range： 4 to 36） weeks and perform live on the stage in 16.2 ± 12.2 （range： 5 to 52） weeks on average. Conclusion： Males were 8.64 times more likely to suffer an injury requiring surgery compared to the females （p = 0.003） and twelve （85.7%） of these injuries were lower extremity injuries and were all located in the knee in Anatolian folk dancers.

Clinical and mechanical outcomes in isolated anterior cruciate ligament reconstruction vs additional lateral extra-articular tenodesis or anterolateral ligament reconstruction

BACKGROUND Anterior cruciate ligament(ACL) reconstruction has been a successful treatment for ACL rupture.However ongoing rotational instability can be an issue.Several surgical techniques have been recommended to overcome this including lateral extra-articular tenodesis(LET) and more recently anterolateral ligament reconstruction(ALLR).AIM To compare the clinical outcomes following ACL reconstruction(ACLR) alone or ACLR with either LET or ALLR.METHODS A systematic review was conducted by means of four databases(MEDLINE,EMBASE,Cochrane and Clinical.Trials.Gov),and the Reference Citaion Analysis(https://www.referencecitationanalysis.com/) to identify all studies investigating either or both of LET and ALLR.The Critical Appraisal Skills Programme checklist for cohort studies was employed for critical appraisal and evaluation of all twenty-four studies which met the inclusion criteria.RESULTS Pooled meta-analyses illustrated that ACLR with additional LET or ALLR results in improved pivot shift test scores,compared to isolated ACLR.There was no statistically significant difference in International Knee Documentation Committee(IKDC) clinical scores with addition of either LET or ALLR.ACL re-rupture rates were compared between LET and ALLR techniques.There was a statistically significant difference between techniques,with a 1.14% rupture rate in ACLR +ALLR,and 4.03% rupture rate in ACLR + LET.Isolated ACLR re-rupture rates were 12.59%,significantly higher than when augmented with either ALLR or LET(P < 0.0001 for both groups).There were no statistical differences in pivot shift test or IKDC scores between LET and ALLR techniques.CONCLUSION This meta-analysis has found that use of either LET or ALLR in addition to ACLR results in improved mechanical outcomes suggesting surgeons should consider augmenting ACLR with an extra-articular procedure in patients with rotatory instability.Furthermore,both anterolateral extra articular procedures in addition to ACLR lead to reduced ACL re-rupture rates compared to isolated ACLR.Moreover,ALLR results in reduced ACL re-rupture rates,compared to LET.More research is needed to compare the two respective extra-articular procedures.