Outcomes of current operative treatments for arthrofibrosis after total knee arthroplasty (TKA) are not consistently positive or predictable. Pharmacological in vivo studies have focused mostly on prevention of arthrofibrosis. This study used a rabbit model to evaluate intra-articular (IA) effects of celecoxib in treating contracted knees alone, or in combination with capsular release. A total of 24 rabbits underwent contracture-forming surgery with knee immobilization followed by remobilization surgery at eight weeks. At remobilization, one cohort underwent capsular release (n = 12), while the other cohort did not (n = 12). Both groups were divided into two subcohorts (n = 6 each) – one receiving IA injections of celecoxib, and the other receiving injections of vehicle solution (injections every day for two weeks after remobilization). Passive extension angle (PEA) was assessed in live rabbits at 10, 16, and 24 weeks, and disarticulated limbs were analyzed for capsular stiffness at 24 weeks.Aims
Methods
Floating shoulder (FS) is, according to Goss et al, a double disruption of the superior shoulder suspensory complex which usually results from a glenoid neck fracture and a ipsilateral midclavicular fracture. However, the interruption can interest the whole scapular belt from acromion to sterno-clavicular joint. It occurs mostly after a violent traumatism with direct lateral impact on the shoulder. That leads to complex therapeutic issues with sometimes uncertain results. Between 1984 and 2009, 35 patients (30 men, 5 women), mean age 35 years [16–72] with FS, were treated in our department. Most of them sustained road accident (31cases) with polytraumatism context in 12 cases. A CT scan was realized in the majority of cases to specify the scapular fracture and look for intra-thoracic immediate complications. Mostly, glenoid neck fracture associated with a clavicular fracture has been found out (15cases). Orthopaedic treatment has been realized in 18 cases. Surgical management has been decided for open reduction of sterno-clavicular joint in 2 cases, isolated fixation of the clavicle in 9 cases, of the scapula in 3 cases, and of both scapula and clavicle in 3 cases. Criteria for clinical evaluation were an algo-functional scale (Oxford Shoulder Score, OSS), a subjective Constant Shoulder Score, a functional incapacity scale (Shoulder Simple Test, SST), scales of life quality (DASH and SF12) and global indications (Single Assessment Numeric Evaluation, SANE).Background
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