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The Bone & Joint Journal
Vol. 102-B, Issue 10 | Pages 1297 - 1302
3 Oct 2020
Addition of corticosteroid to periarticular injections reduces postoperative pain following total hip arthroplasty under general anaesthesia: a double-blind randomized controlled trial
Kurosaka K Tsukada S Ogawa H Nishino M Nakayama T Yoshiya S Hirasawa N
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Aims

Although periarticular injection plays an important role in multimodal pain management following total hip arthroplasty (THA), there is no consensus on the optimal composition of the injection. In particular, it is not clear whether the addition of a corticosteroid improves the pain relief achieved nor whether it is associated with more complications than are observed without corticosteroid. The aim of this study was to quantify the safety and effectiveness of cortocosteroid use in periarticular injection during THA.

Methods

We conducted a prospective, two-arm, parallel-group, randomized controlled trial involving patients scheduled for unilateral THA. A total of 187 patients were randomly assigned to receive periarticular injection containing either a corticosteroid (CS group) or without corticosteroid (no-CS group). Other perioperative interventions were identical for all patients. The primary outcome was postoperative pain at rest during the initial 24 hours after surgery. Pain score was recorded every three hours until 24 hours using a 100 mm visual analogue scale (VAS). The primary outcome was assessed based on the area under the curve (AUC).

Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 168 - 168
1 May 2011
CLASSIFICATION AND MANAGEMENT OF INTRA-ARTICULAR FRACTURES OF THE DISTAL RADIUS BY PREOPERATIVE CT SCANNING
Kuroyanagi G Takada N Yamada K Suzuki H Hasuo T Nishino M
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Background: A classification of intra-articular fractures of the distal radius is described on the basis of observations of consistent patterns of fracture fragmentation and displacement. The Melone intra-articular classification system categorizes articular fractures into 4 types, with the medial complex assuming a pivotal position as the cornerstone of both the radiocarpal and distal radio-ulnar joints. The purpose of this study was to classify AO type-C3 fractures according to the Melone classification system using preoperative CT scan data.

Methods: We retrospectively reviewed the clinical records of all patients who underwent open reduction and internal fixation (ORIF), according to the AO type-C3 classification. Between September, 2006, and May, 2009, 36 patients and a total of 38 fractures were identified. These intra-articular fractures were also classified according to the Melone classification system using preoperative CT scan data. We also investigated a bone fracture type and surgicalprocedures.

Results: Nine fractures were divided into Melone type-1, 17 into type-2 (anterior displacement), 6 into type-2 (posterior displacement), 2 into type-3, and 4 into type-4. Thirty fractures were treated using plate fixation, and 8 fractures were treated using nail fixation. Melone type-1 fractures were usually treated with nail fixation, whereas type-2, -3, and -4 fractures were usually treated using plate fixation.

Conclusions: Classification according to the Melone classification system using preoperative CT scan data enables the identification and elucidation of displacement in the major fracture components and enables the establishment of rational guidelines for the management of ORIF.