Assessment of percutaneous vertebroplasty and percutaneous kyphoplasty for treatment of senile osteoporotic vertebral compression fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects and safety of vertebroplasty and kyphoplasty for the senile osteoporotic vertebral compression fractures.</p><p><b>METHODS</b>From December 2004 to June 2008, 28 patients (40 vertebrae) with osteoporotic vertebral compression fractures were treated with percutaneous vertebroplasty (PVP group), there were 11 males (14 vertebrae) and 17 females (26 vertebrae), with an average age of 72 years (ranged, 70 to 91 years). The fracture site of vertebral body was from T5 to L5. Other 31 patients (43 vertebrae) were treated with percutaneous kyphoplasty (PKP group), there were 13 males (18 vertebrae) and 18 females (25 vertebrae), with an average age of 74 years (ranged, 70 to 92 years). The fracture site of vertebral body was from T4 to L5. Theapeutic effects of all the patients were observed after operation, the item included visual analog scale (VAS), Oswestry score, Cobb angle, the height of anterior and middle column vertebra, and the incidence of cement leakage.</p><p><b>RESULTS</b>There was significant decrease in VAS score and Oswestry score after operation in both groups, there was significant difference between preoperative and postoperative (P < 0.01). There was no significant difference in VAS score and Oswestry score between two groups (P > 0.05). There was no significant difference in Cobb angles and the height of anterior and middle column vertebra between two groups before and after operation (P > 0.05). Among them, there were 3 vertebrae cement leakage in PVP group (7.5%) and 2 in PKP group (4.7%), but no clinical sympton occurred. There was no significant difference in the incidence of cement leakage between two groups (P > 0.05).</p><p><b>CONCLUSION</b>Vertebroplasty and kyphoplasty are safe and effective methods in treating senile osteoporotic vertebral compression fractures, which can restore the height of fractured vertebra, relieve pain and improve function as well as minimize the incidence of cement leakage.</p>

Systematic review of the earlier safety of closed suction drainage for knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the earlier safety of closed suction drainage systems for knee arthroplasty.</p><p><b>METHODS</b>All randomised or quasi-randomised trials comparing the use of closed suction drainage systems with no drainage systems for all types of knee arthroplasty were searched. The trials' quality were assessed, and data was extracted. Where appropriate, results of comparable studies were pooled.</p><p><b>RESULTS</b>Twelve studies involving 1122 participants with 1191 surgical wounds were identified. The methodology of the studies identified and included in the analysis varied considerably. Pooling of results indicated no statistically significant difference in the incidence of wound haematoma, dehiscence or deep vein thrombosis between those allocated to drains and the un-drained wounds. Blood transfusion was required more frequently in those who received drains. No difference between the groups was seen with respect to wound infection and the range of movement of the joint after surgery.</p><p><b>CONCLUSIONS</b>There is insufficient evidence from randomised trials to support the routine use of closed suction drainage in knee arthroplasty. It results in an increase in the number of patients requiring blood transfusion. However, because of the poor trial methodology of many of the studies and the inadequate reporting of outcomes, further randomized trials on this topic are justified.</p>