scholarly journals Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-Blind Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Huiming Peng ◽  
Wei Wang ◽  
Jin Lin ◽  
Xisheng Weng ◽  
Wenwei Qian ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Visual Analogue Scale ◽  
Knee Arthroplasty ◽  
Analogue Scale ◽  
Bilateral Total Knee Arthroplasty ◽  
Double Blind ◽  
Motion Range ◽  
Total Knee ◽  
Two Sides ◽  
Hss Score

Multimodal cocktail periarticular injections comprising corticosteroids are the most suggested therapy for postoperative discomfort and swelling following total knee arthroplasty (TKA). Nevertheless, previous findings cannot be applied to instances of unilateral total knee arthroplasty on bilateral knees. This randomized, prospective, double-blind, controlled clinical study examines the efficacy as well as safety of periarticular multimodal cocktail injection along or sans corticosteroids in certain situations. The 60 patients (120 knees) that experienced concurrent bilateral total knee arthroplasty were provided periarticular injections along additional betamethasone (7 mg) in the randomized knee, as well as the other knee, where corticosteroid was not administered. Key results were “pain scores at rest as well as in action” on a visual analogue scale of 11 pt. Other results included motion range, swelling of the thigh, Hospital for Special Surgery score (HSS score), and adverse effects were measured between the two sides. No statistically promising variations were found in the visual analogue scale ranking, motion range, girth of the thigh, and HSS score, as well as complications between the two sides. The impact on treatment outcomes was maintained between the knees on postoperative day 3 or at 3 months of follow-up. Multimodal periarticular injection without corticosteroid will alleviate postoperative swelling and pain. More studies are needed for the use of betamethasone as a corticosteroid in periarticular multimodal cocktail injections. This Chinese Clinical Trial Registry is registered with ChiCTR-OPC-17013503, dated 2017-11-23, available from http://www.chictr.org.cn/showproj.aspxproj=23146.

scholarly journals Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-blind Controlled Trial

2020 ◽  
Author(s):  
huiming peng ◽  
wei wang ◽  
jin lin ◽  
xisheng weng ◽  
wenwei qian ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Visual Analog Scale ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Double Blind ◽  
Total Knee ◽  
Double Blinded ◽  
Hss Score

Abstract Background: Multimodal cocktail periarticular injection(MCPI) including corticosteroids is currently widely applied to reduce postoperative pain and swelling following total knee arthroplasty (TKA). However the addition of steroids is controversial.This prospective, double-blinded, randomized, controlled trial compares the safety and efficacy of MCPI with or without corticosteroids.Methods: A total of 60 patients (120 knees) who underwent simultaneous bilateral TKAs received periarticular injections with added betamethasone (7mg) in a randomly selected knee, and the other knee was injected without added corticosteroids. The visual analog scale(VAS) pain scores at rest and in motion, range of motion (ROM), thigh swelling, hospital for special surgery(HSS) score, and adverse events were compared between the 2 knees.Results: There were no statistically significant differences in the visual analog scale score, ROM, thigh girth, HSS score, and complications between the 2 kness. The patients were unable to detect a difference in the functional recovery between their knees on postoperative day 3or at the 3 month follow-up.Conclusion: Betamethasone injections are ineffective locally for relieving pain, reducing swelling, and improving the postoperative ROM.Trial registration: Chinese Clinical Trial RegistryNumber: ChiCTR-OPC-17013503, Date of Registration: 2017-11-23 URL:http://www.chictr.org.cn/showproj.aspx?proj=23146

scholarly journals Prótesis total de rodilla en pacientes con enfermedad de Parkinson. Resultados preliminares

10.15417/224 ◽  
2014 ◽  
Vol 79 (2) ◽  
pp. 99
Author(s):  
Juan P. Bonifacio ◽  
Matías Costa Paz ◽  
Lisandro Carbo ◽  
Carlos Yacuzzi ◽  
Emilio Corinaldesi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Total Knee Arthroplasty ◽  
Visual Analogue Scale ◽  
Knee Arthroplasty ◽  
Analogue Scale ◽  
Neurodegenerative Disorder ◽  
Title Page ◽  
Yahr Scale ◽  
Total Knee

<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>In­tro­duc­ción: </strong><span>La enfermedad de Parkinson es un trastorno neurodegenerativo progresivo y crónico, con una incidencia aproximada de 31/100.000 habitantes en la Argentina. El objetivo de este estudio fue analizar un grupo de pacientes con enfermedad de Parkinson sometidos a artroplastia total de rodilla.</span></p><p><span><strong>Materiales­ y ­Métodos:</strong>­ </span><span>Entre 2009 y 2011, se evaluó a 11 pacientes (edad promedio 68 años, rango 65-80) con enfermedad de Parkinson que fueron operados por artrosis de rodilla con prótesis cementadas estabilizadas a posteriori. Todos fueron evaluados con la escala analógica visual para el dolor, el Knee Society Scoring, el WOMAC y el grado de satisfacción subjetiva. El grado de afectación de la enfermedad de Parkinson se determinó con la escala modificada de Hoehn y Yahr. Se registraron las complicaciones.</span></p><p><span><strong>Resultados:</strong> </span><span>El seguimiento promedio fue de 2 años (rango 1-3). Las evaluaciones para dolor y funcionales arrojaron los siguientes resultados: la escala analógica visual para el dolor mejoró 3 puntos promedio; KSS dolor 37/74; KSS funcional 36/51, WOMAC 67/31. El grado de satisfacción de los pacientes fue de bueno a excelente en 7 casos. La escala modificada de Hoehn y Yahr fue de 1,5 puntos en el preoperatorio y de 2,6 puntos en el posoperatorio. Hubo 6 complicaciones: dos síndromes confusionales, una trombosis venosa profunda, una luxación protésica y dos prótesis dolorosas.</span></p><p><span><strong>Conclusión:­</strong> </span><span>La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es un procedimiento que mejora los resultados funcionales y el dolor, pero provoca mayores complicaciones que en la población general. </span></p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>Total ­knee­ arthroplasty­ in­ Parkinson’s ­disease­ patients. Preliminary results </strong></p><p><span><strong>Abstract</strong><br /> <strong>Background: </strong></span><span>Parkinson’s disease is a progressive, chronic, neurodegenerative disorder with an approximate incidence of 31/100,000 persons in Argentina.<br /> The aim of this study was to assess a group of patients with Parkinson’s disease who underwent total knee ar</span>throplasty.</p><p><strong>Methods:­</strong> Between 2009 and 2011, 11 patients with Parkinson’s disease (average age 68 years, range 65-80) who underwent cemented posterior stabilized total knee arthroplasty for osteoarthritis were retrospectively reviewed. All patients were evaluated with a visual analogue scale for pain, the Knee Society Scoring, the WOMAC and the degree of subjective satisfaction. Degree of Par- kinson severity was measured with the Modified Hoehn and Yahr Scale. Complications were recorded.</p><p><strong>Results:</strong> The average follow-up was two years (range 1-3). Results for pain and function were: visual analogue scale for pain improved an average of 3 points; KSS pain 37/74; functional KSS 36/51, WOMAC 67/31. Satisfaction was good to excellent in 7 cases. The Modified Hoehn and Yahr Scale was 1.5 points preoperatively and 2.6 points postoperatively. There were 6 complications: two confusional syndromes, a deep venous thrombosis, a prosthetic dislocation and two painful prostheses.</p><p><strong>Conclusion:</strong> ­Total knee arthroplasty in patients with Parkinson’s disease is a procedure that improves functional outcomes and pain, but it produces more complications than in the general population. </p></div></div></div><p><span><br /></span></p></div></div></div>

Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study

2020 ◽  
Author(s):  
Antonio Klasan ◽  
Sven Edward Putnis ◽  
Wai Weng Yeo ◽  
Darli Myat ◽  
Brett Andrew Fritsch ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Selection ◽  
Knee Arthroplasty ◽  
Major Complication ◽  
The Elderly ◽  
Complication Rates ◽  
Bilateral Total Knee Arthroplasty ◽  
Proper Patient Selection ◽  
Patient Reported ◽  
Total Knee

AbstractDespite multiple studies, there remains a debate on the safety of bilateral total knee arthroplasty (BTKA) in the average age patient, with a paucity of data on the outcome of BTKA in an elderly population. This study included 89 patients aged 80 years and older undergoing sequential BTKA over 14 years were identified in a prospectively collected database. Two matched comparison groups were created: patients under 80 undergoing sequential BTKA and patients over 80 undergoing unilateral TKA (UTKA). An analysis of complications, mortality, revision, and patient-reported outcome measures was performed. Mean age of the elderly cohorts was similar: 82.6 for BTKA and 82.9 for UTKA. The average age BTKA cohort had a mean age of 69.1. Complication rates were higher in bilateral cohorts, more so in the elderly BTKA cohort. Pulmonary embolism (PE) was observed in bilateral cohorts only. In these patients, history of PE and ischemic heart disease was a strong predictive factor for developing a major complication. There was no difference in revision rates and infection rates between the three cohorts, and no difference in patient survivorship between the two elderly cohorts. Through the combination of low revision and high survivorship rates and comparable clinical outcomes, this article demonstrates that simultaneous BTKA is an appropriate option to consider for an elderly patient, with proper patient selection and perioperative management. The demonstrated risk groups show that emphasis on patient selection should be focused on medical history rather than chronological age.

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