ABSTRACT
The aim of this study was to evaluate the effect of a single immediate postoperative instillation of 10 mL of sodium hyaluronate (Viscoseal) into the knee following arthroscopy. A single-center, prospective, randomized, controlled study was undertaken. Consenting knee arthroscopy patients were randomized into two groups following surgery: the study group received 10 mL of sodium hyaluronate intra-articularly, while the control group received an intra-articular instillation of 10 mL of Bupivacaine. Pre- and postoperative visual analogue scale scores for pain and Western Ontario and McMaster Universities (WOMAC) scores for knee function were obtained. Overall, 48 patients under the care of a single surgeon were randomized into two groups of 24. There were no statistically significant demographic differences at baseline. Three patients were lost to follow-up. There was a statistically significant difference in pain scores favoring the study group compared with the control group at 3 and 6 weeks postoperatively (p < 0.05), and a statistically significant difference in WOMAC scores favoring the study group compared with the control group at 3 and 6 weeks postoperatively (p = 0.01). Synovial fluid replacement with sodium hyaluronate following arthroscopic knee surgery conferred statistically significant improvements in pain and function scores compared with Bupivacaine in the short term (3-6 weeks).
Subject(s)
Arthroscopy , Hyaluronic Acid/administration & dosage , Joint Diseases/surgery , Knee Joint/surgery , Pain, Postoperative/therapy , Adult , Aged , Anesthetics, Local/administration & dosage , Biocompatible Materials/administration & dosage , Bupivacaine/administration & dosage , Female , Humans , Injections, Intra-Articular , Male , Middle Aged , Pain Measurement , Pain, Postoperative/drug therapy , Prospective Studies , Recovery of Function , Treatment Outcome , Young AdultABSTRACT
A case report of bilateral acute septic arthritis of knees is presented, which was managed with staged total knee replacements for both knees. A literature review on septic arthritis treated with knee arthroplasty is also presented.
Subject(s)
Arthritis, Infectious/surgery , Arthroplasty, Replacement, Knee/methods , Knee Joint , Staphylococcal Infections/complications , Anti-Bacterial Agents/therapeutic use , Arthralgia/microbiology , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Female , Floxacillin/therapeutic use , Fusidic Acid/therapeutic use , Humans , Middle Aged , Staphylococcal Infections/drug therapy , Staphylococcus aureusABSTRACT
Our study aimed to find out patients' opinion on a foot pump device used for thromboprophylaxis, as compared to subcutaneous low molecular weight heparin injections. A survey of 43 consecutive patients undergoing hip and knee joint replacement was carried out at our hospital. Patients were assessed for pain and a questionnaire was used to gauge patients' attitudes towards the two thromboprophylactic measures. There was no statistically significant difference in the level of discomfort as assessed on the visual analogue score, between two methods. An equal percentage of patients (74.4%) disagreed that either the foot pump or injection was painful (p = 1). Though a larger percentage of patients (footpumps: 44.2%, injections: 27.9%; p = 0.12) would rather not use the foot pump, still 69.8% would be willing to keep on using these foot pumps at home for 4 weeks after discharge from the hospital. Eighty one percent were agreeable to foot pump use if they have another joint replacement later. Overall, the foot pump was at least as well tolerated as subcutaneous low molecular weight heparin in the group studied. Its use as post discharge prophylaxis is also acceptable to the majority of our patients.
