A Comprehensive Review of Total Hip Arthroplasty Outcomes in Post-traumatic Hip Arthritis: Insights and Perspectives

Post-traumatic hip arthritis presents a challenging condition characterized by degenerative changes in the hip joint following traumatic injury. Total hip arthroplasty (THA) is a cornerstone in managing this condition, offering significant pain relief, functional improvement, and enhanced quality of life. This comprehensive review aims to synthesize existing literature to elucidate the outcomes of THA in post-traumatic hip arthritis, exploring factors influencing surgical success and identifying areas for further research. Key findings reveal favourable clinical outcomes associated with THA, though considerations such as patient characteristics, surgical techniques, and implant selection impact outcomes. Implications for clinical practice underscore the importance of tailored preoperative assessment and ongoing advancements in surgical approaches and implant technology. Furthermore, opportunities for future research lie in long-term durability studies, patient-reported outcomes assessment, and exploration of innovative surgical techniques. Overall, THA emerges as a promising intervention for post-traumatic hip arthritis, yet continual refinement through research and innovation remains imperative to optimize patient care in this population.

Factors influencing delays and overtime during surgery: a descriptive analytics for high volume arthroplasty procedures

The aim of this article is to analyze factors influencing delays and overtime during surgery. We utilized descriptive analytics and divided the factors into three levels. In level one, we analyzed each surgical metrics individually and how it may influence the Surgical Success Rate (SSR) of each operating day. In level two, we compared up to three metrics at once, and in level three, we analyzed four metrics to identify more complex patterns in data including correlations. Within each level, factors were categorized as patient, surgical team, and time specific. Retrospective data on 788 high volume arthroplasty procedures was compiled and analyzed from the 4-joint arthroplasty operating room at our institution. Results demonstrated that surgical team performance had the highest impact on SSR whereas patient metrics had the least influence on SSR. Additionally, beginning the surgical day on time has a prominent effect on the SSR. Finally, the experience of the surgeon had almost no impact on the SSR. In conclusion, we gathered a list of insights that can help influence the re-allocation of resources in daily clinical practice to offset inefficiencies in arthroplasty surgeries.

Auricular acupressure for treating early stage of knee osteoarthritis: a randomized, sham-controlled prospective study

OBJECTIVE

We examined whether auricular acupressure (AA) at four specifically preselected AA points can alleviate knee pain and decrease non-steroidal anti-inflammatory drugs (NSAIDs) consumption and its adverse effects for osteoarthritis patients.

METHODS

Sixty-two patients (more than 40 years) with knee osteoarthritis of Kellgren-Lawrence grades of I or II upon radiographic classification were enrolled in this randomized, sham-controlled prospective study, and divided into two groups (AA group and control group). The AA group received true AA by embedding vaccaria seeds at four specific AA points (knee joint, shenmen, subcortex and sympathesis) ipsilateral to the knee osteoarthritis site, while the control group received four nonacupuncture points on the auricular helix. Visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, the number of patients who needed celecoxib pills and adverse effects were recorded.

RESULTS

VAS and WOMAC scores in the AA group were significantly lower than that in the control group (P < 0.05) at Days 3 and 7 postsugery. The VAS and WOMAC score were significantly decreased after the treatment in the AA group compared with that before the treatment (P < 0.05). The use of celebrex is significantly lower in the AA group than in the control group (P < 0.05), no major side effects were observed during the auricular acupressure treatment.

CONCLUSION

Auricular acupressure plays a role in analgesic effect and can effectively decrease NSAIDs requirements without causing adverse events for the treatment of human knee osteoarthritis.

The efficacy and safety of auricular point pressing therapy for knee osteoarthritis: A protocol for systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of auricular point pressing therapy for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of auricular point pressing therapy for treating KOA.

METHODS

Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched. All randomized controlled trials related to auricular point pressing therapy for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale. Risk of bias will be assessed using the Cochrane Collaboration tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed by 2 independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development.

RESULTS

The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy on KOA.

CONCLUSION

The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy for KOA patients.

ETHICS AND DISSEMINATION

For this review, ethical approval is not required. Patients will not be involved. The findings will be published in a peer-reviewed journal.

INPLASY REGISTRATION NUMBER

INPLASY 202220077.

Effect of the combinative use of acupotomy therapy and ultrasonic drug penetration in treating knee joint osteoarthritis

BACKGROUND/INTRODUCTION

Knee joint osteoarthritis is a chronic disease that affects the health in aging population.

AIM

We explore a minimally invasive surgery combining the use of ultrasonic drug penetration to treat early stage of knee joint osteoarthritis.

DESIGN

In total, 75 patients were participated in acupotomy therapy and ultrasonic drug penetration to treat joint osteoarthritis.

METHODS

The WOMAC (the Western Ontario and McMaster Universities Osteoarthritis Index) scores were used to assess the performance.

RESULTS

There was a significant difference in the WOMAC score between the two groups of patients (P < 0.05). The total performance rate was about 86.4% and 50% in experiment and control groups.

CONCLUSION

The combination of acupotomy therapy and ultrasonic drug penetration has demonstrated to be effective and promising to treat knee joint osteoarthritis.

Use of a Percutaneous Needle Release Technique for Trigger Thumb: A Retrospective Study of 11 Patients from a Single Center

Background

Trigger finger is a very common disorder that occurs in both adults and children. Trigger finger presents mainly as pain and limited movement of the affected digit. This report describes a modified percutaneous needle release and an evaluation of its clinical efficacy to treat trigger thumb.

Material/Methods

Trigger thumb of 11 patients was released percutaneously using a specially designed needle (0.8×100 mm) with a planus tip. Complete release was ensured when no more grating sound was heard and the needle moved freely at the tip. Pain-related functional score was evaluated preoperatively and at 3 months postoperatively. Resolution of Notta’s node, triggered or locked, Quinnell’s criteria, and patient satisfaction were also assessed at 3 months after the operation.

Results

After the percutaneous trigger thumb release, the overall visual analog scale (VAS) and pain-related functional scores declined significantly (P<0.01). There was no recurrence of thumb locking or triggering or Notta’s node. Only the first patient had incomplete release of the first annular pulley, and all patients showed high satisfaction with the procedure at 3 months after their operation. During the study, patients did not experience any complications such as inflammation, edema, or digital nerve injury.

Conclusions

This study demonstrated that the percutaneous technique is effective, less time-consuming, and safe for treating trigger thumb. Our release technique using a specially designed percutaneous needle is a valuable treatment for trigger thumb.

3D printed chitosan-gelatine hydrogel coating on titanium alloy surface as biological fixation interface of artificial joint prosthesis

To improve the fixation of the prosthesis-bone interface and to prevent postoperative infection, a novel antimicrobial hydrogel coating is designed as the biological fixation interface of the artificial joint prosthesis. Antimicrobial chitosan (CS) and gelatine (GT) were used as bioinks to print a CS-GT hydrogel coating with reticulated porous structure on the titanium alloy substrate by 3D printing technology. The experimental results show that the 7CS-10GT hydrogel coating has a macro-grid structure and honeycomb micro-network structure, excellent hydrophilicity (35.64°), high mechanical strength (elastic modulus 0.92 MPa) and high bonding strength (3.36 MPa) with the titanium alloy substrate. In addition, the antimicrobial effect of 7CS-10GT hydrogel against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) is enhanced after immersion in nano‑silver. Moreover, the 7CS-10GT hydrogel displays good cell compatibility and supports proliferation of NIH-3 T3 cells. In summary, the 3D printed CS-GT antimicrobial hydrogel coating provides an ideal microenvironment for cell adhesion and bone growth due to the dual-scale porous network structure, good hydrophilicity and biocompatibility, thus promoting rapid fixation of the bone interface. This technology opens a new possibility for this biological fixation interface in artificial joint replacement.

Performance of Double-Arm Digital Subtraction Angiography (DSA)-Guided and C-Arm-Guided Percutaneous Kyphoplasty (PKP) to Treat Senile Osteoporotic Vertebral Compression Fractures

Background

Osteoporotic vertebral compression fracture (OVCF) is a common fracture in the elderly. Conservative treatment requires prolonged bedding, which may lead to serious complications. To explore optimized use of percutaneous kyphoplasty (PKP) in the treatment of senile osteoporotic thoracolumbar vertebral compression fractures, in this study, we used C-arm-guided and double-arm digital subtraction angiography (DSA)-guided PKP to treat OVCF in elderly patients and analyzed the effective recovery.

Material/Methods

In all, 60 patients who presented with osteoporotic vertebral compression fractures at our hospital between July 2017 and February 2019 were analyzed. They were randomly divided into C-arm-guided group and the double-arm DSA-guided groups. Both groups were treated with percutaneous kyphoplasty.

Results

A pain VAS score analysis revealed that there was no significant difference between the two groups before surgery (P>0.05). After surgery, the VAS scores showed a significant difference between the C-arm-guided group and the double-arm DSA-guided PKP treatment group (P<0.01). Moreover, with respect to the bone cement dosage, vertebral correction height, operation time, cumulative radiation dose, percolation rate, and volume of bone cement, the double-arm DSA-guided PKP treatment showed significantly better results than the C-arm-guided PKP treatment (P<0.01).

Conclusions

Our data revealed that double-arm DSA-guided PKP was more accurate in treatment of senile osteoporotic thoracolumbar vertebral compression fractures, producing excellent performance with more accurate intraoperative evaluation, shorter operative time, lower incidence of bone cement leakage, less intraoperative radiation dose, and higher safety, and thus, could be extensively applied to clinical surgery.