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Objective To systematically evaluate the efficacy of small-needle-knife therapy combined with manipulation in treating frozen shoulder. Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI, CBM, VIP, Wanfang Data, Embase, Cochrane Library and Pubmed database were searched. Retrieval time was from the establisment of the database to February 2017. Two researchers screened literature, extract materials independently. The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. Results 12 articles were included in a systematic review, a total of 1118 cases of patients. Meta-analysis showed that, compared with small-needle-knife therapy alone, small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate [OR=5.07, 95%CI(3.07, 8.37), P<0.000 01] and cure rate [OR=2.89, 95%CI(2.21, 3.78), P<0.000 01], enhance motor function score [MD=63.98, 95%CI(38.61, 89.35), P<0.000 01], with statistical significance. Conclusion Small-needle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder. However, the quality of included research is relatively low, so large-sample, multi-center and high-quality randomized controlled trials are required for verification.
ABSTRACT
BACKGROUND: Dermal hypoesthesia surrounding the incision usually occurs after total knee arthroplasty (TKA), which severely affects the patients' life quality. But the relevant studies are still immature, and its prevention methods and prognosis remain controversial.OBJECTIVE: To review the research and progress of dermal hypoesthesia following TKA.METHODS: A computer-based online research of CJFD, WanFang, VIP and Medline databases was performed for the literature addressing the dermal hypoesthesia surrounding the incision after TKA published from December 2001 to December 2016. The keywords were "total knee arthroplasty, incision, numbness, abnormal sensation" in English and Chinese, respectively. Finally, 36 eligible articles were selected for result analysis after excluding the repetitive ones.RESULTS AND CONCLUSION: (1) Dermal hypoesthesia surrounding the incision following TKA is commonly seen, but the related researches are few. Most of researches concentration on protecting against cutaneous nerve injury by modifying surgical approach, nerve conduit, neural nutrients and surgical repair, but all possess certain shortcomings, so there is a lack ideal prevention scheme. (2) The repairing methods for peripheral nerve injury, including biomolecular, cell and catheter therapies, have been applied in the repair of cutaneous nerve injury following TKA, but still on initial stage,and its effectiveness and safety need to be confirmed in depth. (3) Therefore, whether dermal hypoesthesia surrounding the incision following TKA needs treatment or not, and how to treat is an urgent problem for joint surgeon.
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BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, fewer complications and higher patient satisfaction. However, for the mobile bearing and the fixed bearing, the choice of single condylar prosthesis is till controversial.OBJECTIVE: To investigate the difference of LINK fixed-bearing and Oxford mobile-bearing unicompartment arthroplasty in relieving knee joint pain, reconstruction of the knee joint function, correct the knee joint deformity for medial unicompartment knee osteoarthritis, thus providing the basis for selecting a better prosthesis.METHODS: Ninety patients with medial unicompartment knee osteoarthritis undergoing unicompartmental knee arthroplasty in the Department of Joint Surgery, Guangdong Provincial Hospital of TCM from December 2014 to June 2016 were analyzed retrospectively, followed by allotted into Oxford mobile-bearing and LINK fixed-bearing groups (n=45 per group). The preoperative and postoperative pain level, range of motion of the knee, complications, and limb alignment were assessed. The range of motion and function of the knee were evaluated by Knee Society Score system.RESULTS AND CONCLUSION: (1) The two kinds of prosthesises both could obtain good clinical effectiveness. (2)There was no significant difference in the Knee Society Score, Visual Analogue Scale scores, or the range of motion of the knee between two groups (P > 0.05). (3) No complications such as deep vein thrombosis, prosthesis loosening and joint revision were found in both groups. (4) The correction of limb alignment showed significant difference between two groups (P < 0.05). The corrective femorotibial angle in the Oxford mobile-bearing group was larger than that in the LINK fixed-bearing group. (5) These findings manifest that under the precondition of strictly mastering the indications, both fixed-bearing and Oxford mobile-bearing unicompartment arthroplasties can effectively relieve the pain and improve the function of knee joint in the treatment of unicompartmental knee osteoarthritis. Oxford mobile-bearing prosthesis exhibits advantage in restoring the limb alignment; the movable platform lower limb alignment correction angle is often bigger than fixed platform correction angle, but may accelerate the lateral cartilage wear.
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BACKGROUND: Periprosthetic infection after total knee arthroplasty (TKA) has become the most serious complication. However, there is still a lack of clinical study on the distribution of pathogenic bacteria. Therefore, understanding the distribution characteristics of the main pathogenic bacteria is critical for preventing and treating OBJECTIVE: To analyze the bacteriological characteristics in the patients with periprosthetic joint infection following TKA, so as to provide reference for early prevention and treatment. METHODS: CNKI, VIP, WanFang and PubMed databases were retrieved for the literature concerning periprosthetic infection following TKA published before 2016. The incidence of periprosthetic joint infection after TKA was statistically analyzed. RESULTS AND CONCLUSION: (1) 103 articles were included, involving 1 399 patients. (2) The main pathogenic bacteria were Staphylococcus aureus,coagulase negative Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli, Streptococcus and Enterococcus.There is no significant difference in the distribution of bacteria at home and abroad. Treatment strategies are divided into conservative and surgical treatments. (3) The key for successfully preventing and treating periprosthetic infection after TKA lies in the multiple disciplinary team collaboration, understanding the distribution of bacteria, early diagnosis and active preventive measurements, as well as rational treatment strategies.