ABSTRACT
Purpose: COVID-19 pandemic makes outdoors rehabilitation a potential hazard. Patient education to perform simple home-based exercises seems to be an interesting and sometimes a mandatory option. This study provides a comparison between the conventional and home-based virtual rehabilitation after surgical repair of medial meniscus root tears. Methods: : All patients who underwent MPRT repair with a modified trans-tibial pull-out technique from March 2019 to March 2021 were evaluated. Those who underwent surgery after December 2019 were trained to perform self-rehabilitation. The rest had undergone outdoors specialized rehabilitation according to a unified protocol and these were used as a historical control group. All patients were followed up for a minimum of 2 year after surgery. Final Lysholm scores were utilized to compare functional outcomes. Results: : Forty-three consecutive patients with medial meniscal root tears were studied. Thirty-nine (90.7%) were women and 4 (9.3%) were men. The mean age of participants was 53.2 ±8.1 years. The total Lysholm knee score, and all its items were significantly improved in both groups at a two-year follow-up (p<0.05), except the “Using cane or crutches” item (p=0.065). Nevertheless, the final Lysholm knee score improvement was higher in patients who performed outdoors specialized rehabilitation and in patients with shorter time-to-surgery. Conclusion: Regardless of age and gender, home-based rehabilitation after meniscal root repair with the modified trans-tibial pull-out technique improved the patients’ function at a two-year follow-up. Nonetheless, this effect was still significantly lower than that of the outdoors specialized rehabilitation. Future work is required to clarify basic protocols for home-based tele-rehabilitation programs and determine clinical, radiological and functional results. Level of evidence: Level IV, therapeutic, historically controlled study
Subject(s)
COVID-19 , Retinal PerforationsABSTRACT
Introduction: The novel COVID-19 disease was presented at first in Wuhan, China, in December 2019. During COVID-19 pandemic, approaching trauma patients, whom could have COVID-19, is a challenging issue required special consideration and healthcare setting.Methods and materials: This retrospective cohort study was conducted at Emtiaz hospital, the main trauma center of the south of Iran, between March 2020 and August 2020 from the beginning of the COVID-19 pandemic. Trauma-related data such as the mechanism of trauma, injury pattern, and surgical intervention procedure of all the suspicious COVID-19 patients were documented. ICU admission and mortality rate were investigated as outcome variables.Results: During six months of the pandemic period, 9248 patients were referred to our referral trauma center, with 222 patients suspicious of having COVID-19 infection. Among sixty-four cases, whom were confirmed to be positive, 33 orthopedic injured patients were observed. The mortality rate of COVID-19 positive cases was 15.6 % (10 patients out of 64) and COVID-19 negative ones was 10.1 % (16 patients out of 158) which was not statistically significant (p.value:0.25). Multivariate analysis of the effect of the baseline and trauma related factors on mortality rate, showed that older age (p. value: 0.001), COVID-19 infection (p. value: 0.033), and surgical procedure (p.value:0.038) are the poor prognostic factors associated with mortality rate.Conclusion: The mortality rate of trauma patients with COVID-19 positive infection was 15.6 % (10 patients). Older age, COVID-19 infection, and surgical procedure were observed as the statistically significant prognostic factors leading to more mortality rate.Level of Evidence: III