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Метка: Knee

Новый сисобзор по травме! Migliorini 2019

Откуда инфа? См. запрос PubMed!
title = {Better outcomes with patellar resurfacing during primary total knee arthroplasty: a meta-analysis study},
issn = {1434-3916},
shorttitle = {Better outcomes with patellar resurfacing during primary total knee arthroplasty},
doi = {10.1007/s00402-019-03246-z},
abstract = {BACKGROUND: Total knee arthroplasty (TKA) is a feasible and cost-effective procedure. However, resurfacing of the patella sparks a heated debate. Anterior knee pain after TKA was supposed to be correlated to the patellofemoral joint, and the resurface of the patella was believed to be effective to avoid this complication.
AIM: A meta-analysis was performed to update current evidence concerning the outcomes of patellar resurfacing versus retaining for total knee arthroplasty. The first outcomes of interest were to compare the rate of anterior knee pain and revision surgeries.
MATERIAL AND METHODS: This study was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). A comprehensive review of the literature was conducted accessing the main databases: Embase, Google Scholar, PubMed, Scopus. All the prospective clinical trials comparing the outcomes between patellar resurfacing versus retaining were included in this study. Only articles classified as level of evidence I to II were considered for inclusion. Only studies reporting a minimum 24 months follow-up were included. The following data were extracted: demographic baseline, anterior knee pain, reoperations, clinical scores (HSS, KSS and related subscales) and range of motion (ROM). Studies solely reporting quantitative data under the outcomes of interest were included.
RESULTS: In favor of the resurfacing group, we observed a statistically significant reduced rate of anterior knee pain (odd ratio 1.73) and reoperation (odd ratio 3.24). In the resurfacing group, a prevalence of anterior knee pain of 11.15\% was detected, whereas in the retaining group it amounted to 17.39\%. Furthermore, a greater KSS pain (+ 0.97\%), KSS clinical (+ 0.23\%), KSS functional (+ 2.44\%), KSS overall (+ 2.47\%) and HSS (+ 5.64\%) were reported. In the retaining group, we found a better range of motion (+ 3.09°).
CONCLUSION: Based on the main findings of this meta-analysis, patellar resurfaced TKA was demonstrated to have performed superior overall. Patellar resurfacing detected a lower rate of postoperative anterior knee pain and reoperation. Moreover, the resurfacing group showed greater value of the HSS, KSS and related subscales. In favor of the retaining group, a slightly better ROM was evidenced.
LEVEL OF EVIDENCE: Level II, meta-analysis of prospective clinical trials.},
language = {eng},
journal = {Archives of Orthopaedic and Trauma Surgery},
author = {Migliorini, Filippo and Eschweiler, Jörg and Niewiera, Marc and El Mansy, Yasser and Tingart, Markus and Rath, Björn},
month = jul,
year = {2019},
pmid = {31367842},
keywords = {Anterior knee pain, Patellar resurfacing, Patellar retaining, Prosthesis, Total knee arthroplasty}

Новый сисобзор! Orhurhu 2019

Откуда инфа? См. запрос PubMed!
 title = {Systematic {Review} of {Radiofrequency} {Ablation} for {Management} of {Knee} {Pain}},
 volume = {23},
  issn = {1534-3081},
 doi = {10.1007/s11916-019-0792-y},
  abstract = {PURPOSE OF REVIEW: Chronic pain of the lower extremity remains challenging to manage. Radiofrequency ablation procedure applies heat to nerve fibers with the goal of mitigating chronic pain conditions of the knee. However, the clinical efficacy has not yet been adequately established. The goal of this review paper is to report the use of radiofrequency ablations in the treatment of osteoarthritis of the knee.
RECENT FINDINGS: PubMed and the Cochrane Controlled Trials Register were searched (final search 28 February 2018) using the MeSH terms "radiofrequency ablation," "neurolysis," "radiofrequency therapy," "pain syndrome," "analgesia," and "pain" in the English literature. Bibliographies of the published papers were screened for relevance to lower extremity radiofrequency ablation therapies. The quality of selected publications was assessed using the Cochrane risk of bias instrument. Of the 923 papers screened, 317 were further investigated for relevance. Our final search methodology yielded 19 studies that investigated the use of radiofrequency ablation at the knee. Of these 19 studies, there were four randomized control trials, two non-randomized control trials, three prospective studies, two retrospective studies, one case-control study, one technical report, and seven case reports. In summary, the data available suggests radiofrequency ablation as a promising and efficacious with all 19 studies revealing significant short- and long-term pain reductions in patients with knee pain.},
  language = {eng},
   number = {8},
   journal = {Current Pain and Headache Reports},
  author = {Orhurhu, Vwaire and Urits, Ivan and Grandhi, Ravi and Abd-Elsayed, Alaa},
 month = jul,
    year = {2019},
  pmid = {31286282},
  keywords = {Knee pain, Neurolysis, Pain therapy, RFA, Radiofrequency ablation, Radiofrequency therapy},
 pages = {55}

Новый сисобзор! Kizaki 2019

Откуда инфа? См. запрос PubMed!
title = {Arthroscopic versus {Open} {Osteochondral} {Autograft} {Transplantation} ({Mosaicplasty}) for {Cartilage} {Damage} of the {Knee}: {A} {Systematic} {Review}},
issn = {1938-2480},
shorttitle = {Arthroscopic versus {Open} {Osteochondral} {Autograft} {Transplantation} ({Mosaicplasty}) for {Cartilage} {Damage} of the {Knee}},
doi = {10.1055/s-0039-1692999},
abstract = {Osteochondral autograft transplantation (OAT) is a surgical option for repairing cartilage damage in knees, and can be performed using open or arthroscopic procedures. The aim of this review was to report clinical outcomes, postoperative complications, defect location, and defect size between open and arthroscopic OATs. Three electronic databases (EMBASE, PUBMED, and MEDLINE) were searched for relevant articles. In regard to eligibility criteria, knee articular damage cases solely treated with OAT were included and cases concomitant with ligament reconstruction, limb realignment, and meniscus repair were excluded. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and descriptive statistics are presented. A total of 24 studies were included with a total sample of 1,139 patients (532 in open OAT vs. 607 in arthroscopic OAT). Defect size in open OAT was three times larger than that of arthroscopic OAT (2.96 ± 0.76 vs. 0.97 ± 0.48 cm2). In terms of defect location, the medial femoral condyle (MFC) was the most common (75.4\%), followed by the lateral femoral condyle (LFC; 12.1\%), patella (6.7\%), and trochlea (5.7\%). All of these defect locations were treated with open OAT, whereas arthroscopic OAT treatments were restricted to the MFC and LFC. The clinical outcomes were overall favorable with the modified Hospital for Special Surgery knee scores being 89.6 ± 8.0 (36.1-month follow-up) versus 90.4 ± 6.0 (89.5-month follow-up) and the Lysholm scores being 81.6 ± 8.9 (44.2-month follow-up) and 83.3 ± 7.4 (12.0-month follow-up) between open and arthroscopic OATs, respectively. Fifty-three postoperative complications were observed (39/279 vs. 14/594) and the most common complication was hemarthrosis (13/39 in open, vs. 1/14 in arthroscopic OAT). The overall clinical outcomes were favorable in open and arthroscopic OATs, whereas open OAT allowed for treatment of lesions approximately three times greater in dimension than in arthroscopic OAT. Also, defect location was restricted to MFC and LFC in arthroscopic OAT. The most common complication was hemarthrosis.},
language = {eng},
journal = {The Journal of Knee Surgery},
author = {Kizaki, Kazuha and El-Khechen, Hussein Ali and Yamashita, Fumiharu and Duong, Andrew and Simunovic, Nicole and Musahl, Volker and Ayeni, Olufemi R.},
month = jul,
year = {2019},
pmid = {31288271}