Evaluation of simvastatin in the process of fracture healing in tibiae of rats

OBJECTIVE: Evaluate the effects of simvastatin in the process of fracture healing in rat tibia. METHODS: Thirty-six rats were subjected to diaphyseal fracture of the leg bones and divided in the statin group (GE) and control group (GC), being subdivided into three subgroups according to days post-fracture (7th, 14th and 28th day) to assess bone healing. In GE was administered by gavage a solution of simvastatin to the sacrifice. In the control group was administered saline by the same route of SG. Immobilization was not used. After the sacrifice was made to limb amputation in the distal femur and conducted the clinical, radiological and histological analysis. Clinical evaluation was made as to the mobility of the fracture. Then the samples were radiographed and evaluated for callus diameter. Histological examination was performed with cuts of 5 micrometers and stained with hematoxylin-eosin, Masson's trichrome and Alcian blue pH 2.5. The level of significance to exclude the null hypothesis was 5%. RESULTS: All GE animals showed greater stability of the fracture and higher callus area. There were no significant changes in the histological study. CONCLUSION: Simvastatin accelerates the consolidation process by increasing the callus, but does not alter the histology of the newly formed bone. .

Avaliação da perda sanguínea na artroplastia total do joelho com e sem soltura do torniquete / Blood loss in total knee arthroplasty with and without tourniquet release

OBJETIVO: Avaliar a perda sanguínea em pacientes submetidos à artroplastia total cimentada do joelho com e sem soltura trans-operatória do torniquete pneumático para a hemostasia. MÉTODOS: Foram estudados 72 pacientes submetidos à artroplastia total, num total de 80 joelhos, divididos em dois grupos: Grupo 1 onde se manteve o torniquete pneumático até a sutura e curativo da ferida operatória, e Grupo 2 onde foi realizada a soltura do torniquete pneumático após a cimentação da prótese, com realização de hemostasia direta, antes da sutura e curativo. Os pacientes foram avaliados quanto ao sangramento pelo dreno de sucção e à contagem de hemoglobina e hematócrito, considerando os intervalos de duas, 24 e 48 horas de pós-operatório. RESULTADOS: Não houve diferença significante entre os dois grupos quanto ao sangramento pós-operatório e decréscimo dos parâmetros hematimétricos. Somente um paciente do Grupo 2 necessitou transfusão de concentrado de hemáceas no pós-operatório. CONCLUSÃO: O sangramento pós-operatório na ATJ mostrou-se igual com e sem a soltura do torniquete pneumático para a realização da hemostasia.

OBJECTIVE: To evaluate blood loss in patients submitted to cemented total knee arthroplasty with and without perioperative tourniquet release for hemostasis. METHODS: Seventy-two patients (eighty knees) were submitted to total knee arthroplasty, allocated into two groups: in Group 1, in which the pneumatic tourniquet was maintained until suture and dressing of the operated wound, and Group 2, in which the pneumatic tourniquet was released intraoperatively after cementing the prosthesis, with direct hemostasis, before the suture and dressing. The patients were evaluated for blood loss by the suction drain, and hemoglobin and hematocrit counts, at intervals of 2, 24 and 48 hours in the postoperative period tube. RESULTS: There was no significant difference between the groups in terms of postoperative blood loss or decrease in hemoglobin and hematocrit parameters. Only one patient, from Group 2, required a blood transfusion in the postoperative period. CONCLUSION: Postoperative blood loss in TKA was similar with and without perioperative release of the pneumatic tourniquet for hemostasis.