Spontaneous osteonecrosis of the knee (SONK) mainly affects the medial femoral condyle, would be a good indication for UKA. The primary aim of this study was to assess the clinical, functional and radiographic outcomes at middle to long-term follow-up, of a consecutive series of fifty UKA used for the treatment of SONK. The secondary aim was to assess the volume of necrotic bone and determine if this influenced the outcome. We reviewed 50 knees who were treated for SONK. Patients included ten males and 38 females. The mean age was 73 years (range, 57 to 83 years). The mean height and body weight were, respectively 153 cm (141 ∼171 cm) and 57 kg (35 ∼75kg). All had been operated on using the Oxford mobile-bearing UKA (Zimmer-Biomet, Swindon, United Kingdom) with cement fixation. The mean follow-up period was 8.4 years (range, 4 to 15years). We measured the size (width, length and depth) and the volume to be estimated (width x length x depth) of the necrotic bone mass using MRI in T1-weighted images. The clinical results were evaluated using the Knee Society Scoring System (KSS) and Oxford Knee Score (OKS). The flexion angle of the knee was evaluated using lateral X-ray images in maximum flexion.Aims
Patients and Methods
There have been only a few reports about the efficacy of postoperative cryotherapy following total hip arthroplasty (THA), and past studies have described that local cooling is efficacy for pain relief. The purpose of this study is whether the continuous local cooling following THA is effective for pain relief and the reduction of blood loss, swelling, and the duration of hospital stay. Thirty-eight patients (39 hips) underwent primary cementless THA for osteoarthritis and were divided into a cryotherapy group (30 subjects; from Apr. 2013 to Oct. 2013) and a control group (9 subjects; from Nov. 2012 to Mar. 2013). In the cryotherapy group, a continuous cooling pad was applied on the surgical wound and the thigh with a cloth anchor band (CF-3000, Sigmax, Japan) with the cooling temperature set to a constant 5°C for 72 hours immediately after surgery. Blood was collected on postoperative days 1,4,7,14, and 21 to determine Hb, CK, and CRP levels. Postoperative pain of the hip was scored by using a visual analog scale questionnaire on postoperative days 1 to 28. Total doses of selecoxib and dicrofenac sodium used for pain relief were measured. The circumference of patellar superior border was measured on postoperative days 4,7,14, and 28. The unpaired t-test was used for blood tests as well as for comparisons between the cryotherapy and control groups, and the Mann-Whitney U test was used for the analysis of age, BMI, approach of the surgery, analgesic use, pain scores, the circumference of the thigh and the duration of hospital stay.[Purpose]
[Materials and Methods]
Surgical-site-infections (SSI) prolong hospital stay, and they are leading nosocomial cause of morbidity and a source of excess cost. Recently, a waterless hand-rubbing protocol containing aqueous 1% chlorhexidine gluconate was developed before surgery, but there is no literature in orthopaedic surgery. The aim was to compare the SSI rates between waterless hand-rubbing and traditional hand-scrubbing protocol. STUDY 1: A total of 996 consecutive patients who underwent orthopaedic surgery between August 1, 2012 and January 31, 2014, were screened for SSI within 30 days after surgery. 500 patients from August 1, 2012 to April 1, 2013 were used by traditional hand-scrubbing, and 496 patients from June 1, 2013 to January 1, 2014 were by waterless hand-rubbing. STUDY 2: The twelve operating room staff members were randomly recruited, and the participants were assigned equally to use either a traditional hand-scrubbing protocol or a waterless hand-rubbing on 2 separate days. Washing times were recorded and microorganisms on hands were sampled on bacterial culture plates. Two days after sampling, the grown colonies were counted.[Introduction]
[Materials and Methods]
