The Use of a High-Tech Knee Pad for Reduction of the Postoperative Effusion after Total Knee Arthroplasty

Antiedematous Effect Promoted by Occlusion of Legs with Compressive Socks Containing Infrared-Emitting Ceramic Particulates

Background: Published literature reports significant improvements in pathological conditions, such as pain, blood dyscrasias, and cellulite, after using topical occlusive accessories containing particulate ceramic materials. Objective: In this study, we investigated whether the use of a topical occluding garment made with synthetic fibers embedded with powdered ceramic materials could be beneficial to patients suffering from edema of lower limb extremities. Materials and methods: The cohort comprised 30 volunteers of both genders who were divided into two study groups. The bioceramic (BC) group wore compressive socks made of fabrics with embedded ceramic powder for 8 h a day for 28 days. The placebo group wore compressive socks of the same material without ceramic powder. The efficacy of the treatment was quantified through weekly plethysmographic measurements. In addition, pain relief was evaluated through a visual analog scale (VAS). Results: Data showed a statistically significant reduction in the edema volume for the BC group compared with the placebo group: 78.9 ± 10.7 mL versus 41.3 ± 5.6 mL, p = 0.003. Further, there was also greater pain relief for the BC group when compared with the placebo group, with a pain decrease of 7.0 ± 0.2 U versus 3.3 ± 0.2 U, respectively, on the VAS from 0 to 10 (p = 0.024). Conclusions: The topical occlusive therapy with compressive socks containing infrared-emitting ceramic particulate in its fabrics showed that they were more beneficial than the placebo garment in the treatment of edema of the inferior member extremities as well as in relief of associated pain.

Development of a reference chart to monitor postoperative swelling following total knee arthroplasty

Title: Development of a reference chart to monitor postoperative swelling following total knee arthroplasty.Purpose: Lower extremity swelling is a feature of total knee arthroplasty. Until recently, clinicians lacked tools to accurately measure swelling in clinical settings, but bioelectrical impedance assessment has shown promise in this regard. The purpose of this study was to develop a reference chart of lower extremity swelling following total knee arthroplasty.Method: Fifty-six participants (54% male, mean age = 64 years) were followed for the first 7 weeks following total knee arthroplasty, during which frequent lower extremity bioelectrical impedance assessments were performed. Using Generalized Additive Models for Location Scale and Shape, a reference chart for swelling was developed with bioelectrical impedance assessment data from the first 40 patients enrolled in the study (223 observations) and preliminarily tested for performance in the remaining 16 patients' data (96 observations).Results: The reference chart illustrates approximately 10% per day increase for the first 3 days following surgery. Peak swelling occurs 6-8 days following surgery; the 10th percentile demonstrates a peak of 25%, whereas the 90th percentile peaks at 47%. In the test data, this reference chart demonstrated accurate coverage at each estimated centile.Conclusion: The reference chart provides a novel framework for monitoring swelling following total knee arthroplasty and may augment clinical decisions to improve postoperative swelling management.Implications for rehabilitationThe use of bioelectrical impedance assessment provides an accurate and easily implemented approach for rehabilitation professionals to measure swelling.The reference chart provided allows for monitoring of patient recovery of swelling following total knee arthroplasty.Precise depictions of where a patient's swelling is in reference to others will improve clinical decision making at the individual level.

Evaluation of the internal fixation effect of nano-calcium-deficient hydroxyapatite/poly-amino acid composite screws for intraarticular fractures in rabbits

Objective

To evaluate the internal fixation effect of nano-calcium-deficient hydroxyapatite/poly-amino acid (n-CDHA/PAA) composite screws in the intraarticular fracture model.

Materials and methods

A total of 35 New Zealand White rabbits were used in a bilateral femoral intercondylar fracture model and randomly divided into two groups. n-CDHA/PAA screws were used in the experimental group, and medical metal screws were used in the control group. The fracture condition, range of motion, and the screw push-out strength were assessed, and an arthroscopic examination of knee joint was performed at 4, 8, and 12 weeks after surgery. The biodegradation of the n-CDHA/PAA screws in vivo was tested through weighing, and changes in screw structure were assessed by X-ray diffraction at 12 weeks after surgery.

Results

The general situation of all animals was good and showed no incision infection and dehiscence after surgery. X-ray scanning showed that significant callus growth was present in both groups at 4 weeks after surgery, and there was no significant difference (P>0.05) in the Lane-Sandhu score between the experimental and control groups at all time points after surgery. There were no statistically significant differences (P>0.05) in the range of motion and Oswestry Arthroscopy Score of arthroscopic examination of the knee joints between the two groups. The screw push-out strength of the control group was stronger than that of the experimental group at 4 weeks after surgery (P<0.05), but after that, there was no significant difference between the groups (P>0.05). The degradation tests showed that the n-CDHA/PAA screws degraded gradually after implantation, and the weight loss rate was approximately 16% at 12 weeks after surgery. The X-ray diffraction results showed that the crystal structure of the outer surface of the n-CDHA/PAA screw has changed at 12 weeks after surgery.

Conclusion

The n-CDHA/PAA screw is an effective and safe implant as a potential internal fixation device for an intercondylar fracture of the femur, and its internal fixation effect was similar to that of medical metal screw.