Long-term results of synovectomy in total knee arthroplasty: a prospective, randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Synovectomy has been introduced into total knee arthroplasty (TKA) with the aim of relieving pain and inflammation of the synovium. However, there are no long-term, comparative data to evaluate the effect of synovectomy in TKA. This study was aimed at assessing pain, function, and complications in patients undergoing synovectomy during TKA for osteoarthritis (OA) at long-term follow-up.@*METHODS@#This was a prospective randomized controlled trial of 42 consecutive patients who underwent staged bilateral TKA. Patients undergoing the first-side TKA were allocated to receive TKA with or without synovectomy followed by a 3-month washout period and crossover to the other strategy for the opposite-side TKA. The overall efficacy of both strategies was evaluated by determination of blood loss, the Knee Society score (KSS), and knee inflammation conditions during a 3-month postoperative period. The postoperative pain, range of motion (ROM), and complications were sequentially evaluated to compare the two groups until 10 years after surgery.@*RESULTS@#At the 10-year follow-up, both groups had a similarly significantly improved ROM (114.88 ± 9.84° vs. 114.02 ± 9.43°, t  = 0.221, P  = 0.815) and pain relief with no differences between the two groups (1.0 [1.0] vs. 1.0 [1.5], U  = 789.500, P  = 0.613). Similar changes in total blood loss, KSS, and knee inflammation were found in both groups during 3 months postoperatively ( P  > 0.05). Additionally, there was no significant difference regarding complications and satisfaction between the two groups ( P  > 0.05).@*CONCLUSIONS@#Synovectomy in conjunction with TKA for primary OA does not seem to provide any benefit regarding postoperative pain, ROM, and satisfaction during a 10-year follow-up. In addition, it may not result in more blood loss and increased incidence of long-term complications. Based on our long-term findings, it should not be performed routinely.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR-INR-16008245; https://www.chictr.org.cn/showproj.aspx?proj=13334 .

Effects of milrinone on plasma levels of C-reactive protein and cytokines during and after CPB in children undergoing operation for tetralogy of Fallot / 中华麻醉学杂志

Objective To evaluate the effects of milrinone on plasma levels of C reactive protein (CRP) , TNF-?, IL-8 and IL-10 during and after operation for tetralogy of Fallot performed under cardiopulmonary bypass (CPU) in children.Methods Sixteen ASA Ⅲ-Ⅳ pediatric patients aged l-12yr scheduled for operation for tetralogy of Fallot under CPB were randomly divided into two groups : (1) milrinone group ( M, n = 8) and (2) control group (C, n = 8) . In group M a loading dose of milrinone 50 ?g?kg-1 was given i.v. within 10 min, immediately after aortic unclamping, followed by continuous infusion at 0.2?g?kg ?min-1 . In group C equal volume of lactated Ringer's solution was infused instead of milrinone. Blood samples were taken from the CVP line before anesthesia (T0), 5 min after release of aortic cross-clamp (T1), 5 min after discontinuation of CPB (T2) , at the end of surgery (T3) and 24 h and 48h after operation (T4,5) for determination of plasma levels of CRP, TNF-?, IL-8 and IL-10 by radioimmunoassay.Results There was no significant change in plasma TNF-a concentration in both groups. Plasma CRP level increased significantly at 24 and 48 h after operation (T4 , T5 ) , in both groups and was significantly higher in group M than that in group C. Plasma IL-8 level increased significantly only at T2 and T3 compared to pre-anesthesia value (T0) in group M while in group C it increased significantly from T1-5 (P