Efficacy and safety of tranexamic acid in unicompartmental knee arthroplasty: A systematic review and meta-analysis.

This meta-analysis aimed to assess whether administration tranexamic acid (TXA) could reduce blood loss and vascular events in patients undergoing unicompartmental knee arthroplasty (UKA). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and case control trials (CCT) that compared outcomes of patients who did and did not receive TXA during UKA. We searched Cochrane Central Register of including PubMed, EMBASE, Web of Science, the Cochrane Library, Wan Fang data, CBM and CNKI for relevant studies. We assessed the risk of bias of the included studies and calculated pooled risk estimates. The primary outcome was operation time, intraoperative blood loss, postoperative HCT, postoperative HB, transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, total blood loss, postoperative ROM,postoperative VAS score, postoperative complications. Data were using fixed-effects or random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively. Finally, 9 clinical studies with 744 patients were included in this meta-analysis. Compared with the control group, TXA group could reduced transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, and total blood loss, and increased postoperative HB with statistically significance. The main findings of this meta-analysis are that the transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, total blood loss and postoperative HB in the tranexamic acid group were superior to those in the routine group. Additional high-quality RCTs should be conducted in the future.

Evaluation of the reliability and validity of Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded in elderly patients with chronic orthopaedic diseases.

BACKGROUND: The Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) scale can simultaneously evaluate the quality of life and spiritual health level of patients with chronic orthopaedic diseases. We performed the FACIT-Sp-Ex scale in Chinese, and tested its reliability and validity in patients with chronic orthopaedic diseases. METHODS: There were 249 patients with chronic orthopaedic diseases who were selected for the questionnaire survey. AMOS 23.0 and SPSS 25.0 were used for statistical analysis to calculate the reliability and validity of the Chinese version of the scale. RESULTS: The Chinese version of FACIT-Sp-Ex scale showed that root mean square error of approximation (RMSEA) was 0.06. Cronbach's alpha coefficient was 0.83, the subscale was 0.72 ~ 0.82. The meaning, peace, relational subscales and total scale of the FACIT-Sp-Ex were negatively correlated with hospital anxiety and depression scale (HADS) and positively correlated with health-related quality of life (HRQOL). All four subdomains were inversely associated with HADS anxiety symptoms, the peace and relational subscales were inversely associated with HADS depressive symptoms. Elderly female patients score higher than male patients in faith subscale. The highest-scoring disease in FACIT-Sp-Ex faith scale was osteoarthritis, which in FACIT-Sp-Ex total scale are piriformis syndrome and osteoarthritis. CONCLUSION: The Chinese version of FACIT-Sp-Ex scale has good reliability and validity, which can be used as an evaluation tool for the spiritual status and quality of life of Chinese elderly chronic orthopaedic patients.

A meta-analysis of efficacy and complications of 3D printing-assisted surgery for schatzker iv-vitibial plateau fractures / 中国组织工程研究

BACKGROUND: Although 3D printing technology has been gradually applied in the operation of tibial plateau fracture, there are still few reports about 3D printing assisted operation of Schatzker IV-VI tibial plateau fracture. Thus, it is necessary to make a meta-analysis and evaluation of the application value and complications of 3D printing assisted operation of Schatzker IV-VI tibial plateau fracture compared with traditional operation. OBJECTIVE: To evaluate the effect of 3D printing technology on therapeutic effect and complications of Schatzker IV-VI type tibial plateau fractures by meta-analysis. METHODS: PubMed, Cochrane Library, Web of Science, CNKI, CBM, and Wanfang databases were systematically searched by computer until December 2019. Two researchers independently screened the literature, evaluated the quality and extracted the data. The included literature was statistically analyzed using Stata 15.0 software. RESULTS AND CONCLUSION: (1) A total of 15 Chinese literatures were included, including a total of 758 patients, of which 342 underwent surgery assisted by 3D printing technology, 416 underwent traditional surgical treatment. (2) The results of meta-analysis showed: Operation time [SMD=-2.023, 95%CI=-2.418~-1.628, P < 0.05], intraoperative blood loss [SMD=-1.981, 95%CI=-2.489~ -1.474, P < 0.05], intraoperative fluoroscopy [SMD=-3.183, 95%CI=-5.758~-0.608, P < 0.05], fracture healing time [SMD=-0.797, 95%CI=-1.504~-0.090, P < 0.05], and complication rate [RR=0.383, 95%CI=0.215~0.680, P < 0.05] were significantly lower in the 3D printing group than in the traditional group. (3) The Hospital for Special Surgery score at 6 months [RR=0.779, 95%CI=0.510~1.048, P < 0.05], the Hospital for Special Surgery score at 12 months [RR=0.603, 95%CI=0.334~0.871, P < 0.05], the excellent and good rate of Hospital for Special Surgery [RR=1.206, 95%CI=1.092~1.331, P < 0.05], and the excellent and good rate of Rasmussen score [RR=1.178, 95%CI=1.037~1.338, P < 0.05] were significantly better in the 3D printing group than in the traditional group. (4) The 3D printing technology in Schatzker type IV-VI tibial plateau fracture surgery has the advantages of shortening operation time, lessening intraoperative blood loss, few complications, less intraoperative fluoroscopy, and fast healing, which can improve the precision of tibial plateau fractures and postoperative knee function recovery.