Can education close the racial gap in joint-replacement therapy?

Joint replacement therapy (JRT) commonly performed in advanced countries is being introduced in some developing countries. The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria. This was a cross-sectional descriptive study of patients for JRT at Benue State University Teaching Hospital, Makurdi, Nigeria from 23/6/2014 to 31/8/2016. Data analyzed from the anaesthetic/surgical records included age, sex, ethnicity, ASA classification, Ficat and Arlet classification of avascular necrosis, Gardens classification of fracture neck of femur, indication/type of surgery, packed cell volume (PCV), anaesthesia type, estimated blood loss, transfusions, duration of surgery and hospital stay, post-operative PCV, pain management, complications and surgical outcome. Results were summarised as means, median and percentages using SPSS version 21.0 for Windows®. One-way test of ANOVA was used for statistical significance (p= 0.05). Seventeen patients aged 27-90 years (mean 54.71±19.69). Indications were femoral neck fracture (47%), chronic osteoarthritis (35%), avascular necrosis (18%). The commonest procedure was hemiarthroplasty (41%), total hip replacement (35%), and total knee (24%). All were under regional anaesthesia with spinal (53%) and combined spinal-epidural (47%). Multimodal post-operative analgesia was used. There was no significant difference between pre and post-operative PCV (t = 0.708, p=0.05). Mean duration of hospital stay was 19.44±9.61 days. The outcome was good in all. JRT can be established in a new center with proper planning. Regional anaesthesia with multimodal analgesia is recommended. With relevant surgical skill, patient outcome is good.

Download Full-text

Anaesthetic and Surgical Experience from Joint Replacement Therapy in a Teaching Hospital in Makurdi, Nigeria

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp2i1.2019104 ◽

2019 ◽

Vol 2 (1) ◽

pp. 45-51

Author(s):

B E Edem ◽

O O Oku ◽

M E Efu ◽

D D Mue ◽

I C Elachi

Keyword(s):

Hospital Stay ◽

Replacement Therapy ◽

Avascular Necrosis ◽

Teaching Hospital ◽

Joint Replacement ◽

Regional Anaesthesia ◽

Estimated Blood Loss ◽

Significant Difference ◽

Duration Of Surgery

Joint replacement therapy (JRT) commonly performed in advanced countries is being introduced in some developing countries. The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria. This was a cross-sectional descriptive study of patients for JRT at Benue State University Teaching Hospital, Makurdi, Nigeria from 23/6/2014 to 31/8/2016. Data analyzed from the anaesthetic/surgical records included age, sex, ethnicity, ASA classification, Ficat and Arlet classification of avascular necrosis, Gardens classification of fracture neck of femur, indication/type of surgery, packed cell volume (PCV), anaesthesia type, estimated blood loss, transfusions, duration of surgery and hospital stay, post-operative PCV, pain management, complications and surgical outcome. Results were summarised as means, median and percentages using SPSS version 21.0 for Windows®. One-way test of ANOVA was used for statistical significance (p= 0.05). Seventeen patients aged 27-90 years (mean 54.71±19.69). Indications were femoral neck fracture (47%), chronic osteoarthritis (35%), avascular necrosis (18%). The commonest procedure was hemiarthroplasty (41%), total hip replacement (35%), and total knee (24%). All were under regional anaesthesia with spinal (53%) and combined spinal-epidural (47%). Multimodal post-operative analgesia was used. There was no significant difference between pre and post-operative PCV (t = 0.708, p=0.05). Mean duration of hospital stay was 19.44±9.61 days. The outcome was good in all. JRT can be established in a new center with proper planning. Regional anaesthesia with multimodal analgesia is recommended. With relevant surgical skill, patient outcome is good.

Download Full-text

Genes Related to Muscle Strength, Behavioral Trait, Pain Response, and Inflammation are Associated with Poor Outcome of the Total Joint Replacement Therapy in Primary Osteoarthritis Patients

OrthoMedia ◽

10.1302/3114-210200 ◽

2021 ◽

Keyword(s):

Muscle Strength ◽

Replacement Therapy ◽

Joint Replacement ◽

Total Joint Replacement ◽

Pain Response ◽

Behavioral Trait ◽

Poor Outcome ◽

Primary Osteoarthritis

Download Full-text

Skeletal muscle health in osteoarthritis andtotal joint replacement therapy: effects of prehabilitation on muscular rehabilitation

Deutsche Zeitschrift für Sportmedizin ◽

10.5960/dzsm.2019.383 ◽

2019 ◽

Vol 2019 (6) ◽

pp. 145-152 ◽

Cited By ~ 1

Author(s):

A Franz ◽

J Becker ◽

M Behringer ◽

C Mayer ◽

B Bittersohl ◽

...

Keyword(s):

Skeletal Muscle ◽

Replacement Therapy ◽

Joint Replacement ◽

Muscle Health

Download Full-text

Anaesthetic and Surgical Experience from Joint Replacement Therapy in a Teaching Hospital in Makurdi, Nigeria

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp.v2.i1.2019.104 ◽

2019 ◽

Vol 2 (1) ◽

pp. 45-51

Author(s):

B E Edem ◽

O O Oku ◽

M E Efu ◽

D D Mue ◽

I C Elachi

Keyword(s):

Hospital Stay ◽

Replacement Therapy ◽

Avascular Necrosis ◽

Teaching Hospital ◽

Joint Replacement ◽

Regional Anaesthesia ◽

Estimated Blood Loss ◽

Significant Difference ◽

Duration Of Surgery

Joint replacement therapy (JRT) commonly performed in advanced countries is being introduced in some developing countries. The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria. This was a cross-sectional descriptive study of patients for JRT at Benue State University Teaching Hospital, Makurdi, Nigeria from 23/6/2014 to 31/8/2016. Data analyzed from the anaesthetic/surgical records included age, sex, ethnicity, ASA classification, Ficat and Arlet classification of avascular necrosis, Gardens classification of fracture neck of femur, indication/type of surgery, packed cell volume (PCV), anaesthesia type, estimated blood loss, transfusions, duration of surgery and hospital stay, post-operative PCV, pain management, complications and surgical outcome. Results were summarised as means, median and percentages using SPSS version 21.0 for Windows®. One-way test of ANOVA was used for statistical significance (p= 0.05). Seventeen patients aged 27-90 years (mean 54.71±19.69). Indications were femoral neck fracture (47%), chronic osteoarthritis (35%), avascular necrosis (18%). The commonest procedure was hemiarthroplasty (41%), total hip replacement (35%), and total knee (24%). All were under regional anaesthesia with spinal (53%) and combined spinal-epidural (47%). Multimodal post-operative analgesia was used. There was no significant difference between pre and post-operative PCV (t = 0.708, p=0.05). Mean duration of hospital stay was 19.44±9.61 days. The outcome was good in all. JRT can be established in a new center with proper planning. Regional anaesthesia with multimodal analgesia is recommended. With relevant surgical skill, patient outcome is good.

Download Full-text

Hormone Replacement Therapy and Voice

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig3-2018-0007 ◽

2019 ◽

Vol 4 (4) ◽

pp. 607-614

Author(s):

Jean Abitbol

Keyword(s):

Replacement Therapy ◽

Symptom Severity ◽

Low Dose ◽

Hormone Replacement ◽

Clinical Signs ◽

Female Voice ◽

Fat Cells ◽

High Pitch ◽

Endocrine Effects ◽

The Voice

The purpose of this article is to update the management of the treatment of the female voice at perimenopause and menopause. Voice and hormones—these are 2 words that clash, meet, and harmonize. If we are to solve this inquiry, we shall inevitably have to understand the hormones, their impact, and the scars of time. The endocrine effects on laryngeal structures are numerous: The actions of estrogens and progesterone produce modification of glandular secretions. Low dose of androgens are secreted principally by the adrenal cortex, but they are also secreted by the ovaries. Their effect may increase the low pitch and decease the high pitch of the voice at menopause due to important diminution of estrogens and the privation of progesterone. The menopausal voice syndrome presents clinical signs, which we will describe. I consider menopausal patients to fit into 2 broad types: the “Modigliani” types, rather thin and slender with little adipose tissue, and the “Rubens” types, with a rounded figure with more fat cells. Androgen derivatives are transformed to estrogens in fat cells. Hormonal replacement therapy should be carefully considered in the context of premenopausal symptom severity as alternative medicine. Hippocrates: “Your diet is your first medicine.”

Download Full-text