ABSTRACT
Summary: Total knee replacement is increasingly widely prescribed, not only for degenerative joint disease but also for other problems such as articular cartilage disease, misalignment due to causes other than degeneration, bone and joint cancer, and diseases that cause joint destruction. However, changes in knee joint biomechanics as well as complications of the patellofemoral joint after surgery lead to instability, joint pain, patellar rupture, and patellar tendon rupture. These are issues that challenge surgeons as well as make patients hesitant when considering knee replacement surgery. Understanding the changes in patella index that can occur after total knee replacement surgery will help surgeons carefully evaluate patients before surgery and calculate intraoperative techniques to minimize complications. Methods: Fifty-eight patients with 62 knees were diagnosed with osteoarthritis and underwent total knee replacement surgery. All patients had clinical and radiographic evaluation of the knee joint before and after surgery. Results: Patellar indexes did not change significantly after surgery compared to before surgery. Before surgery, 2 patients (3.23%) had true patella baja. After surgery, 7 patients (11.29%) had true patella baja and 3 patients (4.84%) had pseudo-patella baja. The average knee flexion amplitude after surgery was 103.11±15.440, with only 2 patients losing extension >50º. The average KS score after surgery was 83.69±9.98, significantly improved compared to before surgery 33.44±11.38. Similarly, KFS score after surgery was 81.01±8.84 compared to before surgery 37.05±8.08. Conclusion: Changes in index of the patella before and after surgery affect the surgical results, the normal patella group has better results than the group with patella baja.
ABSTRACT
Background: The anatomical parameters of the acetabulum vary among races and geographical regions. Multislice Computed Tomography (CT) has proven to be a practical approach to assess morphological parameters of the acetabulum. The purpose of this study was to explore morphological characteristics of the acetabulum measured by CT scans in Vietnamese adults. Methods: Thirty-five consecutive patients aged 18 years and older received indications and eligibility for total hip replacement surgery. Sixty-three acetabulum were examined with multislice computed tomographic system (CT) with multiplanar reconstruction (MPR). Measured morphometric parameters of acetabulum included acetabular inclination angle (AIA), acetabular anteversion angle (AAA), acetabular angle of sharp (AAS), sagittal acetabular angle (SAA), acetabular horizontal offset (AHO), transverse acetabular ligament anteversion (TALA), transverse acetabular ligament inclination (TALI), acetabular depth (ADe), acetabular depth ratio (ADr) and acetabular diameter (ADi). Results: The mean values of acetabular diameter, femoral head diameter, AIA, AAA, AAS, SAA, TALA, TALI, AHO, ADe, ADr were 50.22±3.56 mm, 43.54±3.68 mm, 40.27±5.09 mm, 13.30±5.54 mm, 39.46±5.41 mm, 26.38±9.01 mm, 9.49±3.92 mm, 47.70±6.73 mm, 3.06±0.37 mm, 18.62±2.95 mm and 309.60±41.87 mm. Conclusion: Our initial data has showed morphological characteristics of the acetabulum in Vietnamese adults, different from the populations from other parts of world. Also, significant correlation between the orientation of the acetabulum and the transverse acetabular ligament was documented.
ABSTRACT
BACKGROUND: Currently, intramedullary nailing for tibial fractures has very good postoperative treatment results. Combining the advantages of traditional medicine and modern medicine is a comprehensive treatment method that brings the best benefits to the patient. METHODS: The study method was a controlled clinical trial. The study included 60 patients with a definitive diagnosis of tibial fracture who underwent intramedullary nailing surgery. These patients were divided into 2 groups: with and without electroacupuncture treatment. RESULTS: Electro-acupuncture had a significant analgesic effect in 24-48 h after surgery: After 24 h or electro-acupuncture, the pain difference in the study group and the control groups was 3.03 ± 1.25 and 2.46 ± 1.33, respectively (p < 0.05). The VAS score difference between day 1 and day 2 in the study group and the control group was 0.61 ± 0.71 and 0.59 ± 0.67, respectively (p < 0.05). At 48 h postoperatively, the circumference of the calf on the fractured side in the study group and the control group was 36.1 ± 2.1 and 37.3 ± 2.2 cm, respectively (p < 0.05). At 72 h postoperatively, the circumference of the calf in the study group and the control group was 35.9 ± 2.6 and 37.6 ± 2.8 cm, respectively (p < 0.05). The effect of electro-acupuncture on bone healing did not differ between the study group and the control group (p > 0.05). During 7 days of using the treatment regimen, there were 3.3 % of patients with dizziness, 3.3 % of patients with vomiting/nausea, 3.3 % of patients with bleeding at the injection site. There was no difference in blood pressure, pulse rate, hematological indexes and biochemical indexes of patients before and after using the treatment regimen. CONCLUSION: Electro-acupuncture has a significant analgesic effect 24 h-48 h after surgery. The effect of electroacupuncture on bone healing was not different between the two groups. Electroacupuncture is a safe, effective method with few side effects.
